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An ICU doctor’s essay on COVID-19, deaths, and vaccines

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24min 53sec
Dr. Jeff Sippel
Dr. Jeff Sippel
Dr. Jeffrey Sippel is a pulmonologist and ICU physician at the University of Colorado Anschutz Medical Campus in Aurora.

Jeffrey Sippel’s life is consumed by COVID. As a pulmonologist and ICU Physician at the University of Colorado Anschutz Medical Campus in Aurora, Dr. Sippel sees the devastating effects the virus has on the unvaccinated and the lives it takes every day in his hospital. Frustrated by how many people unvaccinated by choice seem unphased by what’s going on in ICUs across the state, Dr. Sippel penned an essay, expressing his concerns, and his heartache, over the devastating toll COVID has had on him, his peers, and those he’s fighting to save everyday. He spoke with Colorado Matters host Nathan Heffel.

An ICU doctor’s perspective on COVID-19, death, and vaccines

By Dr. Jeff Sippel

I see and think about death every day.

For two years, death from COVID-19 has happened nonstop in intensive care units just like mine across this country.

But when I talk with unvaccinated family and friends about the illness, I sense that they don’t understand my reality. I imagine that if they saw and felt death as I do, they would relinquish their unvaccinated state. I imagine if they witnessed the cold, unfeeling reality of a COVID death they would take any steps possible to avoid this fate, including vaccination.

Still, they remain unvaccinated and mask-free, at least in part because they don’t see what I see. Across this chasm, I want my family and friends to better understand me and my profession. I want them to understand why seeing death influences how I feel about COVID vaccines. I hear their reasons for refusing vaccination. I think I understand their thoughts behind their inaction. Yet I feel their worldview is incomplete because they haven’t seen and felt death as I have. 

Everyone’s social groups in the US might be affected first-hand by COVID deaths if deaths were at one per 100 people. Yet deaths are at about one in 300, so most groups haven’t seen it first-hand. This means death happens in someone else’s group, not in theirs.

However, these numbers overlook a harsh reality: those of us working in hospitals see everyone’s social groups. We can’t push death off as affecting other people and other groups, because we see them all. We can’t externalize or ignore death because we witness and feel it the same way, every day, no matter whose name is on the death certificate. We can’t hide from the damage this virus causes. I’d like to think that everyone understands and feels the personal impact and sheer magnitude of death from COVID as I do, but since most social circles haven’t truly experienced death first-hand, they don’t. 

I grew up in rural Montana and have spent most of my life in the Rocky Mountains. I know the independent, pioneer spirit that exists across the west, including much of Colorado. Friends and family have told me in very direct terms that vaccine and mask mandates violate their freedom of choice. Yet important topics are glossed over when using individual choice as justification to avoid the social responsibility of a pandemic. We must acknowledge that no one with free choice would select death over life except in purely rhetorical discussions.

A preventable illness that carries a two percent mortality rate is far more lethal than any illness ever seen in our lifetimes - by a factor of 20. Even though COVID deaths are more than double the number of all cancer deaths last year, this still rings hollow for most people. One death is tragic, though seemingly only if you know that person. Nearly 900,000 U.S. deaths from this illness likely feels like a faceless statistic to most Americans.

It’s tragic when death on this scale is glossed over merely because a freedom of choice mindset prevails unchecked. As jarring as the death toll is, how death unfolds with COVID should be equally eye-opening. Although my profession does an exceptional job of providing comfort in time of need and death, the process of a COVID death can be agonizingly drawn out over days to weeks.

The infection slowly turns the person’s lungs – which normally hold a few quarts of air in a single breath – into something more like a wet leather satchel that struggles to hold two cups of air even when placed under immense pressure. I’ve seen this death too many times. From the outside, it’s a death no one should suffer. From the inside, the best I can do is pray we keep our loved ones comfortable and in peace when their time on Earth is over. This theoretical freedom of choice leads to nothing more than an empty rhetorical victory when held up against this harsh reality. 

There is a long list of reasons people share for choosing no vaccines and no masks. They all warrant our consideration, and I try to listen as intently as possible. All these reasons – religious preferences, doing your own research, distrust of science and institutions, opting for natural immunity, good health and countless others – have points of truth to them.

Yet if we feel the ability to make rational decisions is a trait that defines at least a part of our humanity, then we must balance these points against the collective burden of COVID. Although collective burden includes emotionless terms like lost productivity and revenues, and personal terms like inconvenience and hassle, what underlies all this and is never stated is death. It’s a death that is personal to nearly 11,000 Colorado citizens and their families. It’s a death that happens only after every nook and cranny of the body has been invaded by medical tubes, lines, and drains. It’s a death surrounded by unstoppable noise from alarms and bells, in a cold and sterile room that feels like a freezing mist. It’s death in slow-motion that is as unstoppable as the setting sun, a process that feels like a daily bloodletting which will cease only when my profession has no more blood to give. 

I would like my family and friends to understand that there are millions of health care providers in this country working diligently to support our citizens who become infected with COVID. This is what we are trained to do, and we are truly honored to do this work.

But we need help.

We see too much death. We see death at its most uncomfortable point. We see death when no one wants to acknowledge it and when no one wants to talk about it. We see death that tries to hide, but needs to be acknowledged, heard, felt and accepted. We don’t have to like death, but I need my family and friends to understand that we can’t deny its reality. I want them to understand that the best way to address the agony of these pandemic deaths is by having all citizens participate in honoring their social contract with society, just as healthcare workers do every day. This might just require them to put their reasons behind them, get vaccinated and wear masks. Because my profession needs their help. 

Jeff Sippel is a pulmonologist and ICU physician at the University of Colorado Anschutz Medical Campus in Aurora