On March 7, I received the COVID-19 vaccine at no charge at one of the San Juan Basin Vaccination Clinics. I clearly remember the immediate feeling of relief I felt. Gone were the countless days of worrying about the possible severe health consequences or actual death that could result from contracting the virus. Gone were the days of counting “the last date of potential exposure” after going to the grocery store, bank or post office for essential activities while dodging the numerous anti-maskers that roam in this small town. The chances of contracting COVID-19 are still real, given that no vaccine is 100 % effective. Yet, the probability of experiencing a full blown breakthrough COVID infection that could involve hospitalization, intubation or death, is now minimal or almost nil.
Equally important is the probability that once vaccinated, I will not put someone’s health or life, at risk of harm.
Amesh Adalja, MD, senior scholar and infectious disease expert at Johns Hopkins Center for Health Security states that “It’s pretty unlikely that a vaccinated person will become infected and extremely rare they’d be hospitalized or die. Recent data shows the risk of getting infected after vaccination is 0.008% (which includes asymptomatic and mild cases). Even if a vaccinated person were to get infected, the chances of them transmitting it to others is slim. Multiple studies have shown that vaccinated people with breakthrough infections have very low viral loads that are ‘not necessarily likely to be contagious to others.’…”
For additional information on this topic, feel free to review information from the CDC here: COVID-19 Breakthrough Case Investigations and Reporting
From the beginning of the pandemic to the present time, I have spent most of the time at home, only going out for some essential activities. I adapted quickly to a new way of life and without being mandated to do so, and tried to make the best out of such threat to human life. Small matters did not seem to affect me as they might have in the past. Taking perspective became a form of meditation, a calming influence during the storm. In the large scale of things, staying alive and doing my part to combat this pandemic was a top priority.
In spite of the threat this virus posed to human life, I also found joy and solace in music, reading, renovating my home, taking short day trips on weekends to breathe in the beauty around Pagosa, and having more frequent phone contact with my loved ones. I did not feel the craving need to travel near or far, go to social venues and restaurants, or visit anyone anywhere indoors as doing so could have put myself or others at risk. I count myself lucky as I have been able to work via telehealth (secure video app or phone.)
A family member of mine had to cancel her long and wished for international trip to Colorado, given the rapid spread of infection around the world. Let’s not forget: we are still number 1 in cases and deaths across the globe. Yet, it is interesting to hear in casual conversations with others about how awful things are in other countries, such as in India right now. Well, any country seems to be in much better shape than us in the USA. India for example, reports about 310,000 deaths with its population of 1.4 billion. This represents about half the deaths we’ve seen in the US, in a country with 4 times our population.
As mentioned above, I only went out ‘for some essential activities.” Unfortunately, with the virus being so widespread and after a couple of bad experiences, I decided it was best to also forego some activities I considered essential, such as going to routine medical appointments. In my mind, doing so during the pandemic would have posed additional risks to the self and others.
The first failed attempt was at a dental practice in Bayfield. When I asked what the practice was doing differently to protect everyone during this pandemic, I was told that the practice managed the covid 19 virus the same way as the HIV/AIDS virus; thus, ignoring the very vast difference in how these two viruses are transmitted. Later on, optimistic me, I ventured out to the Pagosa Springs Medical Center (PSMC) for blood work, only to walk out very frustrated and appalled. While patiently registering for the labs — the process took more than 45 minutes — a young lab technician approached and reached over my back and head to give the registration staff some paperwork. In doing so, she engulfed me with her body as she and the registration person talked. Behind her on the wall there was a sign posting the need for social distancing.
After these disappointing events, I decided to postpone all medical appointments to a later, safer or saner time. I was astonished to find out the blatant disregard towards patient’s protection and professional, adequate medical care in both situations.
With the recent arrival of the vaccines I thought it timely to resume this essential self-care item which had to put on a long hold.
