Wash. Hospital COVID Vax Mandate Looms—How Many Will Quit?

The News Tribune (Tacoma, Wash.)

A new statewide survey of hospitals in Washington state offers indications of how many hospital workers are following the state's mandate to be vaccinated against COVID-19 by the Oct. 18 deadline.

The full tally might not be known until early November as some workers will be put on administrative leave to complete their vaccinations as a result of not gaining an exemption or other accommodation.

With 94 percent of Washington's hospitals reporting, the survey shows an overall rate of staff vaccination rate of 88 percent, according to the Washington State Hospital Association, which conducted the survey.

Staff were surveyed after Oct. 4, which was the cutoff to be vaccinated in time for the Oct. 18 deadline. The mandate was announced by Gov. Jay Inslee in August after several health systems had announced their own COVID vaccination requirements.

According to WSHA, the remaining 12 percent "are a mix of staff who are partially vaccinated, have an approved exemption and accommodation, have applied or plan to apply for an exemption that has not yet been reviewed, have not yet provided verification, or are choosing not to be vaccinated."

It added, "The hospital association believes that statewide, 2 to 5 percent of hospital staff could leave the workforce because of the vaccination requirement. The final number will not likely be known until early November."

That translates to 3,000 to 7,500 hospital workers, according to Cassie Sauer, CEO of the Washington State Hospital Association, with the biggest impacts felt in rural and Eastern Washington.

"We know there will be some impacts on services, and we will continue to support hospitals and health systems in navigating the vaccine requirement," Sauer said in a statement ahead of Monday's news briefing.

According to WSHA, several hospitals "reported that they will need to reduce or consolidate some services." Additionally, "hospital association members expressed concern about the impact of the vaccine requirement on other services essential to the functioning of the health care system," WSHA said in its release. "These include long-term care providers and emergency medical services to transport patients to and between health care facilities."

Representatives for Newport Hospital & Health Services who attended Monday's WSHA briefing for reporters said they were losing more than 2 to 5 percent. Newport is north of Spokane and along the Washington-Idaho border.

"We're looking at probably losing 50 percent of our physical therapy department," said Christina Wager, chief operating officer, Newport Health & Services, out of a staff of 15, and a 10 percent loss to overall staff.

"It is clear that staffing remains constrained across the health care system, and the loss of staff will have an impact on patients, including continued delays for less urgent procedures and longer waits for outpatient appointments," Sauer said.

Dr. Julie Buck, emergency department physician with Harbor Regional Health and medical program director of the Grays Harbor EMS & Trauma Care Council, said during the briefing that staff shortages were keenly felt in Grays Harbor County.

"There's not just a nursing staff shortage, but I'm sure people across the state have experienced housekeeping, registration, respiratory therapists — just every role in the hospital is understaffed at this point," Buck said.

"Some nights, there's only one nurse that scheduled for the ER, because the shortage is already so severe. So even losing one more person is going to be crippling."

She said EMS crews were challenged with longer turnaround times to get to the next call because of so many transports, which could take upwards of two hours one-way to get patients to other hospitals.

Details about individual hospital systems' level of vaccination were not released with the survey results. MultiCare and Virginia Mason Franciscan Health did not immediately respond to a request for their own updated numbers from The News Tribune.

A MultiCare representative at the Oct. 4 WSHA briefing said the health system's rate as of that morning was a little over 90 percent.

Dr. Tim Dellit, chief medical officer with UW Medicine, said during Monday's briefing that 98 percent of the medical staff was vaccinated, with advanced practice providers at 99 percent. Roughly 400 applied for exemption, he said.

"We accepted about a third of those. The positive thing that we did see is that the majority of those for whom their exemption was denied went on to start that vaccine series, which is really terrific."

Case Levels Remain High

Along with fears of limited staffing, the level of COVID-19 cases, while slightly lower, is still at elevated numbers in hospitals with 1,100 cases, down from 1,700 at its peak, and the rate of decline has slowed.
Sauer noted there was only a 2 percent decline in the past week after previous weeks saw upwards of 10 percent drops.

"We have 15 to 20 deaths a day in Washington state from COVID and that's lower than it was a couple of weeks ago, but that would be as if a medium sized jet was crashing at Sea-Tac or Spokane every week," Sauer said. "And that's just the deaths happening in the hospitals."

Stacey DeMaranville, registered nurse and director of the Family Birth & Midwifery Birth Center at St. Joseph Medical Center in Tacoma, said during the briefing that pregnant women are taking a serious risk if they remained unvaccinated.

"No one wants to believe that they could end up in ICU bed pregnant because of COVID-19," DeMaranville said.

The vaccine, she noted, "is safe for all women, all women who are currently pregnant, those who are planning to become pregnant. And we are not seeing concerns about fertility currently or in the future.

"But we do see illness, and we unfortunately do see death. There is an opportunity to prevent this extreme illness, and those that we are seeing in this state are unvaccinated."