Vaccination Status May Be Considered To Get ICU Beds

[Calliecake]

Forbes ran an article yesterday stating vaccination status may be considered to get ICU beds in Dallas area hospitals if covid spread worsens. Doctors are concerned this is increasingly becoming likely. Vaccinated patients would be prioritized based on the assumption that they are more likely to survive.

 

[qubitasaurus]

Forbes ran an article yesterday stating vaccination status may be considered to get ICU beds in Dallas area hospitals if covid spread worsens. Doctors are concerned this is increasingly becoming likely. Vaccinated patients would be prioritized based on the assumption that they are more likely to survive.

This is thuroughly sensible. If it is being considered in combination with a bunch of other factors which influence the probability of survival and expected quality and number of years of life after recovery, then it's a perfectly rational thing to do. The hospital is always going to try to save everyone, its just that at some stage they may have to make a choice who they save first.

Im a bit sad for the imunocompromised though, as they're forced to live in a world where many people want their old normal back so much that they're OK just spreading it (while arguing they're vaccinated and thus safe). And yet the imunocompromised possibly have multiple indicators for lower chance of survival and also may not be eligible for the vaccine. And now possibly a lower chance of being saved when they're forced to live with others choices.

 

[Asscherhalo_lover]

That's triage. This has been my fear since the beginning when NYC was in a terrifying state of infection. The fact that it's being considered now when a vaccine has long been available is mind blowing to me.

 

[canuk-gal]

Injuries/trauma/disease/incidents outside of Covid.. Everyday single day. Have always been.

Check vaccine status: who chooses your ICU entrance? Can't speak/discuss? What assumption for survival for what occurrence?

1) MVAs--multiple trauma/brain/body etc need OR time +-intubation . RU vaccinated?

2) Newly ^ +- undiagnosed or untreated disease. Ketoacidosis, Cardiac and acute Kidney disease. RU vaccinated?

2) Falls--^. I was walking my dog/cat tripped me. I live in a care facility/I live by myself. I fell accidently/tripped in my garden/while exercising. i was leaving my workplace and fell , icy . RU vaccinated?

3) Assult. ^. RU vaccinated?

4) Childbirth. RU vaccinated?

the list goes on.

 

[Matata]

the list goes on.

All of your examples above are currently not be treated in the hospitals in my city because there is no room -- no beds, and insufficient nurses to care for the people who are already in hospital. New patients are being flown anywhere a bed can be found. Some of those people won't survive the trip. In my area, we are in a lose/lose situation. The worst of this could have been avoided if people would have gotten vaccinated and practiced covid safety measures.

 

[kenny]

This sounds fair.

Oh, and what I wrote does not mean "wishing death" upon someone.

 

[RunningwithScissors]

If you have not gotten a vaccine, and are eligible, then it is your own darn fault you have Covid bad enough to go to the hospital, so you should be at the bottom of the list for a bed in my opinion. Your own selfishness has landed you there.

Give the beds to people who are in the hospital through no fault of their own.

What if I get hit by a drunk driver and need to be in the ICU and can't because 1000+ a-holes who chose not to be vaccinated are there filing it to capacity?

My father had a vein pop in his head earlier this year. Thank goodness there were ICU beds at the time. He had worked hard his whole life to be physically fit and had no life-style reasons for the stroke, he maintained a healthy weight, worked to keep his blood pressure and cholesterol low, etc etc.

I believe to be part of a society, and to reap the benefits of that society, you have a responsibility, an obligation, to the community to do your part. You need to try to be a good citizen, and that includes getting vaccinated, voting, holding a job, paying your taxes, etc etc.

Hate on me if you will, but that is what I believe. Personal responsibly. You can't have "liberty" without responsibility. We have become a society of children.

 

[canuk-gal]

This sounds fair.

Oh, and what I wrote does not mean "wishing death" upon someone.

For goodness sakes, take some chips/cheese and gravy if you can. It's been reputed/anecdotal for health?. But don't get an acav--jfc.

 

[lovedogs]

That's triage. This has been my fear since the beginning when NYC was in a terrifying state of infection. The fact that it's being considered now when a vaccine has long been available is mind blowing to me.

Exactly how I feel and what I have been afraid of.

 

[Dancing Fire]

So the person with 3 Covid shots get the first available bed? then 2 , then 1?

