The Crucible: Global Pandemic Wears on Healthcare Systems

October 23rd, 2020

By Gary Evans, Medical Writer

As a continuing global pandemic threatens to overwhelm the medical response, there is great expectation of a vaccine to protect the battered healthcare workforce.

As we previously reported, healthcare workers have been designated by the CDC’s Advisory Committee on Immunization Practices (ACIP) as the first group to receive a safe and effective SARS-Co-2 (COVID-19) vaccine cleared for use in the United States. The FDA has said it would accept a vaccine with 50% efficacy as long as there was high confidence that it would be no lower than 30% effective.

About 10% of healthcare workers with COVID-19 develop serious infections, with outcomes including hospitalizations and deaths. Beyond the clinical consequences there is an immense mental toll, as they know they are one exposure away from endangering their own lives and those of their family, colleagues and patients.

Given this backdrop, Hospital Employee Health asked ACIP member Grace Lee, MD, MPH, a frontline pediatrician and professor of at Stanford University, a hypothetical question: what would it mean to a healthcare worker to be immunized with a safe and effective COVID-19 vaccine?

“I do feel it will be extremely helpful,” Lee says. “Our healthcare worker force is exhausted. The constant worry about COVID is just hanging over us as we are caring for patients and their family members. It’s going to be one really important strategy and it will give it us a sense of enhanced protection. It won’t take away the need for us to continue to use PPE, but I feel like it will give me an extra layer of confidence that if I don’t do everything perfectly all of the time then I am putting myself and my family at risk. I think that is what gets exhausting. I was on clinical service last week and I have to tell you I was exhausted by the end of the day. I couldn’t think.”

Shortages of personal protective equipment and other healthcare delivery issues have exacerbated the situation, particularly in hot spots of community spread as demand for ICU beds increase. Under such conditions, the margin for error is razor thin.

“We cannot afford to lose more health care workers --- we have to protect those on the front lines of this battle,” said Tom Frieden, MD, MPH, former director of the CDC during the Obama administration. Delivering a keynote address at the IDWeek 2020 Conference in Philadelphia on October 22, Frieden said other diseases will arise if COVID-19 undermines the healthcare systems in Third World countries.

“Perhaps my biggest fear in this entire pandemic is that there will be millions of preventable deaths in Africa from measles, malaria, HIV and tuberculosis,” he said. “We must protect health care and we must use data to drive progress.”