The Big Question


How do we deal with the volume of demand from COVID-19 patients on our healthcare systems so that we avoid a total system collapse.

Public Health Ontario – Confirmed Cases of COVID-19 Following Vaccination in Ontario: December 14, 2020 to December 12, 2021

The statistics show that about 90% of the people admitted to hospitals in Ontario are unvaccinated. The obvious conclusion we can drawn is that we can reduce pressure on our healthcare system by getting those people vaccinated. The unvaccinated population amounts to around 12% of those eligible; 87.5% of the eligible population has received at least one dose as of this date [1].

Various approaches to overcome this resistance have been tried: pay to get vaccinated, mandates, limitations or denial of services, various social constraints, peer pressure. More recently the conversation has moved to having unvaccinated people pay for hospital services to treat COVID, otherwise given freely to vaccinated people.

I expect asking the unvaccinated to pay could motivate some, especially if the full cost is applied, which I suspect would bankrupt many, but that route simply attempts to create a moral equivalence using cash … i.e., buying your way out of a problem (into the hospital), which I’m not sure can be argued successfully as being balanced when the life of a vaccinated person is at risk. Yet, there is a question of consistency; there are many things people do that they shouldn’t that result in hospitalizations: drive too fast, smoke, drink, ski, … so why is being unvaccinated any different?

Does money balance access rights for the unvaccinated with the vaccinated for health services?

Clearly the demand placed on our healthcare system by the volume of people is an issue. It appears society is willing to accept some level of “needless” hospitalizations, but when the volume causes the system to fall apart, then it might be that a line has been crossed. To avoid facing the consequences of crossing this line, the Federal Government is saying that we as a society are going to have to face the question of universal vaccine mandates, which Alberta and Saskatchewan have already rejected.

Medications that are soon to be on stream might side-step this volume impact on healthcare, but these too will need to be rationed, at least at first. So in a constrained system, who has the right, the priority, to getting service? Someone who has considered public health, and got vaccinated, or one who has not. Put another way, if this latter group of people is not willing to consider public health, then why should public health consider them? I guess the question will be faced square on when an unvaccinated person is asked to leave the hospital to make room for a vaccinated person. I’m not sure a compassionate society is able to deal with this.

To avoid that scenario, hospitals could put caps on the number of people admitted to ensure there remains capacity to accept vaccinated COVID patients and regular demand. We already have caps on the number of people that can be admitted into a hospital — determined by the number of bed, doctors and nurses — so having caps is not really a question. The question is do we limit the number of unvaccinated people admitted so vaccinated people can continue to receive the service they have always had and to relieve the stress on healthcare workers.


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