Editor’s Note: Torsten Durkan is a Physician’s Assistant in California’s Santa Clara Valley Medical Center’s ER.
It’s day 249 on the COVID-19 calendar at Santa Clara Valley Medical Center’s Emergency Department. I began working here in April, shortly after the Coronavirus pandemic turned the world on its head. Today, I’m the lone provider while several nursing staff work in COVID tents outside, triaging all patients seeking medical attention. Our tent has 15 people with likely COVID-related illnesses; two require supplemental oxygen. I call the charge nurse inside to check up on getting these sicker patients inside where they belong, to be on cardiac monitoring, and eventual ICU placement. He responds the same as he did an hour or so before: “We have nothing. We’re still waiting on ICU beds for the patients already in here. There’s no movement in the entire hospital.”
Not a good sign, making it clear that our hospital is at or near capacity.
After growing up on Maui before moving to California as a med student, I’d take a 50-footer on the head at Pe’ahi any day over getting this virus. I’ve seen hundreds of patients with it since the onset of the pandemic, presenting itself in myriad ways, from abdominal pain, blood clots, heart muscle inflammation, odd rashes, and pink eye, to the classic loss of smell, cough, and respiratory distress. I discharge most and send them home with nothing more than fever reducers and cough medicine or an inhaler, always with strict return precautions if anything worsens.
Others, however, are not so lucky — the fate of their own immune system going violently out of control, literally drowning in their own lung secretions from the inflamed tissue, landing a direct admit to our ICU. I’ve also seen many other people coming in who have survived the virus only to return months later with complaints of chronic fatigue and residual shortness of breath, stating they’ve never fully recovered. Other long term effects of the virus are likely yet to be discovered. So all of this makes the news of effective vaccines in the world’s fight against COVID-19 a glimmer of hope.
While the race to develop a vaccine ran through most of 2020, I was especially skeptical of the newer mRNA types. I hadn’t done much research on how they work but the thought of a quickly made, new way of achieving immunity to a virus didn’t sit well with me. As an ER provider, I would be one of the first offered the opportunity for inoculation, and I found that some of my colleagues shared the same reservations many people have about being vaccinated against a virus that is so new.
In medical school, we are taught to be skeptical of new medicine. So I took up researching the progression of the COVID-19 vaccine even before Pfizer’s emergency approval by the FDA in December. I learned that this new vaccine was developed with the same mRNA techniques used to vaccinate against the Zika virus, only that development didn’t go through the robust trials this one did. My own research about the current vaccine showed a scientifically-sound process that is actually less invasive than safe, traditional vaccines that have been used for centuries. One common concern had been that the new vaccine could alter DNA, but I learned that the mRNA vaccine doesn’t enter the nucleus of the cell, so it’s not able to alter our DNA. I also saw that phase three trials of more than 40,000 people showed limited reactions.
This newfound knowledge helped me weigh the risks of getting COVID and spreading it to others against any risks associated with the vaccine. From that standpoint, it was a no-brainer, and on December 19, I was among the first to voluntarily get the shot at my workplace. The only reaction I had was a sore arm at the injection site — less painful than the flu shot, in fact — that lasted only a day or so. On January 6, 2021, I got my second shot.
The lesson I’ve come to learn is that everyone should make an effort to educate themselves and skepticism is a good thing, it allows you to make an informed decision. Ultimately, we all need to do what is right for ourselves and the community around us, becoming healthier and wiser in the process. Skepticism is a good thing. I think it’s perfectly healthy, and I want people to know I was in the same boat many people are today about being vaccinated. A skeptical mindset is what fuels inquiry, and you ultimately have to use that to find your way to a realistic and intelligent conclusion.