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Some patients ‘would rather die than get the vaccine,’ says Mississippi doctor

July 31, 2021, 3:00 PM UTC

As cases surge in low-vaccination areas across the country, medical professionals are girding themselves for yet another wave of critically ill COVID-19 patients. One of the states that has been hit the hardest is Mississippi, where cases have surged by 274.4% over the past two weeks, driven largely by the highly-contagious Delta variant. It’s also among the states with the lowest vaccination rates, with just 34% of the population fully vaccinated. Ijlal Babar, director of pulmonary and critical care at Singing River Health System on Mississippi’s Gulf Coast, has seen an increase of critically-ill patients across the system’s three hospitals. All of the most seriously ill have not been vaccinated. He spoke to Fortune from the ICU this week about what he’s experiencing.

When we talked a few weeks ago, you were anticipating a surge in cases and in hospitalizations. Has that happened?

Our hospital system’s case numbers are seven times what they were in June. We had one person, maybe two, in the ICU with COVID-19. Now we have about 20. Right now, in the ICU where I’m sitting, which is at Ocean Springs Hospital, we have nine. Most of them are on the ventilator. There’s a 10-hour wait in the emergency room to get in and get tested. It’s literally exploding right now, and nearly all the patients are unvaccinated.

How are you and your colleagues doing? 

Doctors do one week in the ICU, one week in other parts of the hospital. If we were talking during my week in the ICU, which is next week, I would be very tired. I will be fatigued. The nurses, who are at the bedside continuously, are definitely fatigued. 

I was just told that one of our really good ICU nurses says she just can’t do it anymore. Part of her reason, according to our manager, is the frustration and anger she’s feeling at these patients who opted not to get vaccinated and are in the ICU. 

We know that this is preventable. The vaccine is definitely preventing people from getting really sick, even if they catch COVID. 

Babar Ijlal
Ijlal Babar, director of pulmonary and critical care at Singing River Health System
Courtesy of Singing River Health System

What are you doing when you’re not in the ICU?

One of the things I do is see about 15 patients per day in the clinic. Every day I’m asking my patients if they are getting vaccinated, and in every clinic I’m going to run across one or two who are not vaccinated. I encourage them to get vaccinated, but I can tell they’re not happy to be asked the question. 

What kinds of conversations are you having with patients?

There was one individual who is at high risk of complications because she’s young and she’s very overweight. I told her that if she gets the disease, she would not do well. Her words to me were that she would rather die than get the vaccine. 

That really struck me. The assumption that you want to amend for them is that dying from COVID-19 is not like a light switch that’s going to be switched off and they’re gone. They’re going to go through a very painful and lonely process.

At that point, with that particular patient, I could see that I couldn’t continue to explain these things to her anymore with her just walking out. 

What about with other people?

I’ve also spoken to three of four patients who did not get vaccinated and who were now in our hospital very sick. They agreed that they had made a mistake, and promised to get vaccinated [after they recover]. 

I remember one young man in his thirties, who was hospitalized with COVID-19. I told him, you need to get vaccinated afterwards. He promised to put the word out and talk to his peers and tell him. I’ve had other conversations like that with people under 50 who weren’t vaccinated and got really, really sick. I don’t know if they will. 

I have not talked to families [of COVID patients] about this yet. There’s a hesitancy I have about the kind of reaction I’m going to get from families, that they will get offended if you ask them. 

I’ve never seen anything like this response to a vaccine before. Influenza vaccine is something that we have always discussed, and there will always be a few people who absolutely refuse to take it. But we’re talking about a small percentage of people. Nothing like this. 

What do you wish they understood? 

I wish I could really explain to people how terrible this whole experience is. I wish I could have them come and see the people in the ICU who are on the ventilator and the people who are struggling for breath before they go on the ventilator. 

The other thing is, I wish people would understand that even if they feel that they don’t need the vaccine for themselves, it’s about everybody else around them. Even if they’ve had the infection and they did fine the last time, or they feel that they’re in very good health and would be okay. I wish they would do it for the community. 

What does the ICU look like? 

The doors to each room are closed, which is your first hint that this is a COVID situation. The screen which controls the ventilator is sitting outside each patient’s room. When you look inside their room, the patient is lying on their stomach with the ventilator breathing for them. All the masks and gowns for staff are waiting outside the room to be put on before you go in. 

It’s very quiet. In more normal times, the doors to the rooms are open, and there is noise, people calling for nurses, talking, and visitors. Now there are no visitors, because there can’t be visitors.  

What are you worried about in the coming weeks and months?

There’s only so much we can do. There is a possibility that we will have to close our doors because we can’t take on any more patients. That’s not just about lack of beds, it’s also our nursing staff. We’ve been hit terribly by the nursing shortage.

At this point, we already can’t do anything but serve the community here. We can’t take any transfers, which is how the state got through the last wave. 

What can be done?

We’ve initiated a survey in all our outpatient clinics with a questionnaire designed to try and find out what is keeping people from getting vaccinated. We’re asking questions like, what are your fears? Do you think the vaccines weren’t researched enough? Are you afraid of side effects? Who are the people who influenced you? We’re hoping to find some answers in that.

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