How the delta variant took over the US
The delta variant has overtaken the U.S. in a matter of weeks as it spreads around the world in what President Biden’s chief medical adviser Anthony Fauci called a “global outbreak” of the strain.
The highly contagious variant of COVID-19 is considered at least two times more contagious than the previously dominant alpha strain, and experts say the increased transmissibility has likely fueled the surge in COVID-19 cases, hospitalizations and deaths nationwide.
But much is still unknown about delta as scientists scramble to better understand the strain.
Here’s what we know about the delta strain and how it blunted earlier momentum in the fight against the coronavirus.
Delta is more transmissible than previous COVID-19 strains
Delta’s contagiousness is considered key to its domination, having spread to at least 117 countries after first being detected in India. Like other viruses, COVID-19 is evolving, particularly through unplanned mutations.
A study from the United Kingdom in May suggested the delta strain could be 60 percent more transmissible than the alpha variant, which was already more contagious than the original strain.
But experts are split on that figure, with some saying delta could be more transmissible and others saying it could be less.
“You don’t necessarily want to attribute that all to the virus. You know, a lot of it may reflect the people as well,” said David Dowdy, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.
Researchers aren’t certain about what makes the delta variant more transmissible, but there are some clues.
Michael Farzan, head of the Department of Immunology and Microbiology at Scripps Research, said one of the variant’s advantages is that it can more strongly attach to a certain receptor when spreading in the body.
“This is one of the reasons why the virus … in a person gets made at a higher level, meaning that there’s a lot more being spit out or coughed out, meaning that it’s more likely to hit the next person,” he said.
The Centers for Disease Control and Prevention (CDC) has its own figures illustrating how the strain became so prevalent this summer. The agency’s latest projection is that 97.4 percent of all coronavirus cases come from all the different lineages of the delta variant, as of the week ending last weekend.
That marks an astronomical increase from the 1.6 percent estimated at the beginning of May and the 14.1 percent from the beginning of June.
Most people infected with COVID-19 at this point won’t know for sure whether they contracted the delta strain since available testing doesn’t make the distinction between strains — it only shows whether the virus itself is present.
It has a higher magnitude of viral loads
Health experts are examining the delta variant’s viral load, the measure of how much virus a person carries and can potentially transmit, compared to previous COVID-19 strains.
A study from China suggested that the strain’s viral load could be more than 1,000 times higher than the original strain, which Fauci on Thursday said “is a mechanistic reason why you have such a tremendous increase in transmissibility.”
Basically a higher viral load can make it more likely that an infected person can “shed” the virus, allowing someone nearby to contract it.
“If a little droplet that you sent out, it has more particles and that means it’s more likely to infect the next person over and it’s more likely to infect the next person over more times,” Farzan said.
Dowdy of Johns Hopkins cautioned that other variables, including people’s behavior, may be influencing how scientists understand delta’s viral load. With more people relaxing their COVID-19 precautions and interacting with others indoors, those same people could contract more of the virus than they might otherwise.
A study of a Massachusetts outbreak indicated that delta led to fully vaccinated people having a similar viral load compared to the unvaccinated, sparking the CDC to update its mask guidance late last month.
The outbreak on Cape Cod, where nearly three-quarters of confirmed cases were among fully vaccinated people, suggested that vaccinated people could potentially transmit and spread the delta variant. But researchers said at the time that microbiological studies would be needed to confirm whether vaccinated individuals can transmit the strain.
Vaccines are still effective against delta
Studies have found that at least five vaccines, including all three used in the U.S., are effective against the delta variant in lab and real-world settings, Fauci said on Thursday.
It was previously unclear whether the Johnson & Johnson vaccine, which requires only one dose instead of two, was equally effective. But a study released last week found the immune response lasted at least eight months, resulting in the first real-world data for the vaccine, Fauci said.
Recent studies have indicated that vaccines may see a very slight dip in effectiveness against symptomatic versions of the coronavirus caused by the delta variant. The COVID-19 vaccines, like any other, are also not perfect at preventing all delta infection and illness.
