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As Vaccine Deadlines Approach, Hospitals Fear Staffing Shortages Will Occur

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Michelle Chester, director of employee health services at Northwell Health, prepares the Moderna COVID-19 vaccine at Long Island Jewish Valley Stream hospital. Hospitals and nursing homes across the country are preparing for worsening staff shortages as state deadlines arrive for employees to get vaccinated against COVID-19. Eduardo Munoz/AP hide caption

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Eduardo Munoz/AP

Hospitals and nursing homes around the U.S. are bracing for worsening staff shortages as state deadlines arrive for health care workers to get vaccinated against COVID-19.

With ultimatums taking effect this week in states including New York, California, Rhode Island and Connecticut, the fear is that some employees will quit or let themselves be fired or suspended rather than get the vaccine.

“How this is going to play out, we don’t know. We are concerned about how it will exacerbate an already quite serious staffing problem,” said California Hospital Association spokesperson Jan Emerson-Shea, adding that the organization “absolutely” supports the state’s vaccination requirement.

New York health care employees had until the end of the day Monday to get at least one dose, but some hospitals had already begun suspending or otherwise taking action against holdouts.

Erie County Medical Center Corp. in Buffalo said about 5% of its hospital workforce has been put on unpaid leave for not being vaccinated, along with 20% of staff at its nursing home. And the state’s largest health care provider, Northwell Health, said it has begun removing unvaccinated workers from its system, though it said its workforce is nearly 100% vaccinated.

“To those who have not yet made that decision, please do the right thing,” New York Gov. Kathy Hochul said.

Some New York hospitals prepared contingency plans that included cutting back on noncritical services and limiting nursing home admissions. The governor also drew up plans to summon help from National Guard members with medical training, retirees or vaccinated workers from outside the state.

About a dozen states have vaccination mandates covering health care workers in hospitals, long-term care facilities or both. Some allow exemptions on medical or religious grounds, but those employees often must submit to regular COVID-19 testing.

States that have set such requirements tend to have high vaccination rates already. The highest rates are concentrated in the Northeast, the lowest ones in the South and Midwest.

The Biden administration also will require the roughly 17 million workers at health facilities that receive federal Medicare or Medicaid to be fully vaccinated under a rule still being developed.

That has worried some hospital officials, particularly in rural communities where vaccination rates tend to be lower.

“We are looking at the need to reallocate staff, in some cases just to maintain services that are essential, and there are going to be some delays” in care, said Troy Bruntz, president and CEO at Community Hospital in McCook, Nebraska.

He said 25 of the hospital’s 330 employees said they would definitely resign if they were required to be vaccinated. The remainder of the approximately 100 unvaccinated employees — a group that includes nurses as well as cleaning and maintenance staff — haven’t decided.

He also worries that it will be difficult to hire new workers when the hospital is already short-handed.

“It doesn’t make us feel too confident that this isn’t going to turn into something short of a nightmare for American health care,” he said.

Many hospitals and nursing homes are already suffering staff shortages because many nurses and others have quit as a result of pandemic-related burnout or have left for lucrative jobs traveling from state to state.

White House press secretary Jen Psaki noted that hospitals in Houston and Maine lost a relatively small number of employees recently after requiring employees to get vaccinated.

“We’re seeing in a lot of places that this is working, it’s effective. It’s creating more certainty and protection in their workforces,” Psaki said.

In California, where health care workers have until Thursday to get fully vaccinated, some hospitals are anticipating firings, suspensions or the moving of people to other positions, Emerson-Shea said. She said many traveling nurses have declined assignments in California because of the state’s vaccine requirement.

But with a statewide mandate, health workers won’t be able to just quit their jobs and go to other hospitals, said Dr. Jeff Smith, CEO and executive vice president of hospital operations at Los Angeles-based Cedars-Sinai Medical Center.

He expects that about 97 percent of Cedars-Sinai’s almost 17,000 employees affected by the vaccine mandate will comply by the deadline. Another 1 percent have applied for medical or religious exemptions. Those who don’t comply by Friday will be suspended for a week, and fired on Oct. 8 if they don’t comply or if there are not extenuating circumstances, he said.

The hospital also was able to hire over 100 nurses in the past month and uses some travel nurses.

“We’re in a good place but don’t want to minimize the challenges other hospitals are likely facing,” Smith said.

In Rhode Island, where the vaccine mandate takes effect Friday, the state said hospitals can allow unvaccinated employees to keep working 30 days past the deadline in cases where firing them would compromise patient safety. The mandate is being challenged in court because it doesn’t allow religious exemptions.

In states that don’t have mandates, some hospitals are imposing their own.

Ginger Robertson, a registered nurse who works in a mental health clinic at a hospital in Bismarck, North Dakota, has requested a religious exemption from her hospital’s vaccination requirement. She said she will look for other work if she doesn’t get it.

“Honestly, I really love my job. I am good at it. I enjoy my patients. I enjoy where I am at,” she said. “So this is a really hard place, to have to choose between two things I don’t want to do. I don’t want to leave, and I don’t want to get the vaccine.”

She said other nurses are also considering leaving over what she called the “insulting” mandate.

