Data shows vaccine mandates
have dramatically increased
health care worker inoculation numbers
At the end of a week that began with fears of severe staffing shortages at New York hospitals due to the state’s Monday deadline for health care workers to get vaccinated, data showed a dramatic increase in vaccination.
Ninety-two percent of hospital staff members and nursing home staff have now received at least one dose of a COVID-19 vaccine, New York Gov. Kathy Hochul reported this week. On Aug. 24, just 71 percent of hospital workers had received one dose of the vaccine, according to state figures.
“This new information shows that holding firm on the vaccine mandate for health care workers is simply the right thing to do to protect our vulnerable family members and loved ones from COVID-19,” Hochul said in a press release praising the “dramatic action” that her predecessor, Andrew Cuomo, announced in late July as a way to slow the spread of the virus.
High rates of compliance with vaccine mandates are being seen in other states as well. Despite headlines showing fringe resistance nationwide, the vast majority of health care workers are getting their shots.
At Houston Methodist Hospital, one of the first to announce a vaccine mandate, just 153 hospital staff members, or 0.58 percent of more than 26,000 employees, were fired or resigned because they refused to get vaccinated for COVID-19.
At Novant Health System in North Carolina, 175 workers, or 0.50 percent, of the 35,000-person workforce have been terminated due to vaccine noncompliance. And at Indiana University Health, which employs a workforce of roughly 28,500 people, just 125 employees no longer have a job because they refused to take the vaccine.
All of these hospitals have, in turn, hired vaccinated health care workers to fill the open positions left by those who refused to be inoculated for a disease that has so far killed nearly 700,000 Americans.
Dr. Leana Wen, an emergency physician and a public health professor at George Washington University, says mandates are critical for any kind of substantial progress on the pandemic.
“We are seeing all across the country that vaccine mandates work,” Wen told Yahoo News. “If there are people who remain unvaccinated, there is a higher likelihood that they could end up becoming infected and being out of work for that reason, [in turn] infecting other people and causing other people to be out of work.”
A recent Centers for Disease Control and Prevention study showed that unvaccinated people are 29 times more likely to be hospitalized with COVID-19 than those who are vaccinated. Many hospitals saw those statistics play out in real time over the summer months when, thanks to the Delta variant, infections spiked. More than 97 percent of all COVID-19 patients in hospitals over that period were unvaccinated.
But for critics of the vaccine, including some health care workers who choose not to get inoculated, the data does not outweigh what they see as an infringement of personal liberty.
Dr. Mollie James, a critical care doctor in Queens, N.Y., has been treating COVID-19 patients since the beginning of the pandemic. But last Monday was her last day on the job because of what she calls a “ridiculous vaccine mandate.”
“Mandates are not health care,” James told Yahoo News. “Many doctors and nurses in New York have already had COVID, so we have the protection of natural immunity — which has been shown to be far more durable than the vaccine.”
But according to a CDC study released in August, “COVID-19 vaccines offer better protection than natural immunity alone, and ... vaccines, even after prior infection, help prevent reinfections.” the agency says on its website.
James has been a surgeon for the past 11 years at multiple hospitals in the New York City area and two major Midwestern health systems. She’s now looking to go into a private practice and says she’s also willing to seek employment in states that don’t have vaccine mandates.
“At this point, it seems likely that every person will end up getting the virus, so early outpatient treatment should be our primary focus,” she said, adding, “My colleagues are generally supportive of me; most are infuriated that early outpatient therapy has been censored and led to hundreds of thousands of unnecessary deaths.”
For many, outpatient treatment begins and ends with the COVID-19 vaccine.
“This is not just about your individual choice about whether or not to be vaccinated — it’s also about the health and well-being of everybody else around you,” Dr. Alyssa Burgart, a bioethicist and pediatric anesthesiologist at Stanford University, told Yahoo News. “And that's the core tenet of vaccination.”
As vaccine mandates for health care workers grow in popularity, a similar dynamic is playing out in school districts where vaccine mandates have been implemented.