But scientists agree that studies have demonstrated that the vaccinated population is less likely to get infected and much less likely to be hospitalized or die from the delta variant than the unvaccinated.
“The only reason our case numbers are lower now than they were back in December is because half of our population has been fully vaccinated,” Dowdy said.
Still more to learn
Experts acknowledge there is much more to learn about the delta variant.
“A big thing is we still don’t know how much of what we’re seeing is due to the virus versus due to behavior,” Dowdy said. “That makes a big difference because things that are due to the virus, we can’t really change as a society.”
Although there’s a growing number of studies, not all scientists are certain that the variant itself necessarily causes more serious illness among the unvaccinated, leading to more hospitalizations and deaths. It’s also unclear whether the strain is sparking more severe illness among children as pediatric hospital admissions have picked up.
Additionally, scientists have more analysis to do on under-researched mutations that may give the virus more of an advantage, Farzan said.
Just a month ago, even as signs of a fourth wave of COVID-19 infections in the U.S. were blossoming in the lower Midwest, the memory of a long, miserable winter kept us warm. Even places with burgeoning case rates were far below their catastrophic peaks over the holidays, when a combination of cold weather and defiant travelers contributed to a third wave in infections and deaths that drowned out the previous two spikes in April and July of 2020.
This is regrettably no longer the case. In four states—Hawaii, Louisiana, Mississippi and Florida—the current number of daily new COVID-19 infections, averaged across seven days, has surpassed that winter peak, even with a substantial percentage of the population having received a complete dosage of the COVID-19 vaccine (though not nearly as many as public officials would prefer).
Hawaii is something of an anomaly, as its winter peak was not nearly as high as in colder, more accessible regions. But several other states threaten to join this quartet in the near future. Oregon’s daily rate of new infections is at 36.5 per 100,000 residents, or 99% of the peak value on Dec. 3, 2020. Nationwide, the rate is 37.7, just under 50% of the winter peak of 76.5.
While plenty of states remain far below the winter peaks, as the Delta variant tears across the country, we can expect more and more states to experience a fourth wave that crests higher than the third, even as new outbreaks are inspiring more vaccine holdouts to hold out their biceps and breakthrough infections, while frightening and non-trivial, remain reasonably rare.
What is perhaps most sobering about this surge is that COVID-19-related deaths, which typically lag behind case surges by about two weeks, are starting to rise again. No state has yet surpassed the winter peak in deaths, but at 65%, Louisiana very well may. That figure is still 15% nationwide, well below the Jan. 13, 2021 peak of 1.04 fatalities per 100,000 people. It is currently at 0.16.
When it comes to the pandemic, no one wants to sound like Chicken Little. The sky might not be falling. But neither is the national case rate, or the number of people dying.
Dr. Jesse O’Shea, an infectious disease physician, posted this x-ray showing the difference between two of his patients; one with and one without the vaccination. Very telling and compelling visual, and we wanted to share.
To follow his page, please visit: https://www.instagram.com/jesseosheamd“A Story of Two Chest X-Rays. One patient with a vaccine and one patient without. Version 2—for the crowd that wants specifics without violating patient privacy (these are published cases).
The top picture is a 47-year-old man who received Pfizer vaccine (1) and developed COVID19 2 weeks after. He was overweight (BMI = 29), but without any known comorbidities. He had runny nose, mild body aches, mild cough. His chest X ray is relatively normal.
The bottom picture is a 50-year-old active female patient without obesity and not on medications. Her chest X-ray shows diffuse opacities, consolidations in both lungs with lung damage (all the fluffy white) and a pattern that looks like the worst feared complication of COVID19—acute respiratory distress syndrome (ARDS). She needed intubation, mechanical ventilation, and ECMO (extra-corporal membrane oxygenation) – the most life support we can offer.
The mRNA vaccines are effective at preventing severe disease and death— even with the Delta variant.