I started off with the dental appointment I had left behind in May last year. I made an appointment at a dental clinic in Pagosa Springs in April. I was pleased to hear over the phone that they were checking patients for COVID-19 symptoms and had implemented a number of protective measures against its transmission. During my first visit, I was asked at the door for COVID symptoms and my temperature was taken. Once at the registration counter, I refused a picture being taken for my file. I was also asked to pay my balance upfront — prior to any services being delivered. All of this was eventually negotiated to a mutually satisfying agreement. Then X-rays were taken and a dental exam administered, resulting in a need for a crown.
At my second appointment, I went through the same procedures at the door, the questions about COVID symptoms. I responded “no” to all questions and volunteered that I was vaccinated. Then it occurred to me that I would ask the same questions to them. After all, this is not an individual issue; it is not just about me. It is not just about the patients. It is a two-way street. It is about me and you, whoever you are and specially about you if you are a health care provider. My approach was not welcomed, yet I proceeded to continue to ask questions. I learned that only two people out of probably 8-9 in the practice had been vaccinated with all others rejecting the vaccine, including the owner.
I voiced my opinion, stating that I found such practice reprehensible and very irresponsible. After that, I was no longer welcome and was told I would be offered referrals to a different practice. This never happened either, even though doing so is a standard professional practice. I was refused service for asking appropriate questions and for being… vaccinated.
I have called other dental practices and have asked on the phone about the vaccination status of all staff. The most common answer is that the information I seek is “private.” The double standard is tangible and thick: it is not private for the patient but it is being made private for the providers. In response to this double standard, I contend that given the threat to human life that this pandemic poses, there is no privilege to confidentiality with regards to COVID disclosures. As a public health threat; there is nothing private or confidential about it. Claiming the right to privacy or confidentiality relative to vaccine status is “utter nonsense”, according to Alan Meisel, professor of Law and Bioethics at the University of Pittsburg – see following article below.
In addition, the privilege to confidentiality has a number of waivers for health care providers. These include in the most part instances when the patient is at risk of harm or death. In this discussion, the provider himself or herself can pose risk or harm to patients, and the waiver applies: The vaccination status must be disclosed to the patient. Transparency is a requirement for health care workers and facilities; consumers need this level of protection to make their personal choices for health care. The double standard just mentioned, as well as questions and disclosures regarding COVID vaccination status is covered here: Fact check: Asking about vaccinations doesn’t violate HIPAA
What is not covered in the article, but should be, is that just as health care providers ask patients about COVID symptoms and vaccine status, consumers have every right to ask the same and/or more, keeping in mind we are seeking treatment for health reasons and protection from any risk of harm. The purpose of consumer protection is to inform the consumers in order for them to make informed decisions about their health care providers and facilities. It is in essence an intrinsic part of informed consent.
My latest experience at a dental practice was a complete and unexpected shock. To think that healthcare providers are rejecting the vaccine and continue to treat patients is absolutely beyond any professional, logical and ethical reasoning.
With these concerning new insights, I approached the Pagosa Springs Medical Center (PSMC) to inquire if the hospital requires all its employees, clinical and administrative, to be vaccinated. By this time and not surprisingly, I learned that the COVID vaccine is not required at our medical center and that the PSMC’s approach to promote vaccination is educational in nature. Such educational initiatives include, per personal communication, social media; speaking at the County meeting and the Town meeting in the past; press releases in the paper; radio talks once a month; discussions at our public board meetings; notices posted in the building, and part of our hold message; speaking at the Rotary and working with public health officials.
If consumers had other hospital options available in town, this issue would not be so concerning, but this is not the case. This is the only hospital we, consumers have in Pagosa. PSMC of course offers telehealth appointments, yet not all medical issues can be addressed remotely. I think for example, of oncology patients that require physical appointments for cancer treatments and the impact of exposure given their very vulnerable immune systems. In less extreme situations, anyone going to the Medical Center does so due to health reasons of varying degrees of concern.
Ana M. Sancho Sama, PhD, Licensed Psychologist, lives in Spain.