With its 150,000 employees, New York City’s public school district is the nation’s largest. Come Friday at 5 p.m., school personnel will be required to have at least one dose of a COVID-19 vaccine or face termination. As of Monday, 97 percent of principals and about 95 percent of teachers had been vaccinated, according to city and teachers' union data, and about 87 percent of nonteaching staff had received the vaccine.
Still, some schools have longer noncompliant lists than others. The city’s teachers' and principals' unions have pushed back on the upcoming deadline, saying the tight window would leave many schools ill equipped. New York City Mayor Bill de Blasio first announced the mandate in late August, but after an unsuccessful court challenge this week to the mandate guidance, some school staff members had only days to get vaccinated.
“At this point, principals and superintendents have been reaching out consistently to tell us that they are concerned about not having enough staff,” Mark Cannizzaro, president of the Council of School Supervisors and Administrators, said during a press conference last Friday. “I've heard from several schools that have anywhere between 30 and 100 people currently on a noncompliant list.”
“It’s not just teachers and administrators that are needed in schools,” Cannizzaro added. “We need to have our custodial staff, our paraprofessionals, our kitchen staff, our school aides and, of course, our school safety agents.”
The mayor’s office is choosing to move forward with the policy that could cost some staff members their jobs.
“We have thousands and thousands of vaccinated, experienced substitute teachers ready to go,” de Blasio said last week. “That's the obvious first go-to, but it's also true that central staff has thousands of educators, certified educators, who could step into different roles if needed.”
But de Blasio made clear that he hoped workers would simply comply with the mandate.
“The reality we’re seeing right now is we think the overwhelming majority of our educators and staff are going to be there on Monday, having gotten that first dose and moving forward,” he said.
While vaccine hesitancy has helped account for low inoculation rates nationwide, it’s clear that mandates, and the threat of job termination, have helped increase the percentage of vaccinated Americans.
And while critics have assailed governments and businesses that have put the mandates in place for what they perceive as infringing on their rights, Wen believes that misses the point about why vaccines are needed.
“If you are a health care worker treating vulnerable patients, if you’re a teacher working around children too young to be vaccinated, it’s your responsibility, first and foremost, to not get them sick,” she said. “If you're a health care worker, you are required to be vaccinated against the flu every year. You are required to show proof of vaccination against hepatitis, against measles and chickenpox. We need to look at COVID-19 no differently.”
Cover thumbnail photo illustration: Yahoo News; photos: Eduardo Munoz Alvarez/Getty Images, John Moore/Getty Images, J. Conrad Williams, Jr./Newsday RM via Getty Images
No cheap, easy or quick fix'; Hospitals oust unvaccinated workers in preview of 50-state mandate
New York this week gave the nation an early glimpse of what the Biden administration's 50-state vaccine mandate for health care workers might look like.
The Empire State's hospitals dismissed or suspended dozens of workers for failing to meet a Monday deadline requiring workers get at least their first dose of the COVID-19 vaccine.
Anticipating service disruptions from frontline health workers quitting or getting fired, health systems from New York City to upstate delayed non-emergency operations, cut clinic hours and paid travel nurses up to $200 an hour to fill vacant shifts.
The dismissals represented a small percentage of workers at large health systems. Most holdout employees got vaccinated in the days leading up to Monday’s deadline as Gov. Kathy Hochul touted a 92% immunization rate among hospital staff this week.
"I’m not going to sugarcoat it – it’s certainly been difficult," said Bea Grause, president of the Healthcare Association of New York State.
Despite the short-term headaches, Grause said the mandate is critical "to put COVID-19 in the rearview mirror" and protect workers, patients and the communities they serve.
“There’s no cheap, easy or quick fix to it, and we’re just going to have to problem solve as we move forward,” she said.
'More and more jobs open'
President Joe Biden last month announced all hospitals that take Medicare and Medicaid reimbursement must vaccinate their workers. The agency that oversees those federal health programs has yet to announce details on when a national mandate will take effect.