“We feel demoralized, like as though we aren’t intelligent enough to make these choices for ourselves,” Robertson said.

A North Carolina-based hospital system announced Monday that more than 175 of its 35,000-plus employees have been fired for failing to comply with its COVID-19 vaccination requirement.

Last week, Novant Health announced 375 workers had been suspended and given five days to comply. Nearly 200 of them did so — including those who submitted approved exemptions — before the Friday deadline, spokesperson Megan Rivers said.

Massachusetts’ mandate, issued by Republican Gov. Charlie Baker, applies only to rest homes, assisted living facilities, hospice programs and home care programs. It allows for medical and religious exemptions but doesn’t require regular testing. The deadline is Oct. 31.

In Connecticut, a vaccine mandate for employees of state-run hospitals took effect on Monday. It does not apply to privately run hospitals, some of which are imposing their own requirements. Medical and religious exemptions are possible, but anyone else who fails to get vaccinated will be barred from the workplace.

About 84% of over 450,000 hospital workers in New York were fully vaccinated as of Wednesday, according to state data. Nursing home data through Sunday showed about 89% of nursing home workers fully vaccinated.

New York City’s hospital system reported a 95% vaccination rate for nurses and a higher rate for doctors.

In Missouri, which became a severe COVID-19 hot spot over the summer, the Mercy hospital system is requiring vaccinations among staff at its hundreds of medical centers and clinics in Missouri and neighboring states by Thursday.

Anyone who doesn’t comply by then will be placed on a 30-day unpaid suspension, said Mercy spokeswoman Bethany Pope.

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Source: https://www.npr.org/sections/coronavirus-live-updates/2021/09/27/1041047608/vaccine-deadlines-hospitals-fear-staffing-shortages

Covid19

The CDC emphasizes COVID vaccinations as a key to safe holiday gatherings

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A video call on a laptop screen during Christmas. The Centers for Disease Control and Prevention released new guidance on Friday for safely celebrating the upcoming holiday season. FilippoBacci/Getty Images hide caption

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FilippoBacci/Getty Images

Following confusion earlier this month on how the country should safely celebrate the holidays, the Centers for Disease Control and Prevention has released its updated guidance around gatherings and traveling amid the COVID-19 pandemic.

In the new guidance issued Friday, the CDC says the best way to safely celebrate the holiday season is by being vaccinated (if eligible) against the coronavirus.

“Protect those not yet eligible for vaccination such as young children by getting yourself and other eligible people around them vaccinated,” the CDC said on its website.

Health officials said that having every person in attendance vaccinated against the virus is particularly important for protecting those who can’t get a shot, such as children under 12.

The CDC recommends that those who aren’t fully vaccinated delay their travel plans. For those that do travel, the CDC offers recommendations for domestic or international travelers.

In addition, the CDC suggests those who aren’t fully vaccinated wear well-fitting masks over the nose and mouth if in public indoor settings. It says outdoor celebrations, if possible, are recommended instead of indoor ones.

If in an outdoor setting, those who are vaccinated do not need to wear a mask, unless they are in areas with a high number of COVID-19 cases.

“By working together, we can enjoy safer holidays, travel, and protect our own health as well as the health of our family and friends,” the CDC said.

Just this week, Dr. Anthony Fauci, the nation’s top infectious disease expert, said that trick-or-treating can resume this Halloween, should those that are fully vaccinated feel comfortable doing so.

“I think that, particularly if you’re vaccinated, you can get out there and enjoy it,” Fauci told CNN’s State of the Union.

According to the American Academy of Pediatrics website, HealthyChildren.org, officials recommend that families that decide on outdoor trick-or-treating do so in small groups.

When it comes to handing out candy, the website says to sit outside and line up individually prepackaged treats for children to take, including non-edible treats for those with food allergies.

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Source: https://www.npr.org/sections/coronavirus-live-updates/2021/10/15/1046615372/cdc-new-covid-guidelines-holiday-celebrations

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United States commits another 17 million COVID vaccine doses to the African Union

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The vial of the Johnson & Johnson COVID-19 vaccine. The White House says Thursday that the U.S. will commit 17 million additional doses of the Johnson & Johnson vaccine to the African Union. Picture Alliance/dpa/picture alliance via Getty I hide caption

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Picture Alliance/dpa/picture alliance via Getty I

The White House says the United States will donate more than 17 million doses of the Johnson & Johnson COVID-19 vaccine from its domestic supplies to the African Union.

President Biden made the announcement Thursday as he met with Kenyan Uhuru Kenyatta at the White House, Biden’s first one-on-one meeting with an African leader.

“We’re continuing our shared fight against COVID,” Biden said during the meeting.

The vaccine donation comes on top of the 50 million vaccines doses already donated by the United States to the African Union, according to the White House.

The 17 million J&J vaccines will be available for delivery immediately and will be delivered to the African Union within the coming weeks.

Kenyatta thanked Biden for assisting both Kenya and other African countries, saying that the U.S. has “stepped up” when it comes to vaccine donation and access to vaccines for other countries.

