When you are with a patient and their oxygen levels are low and the ambulance is on its way, there is a terrible moment when you have to ask: ‘… and have you been vaccinated?’
You try for it not to be the first or second question — they will be about their symptoms — but it has to come. And when they say ‘no’, which they often do, you cannot say: ‘Why not?’
Discussion, debate, whatever you want to call it, is by this point redundant. It is too late. It’s part of the job to bite your tongue, but it’s one of the hardest things to do in this predicament we are in.
I’m afraid with patients I see about non-Covid matters, I take a different tack, because with them it is not too late.
If I’m speaking to them in person or remotely — as is often the case — I look at their vaccination status, and then I really do jump on them. Nicely, obviously.
I say: ‘Can I arrange your Covid vaccination for you? It’s the easiest thing in the world. It takes me a minute to do on the website.’
If they say no, I will try to explore what it is that stops them. I am, frankly, exhausted by having to do this.
Dr David Lloyd (pictured) is a GP who supports mandatory vaccination, at least for adults — arguing that there should be a fine for those who refuse to comply
Yes, it is controversial, but I am a GP who supports mandatory vaccination, at least for adults — and what’s more, there should be a fine for those who refuse to comply.
As someone who has been on the frontline of this thing (and who is in the unusual position of splitting my work between Covid patients and non-Covid patients), I strongly believe that the time has come for the UK to take a stronger line, as European countries are doing.
Frankly, we have no other choice, because asking people to be vaccinated is simply not working and the anti-vaxxers are threatening our recovery.
And it’s time to do it now.
At every step we have been too slow, and have been surprised by the ferocity of what has come. And now here we are, sitting on a fourth wave and we do not know what variants are coming.
There are those who say obliging people to be vaccinated is too much, that it is not British, it is a challenge to democracy.
I have read of Austria — where the country is now in another lockdown, as the laws go through — being called a dictatorship. I do not agree. There is evidence, closer to home, of where mandatory vaccination works.
In France, even pre-dating the Covid era, parents are obliged by law to ensure their children are vaccinated [against a number of infections, such as whooping cough, influenza and meningitis C] before they go to school. If they are not, child benefit is not paid.
Does this make France an undemocratic country? Of course, it doesn’t. It’s a matter of public health, not politics.
On this issue, I have always been towards this end of the spectrum. That comes from having lived and worked through the whooping cough scare, where people thought the whooping cough vaccine killed babies.
I worked through the MMR scandal, instigated by that man Andrew Wakefield, where untold damage was done because of scare-mongering.
It is our job, as doctors, to follow the science, and the science here is sound. I carry a picture of an astonishing Pfizer graph on my phone. I whip it out to show patients.
‘Look,’ I say, ‘this line shows the number of deaths in vaccinated patients, and this one shows it in unvaccinated patients. Your choice could be between life and death.’ That graph should be on the front cover of every newspaper in the country.
Of course, alongside the science is my own experience of being in uncharted waters. I never expected to find myself on the frontline of a pandemic.
I was due to retire on March 31 last year, after 42 years working as a GP. I changed my plans because I was needed.
On the day I was due to retire, I started running a Covid hub in the community, assessing and treating patients with suspected Covid, and arranging when they needed to go to hospital.
I still do this. Yesterday I spent the morning treating regular patients, and the afternoon at the Covid hub.
As someone who has been on the frontline, Dr Lloyd said he strongly believes the time has come for the UK to take a stronger line, as European countries are doing (stock image)
Straddling both worlds — Covid and non-Covid — gives me an unusual perspective, so I do feel I can go in a bit heavier with people when it comes to conversations about whether to have the vaccine.
I can give them my first-hand experiences of having to be the one to tell relatives, as the ambulance is pulling up: ‘Look, you cannot go with your father. You must say your goodbyes now.’
That’s how it was at the height of the pandemic and it was terrible, something that will never leave me. This was not what I was expecting to tell my grandchildren about my job.
Even though the rates aren’t at the levels they were, intensive care units (ICU) across the country (and my son is a registrar in A&E, so I get daily updates) are still full — and full of unvaccinated Covid patients.
At the same time, we are trying to get our healthcare system back to normal, and we cannot. My patients who are waiting for hip replacements and knee operations are even more frail, so that even those who are waiting for quite routine operations will now need an ICU bed.
There is huge frustration in the medical community, trying to hold this together. We’ve been at it now for 20 months and we are getting very, very, tired. Those on the front line are exhausted.
The latest data suggests that 8 per cent of GPs are going to retire in the next year. Nurses are taking early retirement. The thought of a fourth wave is difficult to swallow.
Sometimes, I say to patients that if they will not be vaccinated for themselves, will they do it for their mothers, grandmothers, for society in general? Let’s get society open again, so we can go back to normal.
Why do my unvaccinated patients say they have not had the vaccine? There isn’t just one reason, which is part of the problem in getting the message across.
Some of my patients from the Afro-Caribbean community have referenced the Tuskegee scandal, in Mississippi, where African-American men were subjected to a racist, bigoted unethical medical trial which went on for years and years. The stories, and suspicions, have been passed down.
Another group says: ‘Goodness me, the fact this vaccine has been developed so quickly is worrying,’ and they talk of an experimental vaccine. It is not experimental. Millions and millions of man hours have gone into developing it.
The last group is tricky, those who object to putting something into their body.
You can have the conversations, but it is an uphill battle. My heart always falls when they say: ‘Thank you doctor, I’ll go home and do my own research.’ And they end up on Facebook or on anti-vaxxer sites.
The problem is that this has become a political issue. It was interesting in the U.S. where you could see red states and blue states with different Covid rates depending on political leanings.
Here, it’s more difficult to assess, but it would have been great to have had the Prime Minister and Keir Starmer making a joint statement about vaccination — drumming home it was not about politics, but about life and death.
That message is not getting through. I was in Trafalgar Square at the weekend, and I barely saw a mask. People were piling into beer gardens as if this was over.
It is not over, and the clock is ticking.