While health leaders acknowledge and support mandatory vaccination, some worry workforce disruptions punctuate a widespread shortage of health care workers at hospitals and clinics nationwide. The number of health job openings swelled during the pandemic with the Bureau of Labor Statistics reporting 1.8 million health care openings as of July, up from 1.1 million open jobs in July 2020.
Staffing agencies that provide nurses and other temporary health care workers said requests from hospitals have surged during the pandemic. And once the Biden mandate kicks in for hospitals, requests for contract nurses are likely to go higher to fill vacancies amid a nationwide labor shortage.
New York hospitals have achieved a high vaccination rates and hospitals and health facilities have plenty of current and retired health pros to draw from. Perhaps the bigger disruptions will come in smaller communities with lower vaccination rates, said Todd Walrath, CEO of ShiftMed, which places nursing assistants, licensed practical nurses and registered nurses with hospitals and nursing homes.
"We continue to see an erosion of available workers, and more and more jobs open," Walrath said.
Nevertheless, states are pushing ahead with mandates.
Large California hospitals reported vaccination rates above 90% for a mandate that took effect Thursday for hospital and other health care workers. Two other states, Maine and Connecticut, delayed deadlines to give hospitals and workers more time to comply. Maine's vaccination deadline for health care workers was pushed back a month to Oct. 29. Connecticut's state hospital and nursing home employees must get vaccinated by Oct. 4, a week later than the state's original deadline.
Private health systems are pursing their own mandates, even in states that don't have a broader mandate for health care workers. North Carolina-based Novant Health last week suspended 375 unvaccinated workers and gave them five days to comply with its mandate. Nearly 200 were vaccinated and the remaining employees were dismissed or quit.
About 99% of the health system’s 35,000 employees across 800 locations agreed to get vaccinated.
Carl Armato, president and CEO of Novant Health, said in a statement the health system has added travel workers throughout the pandemic to plug coverage gaps. In the last week, the health system hired more than 150 health workers.
“Without a vaccine mandate for team members, we faced the strong possibility of having a third of our staff unable to work due to contracting, or exposure to, COVID-19,” Armato said in a statement. “This possibility only increases heading into a fall season with the more contagious and deadly delta variant.”
Rural hospitals brace for mandate
Other experts agree that vaccine mandates are necessary. Not only must hospitals ensure workers are healthy, they must set an example for patients and families, said Dr. Kenneth Campbell, an assistant professor in the Tulane School of Public Health and Tropical Medicine.
As a former operations analyst for the Cook County Health & Hospitals System, Campbell helped implement the Chicago-based health system's policy requiring employees get flu shots. The vast majority complied. A small number of objectors were suspended.
Hospital executives are accustomed to worker shortages caused by strikes, retirements or chronic staffing gaps. And even though more workers might quit or be dismissed for refusing COVID vaccination, Campbell said it's a necessary tradeoff.
"If we don’t make this stand now, we can lose this war," said Campbell. "Thousands and thousands more lives can be lost."
Rural hospitals faced chronic doctor and nurses shortages before the pandemic began, and things worsened over the past 18 months, said Alan Morgan, CEO of National Rural Health Association.
Rural communities have higher rates of unvaccinated people, and COVID death rates are higher that metro areas. Unlike large urban hospitals that can recruit staff from big cities and suburbs, rural hospitals don't have the labor pool or financial resources to tap in times of crisis.
Morgan is concerned the federal government hasn't articulated a plan to address inevitable staffing gaps at rural hospitals. The Biden administration could reassure rural hospitals if it released a plan that included steps such as deploying public health service workers and Federal Emergency Management Agency teams, providing funding for hospitals to hire travel nurses or sharing information about available federal grants, Morgan said.
Morgan cited New York Gov. Hochul's plan to make National Guard troops available to plug staffing gaps at as the "the type of leadership we need" to assist rural hospitals.
"There are a lot of tools available," Morgan said. "But to date, there’s been no indication there's any plan, other than the administration saying we don’t anticipate a problem."
This article originally appeared on USA TODAY: New York's COVID vaccine law provides a glimpse of Biden's mandate
No comments:
Post a Comment