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ICU Doctor On Why Health Workers Shouldn't Be Prioritized In Coronavirus Vaccination


The hopes for a coronavirus vaccine are looking better and better in the U.S., but one doctor says that putting nurses and doctors at the front of the line to receive it is the wrong thing to do. Dr. Joel Zivot works in the ICU at Emory University, where he is also an associate professor. We spoke earlier today, and I asked him what was wrong with that idea.

JOEL ZIVOT: And when I heard this plan that the priority was to vaccinate health care workers first, I thought, well, that actually isn't going to solve my problem. And my problem is this - that as an ICU doctor, the ICUs are full of patients. Now, I want to point out that where I work, we've done a pretty good job at managing our flow. And we are not overwhelmed, although other hospitals around the country are very much overwhelmed. And when I say overwhelmed, I mean the ICUs specifically, which is where I work, are really suffering from an excess amount of patients. And if you want to help me, I think what I need for you to do is unclog the ICU.

CHANG: Well, what about the argument that we are talking about health care workers who are on the front line, who are mixing with the virus almost every single day? Why not give them the peace of mind to get vaccinated?

ZIVOT: What troubles me is that I feel like now I'm trading off - I don't know - my convenience for your death. Sure, we want to be given the means to do our job, but we can do our job if you give us supplies. Give us the right number of supplies and the right number of space. Let's just say that you vaccinate everyone in an ICU, and everyone - and in every case, the vaccination works and confers some kind of immunity. I still have an ICU full of patients who are dying, and that's the problem. Right now we're in a point of crisis, and the crisis is death. And we need to stop the dying and stop the dying by vaccinating the kinds of patients that are ending up in the ICU and dying there. And I can wait.

CHANG: OK, then let's talk about who you are seeing getting sick in these ICUs. Who, in your mind, should get vaccinated first?

ZIVOT: It's the people who are elderly, the people who have coexisting health conditions, the people who - there's people who are obese. There are people who have either poor insurance or who are underinsured.

CHANG: And how would you get to those populations quickly to get them vaccinated?

ZIVOT: Well, I think that one way that might be a way to begin would be to target just simply people on Medicare and Medicaid. We know that if you just look at that population that that's going to include the - generally the over 65, the people with disability and people, you know, of poor means. And that population, I think, we can identify. And it might, for example, be a job, say, of the family doctor or the clinic to reach out to patients, you know, in their own particular group that have that kind of insurance and reach out to them and provide them with vaccinations.

So it's not going to be easy. But I think you just need to start - you know, you need to start with those populations. I think also that if we let the family doctor or clinics do that, there's a relationship there between, I think, you know, the patient and the doctor. And I think that that relationship can be used to the benefit of everyone because one of the issues here, I think, also is going to be, you know, vaccine hesitancy and concerns about, you know, maybe a lack of trust of health care. And so we need to address that head-on. And I think one way to do that would be, again, to make the distribution point, you know, the family doctor, the clinic, these places, and start with that.

CHANG: Dr. Joel Zivot is an associate professor at Emory University.

Thank you very much for being with us today.

ZIVOT: Sure. Transcript provided by NPR, Copyright NPR.