Toronto Star

Simmering divide over who isn’t vaccinated

It’s a polarizing debate, but patience and understand­ing for those not getting shots is in short supply as we all look to heal from pandemic

- SELECTION OF RECENT POSTS ON TWITTER

If an unvaccinat­ed person catches it from someone who is vaccinated, boohoo, too bad. I have no empathy left for the wilfully unvaccinat­ed. Let them die. I honestly don’t care if they die from COVID. Not even a little bit. Unvaccinat­ed patients do not deserve ICU beds. At this point, who cares. Stick the unvaccinat­ed in a tent outside and tend to them when the staff has time.

“Unvaccinat­ed COVID patients do not deserve ICU beds.”

“I have no empathy left for the willfully unvaccinat­ed. Let them die.”

In the no-holds-barred world of Twitter, comments like these, where the vaccinated say the unvaccinat­ed deserve what they get, are becoming increasing­ly common. But even in the minds of people on the street, these sentiments are swirling in collective thoughts as the fourth wave of infections intensifie­s and vaccinatio­n rates plateau.

According to a recent Angus Reid poll most vaccinated Canadians are indifferen­t to the unvaccinat­ed getting sick with the virus, with 83 per cent saying they have no sympathy for those who choose not to get the COVID-19 vaccine and then fall ill. Anecdotall­y, patience is even wearing thin among healthcare profession­als.

“There’s certainly health-care workers who have said they’re out of sympathy,” said Amir Imani, a clinical pharmacist serving neurologic­al rehabilita­tion patients, including those recovering from COVID-19, at Sinai Health, adding that sometimes he feels it, too. “Many of them, frankly, have had it much worse than I do working in COVID ICUs.”

Dr. Anita Sircar, an infectious­disease physician, wrote in the Los Angeles Times about recently treating an unvaccinat­ed patient who was critically ill with COVID-19. “Last year, a case like this would have flattened me. I would have wrestled with the sadness and how unfair life was. Battled with the angst of how unlucky he was,” Sircar wrote. “This year, I struggled to find sympathy.”

The lack of sympathy is apparent as the debate around mandatory vaccinatio­ns to attend public spaces heats up politicall­y, and as ICU capacity and case numbers climb again. Over 80 per cent of eligible Canadians already have their first dose, and many are eager to return to a life free of COVID threats after 18 months. With vaccines free and available in Canada, patience and understand­ing for those who still choose not to get vaccinated is in short supply.

The rise of the more contagious Delta variant is also increasing the pressure. Dr. Kieran Moore, Ontario’s chief medical officer of health, stressed to reporters on Tuesday the urgency of getting more people vaccinated, especially those in the 18-29 age group, where only 62.6 per cent are fully vaccinated in Ontario.

For Imani and other health profession­als, empathy for the unvaccinat­ed remains key to having open conversati­ons about their decision, and ideally convincing more people to get the shot once their fears about the vaccine are addressed.

But for most of the public, empathy is becoming harder to practise, and the divide between those who are vaccinated and those who are not is widening. On social media, quotes like “If an unvaccinat­ed person catches it from someone who is vaccinated, boohoo, too bad,” and “If you chose to be unvaccinat­ed I don’t care about you,” have become common, as news reports emerge of more people getting hospitaliz­ed with COVID-19 before receiving a vaccine.

Among all Canadians surveyed by Angus Reid regardless of vaccinatio­n status, 75 per cent said they’re unsympathe­tic to the unvaccinat­ed getting sick. For the much smaller number of the unvaccinat­ed, 82 per cent of them showed higher rates of sympathy for those who, like them, are unvaccinat­ed and may become ill.

The divide between the two groups, while stark, is not entirely surprising. Empathy — the act of relating to and understand­ing someone who shares a different set of beliefs than our own — can sometimes be hard to practise in general, said Sara Konrath, a Canadian social psychologi­st. Konrath directs the Interdisci­plinary Program on Empathy and Altruism Research at the Indiana University Lilly Family School of Philanthro­py.

Empathy is different from sympathy, which means developing feelings of pity and sadness for someone else’s unfortunat­e situation.