 

[LilAlex]

the list goes on.

I don't understand what you mean with this post. Triage based upon vaccination status is appropriate or inappropriate in your opinion? I believe the reference at the top of the thread was to vaccination status for COVID-related admissions.

 

[LilAlex]

So the person with 3 Covid shots get the first available bed? then 2 , then 1?

That would not make sense, policy-wise, except for manufacturing anger as a hypothetical -- like this one.

For one thing, the "threes" would be mostly immunocompromised and those > 6 - 8 months out from their first two -- and those groups are not expected to have a survival advantage. (There are currently nearly no people with three.)

The number of people with one but not two injections is very, very small since we can only be in that window for a few weeks.

 

[MollyMalone]

Falls, assaults (short of attempted murders), and childbirth don't typically require ICU, @canuk-gal. And @LilAlex is correct; vaccination as a triage factor is not contemplated as coming into play in every situation. From the Forbes article:

Dr. Mark Casanova, the task force's spokesman, told Forbes that other factors—like pre-existing conditions—would be taken into effect in situations where patients have to be prioritized for care, and unvaccinated status will not be used as an "exclusion criteria."​

​

But if all things are equal between two patients suffering from Covid-19, the one who is vaccinated would be seen as more likely to survive, Casanova said, meaning they would receive care first.​

Vaccination Status May Be Considered To Get ICU Beds At Dallas-Area Hospitals If Covid Spread Worsens

Covid cases are skyrocketing with no signs of a slowdown there.

www.forbes.com

 

[Calliecake]

If younger people start needing ICU beds things will really get ugly. Most 20 and 30 year olds don’t have pre-existing conditions. It could easily come down to the person who is vaccinated getting the bed due to them having a better chance at survival.

@Matata, Are they talking about setting up field hospitals like they did during the first round of Covid? They turned a convention center in Chicago into a field hospital when NY was getting hit so badly. They were also sending texts to everyone’s phones asking for nurses who had retired or we’re staying home raising their children to please register to help if additional help was needed. What you described in your post is heart breaking. Truly a no win situation.

 

[Sprinkles&Stones]

I understand why hospitals would do this.

My heart hurts for the family members of those who aren’t vaccinated. my parents refuse to be vaccinated and it breaks my heart knowing that I could lose them to Covid, by their own choice.

I think to myself every day that I have to accept the might die because of this. And it breaks my heart. I am not saying I agree or disagree with the article above, but dang it hurts when you can’t force your loved ones to do something you wish they would do to protect themselves and others.

 

[Matata]

Are they talking about setting up field hospitals like they did during the first round of Covid?

Yes, we have one already up and running and the Governor is sending in non medical national guard personnel to help with paperwork and logistics at local hospitals. Our fairgrounds and convention centers have been turned into testing and vaccination sites because of the huge numbers of new cases.

 

[Dancing Fire]

No need to fight for hospital beds. We'll all be dead come this fall. Please excuse me I had too many drinks tonight.

 

[missy]

I haven't read anyone's post yet but the first thing that comes to mind are the people who cannot/should not get vaccinated. This is not, IMO, right or fair to them.

However, for those who can get vaccinated and selfishly refuse for no valid medical reason, then yes, I am fine with this.

So a distinction should be made and perhaps we all carry our vaccine cards with us at all times and those who cannot get vaccinated for valid medical reasons also have a card identifying those reasons so they do not get penalized should they get ill.

For all others they made their beds and now they can lay in them.
Just don't take up precious hospital beds and medical resources when there are shortages.

 

[missy]

That would not make sense, policy-wise, except for manufacturing anger as a hypothetical -- like this one.

For one thing, the "threes" would be mostly immunocompromised and those > 6 - 8 months out from their first two -- and those groups are not expected to have a survival advantage. (There are currently nearly no people with three.)

The number of people with one but not two injections is very, very small since we can only be in that window for a few weeks.

There are a few different vaccines. J&J only requires, at this time, one vaccine. I don't think we should discriminate based on which vaccine an individual has had, only that they have gotten vaccinated. IMO.

 

[LilAlex]

perhaps we all carry our vaccine cards with us at all times

Mine looks pretty cheesy, tbh, and super-easy to fake. I think in no time, vaccine cards will be like Cartier Love rings on eBay -- all the anti-vaxxers' cards will have the same set of numbers .

