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A Call to Arms: The War of the COVID

  • Joseph S. Alpert
    Correspondence
    Requests for reprints should be addressed to Joseph S. Alpert, MD, Department of Medicine, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724-5037.
    Affiliations
    Department of Medicine University of Arizona Tucson

    Editor in Chief The American Journal of Medicine
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  • Arthur William Boylston
    Affiliations
    Department of Pathology Leeds University Leeds, United Kingdom

    Nuffield Department of Clinical Laboratory Sciences Radcliffe Department of Medicine Oxford University Oxford, United Kingdom
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Published:December 29, 2020DOI:https://doi.org/10.1016/j.amjmed.2020.12.004
      “Why did people give themselves smallpox? The practice was then called inoculation; it is now called variolation … An individual could defy providence and choose a safe way to prevent fatal smallpox.”
      • Boylston AW
      Defying Providence. Smallpox and the Forgotten 18th Century Medical Revolution.
      —Arthur W. Boylston, Defying Providence
      “… the plague bacillus never dies or disappears for good … it can lie dormant for years and years in furniture and linen-chests … it bides its time in bedrooms, cellars, trunks, and bookshelves; perhaps the day would come when, for the bane and the enlightening of men, it would rouse up its rats again and send them forth to die in a happy city.”
      • Camus A
      The Plague.
      —Albert Camus, The Plague
      The Coronavirus disease (COVID) pandemic continues to damage and destroy lives throughout the world. The United States leads other countries in the number of cases and the number of deaths due to COVID. What we have seen here in the United States is extreme levels of anxiety, havoc, pain, and chaos as a result of this pandemic.
      • Alpert JS
      Life imitates art: the physician in a time of plague.
      ,
      • Alpert JS
      • Juneman EB
      We will never give up.
      Two safe and effective vaccines against the COVID have just arrived in the United States, and widespread administration of these preparations has begun. However, a frightening number of Americans say that they are undecided as to whether or not they will accept this inoculation, with many firmly opposed to receiving it. The current War of the COVID is not the first time that disease has resulted in societal destabilization. In fact, there is a long history of disease pandemics rocking a wide variety of civilizations and dating back to ancient Greece, with continuity up to the present time.
      • Carrell JL
      The Speckled Monster. A Historical Tale of Battling Smallpox.
      • Coss S
      The Fever of 1721. The Epidemic that Revolutionized Medicine and American Politics.
      • Gottfried RS
      The Black Death. Natural and Human Disaster in Medieval Europe.
      • Zinsser H
      Rats, Lice, and History. A Study in Biography.
      • Cartwright FF
      Disease and History. The Influence of Disease in Shaping the Great Events of History.
      • Twigg G
      The Black Death. A Biological Reappraisal.
      • Eckert EA
      The Structure of Plagues and Pestilences in Early Modern Europe. Central Europe, 1560-1640.
      • Cantor NF
      In the Wake of the Plague. The Black Death and the World it Made.
      • Kolata G
      Flu. The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It.
      • Garrett L
      The Coming Plague. Newly Emerging Diseases in a World Out of Balance.
      Currently, the United States and the rest of the world are experiencing extraordinary pain, suffering, and death as a result of the COVID pandemic. There are only 2 options that can rein in this horrible pathogen: Let the virus take its course until a high percentage of the population has been infected. This strategy will result in massive morbidity and mortality. The second option consists of a large majority of the population accepting one of the new COVID vaccines and thereby protecting themselves and their friends and family while taking an extremely small chance of having an adverse event.
      We humans take multiple chances every single day, for example, when we step out, dripping wet, from a shower or a bath. At such a time, there is a very small but definite chance that this step will result in a ground-level fall and a serious fracture. The same small chance for a disaster occurs every time we drive a car or take an airplane trip. The data from the recent large Pfizer (New York, NY) and Moderna (Cambridge, Mass) COVID population trials strongly support the idea that being injected with this vaccine carries a very, very small chance for any adverse event.
      What are the reasons for insisting that most Americans should receive one of the new COVID vaccines? To answer this question, we performed an internet search using the phrase “arguments in favor of vaccination.” There were many responses to this search. Here is a list of the 10 best arguments in favor of vaccination with one of the new COVID vaccines.

      National Foundation for Infectious Diseases (NFID). 10 Reasons to get vaccinated. Available at:https://www.nfid.org/immunization/10-reasons-to-get-vaccinated. Accessed December 21, 2020.

      AmBetter. Your Better Health Center: 10 reasons to get vaccinated. Available at:https://www.ambetterhealth.com/resources/better-health-center/healthy-living/10-reasons-vaccinated.html. Accessed December 21, 2020.

      University of Kent News Centre. Ten reasons why you should get a COVID-19 vaccine. Available at:https://www.kent.ac.uk/news/covid19/27376/ten-reasons-why-you-should-get-a-covid-19-vaccine. Accessed December 21, 2020.

      JournalFeed. Top ten reasons why I'm getting the COVID-19 vaccine. Available at:https://journalfeed.org/article-a-day/2020/top-ten-reasons-why-im-getting-the-covid-19-vaccine. Accessed December 21, 2020.