Our ICUs are starting to fill up with unvaccinated COVID19 patients again.
“To my fellow healthcare workers, keep your head up!”
https://mailchi.mp/ef14a7cfd8ed/the-weekly-gist-august-6-2021?e=d1e747d2d8
With US COVID case counts hitting levels not seen since February, hospitalizations climbing rapidly in many states—topping the number seen nationally during last summer’s surge—and mortality figures beginning to edge worrisomely upward, it’s increasingly clear that talk of a “hot vax summer” was premature at best.
While this week the nation crested President Biden’s July 4th goal of 70 percent of Americans getting at least one dose of the vaccine, attention has now turned in earnest to the need to dramatically accelerate vaccinations the face of the highly contagious Delta variant.
Of particular concern: a report from the Centers for Disease Control and Prevention (CDC) suggesting that vaccinated people who become infected with the variant may be able to spread the disease at a greater rate than previously thought.
Although it’s clear that we’re largely experiencing a “pandemic of the unvaccinated” at this point, it wasn’t reassuring to learn that the CDC has been citing pre-Delta data (from January to July) on hospitalizations to bolster its reassurances to vaccinated Americans about the low numbers of “breakthrough” cases in hospitals, nor to hear (as we have, anecdotally) from hospital leaders that vaccinated patients now account for 15 percent of COVID admissions.
Attention has rapidly turned to the need for booster shots, with the Food and Drug Administration (FDA) reported to be readying a plan for early September, focused on the over-65 population and those whose immune systems are compromised. Already, Zuckerberg San Francisco General Hospital has begun supplemental mRNA boosters for those who received the one-dose Johnson & Johnson shot earlier this year.
Meanwhile, in an attempt to reassure those still harboring concerns about getting an “experimental” vaccine, the FDA is fast-tracking its full approval process for Pfizer’s vaccine, which can’t come soon enough.
The ticking clock: students of all ages, vaccinated or otherwise, return to school in less than a month. Will we be ready?
More than 99.99% of people fully vaccinated against Covid-19 have not had a breakthrough case resulting in hospitalization or death, according to the latest data from the US Centers for Disease Control and Prevention.The data highlights what leading health experts across the country have highlighted for months: Covid-19 vaccines are very effective at preventing serious illness and death from Covid-19 and are the country’s best shot at slowing the pandemic down and avoiding further suffering.The CDC reported 6,587 Covid-19 breakthrough cases as of July 26, including 6,239 hospitalizations and 1,263 deaths. At that time, more than 163 million people in the United States were fully vaccinated against Covid-19.
Divide those severe breakthrough cases by the total fully vaccinated population for the result: less than 0.004% of fully vaccinated people had a breakthrough case that led to hospitalization and less than 0.001% of fully vaccinated people died from a breakthrough Covid-19 case.
Most of the breakthrough cases — about 74% — occurred among adults 65 or older.
Since May, the CDC has focused on investigating only hospitalized or fatal Covid-19 cases among people who have been fully vaccinated. The agency says the data relies on “passive and voluntary reporting” and is a “snapshot” to “help identify patterns and look for signals among vaccine breakthrough cases.”
“To date, no unexpected patterns have been identified in the case demographics or vaccine characteristics among people with reported vaccine breakthrough infections,” according to the CDC.
The agency shared a study this week that showed the Delta variant produced similar amounts of virus in vaccinated and unvaccinated people if they get infected. Experts continue to say that vaccination makes it less likely you’ll catch Covid-19 in the first place. But for those who do, the findings suggest they could have a similar tendency to spread it as unvaccinated people. That study also convinced CDC leaders to update the agency’s mask guidance on Tuesday, recommending that fully vaccinated people also wear masks indoors when in areas with “substantial” and “high” Covid-19 transmission to prevent further spread of the Delta variant. Guidance for unvaccinated people remains to continue masking until they are fully vaccinated. Beyond severe cases, an analysis of official state data from the Kaiser Family Foundation showed that breakthrough cases of any kind are also extremely rare.vAbout half of states report data on Covid-19 breakthrough cases, and in each of those states, less than 1% of fully vaccinated people had a breakthrough infection, ranging from 0.01% in Connecticut to 0.9% in Oklahoma.