 

[Austina]

We have an NHS App where our Covid vaccinations are recorded, batch numbers, dates etc.

 

[Calliecake]

Mine looks pretty cheesy, tbh, and super-easy to fake. I think in no time, vaccine cards will be like Cartier Love rings on eBay -- all the anti-vaxxers' cards will have the same set of numbers .

Shortly after I was fully vaccinated I overheard a young woman on the phone asking to purchase 100 fake vaccine cards. That was all I needed to hear to know continuing to mask up was a good idea.

 

[PinkAndBlueBling]

I don't think people really understand the impact on hospitals. They think, "Oh the ICU is full. If I'm sick, I'll go to a regular unit." NO, you won't. At my DD's hospital every unit was impacted. It's a top US hospital, and they had huge numbers. Peds was closed and converted. Half of her old unit was converted to COVID, as was every unit. Elective surgeries were cancelled which allowed the units to do this. There was NO space for patients. The public either doesn't understand this or still thinks it would never happen here. Just look at the hospitals diversions in the south.

A group I'm with had a speaker (an ER RN) early last year regarding COVID. She said it was all hype due to the election and would be gone in November. I about crapped! She said (direct quote), "There will never be people in beds in hospital hallways in the US. This isn't China." Most people nodded enthusiastically, and they are also the ones believing it's the flu...

 

[wildcat03]

I haven't read anyone's post yet but the first thing that comes to mind are the people who cannot/should not get vaccinated. This is not, IMO, right or fair to them.

However, for those who can get vaccinated and selfishly refuse for no valid medical reason, then yes, I am fine with this.

So a distinction should be made and perhaps we all carry our vaccine cards with us at all times and those who cannot get vaccinated for valid medical reasons also have a card identifying those reasons so they do not get penalized should they get ill.

For all others they made their beds and now they can lay in them.
Just don't take up precious hospital beds and medical resources when there are shortages.

To be honest, the number of people who have TRUE contraindications to vaccination is vanishingly small. Plenty of people seem to *think* they do, but in reality their statements are often opposed by those of the specialty society of the physicians who care for them (see: ACOG/SMFM and their recent statement in convince other 20 other groups regarding pregnant/lactating individuals and the vaccine). Another good example is the Offspring drummer who said his doctor told him he shouldn't have the vaccine due to a history of Guillain-Barré (this is not the perspective of he American Academy of Neurology: https://n.neurology.org/content/early/2021/07/29/WNL.0000000000012578). Hospitals have actually formed committees to review requests for medical exemptions. Some of them are focused inwardly on exemption requests amongst employees and medical staff, and some outwardly on exemption requests coming in to their employed/affiliated physician offices to be submitted to other employers.

 

[wildcat03]

The problem is that once a COVID patient is in the ICU, they take up the space for quite a while (a month+). Typically many ICU patients turn around in a few days to a week. So, ICUs full of COVID patients mean that my colleagues in other states are literally crowd-sourcing ICU beds via our closed Facebook group. I've seen at least two desperate pleas for two very sick non-COVID patients in the last 24 hours. Terrifying.

 

[missy]

To be honest, the number of people who have TRUE contraindications to vaccination is vanishingly small. Plenty of people seem to *think* they do, but in reality their statements are often opposed by those of the specialty society of the physicians who care for them (see: ACOG/SMFM and their recent statement in convince other 20 other groups regarding pregnant/lactating individuals and the vaccine). Another good example is the Offspring drummer who said his doctor told him he shouldn't have the vaccine due to a history of Guillain-Barré (this is not the perspective of he American Academy of Neurology: https://n.neurology.org/content/early/2021/07/29/WNL.0000000000012578). Hospitals have actually formed committees to review requests for medical exemptions. Some of them are focused inwardly on exemption requests amongst employees and medical staff, and some outwardly on exemption requests coming in to their employed/affiliated physician offices to be submitted to other employers.

True.

What Are The Medical Exemptions For Not Getting A Covid-19 Vaccine?