      • 1.
        Knowledgeable physicians, epidemiologists, and the US Centers for Disease Control and Prevention (CDC) strongly recommend a number of vaccinations starting in childhood in order to prevent disease. This same recommendation has been given to the new COVID vaccines. Taking the COVID vaccine will, with high certainty, prevent a serious and potentially fatal illness for oneself and for one's family and friends. One of the best ways to prevent COVID infection in older individuals is for all family members to be vaccinated.
      • 2.
        Vaccines are just as vital to preserving health as a healthy lifestyle. In fact, it is likely that vaccination is even more effective than a healthy lifestyle in preventing disease. However, doing both maximizes the chance for prevention of illness.
      • 3.
        Vaccines are safe and have been extensively tested to prove that they rarely cause any clinically important adverse events. This is the case with the 2 COVID vaccines certified at this time by the US Food and Drug Administration (FDA).
      • 4.
        It is not true that a vaccine will cause the disease that it is meant to prevent. This fact is part and parcel of the testing protocol that each and every vaccine must pass through before being approved by the FDA. The current vaccines do not contain the COVID virus itself.
      • 5.
        It is not just old people who get sick and die from a COVID infection. This can happen to younger individuals and even children, although the mortality rate is lower in younger patients than in older individuals with a COVID infection.
      • 6.
        COVID infection can cause considerable disability long after the initial episode is over. Large amounts of time may be lost from school or employment.
      • 7.
        A COVID infection can lead to a prolonged illness with late complications including severe fatigue, clotting disorders such as deep venous thrombosis, and brain dysfunction. Many COVID patients, both young and old, have developed prolonged periods of disability following a COVID infection. Both this problem and number 6 above can be prevented by a vaccination against COVID.
      • 8.
        The rapid development of the COVID vaccines does not mean that they are unsafe. An extraordinarily large amount of money and effort enabled the quick development of these vaccines.
      • 9.
        The current COVID vaccine preparations do not interact with a person's DNA, and hence they cannot cause mutations.
      • 10.
        The common post-COVID vaccination side effects such as headache or muscle aches are the result of activation of the immune system and are not dangerous. This shows that the vaccine is having its desired effect. Many alleged side effects are not the result of the vaccination. Headaches and muscle aches are common occurrences in everyday life in the absence of vaccination.
      In conclusion, doctor colleagues, nurses, medical assistants, medical technicians, health care administrators, and anyone else connected to the health care system, please, please, please, take the COVID vaccine yourself and convince as many others as possible to do the same thing. There is no question that this is the best strategy to end the current destructive pandemic. Nothing is more upsetting for a clinician than to see patients suffering from an easily preventable disease.
      Disclaimer: Both authors have recently been vaccinated with one of the new COVID vaccines.
      As always, comments or questions concerning this commentary will always be answered by writing to [email protected] or on our blog at amjmed.org.

      References

        • Boylston AW
        Defying Providence. Smallpox and the Forgotten 18th Century Medical Revolution.
        CreateSpace Independent Publishing Platform, North Charleston, SC2012
        • Camus A
        The Plague.
        Librairie Galliamard, Paris, France1947 (Published in translation in the United States. 1948; Random House, Inc. New York, NY)
        • Alpert JS
        Life imitates art: the physician in a time of plague.
        Am J Med. 2020; 133: 651
        • Alpert JS
        • Juneman EB
        We will never give up.
        Am J Med. 2020; 133: 1111-1112
        • Carrell JL
        The Speckled Monster. A Historical Tale of Battling Smallpox.
        PLUME, the Penguin Group, New York2004
        • Coss S
        The Fever of 1721. The Epidemic that Revolutionized Medicine and American Politics.
        Simon & Schuster, New York2016
        • Gottfried RS
        The Black Death. Natural and Human Disaster in Medieval Europe.
        The Free Press, A Division of Macmillan Publishing Co., Inc., New York1983
        • Zinsser H
        Rats, Lice, and History. A Study in Biography.
        The Atlantic Monthly Press by Little, Brown and Company, Boston, MA1934
        • Cartwright FF
        Disease and History. The Influence of Disease in Shaping the Great Events of History.
        Thomas Y. Crowell Company, New York1972
        • Twigg G
        The Black Death. A Biological Reappraisal.
        Schocken Books, New York1984
        • Eckert EA
        The Structure of Plagues and Pestilences in Early Modern Europe. Central Europe, 1560-1640.
        Karger, Basel, Switzerland1996
        • Cantor NF
        In the Wake of the Plague. The Black Death and the World it Made.
        Free Press, A Division of Macmillan Publishing Co., Inc., New York2001
        • Kolata G
        Flu. The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It.
        TOUCHSTONE, Simon & Schuster, New York1999
        • Garrett L
        The Coming Plague. Newly Emerging Diseases in a World Out of Balance.
        Penguin Books, New York, NY1994
      1. National Foundation for Infectious Diseases (NFID). 10 Reasons to get vaccinated. Available at:https://www.nfid.org/immunization/10-reasons-to-get-vaccinated. Accessed December 21, 2020.

      2. AmBetter. Your Better Health Center: 10 reasons to get vaccinated. Available at:https://www.ambetterhealth.com/resources/better-health-center/healthy-living/10-reasons-vaccinated.html. Accessed December 21, 2020.

      3. University of Kent News Centre. Ten reasons why you should get a COVID-19 vaccine. Available at:https://www.kent.ac.uk/news/covid19/27376/ten-reasons-why-you-should-get-a-covid-19-vaccine. Accessed December 21, 2020.

      4. JournalFeed. Top ten reasons why I'm getting the COVID-19 vaccine. Available at:https://journalfeed.org/article-a-day/2020/top-ten-reasons-why-im-getting-the-covid-19-vaccine. Accessed December 21, 2020.