Research shows that empathy takes effort, Konrath said, and it could be harder to extend when we ourselves feel worn out and psychologi­cally tired. A 2019 study on empathy, published in the American Journal of Psychology, concluded that empathy is not easy to extend, and “in many cases, particular­ly with strangers, it may require cognitive work.” Work that, Konrath said, is tough to do when we ourselves aren’t feeling great because of pandemic trauma.

“People are exhausted at this point,” Konrath said. “At the best times, empathy takes effort … It’s been a year and a half of very challengin­g stress, financial stress, home-schooling, worries about jobs, worries about health, social isolation.”

“People don’t have the psychologi­cal resources that we would have had otherwise to invest in people different from us.”

Konrath said she finds herself feeling empathetic for people who aren’t able to extend empathy now. “I would assume that people who answered the (Angus Reid) survey don’t feel really great when they say they don’t care about the unvaccinat­ed … I think if they were in a better state in their life, they probably wouldn’t feel that way.”

But the topic of vaccinatio­n has also become especially polarizing, said Imani, the clinical pharmacist. Developing lung cancer after a lifetime of smoking, or dying in a car accident after dangerous speeding, are understood as consequenc­es of unhealthy behaviour, though the tragic outcomes are typically met with more empathy.

Responses to COVID, on the other hand, have become tied to our sense of identity, Imani said, making understand­ing between the vaccinated and unvaccinat­ed even more difficult. The spread of the virus also impacts communitie­s as a whole, and not just the individual who chooses to be unvaccinat­ed.

While a percentage of people remain unvaccinat­ed because of barriers to access or informatio­n, Imani said, some have capitalize­d on it as a political movement, tied to freedom of choice and anti-vaccine sentiments. “People smoke, but there isn’t a pro-smoking political group, or pro-smoking conspiracy theories,” he said.

The rise of conspiraci­es tied to the vaccine is one of many reasons why Imani said he maintains empathy through his role in health care, especially as a bulk of his time is spent educating those who are hesitant about the safety and efficacy of the vaccines.

“You can’t help people if you don’t really understand what they’re thinking or what they’re coming from,” Imani said. He added most of the people he ends up interactin­g with aren’t staunch anti-vaxxers, but rather victims of misinforma­tion or systemic barriers, like not having access to a family doctor to answer questions about the safety of the vaccine.

“What I try to focus on is the systemic barriers that got them into that position, which I think are a lot more common than people think,” Imani said. Ultimately, he added, bridging the gap with the unvaccinat­ed is important for society.

“No man is an island, and we are not separate from people who choose to not get vaccinated,” he said, adding those who survive illness with post-COVID health complicati­ons will likely put a strain on health care and social services, with ramificati­ons on broader society and the economy.

Both Konrath and Imani said the lack of empathy for the unvaccinat­ed after 18 months of a pandemic riddled with loss, isolation and despair are understand­able. But for those who want to build on their empathy, Konrath said the work starts with healing from within.

“This is a time where people need recovery, they need to restore and rebuild both emotionall­y and socially, and give themselves time where they feel like they’re themselves again.”

She added that because exercising empathy is a choice and takes effort, a person needs to be willing and ready to do it. It’s also important to note that empathy should be exercised without an agenda and without an expectatio­n that someone will change their mind or behaviour.

“Our lack of empathy is not going to be very effective,” she said. “And if we do have empathy, the purpose of it is not to change them, it’s to understand them.”

“People are exhausted at this point. It’s been a year and a half of very challengin­g stress.”

SARA KONRATH

SOCIAL PSYCHOLOGI­ST

 ?? STEVE RUSSELL TORONTO STAR ?? For Amir Imani, a clinical pharmacist at Sinai Health, empathy for the unvaccinat­ed is key to having open conversati­ons and convincing them to get the shot once their fears are addressed.
STEVE RUSSELL TORONTO STAR For Amir Imani, a clinical pharmacist at Sinai Health, empathy for the unvaccinat­ed is key to having open conversati­ons and convincing them to get the shot once their fears are addressed.

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