The KFF analysis also found that more than 90% of cases — and more than 95% of hospitalizations and deaths — have been among unvaccinated people. In most states, more than 98% of cases were among the unvaccinated.
Pace of vaccinations is going up
But experts say those vaccinated, while they may be able to transmit the virus, remain very well protected against getting seriously ill. Amid the latest surge of Covid-19 cases nationwide fueled by the Delta variant, local leaders across the US are reporting that the majority of new infections and hospitalizations are among unvaccinated people. The Delta variant is now so contagious, one former health official recently warned that people who are not protected — either through vaccination or previous infection — will likely get it. Amid concerns over the rising cases and the dangerous strain, the country has seen a steady rise in the pace of vaccinations in the past three weeks — and an even sharper increase in states that had been lagging the most, according to a CNN analysis of CDC data.
The seven-day average of new doses administered in the US is now 652,084, up 26% from three weeks ago. The difference is even more striking in several southern states: Alabama’s seven-day average of new doses administered is more than double what it was three weeks ago. The state has the lowest rate of its total population fully vaccinated in the US, at roughly 34%. Arkansas, with just 36% of its population fully vaccinated, has also seen its average daily rate of doses administered double in the last three weeks. Louisiana, which had by far the most new Covid-19 cases per capita last week and has only fully vaccinated 37% of its population, saw daily vaccination rates rise 111% compared to three weeks ago.
Meanwhile, Missouri, which has been among the hardest-hit states in the latest Covid-19 surge, now has a daily average of new vaccinations 87% higher than three weeks ago.
Roughly 57.5% of the US population has received at least one Covid-19 vaccine dose and about 49.5% is fully vaccinated, CDC data shows.
Any COVID-19 uptick is a tragedy, but the first major U.S. surge since the start of the vaccination rollout has been uniquely painful to watch because it likely could have been prevented. The Delta variant has driven up cases across the country, with the worst outbreaks in southern states where vaccination rates fall far short of that of the country as a whole, which is nearly half vaccinated. A few examples:
These surges have left many people scrambling to protect themselves, with several hard-hit states reporting an increase in vaccine uptake. In Louisiana, for example, about 52,000 doses were administered during the week ending July 31, compared to about 20,000 the week ending July 10. Unfortunately, people getting vaccinated now won’t be fully protected for another two to four weeks, depending on the shot they receive, meaning the virus will likely continue to spread for some time.
At least some southern governors are taking steps to prevent that, turning to tried and true methods like masking to contain viral spread. Louisiana governor John Bel Edwards (D), for instance, issued an order yesterday mandating face masks in many indoor public settings, including businesses, schools and churches. “I cannot in good conscience sit by while our hospitals lose the capacity to deliver life-saving care to COVID patients and non-COVID patients alike,” Edwards said when announcing the new rules, which begin tomorrow and are currently set to expire Sept. 1.
However, the leaders of other badly hit states are not following suit. Mississippi governor Tate Reeves (R), for instance, has rejected the U.S. Centers for Disease Control and Prevention’s (CDC) updated guidance calling for indoor masking in areas with substantial viral spread, calling it “foolish.” The state may continue to pay the price; Mississippi hospitals are reportedly struggling to find enough nurses to care for patients, even as the state health officer warned last week that new hospitalizations are “skyrocketing” (as of July 27, Mississippi’s seven-day average for new hospitalizations was 126, compared to about 20 on July 1).
The best anyone can do in these states now is get vaccinated, mask up, and socially distance whenever possible. Delta burned hot but fast in India and the United Kingdom, and it’s possible it will do the same in the States as well.
Over 400.6 million doses of the COVID-19 vaccine have been shipped to various U.S. states as of this afternoon, of which some 347 million doses had been administered, according to TIME’s vaccine tracker. About 49.7% of Americans had been completely vaccinated.
