Dr. Alessandra Hirsch: Omicron and the last straw

On Dec. 23, as the Centers for Disease Control released its emergency guidance for health care facilities on returning to work, my ob/gyn residency program was split into three groups. Some of us were preparing to celebrate the Christmas holiday during our time off, making difficult decisions about whether or not to see family, to travel and to risk exposure to ourselves and our co-workers. Others, like myself, were heading into the hospital to brave the worst surge in the pandemic’s history, packing up tins of cookies and doggy bags of Chinese food to bring to our soldiers-in-arms. And a quarter of us finally succumbed to covid-19.

Although we are all vaccinated and boosted, and although we all made it through the first, second and third waves of this unrelenting disease, we are finally falling, exhausted and exposed like never before.

It was in this context that we received the news bulletin from the CDC and our hospital: Health care workers with covid-19 no longer needed to quarantine for the previously recommended 10 days, but could (As if it was our privilege and choice!) return to work early given record staffing shortages. In some institutions, that quarantine could be as short as five days. The bulletin did not include any new information about the spread of the virus, but rather plaintively stated its purpose: to prepare for a strain on hospital systems.

The announcement, which has since been extended to the public, serves as a poetic example of the experience of medical trainees in this country. Resident physicians make $64,000 on average and work up to 80 hours per week — that’s roughly $11/hour after tax. We are responsible for the lion’s share of patient care, medical record creation, labs and medication ordering, and, of course, paperwork. All of which we knowingly signed up for.

What we did not sign up for was an endless pandemic perpetuated, ceaselessly, by the stubbornly ignorant. We did not sign up for repeated exposure to an illness that could have been eradicated, and we certainly did not sign up for this level of fear. We knew, from countless medical school modules on “empathetic patient-centered care” and “shared decision making,” that every individual has a right to bodily and personal autonomy and that many patients might not take our medical advice. But where was the lesson on the purposefully infectious?

Recently I admitted a pregnant patient who was doubly vaccinated and due in a few days for her booster. She was covid-19 positive and terrified for what it meant for her pregnancy and her baby. She had done everything right, after all. We know that pregnant women with covid fare worse than their nonpregnant counterparts. The vaccine may have saved her life. But the unvaccinated and their latest variant endangered it unnecessarily.

This made me think back to my white coat ceremony in medical school, when I first recited the Hippocratic oath.

Where in the Hippocratic Oath does it say “I swear to take care of those who refuse a lifesaving vaccine but insist on unproven and harmful treatments?” I swore to do no harm but I don’t remember swearing to expose myself to it every day.

Health care workers are burnt out, and the CDC announcement was, for many of us, the final straw on the pyre. The government cannot take away my grief. But it can allay some of my fears for the future.

The CDC should retract its recommendation in an effort to affirm that health care workers are, after all, human beings who also have a right to health and safety. And we must all continue to hold each other accountable if we cannot hold each other close.

Alessandra Hirsch, M.D., is a resident physician in obstetrics and gynecology at the University of Chicago Medical Center.