Carilion’s Opportunity to Advance the Knowledge About COVID

by James A. Bacon

Roanoke-based Carilion Clinic, the leading health care system in western Virginia, will try using the carrot and the stick in a campaign to elevate the percentage of employees who have been vaccinated for COVID-19, reports The Roanoke Times. Vaxxed employees will receive $150 in their Oct. 15 paycheck, while unvaxxed employees will be subject to weekly testing.

More than 70% of Carilion’s 13,000-person workforce, including 99% of its physicians, have gotten the jab. But three out of ten have not.

If Carilion will be monitoring roughly 2,500 employees, it strikes me that the health system can turn all those nasal swabs into data that is useful for more than just tracking the incidence of COVID in its workforce.

Here’s the thing: Many hospital anti-vaxxers are COVID survivors. I don’t have a percentage, but anecdotal accounts in news reports suggest that it is considerable. The anti-vaxxer argument is that previous exposure to COVID-19 confers natural immunity. There is considerable scientific evidence to support their position. (GMU professor Todd Zywicki’s lawsuit cited much of that evidence.) But many remain unconvinced.

As far as I can see, the matter has not been investigated systematically. Indeed, the media and public health authorities have consistently and steadfastly refused to distinguish between anti-vaxxers who have survived COVID-19 and those who have not. I was aghast this morning when commentators on “Morning Joe” blamed vaccine hesitancy on ignorant, selfish, don’t-tread-on-me, hyper-individualists in the Red States.

To be sure, some vaccine hesitancy comes from people who read crazy content online. Apparently, there are people out there who believe that the vaccine will make their arms turn into magnets. I’ve never met any of these people, but the media assures me they exist. On the other hand, many vaccine resisters are rational people. They just don’t trust the “experts” whose messaging on everything from masks to COVID origins have been all over the map.

Here’s an idea. If you want to persuade more anti-vaxxers to get the shot, provide hard evidence that getting vaccinated will improve COVID survivors’ resistance to the virus.

How could Carilion go about doing that? I’m no expert in establishing scientific protocols, so I would defer to Carilion’s epidemiologists. But I would suggest something along these lines.

First step. Carilion should determine which of the 2,500 unvaccinated employees have contracted COVID-19. Perhaps the most reliable way is to test them for antibodies. If an unvaccinated employee has COVID-19 antibodies, he or she has been exposed to the virus. Some antibody tests have false negatives and false positives, so more than one test may be necessary. This data can be supplemented by any previous COVID-19 tests employees might have taken.

Second step. Compare COVID survivors to those never exposed to the virus. If the COVID survivors are correct, they are at significantly lower risk of contracting the virus again, and they are far less likely than those who never got sick to get the virus again. If they are wrong, they will show the same rate of infection. We don’t know what will happen. But if the exercise were structured as a valid experiment, we might learn something useful that could be applied beyond Carilion.

From the COVID survivor’s perspective, it would be nice to know with greater certainty that previous exposure confers immunity… or not. Also, it would be nice not to be lumped in the public mind with ignorati who fret that vaccination shots will inject microchips into their arms. Conversely, if a structured study shows no additional resistance to the virus, perhaps some Carilion employees would be induced to get the shot in order to gain the immunity they thought they had.

From society’s perspective, it would be useful to know whether or not the 700,000+ documented COVID survivors in Virginia alone have immunities. If they are as resistant as people who have been vaccinated, it makes no sense coercing them into something they don’t want, and it makes no sense to test them every week.

After a year and a half of fighting COVID-19, there is a lot we don’t know. If hospital systems are going to expend resources on testing the unvaccinated, they ought to structure their programs to advance the state of knowledge.