Nearly 198.9 million people around the world had been diagnosed with COVID-19 as of 1 a.m. E.T. today, and more than 4.2 million people have died. On August 2, there were 556,672 new cases and 7,784 new deaths confirmed globally.
Here’s how the world as a whole is currently trending:
Here’s where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
And here’s every country that has reported over 3 million cases:
The U.S. had recorded more than 35.1 million coronavirus cases as of 1 a.m. E.T. today. Nearly 614,000 people have died. On August 2, there were 127,976 new cases and 451 new deaths confirmed in the U.S.
Here’s how the country as a whole is currently trending:
Here’s where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
The number of hospitals and health systems requiring COVID-19 vaccination for employees is growing.
Here are the healthcare organizations that have announced mandates:
Sutter Health in Sacramento, Calif., is mandating that its workforce be fully vaccinated against COVID-19 by Sept. 30. The mandate will require employees, volunteers and vendors who enter a Sutter facility or provide patient care off-site to provide documentation of vaccination, unless they have received a medical or religious exemption, the health system said Aug. 4.
Washington Regional Medical System in Fayetteville, Ark., has mandated vaccination for medical staff, as well as its 3,300 employees as of Oct. 1, J. Larry Shackelford, president and CEO, shared with Becker’s Aug. 4. The organization is also requiring prospective new hires to provide proof of having received at least one dose two weeks before beginning work, according to a message sent to staff July 21. Employees may request an exemption based on disability or sincerely held religious belief.
Advocate Aurora Health in Downers Grove, Ill., and Milwaukee is requiring its remote and in-person staff, volunteers, and on-site vendors to be fully vaccinated, the health system said in an Aug. 4 news release shared with Becker’s. With limited exemptions for religious or medical reasons, the entire staff must provide proof of full vaccination by Oct. 15.
Nationwide Children’s Hospital in Columbus, Ohio, is requiring all employees, care providers, volunteers and vendors to be fully vaccinated, the hospital told Becker’s Aug. 4. Workers must be fully vaccinated, effective Oct. 1.
PeaceHealth, a system based in Vancouver, Wash., said Aug. 3 that all caregivers will be required to be vaccinated or submit a qualifying medical exemption. The requirement starts Aug. 31. The health system said those who are unvaccinated must undergo regular COVID-19 testing, as well as additional masking, potential reassignment to non-patient care settings and other safety protocols.
OhioHealth will require the vaccine for its 35,000 associates, providers and volunteers, the Columbus-based health system said Aug. 3. The requirement applies to employed and independent physicians, those in patient-facing and non-patient-facing roles, students and vendors. The compliance deadline is Dec. 1.
Valley Children’s Healthcare in Madera, Calif. is requiring its staff, physicians, vendors and those conducting business in its facilities to be vaccinated against COVID-19, effective Sept. 21. If an employee is granted a medical or religious exemption, they will have to undergo weekly COVID-19 testing. A large percentage of the hospital’s patient population is too young to receive the vaccine, which increases their vulnerability to contracting the virus, the hospital told Becker’s Aug. 3.
Dartmouth-Hitchcock Health in Lebanon, N.H., announced Aug. 3 that it will require employees to get vaccinated as a condition of employment, effective Sept. 30. The health system said employees must submit documentation that they have been fully vaccinated or obtain an approved medical or religious exemption.
Baptist Health in Louisville, Ky., will require its nearly 23,000 employees to be vaccinated, CEO Gerard Colman said in a statement shared with Becker’s Aug. 3. Mr. Colman said details of the plans are still being shared with employees and the Baptist Health Medical Group.
MultiCare Health System in Tacoma, Wash., is requiring all hospital and clinic employees to get vaccinated against COVID-19 this fall. Details are still being worked out, and more information will be released in the coming weeks, The Spokesman-Review reported Aug. 3.