Many people have claimed that they are medically exempt from Covid-19 vaccination. But for virtually all of them, this isn't true.

www.forbes.com

“ there are no definite medical exemptions to vaccination with Covid-19 vaccines and the people for which this is a murky gray area likely number only in the thousands in the U.S., a tiny fraction of a percent of the population, not millions of people as some have claimed. Most people are unlikely to ever meet or know someone with a health condition which might qualify them for a medical exemption from vaccination against Covid-19 and these people should consult with a physician to discuss their options.”

 

[missy]

From Bloomberg.com

“ Vaccine Exemptions for Medical Reasons Are Mostly Bogus

There are a few gray areas, but studies show that the shots are safe for virtually everyone, even those with some allergic reactions.
By Faye Flam
August 13, 2021, 8:30 AM EDT

A pervasive myth floating around social media holds that lots of people can’t be vaccinated, or shouldn’t be, or are ineligible due to medical conditions. Even the mainstream media sometimes gives us that impression. A recent New York Times opinion essay, for example, proclaimed that in addition to those refusing vaccines, “…millions more, of course, are children under 12 and those disqualified by underlying health conditions.”

It’s true there are millions of children, but who are these other millions, or perhaps less than millions, disqualified for underlying health conditions? Lots of people might think they are in this group, but not because of any doctors’ orders.

Alfred Kim, a doctor who specializes in immune disorders at Washington University in St. Louis, told me several months ago that some of his immune compromised patients were afraid to get the shots, but that the shots posed no particular danger to them. The danger was that they might still get sick with the virus despite getting vaccinated but there was no question they would be better off getting the shots.

Art Krieg, also a specialist in immune disorders, agreed. When I asked him if there were any health conditions that make the vaccine unadvisable or would make someone “disqualified,” he said, “Absolutely not — there is no health condition where you should not get the vaccine.”

Now there may be a gray area, where people and their doctors could be free to choose whether to get the second shot or be allowed to get past any vaccine requirements with just a single shot of the two-dose regimens. This is different from the claim that hordes of people in the U.S. desperately want a vaccine but can’t get one for medical reasons.

One group that’s been considered for exemption or a single shot would be teenage boys, since the data show the vaccine comes with a small elevated risk of myocarditis, a potentially dangerous inflammation of the heart, especially after the second shot. The risk is rare, but so is severe Covid-19 among teens. While the Centers for Disease Control says it’s OK to give people who got myocarditis after the first shot a second one, a number of experts disagree.

Another group that might reasonably be considered exempt would be people who have had Covid-19, though such people are under no circumstances disqualified. Krieg said research looking at antibody levels found they are only a tenth as high in people who’ve had Covid-19 compared with those who’ve been fully vaccinated. Add to that the fact that some people might wrongly think they’ve had the virus, and there’s also a possibility that some asymptomatic cases might not have had enough of an infection to build up immunity.

So for people who’ve tested positive but not gotten very sick, Krieg said, “They really need the protection of a vaccine which gives much stronger immune responses than the natural protection that most people get after being infected.”


Other vaccines are known to induce better immunity than the disease does, said Paul Offit, director of the Vaccine Education Center and professor of pediatrics at the Children’s Hospital of Philadelphia. Vaccines against HPV and tetanus are two examples. He also said he wished there were better data collected comparing natural infections with vaccinations and looking at rates of infection, hospitalization and death. Some experts have concluded that people who’ve had Covid-19 should get just one shot of the mRNA vaccines, which normally require two.

The only people Offit said might be considered medically disqualified would be partially vaccinated people who had a severe allergic reaction to the first shot. But how common is this?

I asked Elizabeth Phillips, a doctor at Vanderbilt Medical Center who specializes in allergies. She said the initial data on health-care workers showed that the severe form of allergy known as anaphylaxis happened in about 11 out of every million vaccines given. But now that the vaccines have reached the wider population, it looks closer to 5 in a million.

Earlier in the vaccine rollout, she said she and her team were called in to look at people at possible risk from their history of allergic reactions. After examining 29,000 people with a history of allergic reactions, they identified three whose cases warranted delay, and everyone else was vaccinated safely. The three were given further tests and then vaccinated with no incident.

“There are still a lot of unanswered questions,” Phillips said, “but we have a fairly good idea how to manage this safely.” A massive current study on allergic reactions by the National Institutes of Health could provide useful data if people are offered a third shot in the coming months.

