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As delta spreads, hospitals look at vaccine mandates

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St. Francis Hospital in Wilmington became the first in Delaware to require employees to get the COVID-19 vaccination amid a rise in cases spurred by the delta variant. | DBT PHOTO BY JACOB OWENS

The COVID-19 vaccine and employer mandates to get it are a politically charged issue right now, but the recent concerning spread of the delta variant has increased the call for vaccines and mandates alike.

The so-called delta variant is a highly contagious SARS-CoV-2 virus strain that was first identified in India in December. It has spread across the U.S. in recent months and is now the dominant strain, including here in Delaware. With the number of positive cases now on the rise again, the U.S. Centers for Disease Control and Prevention is urging more precautions to stem the spread of the variant, including the wearing of masks by vaccinated individuals in some scenarios. It also leading some to call for more heavy-handed measures to ensure vaccination rates increase, such as employer mandates.

“We call for all health care and long-term care employers to require their employees to be vaccinated against COVID-19,” the American Medical Association and 56 other groups representing doctors, nurses and pharmacists said July 26 in a joint statement.

They noted many health care and long-term care facilities require vaccinations for influenza, hepatitis B and pertussis.

Trinity Health, which operates St. Francis Hospital in Wilmington, is one of America’s first big hospital systems to require COVID-19 vaccinations for employees. Its mandate, which includes contractors and people conducting business in its health care facilities, goes into effect Sept. 21.

The U.S. Department of Veterans Affairs, which runs a hospital for veterans in Elsmere, also announced July 26 that all of its health care staff must be vaccinated within eight weeks and President Joe Biden was scheduled to announce July 29 that the federal government – America’s largest employer – would require employees to get vaccines or repeated tests.

Jennifer Penberthy Buckley | PHOTO COURTESY OF POTTER ANDERSON

“We are certainly seeing more mandates, particularly in health care and residence-based education, such as universities,” said Jennifer Penberthy Buckley, an associate with Potter Anderson & Corroon, a Wilmington-based law firm that specializes in labor law. “It’s something that other industries are considering, too.

“Generally, employers can legally mandate vaccination as a term and condition of employment,” she wrote in a March Op-Ed in Delaware Business Times with Jennifer Gimler Brady.

That assessment was strengthened in May, when the U.S. Equal Employment Opportunity Commission issued supporting guidance, which she said noted that companies need to consider accommodations and exceptions. And “courts don’t seem inclined to reject mandates,” she added.

Representatives from Delaware’s other hospitals – Bayhealth, Beebe Healthcare, ChristianaCare and TidalHealth – were all asked about staff vaccine requirements. They largely did not answer what percent of their staff is vaccinated.

“I think that members are weighing the situation,” said Wayne A. Smith, president of the Delaware Healthcare Association, which represents state hospitals and related organizations.

Vaccines currently have only emergency use authorization by the federal Food and Drug Administration, and he said a key tipping point would be full approval.

“We believe strongly in vaccines and have been working tirelessly since they first became available,” said Cheryl Heiks, executive director of the Delaware Health Care Facilities Association, which represents long-term care facilities.

The association “urges all health care personnel to get vaccinated and to remain vigilant in protecting themselves, their patients, and their families from the ongoing risks of COVID-19. We fully support those providers who have taken the step of mandating the vaccine, knowing that choice may increase the already challenging workforce environment.”

As of July 11, Delaware had a 65.2% staff vaccination rate at long-term care facilities, with another 2.6% partially vaccinated, she said. Of residents, 89.2% were fully vaccinated with another 2.9% partially vaccinated.

“Note that the number of staff and partially residents fluctuates every day, with new residents admitted into facilities and others being discharged – so keeping the resident vaccination rate high is another significant and ongoing effort,” Heiks said.

“Beebe Healthcare continues to discuss this option and to look for guidance regarding mandating vaccinations,” spokesman Ryan Marshall said. “This may change as the vaccine status moves from emergency use authorized to an FDA-approved vaccine, but no decision has been made.”

“At Bayhealth we highly encourage, but do not require, the COVID-19 vaccine,” said spokeswoman Danielle Pro-Hudson, adding that roughly 65% of staff members are vaccinated. “We are not considering this requirement at this time.”

“At TidalHealth, we have been discussing COVID-19 vaccinations a condition of employment; however, we are not making them mandatory at this time,” said Roger A. Follebout Jr., director of strategic communications.

A representative for ChristianaCare did not respond by press time Wednesday regarding the health system’s plans.

When Trinity made the announcement on July 8, the Michigan-based hospital system estimated that 75% of its 117,000 employees were vaccinated.

Dr. Ralph Gonzalez, chief medical officer at St. Francis, said “the vast majority of our 1,035 colleagues are fully vaccinated, and we are encouraged by the support of our colleagues as we look to continue protecting the Wilmington community.”

“We were convinced that the vaccine can save lives,” Dr. Daniel Roth, Trinity’s chief clinical officer, recently told The New York Times. “These are preventable deaths.”

At Trinity, “exemptions are available for religious or health reasons and must be formally requested, documented and approved. Employees who do not meet criteria for exemption and fail to show proof of vaccination will have their employment terminated.”

Across America, 38% of nursing home staff were not fully vaccinated as of July 11, according to U.S. Centers for Medicare and Medicaid Services data analyzed by LeadingAge, The Washington Post reported.

“An analysis by WebMD and Medscape Medical News estimated that about 25% of hospital workers who had contact with patients had not been vaccinated by the end of May,” the Post reported.

On April 1, Houston Methodist became the first hospital in the nation to require workers to get vaccinated. It later prevailed in federal court over the objections of some employees to the mandate.

“Overall, though, Covid-19 vaccine mandates at work remain rare, partly because doing so can be a legal minefield for companies, employment attorneys say,” The Wall Street Journal reported. “In some cases, mandates have resulted in employee lawsuits and termination of workers. And in a tight labor market, employers also risk losing workers who balk at such requirements.”

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