Rochester (N.Y.) Regional Health, the University of Rochester Medical Center and Monroe Community Hospital in Rochester are mandating employees be vaccinated by Sept. 8 or undergo frequent COVID-19 testing, according to an Aug. 2 news release shared with Becker’s.
Norton Healthcare in Louisville, Ky., will require employees, with allowance for religious and medical exemption, to be fully vaccinated, Russell Cox, president and CEO, said Aug. 2. Employees must receive their first dose by Sept. 15.
Kaiser Permanente, an Oakland, Calif.-based organization with more than 216,000 employees and more than 23,000 Permanente Medical Group physicians, said Aug. 2 that it will make vaccines mandatory for workers. Kaiser’s target date to achieve a fully vaccinated workforce is Sept. 30. Unvaccinated employees and physicians must become fully vaccinated or apply for medical or religious exemption.
Hawaii Pacific Health in Honolulu said it will require employees to be vaccinated, the Honolulu Star-Advertiser reported Aug. 2. The health system’s compliance deadline is Oct. 1. According to the newspaper, employees who obtain medical or religious exemptions must get tested regularly.
Queen’s Health System in Honolulu said it will require employees to be vaccinated, the Honolulu Star-Advertiser reported Aug. 2. The health system’s compliance deadline is Oct. 1.
Memorial Hermann Health System in Houston announced its mandatory COVID-19 vaccine policy Aug. 2. Uner the policy, managers and above must be compliant by Sept. 11, the health system said. The deadline for all other employees, in addition to the system’s affiliated providers and volunteers, is Oct. 9. Memorial Hermann will provide exemptions for medical or religious reasons.
Northwell Health in New Hyde Park, N.Y. is mandating vaccines for its employees after vaccine rates stagnated at 77 percent, the health system told Becker’s Aug. 2. Health system employees will have to be fully vaccinated by Aug. 16 or will be required to be tested for COVID-19 on a weekly basis. Unvaccinated employees could also face adverse actions, which could progress to include termination.
All New Jersey hospitals will require their staff to get vaccinated under a new mandate by New Jersey Gov. Phil Murphy. Healthcare staff will have until Sept. 7 to get vaccinated or will have to get a COVID-19 test up to twice a week. However, if vaccination rates don’t increase significantly, the governor will consider requiring vaccinations for healthcare staff as a condition of employment, he said Aug. 2.
Arkansas Heart Hospital in Little Rock said July 30 its directors, executives, managers, advanced practice nurses, physicians and physician assistants will be required to be fully vaccinated for COVID-19 by Sept. 30. On Aug. 1, new employees will be required to receive their first dose within 30 days of employment.
Phoenix Children’s is mandating vaccines for all staff, effective Oct. 1. The hospital told Becker’s July 30 that most of its staff is already fully vaccinated, but it will support the remaining employees as they work toward getting inoculated.
Michigan Medicine in Ann Arbor is mandating its staff be vaccinated against COVID-19, it said July 30. All staff, remote or in-person, must submit proof of vaccination by Aug. 30. Employees who are approved for a religious or medical exemption will be required to complete weekly testing and wear a mask indoors. Ultimately, noncompliant staff will be subject to disciplinary action. As of July 30, 76 percent of hospital employees have reported receiving their COVID-19 vaccines.
Texas Health Resources in Arlington said July 30 that it will require vaccination as a condition of employment. Employees will need to have received either both shots of the Pfizer or Moderna vaccine or one Johnson and Johnson shot, effective Sept. 10. The policy also applies to physicians and advanced practice providers on the medical staffs, students, vendors and contractors.
Conway (Ark.) Regional Health System said July 29 that it will require new hires and leaders, including executive leadership, directors and managers, to get vaccinated. The requirement is effective Aug. 8. Leaders receiving two vaccine doses will be required to receive the second dose by the end of August, the health system said. New hires receiving two vaccine doses will be required to get the second dose within 30 days of employment.
