Hospitals Should Hire, Not Fire, Nurses with Natural Immunity
Among many surprising developments during this pandemic, the most stunning has been the questioning of naturally acquired immunity after a person has had the Covid disease.
We have understood natural immunity since at least the Athenian Plague in 430 BC. Here is Thucydides:
‘Yet it was with those who had recovered from the disease that the sick and the dying found most compassion. These knew what it was from experience and had no fear for themselves; for the same man was never attacked twice—never at least fatally.’ – Thucydides
We have lived with endemic coronaviruses for at least a hundred years, for which we have long-lasting natural immunity. As expected, we also have natural immunity after Covid-19 disease, as there have been exceedingly few reinfections with serious illness or death, despite a widely circulating virus.
For most viruses, natural immunity is better than vaccine-induced immunity, and that is also true for Covid. In the best study to date, the vaccinated were around 27 times more likely to have symptomatic disease than those with natural immunity, with an estimated range between 13 and 57. With no Covid deaths in either group, both natural and vaccine immunity protect well against death.
During the last decade, I have worked closely with hospital epidemiologists. While the role of physicians is to treat patients and make them well, the task of the hospital epidemiologist is to ensure that patients do not get sick while in the hospital, such as catching a deadly virus from another patient or a caretaker.
For that purpose, hospitals employ a variety of measures, from frequent hand washing to full infection control regalia when caring for an Ebola patient. Vaccinations are a key component of these control efforts. For example, two weeks before spleen surgery, patients are given the pneumococcal vaccine to minimize postoperative infections, and most clinical staff are immunized against influenza every year.
Infection control measures are especially critical for older frail hospital patients with a weakened immune system. They can become infected and die from a virus that most people would easily survive. A key rationale for immunizing nurses and physicians against influenza is to ensure that they do not infect such patients.
How can hospitals best protect their patients from Covid disease? It is an enormously important question, also relevant for nursing homes. There are some obvious standard solutions, such as separating Covid patients from other patients, minimizing staff rotation, and providing generous sick leave for staff with Covid-like symptoms.
Another goal should be to employ staff with the strongest possible immunity against Covid, as they are less likely to catch it and spread it to their patients. This means that hospitals and nursing homes should actively seek to hire staff that have natural immunity from prior Covid disease and use such staff for their most vulnerable patients.
Hence, we are now seeing a fierce competition where hospitals and nursing homes are desperately trying to hire people with natural immunity. Well, actually, not.
Instead, hospitals are firing nurses and other staff with superior natural immunity while retaining those with weaker vaccine-induced immunity. By doing so, they are betraying their patients, increasing their risk for hospital-acquired infections.
By pushing vaccine mandates, White House chief medical advisor Dr. Anthony Fauci is questioning the existence of natural immunity after Covid disease. In doing so, he is following the lead of CDC director Rochelle Walensky, who questioned natural immunity in a 2020 Memorandum published by The Lancet. By instituting vaccine mandates, university hospitals are now also questioning the existence of natural immunity after Covid disease.
This is astonishing.
I work at Brigham and Women’s Hospital in Boston, which has announced that all nurses, doctors and other health care providers will be fired if they do not get a Covid vaccine. Last week I spoke with one of our nurses. She worked hard caring for Covid patients, even as some of her colleagues left in fear at the beginning of the pandemic.
Unsurprisingly, she got infected, but then recovered. Now she has stronger and longer-lasting immunity than the vaccinated work-from-home hospital administrators who are firing her for not being vaccinated.
If university hospitals cannot get the medical evidence right on the basic science of immunity, how can we trust them with any other aspects of our health?
What’s next? Universities questioning whether the earth is round or flat? That, at least, would do less harm.
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