Phillips has also studied people who’ve had a severe allergic reaction to the first shot of the Moderna or Pfizer vaccines. In a group of 159 such people in the study, most got the second shot with no reaction. About 20% had an allergic reaction to the second shot but it responded quickly to the use of an antihistamine. The Journal of the American Medical Association published the results last month.

It’s important data, since many people need to be fully vaccinated to carry out their nursing home or health-care jobs, and the study showed how to manage the allergy risk.

What do these findings mean for those responsible for communicating public health information? While it might seem good-intentioned to motivate healthy people to get their shots to protect this mythical group of disqualified individuals, it could backfire. If people wrongly assume that whatever health conditions they have render them among the disqualified, they are worsening the risks to themselves as well as to those who are trying to help them.


“

 

[chemgirl]

I don't think people really understand the impact on hospitals. They think, "Oh the ICU is full. If I'm sick, I'll go to a regular unit." NO, you won't. At my DD's hospital every unit was impacted. It's a top US hospital, and they had huge numbers. Peds was closed and converted. Half of her old unit was converted to COVID, as was every unit. Elective surgeries were cancelled which allowed the units to do this. There was NO space for patients. The public either doesn't understand this or still thinks it would never happen here. Just look at the hospitals diversions in the south.

A group I'm with had a speaker (an ER RN) early last year regarding COVID. She said it was all hype due to the election and would be gone in November. I about crapped! She said (direct quote), "There will never be people in beds in hospital hallways in the US. This isn't China." Most people nodded enthusiastically, and they are also the ones believing it's the flu...

I think this is why something like 70% of people in my province support the concept of vaccination passports.

In Toronto, our hospital parking lots were filled with green tents and there was constant helicopter sound. The running joke was that we were all on the set of a MASH reboot.

That was for an outbreak of the UK variant around Easter. We’re not willing to play around anymore.

 

[chemgirl]

To be honest, the number of people who have TRUE contraindications to vaccination is vanishingly small. Plenty of people seem to *think* they do, but in reality their statements are often opposed by those of the specialty society of the physicians who care for them (see: ACOG/SMFM and their recent statement in convince other 20 other groups regarding pregnant/lactating individuals and the vaccine). Another good example is the Offspring drummer who said his doctor told him he shouldn't have the vaccine due to a history of Guillain-Barré (this is not the perspective of he American Academy of Neurology: https://n.neurology.org/content/early/2021/07/29/WNL.0000000000012578). Hospitals have actually formed committees to review requests for medical exemptions. Some of them are focused inwardly on exemption requests amongst employees and medical staff, and some outwardly on exemption requests coming in to their employed/affiliated physician offices to be submitted to other employers.

My 90’s child Offspring fandom took a huge hit when they played a concert in Chile early into the pandemic. My thought was like come on Dexter you are a microbiologist and your PhD is recent and related to virology. I actually deleted their music from my playlists. I am coming around now that they are refusing to tour with their unvaccinated drummer.

They have a point too. Medical exemptions are very rare. I have two autoimmune diseases and my doctor referred me to be vaccinated early. I’ve heard so many people argue that they are delaying vaccination due to heart conditions, meanwhile my father in law was in congestive heart failure, had valve replacement surgery, and his medical team still wanted him vaccinated ASAP.

Most of the medical exemptions are just excuses.

 

[aljdewey]

If you have not gotten a vaccine, and are eligible, then it is your own darn fault you have Covid bad enough to go to the hospital, so you should be at the bottom of the list for a bed in my opinion. Your own selfishness has landed you there.

........Personal responsibly. You can't have "liberty" without responsibility.

MASSIVE co-sign to this.

Those who legitimately can get vaxxed but opt not to.........what that tells me is that you don't give enough of a sh!t about your own life or the lives of those around you. If you can't be bothered to protect your own life or those of others around you, then no one else should have to save you either, and no one else should have to wait behind you for treatment.

I seriously hope the insurance companies begin to forward the bills to the 'opt out' folks, too. The shot is free - there is no excuse, and if you decide to 'opt out' of a FREE SOLUTION that prevents a stupidly expensive problem, then you should bear the financial responsibility for your reckless, costly choice too.

Interesting, though, how the same people who cite lack of long-term safety outcomes as a reason for refusing the vax are the very same ones gobbling down veterinary medicines (which also have no long-term safety data) when they inevitably get sick.