November-December 2021
The unique privilege of vaccine hesitancy in America. Abortion care: The neglected curriculum. Mental health obstacles amid a COVID-19 resurgence. Medical student activism. The impact of trauma on health.
Although the United States is being hit hard with the COVID-19 pandemic, Americans have access to the Pfizer, Moderna, and Johnson & Johnson vaccines. At the same time, the country has a backup reserve of tens of millions of doses of the AstraZeneca vaccine. As of May 3rd, 2021, the U.S. was the strongest performing country for fully vaccinated people per country (per million) [1]. Inoculations are rising, fueled by growing concerns and anxiety surrounding the new Delta variant, but will it be enough? This highly contagious strain is escalating in 74 countries and is responsible for most COVID-19 cases in the U.S. [11]. Although 49.6% (164.8 million) of the U.S. population has been fully vaccinated as of August 1st, 2021, experts warn that we need at least 80% of our population vaccinated to reach some form of herd immunity [1,2]. However, it doesn’t help that 90 million Americans are still hesitant about getting their shot [3].
Our country is no stranger to vaccine hesitancy. We have previously heard of now-debunked claims of vaccines causing Autism, despite these claims lacking scientific evidence. But, when a global pandemic ensued, conspiracy theories surrounding the COVID-19 vaccines also ran rampant. Some believe that the vaccines can alter their DNA, cause infertility, or cause COVID-19 variants. Others believe that the vaccines have a microchip that the government can use to track them or turn people magnetic due to 5G telecommunication towers [4]. These misconceptions have circled on the internet and social media but have been fact-checked and disproven numerous times by medical and public health experts. Thus, it is vital to check the credibility of any source that claims to offer medical advice.
A 2005 study found that of 78 accredited US medical schools surveyed, only 32% offered a lecture specifically about abortion. Furthermore, less than half of these schools offered a third- or fourth-year elective or clinical experience. Beyond medical school, only 51% of OB/GYN residency programs in the US offer comprehensive abortion training (2). Even when these programs exist, they typically follow an opt-in model rather than existing as a standard of the curriculum.
Students who wish to learn about abortion care in school, whether it be in the basic science years or clinical rotations, must often find training programs elsewhere, typically in external organizations such as the AMSA Reproductive Health Project (3) and Medical Students for Choice (4).
These are great resources for those who seek them out, however, being outside of the curriculum, they are missed by a large proportion of the student body.
Both the overall scarcity of abortion training programs and the opt-in model they follow fail to provide adequate training to most medical students. This is especially detrimental to those who know so little about the topic, who never considered the value they may experience from learning, and ironically would therefore benefit the most. Every physician, regardless of specialty, should be equipped with a basic understanding of abortion care.
Imagine a scenario in which a woman breaks her arm and needs it to be surgically repaired by an orthopedic surgeon. To undergo this procedure, she must have a pregnancy test performed in order to select the best anesthesia. In this scenario, the pregnancy test comes back positive. How will this finding be addressed by the attending physician, and how will they review her options moving forward?
A recent study by the WHO reports increasing rates of anxiety and depression among physicians, nurses and other medical staff caring for COVID-19 patients. “As the pandemic continues, more evidence has been collected to describe the challenging working and psychosocial conditions faced by healthcare workers on a daily basis,” the WHO said.
Moreover, research published by the journal BMJ Nutrition Prevention and Health has uncovered increased rates of insomnia, sleeping disorders and burnout among healthcare workers. According to the authors, their work suggests that these conditions further deteriorate mental health status and serve as significant risk factors for coronavirus infection.
The authors indicated that “lack of sleep at night, severe sleep problems and high levels of burnout may be risk factors for COVID-19 in front-line healthcare workers. Our results highlight the importance of healthcare professionals’ well-being during the pandemic.”
These findings support research by the University of Utah suggesting that “half of doctors, nurses, and emergency responders involved in COVID-19 care could be at risk for one or more mental health problems, including acute traumatic stress, depression, anxiety, problematic alcohol use, and insomnia.”
Andrew J. Smith, director of the University of Utah Health Occupational Trauma Program and a corresponding author of this research, stated that the risk of developing mental health conditions during the pandemic as a healthcare professional was akin to rates seen during the events of 9/11 and Hurricane Katrina.