News of Kenya’s 17 million vaccine donation comes after the World Health Organization said last month the African continent was almost 500 million doses short of what is needed to achieve its goal of vaccinating 40% of people by the end of 2021.

“African countries need clear delivery dates so they can plan properly. We also need strong structures set up to ensure that all promises made are promises kept,” said Dr. Matshidiso Moeti, World Health Organization Regional Director for Africa in a statement addressing the shortage.

To date, under half of the African countries that have received COVID-19 vaccines have fully vaccinated only 2% or less of their populations, according to the WHO.

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Source: https://www.npr.org/sections/coronavirus-live-updates/2021/10/14/1046163404/united-states-donating-covid-vaccines-african-union

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WHO launches a new group to study the origins of the coronavirus

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Tedros Adhanom Ghebreyesus, director general of the World Health Organization (WHO), speaks during a news conference on the COVID-19 coronavirus outbreak in Geneva, in March 2020. Stefan Wermuth/Bloomberg via Getty Images hide caption

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Stefan Wermuth/Bloomberg via Getty Images

The World Health Organization has announced the establishment of a scientific advisory group aimed at identifying the origin of COVID-19 and to better prepare for future outbreaks of other deadly pathogens.

The WHO’s Scientific Advisory Group for the Origins on Novel Pathogens, or SAGO, will include scientists from the U.S., China and about two dozen other countries. It will be charged with answering the question of how the novel coronavirus first infected humans — a mystery that continues to elude experts more than 18 months into the crisis. The group will also be responsible for establishing a framework to combat future pandemics

Maria Van Kerkhove, the head of WHO’s emerging disease unit, called the establishment of the new group “a real opportunity right now to get rid of all the noise, all the politics surrounding this and focus on what we know, what we don’t know.”

The team will be selected from more than 700 applications from experts in fields including epidemiology, animal health, ecology, clinical medicine, virology, genomics, molecular epidemiology, molecular biology, biology, food safety, biosafety, biosecurity and public health, the WHO said in a statement.

“The emergence of new viruses with the potential to spark epidemics and pandemics is a fact of nature, and while SARS-CoV-2 is the latest such virus, it will not be the last,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said. “Understanding where new pathogens come from is essential for preventing future outbreaks with epidemic and pandemic potential, and requires a broad range of expertise.”

Beijing continues to resist investigations in China

The establishment of the group comes as China has continued to resist efforts to study the possible origin of the virus there. After an initial investigation by the WHO, Beijing rejected a plan for a second phase of the probe in July that might delve into various hypotheses about the origin of the virus, including that it escaped from a Chinese government lab in the city of Wuhan.

The so-called “lab-leak theory” was initially dismissed by WHO, but has nonetheless gained traction in recent months, fueled in part by Beijing’s secrecy. Many scientists contend that a lab leak is much less likely than the alternative — that the novel coronavirus has a natural origin.

Beijing did not immediately react to the announcement of the new task force.

The WHO director still wants to look at labs in Wuhan

Despite the WHO’s initial findings, Tedros has called for audits of Wuhan laboratories, including the Wuhan Institute of Virology, which some scientists believe may be the source of the virus that caused the first infections in China.

Some of the proposed SAGO members were on the original 10-person WHO team that studied possible origins in China, including Chinese scientist Yungui Yang of the Beijing Institute of Genomics at the Chinese Academy of Sciences.

An editorial co-authored by Tedros that was published in Science on Wednesday said SAGO would “quickly assess the status of SARS-CoV-2 origin studies and advise WHO on what is known, the outstanding gaps, and next steps.”

It said that “[all] hypotheses must continue to be examined,” including the “studies of wildlife sold in markets in and around Wuhan, China (where cases of COVID-19 were first reported in December 2019); studies of SARS-like coronaviruses circulating in bats in China and Southeast Asia; studies on prepandemic biological sampling around the world; and other animal susceptibility studies.”

“As well, laboratory hypotheses must be examined carefully, with a focus on labs in the location where the first reports of human infections emerged in Wuhan,” it said, adding, “A lab accident cannot be ruled out until there is sufficient evidence to do so and those results are openly shared.”

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Source: https://www.npr.org/sections/coronavirus-live-updates/2021/10/13/1045647249/who-covid-investigation-china-wuhan-lab-leak

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COVID-19 continues to be a leading cause of death in the U.S. in September 2021

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An updated issue brief examines COVID-19’s effect on mortality rates, and estimates that in September 2021, COVID-19 was the number two on the list of the top ten leading causes of death in the U.S. As recently as January 2021, COVID was the number one leading cause of death, though COVID rank had briefly dropped to the 8th leading cause of death in July 2021 before the delta variant, relaxed social distancing and inadequate vaccinations led to a surge in new cases and deaths.

The analysis also estimates that nationally more than 90,000 deaths from COVID-19 since June could have been prevented with vaccines. More than half of those preventable deaths occurred in September.

The analysis can be found on the Peterson-KFF Health System Tracker, an information hub dedicated to monitoring and assessing the performance of the U.S. health system.

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Source: https://www.kff.org/coronavirus-covid-19/issue-brief/covid-19-continues-to-be-a-leading-cause-of-death-in-the-u-s/

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