Is it fair to treat vaccinated Covid patients first?


Around the world, hospitals and clinicians have Generally agree Both Covid and non-Covid patients should apply the same classification principles, care should not be first-come, first-served (because of different accessibility), and the main indicator should be that the person who gets the most leaves the hospital alive.Cultural values ​​sometimes play a role in whether to consider more subtle predictions: quality of life or longevity, or which person is more valuable, if that is Can even calculate(And classification is not the only way to distinguish between vaccinated and unvaccinated; in fact, private insurance companies are Recover payment for Covid care It seems to negate the idea of ​​giving up shooting. )

One thing that ethicists and clinicians come back to time and time again is to avoid “classification exclusion criteria,” which are attributes that exclude someone from the classification run. For example, before vaccines were widely available, the mortality rate of elderly Covid patients was much higher than that of younger patients. But no one wants to exclude the elderly from treatment, right? That’s terrible. Or as a team of Swiss ethicists Arguing Last spring, you might distinguish between “first-order criteria”, such as demographics, and “second-order criteria”. More subtle things will only play a role in the tiebreaker-two patients, in all possible ways. , Similar prognosis, similar diagnosis.But deciding which differences to consider are Very Tricky. If it is a health condition, how do you assess it? How does socioeconomic status affect the prognosis, can you explain this fairly? What the ethicists and the Texas Task Force are discussing is, basically, whether vaccination status may be a secondary exclusion criterion-although it needs to be clear that one of the main points of the working group is the vaccination status itself It cannot be a classification exclusion criterion.

In a way, this is because the whole idea is accompanied by a warning of the size of Texas. Yes, vaccinated people are much less seriously ill.But no one knows if it is serious Vaccinated Compared with severely ill patients, people have better outcomes-stronger survivability Not vaccinated People. It seems that once you are sick enough to be hospitalized, you are sick enough to be hospitalized. But as far as I know, there is no such public data. “From the data I have seen, I personally feel this way, but this is very preliminary data. No peer-reviewed studies have shown this,” Fine said. “So be careful alone.”

Be careful indeed. A large part of the reason for classification guidelines is consistency, so individual doctors do not have to rely on their intuition. “Covid has taught us a lot, but what is certain is that there are a lot of hidden biases in the healthcare system, and of course the Covid results,” Lo said. “And we don’t want to make the situation worse.”

In addition, although we may all understand and sympathize with the anger and frustration of medical staff-emotional exhaustion, epidemiological danger-any accusations we may make may be misled. “We know that people will feel frustrated and angry, but this is not the basis for decision-making,” Fine said.

As Fine pointed out, the vaccination status is more complicated than anger allows. “I think we have to be very careful not to say that some people choose not to get vaccinated. Some people do,” Luo said. “But there are still some people who have difficulty making appointments, are not proficient in the Internet, and do not speak English as their first language. Many people are engaged in work that has no rest time, or if they are unable to work due to the adverse effects of the vaccine for a day, their salary is Will be detained.” How can clinicians trying to classify vaccination status to distinguish these groups, even if they are allowed?

In this regard, even people refuse to get vaccinated because they think they will never get sick or if they do Horse anthelmintic Will save them, or if the vaccine contains a magnetized 5G antenna, Bill Gates can use it to turn them into werewolves (they don’t! These are not things!)-these people are deceived by leaders they trust. Bad information is cheap; better information is expensive. Although Covid figures may spread in the South, anger may be better targeted at political leaders who resist basic public health measures than those who suffer because of it.


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