COVID In’t Over, And Neither Is The Politicizing Of The Virus: Op-Ed

By Dr. Eric C. Last

I am a primary care internist on Long Island.

My colleagues, staff, and I have been dealing with COVID since the start of the pandemic. It’s a pandemic that has changed from an illness that was often managed in a hospital setting, with devastating outcomes, to one that is primarily managed in the outpatient arena.

The number of patients with whom we deal has risen steadily and often overwhelms our ability to handle them, while also providing ongoing care for our regular patients with their myriad, complex medical and social issues. Making this tenuous situation even worse is the pressure on an American health care system having difficulty staffing so many positions, from front desk staff to clinical staff, physician assistants, nurse practitioners, and physicians (who have been retiring in increasing numbers).

I recently began my day overhearing a patient challenging our front desk staff when asked to don a mask. There is no mistaking that our office is a health care facility. Masks are still required in health care facilities in New York. Yet the patient loudly, rudely, and passionately (with curse-studded speech) voiced refusal to put on the mask. Our practice administrator intervened, explaining the need for the mask. I joined the conversation when the patient continued to be resistant. The patient then voiced to me their belief that since our office is in Nassau County, we could not force them to wear a mask. I explained the need for masking, reiterated that masks are required in medical facilities, and explained that it was the patient’s option whether or not to be seen....but that the only way they’d be brought into an exam room was with a mask in place.

Clearly, this patient’s belief and refusal were fueled by the musings and pronouncements of civic leaders. These leaders have politicized and weaponized medicine, science, and public health. They have created a permission structure wherein people feel free to challenge and ignore rules that have been put in place to protect themselves and others. They have given agency to people who are unwilling to even consider that another’s opinion, based on goodwill and science, may have merit. They claim to use ‘evidence based’ information to validate their beliefs, when the evidence they quote is, at best, suspect. They have created an environment in which people of good faith have fallen prey to misinformation and deceit. And because of that, they risk serious illness, or death....or causing others in their world to suffer needlessly.

While my day began with a patient confronting my staff about wearing a mask, I ended it speaking with a sick patient – a septuagenarian with cancer, diabetes, heart disease, and a degenerative neurological condition. Doubtful of the safety, effectiveness, and even legitimacy of COVID vaccines, my patient had declined any more than one booster dose of vaccine. That day, the patient was diagnosed with COVID. Their high-risk status was heightened by being under-vaccinated, warranting treatment that required complex coordination of care. COVID is not over, and my patient’s condition is not at all unusual in the universe of people for whom my colleagues and I regularly render care.

In our current environment, I am most saddened by the pervasive prioritization of the self, the concept of ‘me first’. The mantra ‘don’t tread on me’ is hurled as a threat. It is a threat that negates the bigger concepts of caring for our neighbors, putting others ahead of ourselves, and caring about the greater good. Public health is of no concern.....the need to be able to go maskless for no reason other than as an expression of individual will seems to trump all.

I’m hoping that the discussion in our communities can be tempered, the rhetoric cooled, the anger checked. I, and our colleagues, are happy – always happy – to have discussions based on science and knowledge. But I never again want to feel the need to defend my colleagues and staff from a patient challenging our right to protect ourselves and our other patients.

Dr. Eric C. Last is a clinical assistant professor at the Zucker School of Medicine at Hofsta/Northwell and a doctor of internal medicine for Northwell Health Physician Partners in Wantagh.