Universal Health 2030 Solving Complex Health System Problems
September 2021 New York times; With a Monday deadline looming, thousands of health care workers in the state are risking their jobs by not getting a coronavirus vaccine.
In Buffalo, the Erie County Medical Center plans to suspend elective in-patient surgeries and not take intensive-care patients from other hospitals because it may soon fire about 400 employees who have chosen not to get vaccinated against the coronavirus.
Officials at Northwell Health, New York’s largest provider of health care, estimate that they might have to fire thousands of people who have refused to get vaccinated.
And while the vast majority of staff members at New York City’s largest private hospital network, NewYork-Presbyterian, had been vaccinated as of this week, more than 200 employees faced termination because they had not.
These are just a fraction of the workers at risk of losing their jobs or being put on unpaid leave after Monday, when a state directive requiring hospital and nursing home employees in the state to have received at least one shot of a virus vaccine takes effect.
As of Sept. 22, state data shows, around 84 percent of New York’s 450,000 hospital workers and 83 percent of its 145,400 nursing home employees had been fully vaccinated. But tens of thousands of people are estimated not to have gotten a shot despite being threatened with losing their jobs. The holdouts say they fear potential side effects from the vaccines, have natural immunity or believe that the mandate violates their personal freedom.
On Thursday, Gov. Kathy Hochul said that the Monday deadline was firm and that her administration was developing emergency plans to cover for those who are laid off, going so far as to look into recruiting temporary workers from the Philippines or Ireland.
“What is looming for Monday is completely avoidable, and there’s no excuses,” Ms. Hochul said, pleading for those who have not done so to get vaccinated.
In New York City, health care workers are not the only ones who face an imminent deadline to be vaccinated or face termination. A requirement that virtually everyone working in the public schools — well over 150,000 people — be vaccinated takes effect at midnight on Monday.
Mayor Bill de Blasio’s administration has been temporarily blocked from enforcing the vaccine mandate for nearly all adults in public school buildings after a federal appeals court granted a temporary injunction on Friday. City officials said they expect the mandate will ultimately be upheld but it is not clear if the issue will be resolved before the Monday deadline.
Although about 90 percent of the system’s educators and 80 percent of support staff members have gotten at least one shot, thousands of workers have not. That could cause staff shortages in some schools.
Educators who choose not to get vaccinated will be allowed an unpaid one-year leave with their health insurance intact. But they will not be allowed to enter school buildings starting Tuesday. Unions that represent educators and other school staff members are warning of disruptions for students and have urged Mayor Bill de Blasio to delay enforcement of the mandate.
New York State’s vaccination requirement for health care workers is among the largest mandates of its kind that is set to take effect in the United States, with weekly virus testing not permitted as a substitute measure. How it goes — and whether it leaves hospitals understaffed — will be closely watched. California is requiring health care workers there to be fully vaccinated by Sept. 30, and a similar mandate in Maine will not be enforced until Oct. 29. New York’s willingness to risk large-scale layoffs of health care workers comes amid a national nursing shortage, and the requirement is facing numerous legal challenges.
“We give patients a Bill of Rights, and they are able to choose what procedures or tests or medications they want to put in their system,” said Gregory Serafin, a registered nurse at the Erie County Medical Center, and the lead plaintiff in a New York lawsuit that seeks to stop the mandate. “Health care workers deserve the same medical autonomy to make those decisions.”
Depending on how many health care workers are fired, the policy could also test the resiliency of New York’s health care system. Hospitals across the state are activating emergency staffing plans that they typically reserve for natural disasters or, more recently, surges in Covid-19 cases. Volunteers, students and retirees will fill vacancies, along with traveling nurses.
Northwell, which has 77,000 employees, believes it can weather any loss of employees without the care of patients being affected. The Erie County Medical Center is not as sure.
On Monday, the hospital had 553 inpatients, its busiest day on record. A big reason the hospital is so crowded is that it cannot discharge as many patients as usual to nursing or group homes, because they are also limiting admissions in anticipation of their own staff shortages because of the vaccine mandate.
“This is creating an unprecedented crisis for us,” said Tom Quatroche, the Erie County Medical Center Corporation’s president. “I think we need more time to comply, and I’ve asked for that. For all the right reasons, the vaccine mandate was put in place. But the reality is it is creating a public health crisis in hospitals, with nobody to care for patients.”
In New York City, more than 5,000 of the 42,000 employees of the public hospital system were unvaccinated as of Friday. They will be barred from hospitals starting Monday and from other care facilities beginning Oct. 7, and they will be placed on unpaid leave.
The hospital system anticipates the vaccine mandate could reduce the ranks of radiology technologists and phlebotomists, in particular, and some doctors have been urged to limit the amount of imaging and blood work they order next week, according to an internal message.
Firings under the new directive could prove particularly problematic for nursing homes, which are already facing staffing problems. The New York State Health Facilities Association, a trade group that represents about 250 nursing homes, has asked state officials to temporarily let unvaccinated nursing home workers keep working as long as they get tested regularly.