Millinocket (Maine) Regional Hospital will require employees to receive the Pfizer or Moderna shots when they receive final FDA approval, the Press Herald reported July 29. Staff will be able to request exemptions.
Methodist Health System in Dallas said July 29 that it will require its workforce to be vaccinated by Oct. 1. The health system said once it achieves its workforce vaccination goal, full-time employees will receive a $500 bonus, and part-time employees will receive $250.
Self Regional Healthcare in Greenwood, S.C., is requiring team members to get vaccinated, Fox Carolina reported July 29. The organization said it aims to have unvaccinated employees inoculated by Sept. 30, according to the report.
ChristianaCare said July 29 that it will require employees, medical-dental staff, residents, students, contracted employees, temporary labor, volunteers and vendors to be vaccinated. Caregivers at the Newark, Del.-based health system must receive their first vaccine dose of a two-dose vaccine or their single Johnson & Johnson shot by Sept. 21.
Children’s Hospital of Philadelphia will require workforce members at any location to get inoculated, the hospital said July 29. A deadline has not been announced.
Mary Washington Healthcare in Fredericksburg, Va., will require its workforce to get vaccinated by Oct. 31, the health system said July 29. The requirement will apply to employees, medical staff and volunteers.
UCHealth, an Aurora, Colo.-based health system with 26,000 employees, said July 28 that it will require employees, providers, volunteers and partners to be vaccinated by Oct. 1. UCHealth’s employees may receive the vaccine of their choice or obtain an exemption for medical or religious reasons. Those who obtain an exemption must wear a mask at all times in UCHealth facilities and be tested weekly, the health system said.
Pullman (Wash.) Regional Hospital will require employees to be fully vaccinated or complete the exemption process, by Oct. 27, the hospital said July 28. Employees can request a medical exemption, religious belief exemption or personal belief exemption. The personal belief exemption will expire on June 1, 2022, or within two months of full FDA approval of a vaccine.
Baylor Scott & White Health, a 52-hospital health system based in Dallas, is requiring employees, providers, volunteers, vendors, students and contract staff to receive both doses of the Moderna or Pfizer COVID-19 vaccine, or the single-dose Johnson & Johnson shot, unless granted an exemption, the health system said in a statement shared with Becker’s July 28. The deadline for the requirement is Oct. 1.
State-run New York hospitals will need patient-facing healthcare workers to get vaccinated by Labor Day, Gov. Andrew Cuomo said July 28. Employees who are not patient-facing and do not get vaccinated will be required to get tested weekly. The requirement will be instated at 10 hospitals and healthcare facilities.
Spectrum Health in Grand Rapids, Mich., said July 28 that it will require the COVID-19 vaccine for team members, medical staff, students, volunteers and contractors. The 14-hospital health system plans to require vaccination within eight weeks of the FDA approving the first vaccine, or sooner depending on pandemic circumstances. Spectrum will consider exemptions.
Ascension, a 149-hospital health system based in St. Louis, will require COVID-19 vaccination for its 160,000 employees. Ascension’s requirement will apply to workers who provide direct patient care, as well as those who work in health system sites of care or remotely, the health system said July 27. This includes workers employed by subsidiaries and partners; physicians and advanced practice providers (employed and independent); and volunteers and vendors entering health system locations. Ascension said employees have until Nov. 12 to complete the vaccine series and meet the vaccination requirement.
Care New England is moving forward with mandatory vaccination for all staff, the Providence, R.I.-based health system said July 27. Vaccination has been required for students, volunteers and new hires since July 1, and the next step is to require managers to begin the vaccination series before Labor Day, said Care New England.
Baystate Health said July 26 that employed team members, including those working remotely, clinical staff, contractors, volunteers, students, and those conducting business within the Springfield, Mass.-based health system, will be required to be fully vaccinated by Oct. 1. Employees will be able to request an exemption for religious or medical reasons, and pregnant employees may request a deferral.
California healthcare organizations will be required to have all of their employees fully vaccinated or they will be required to get tested weekly, Gov. Gavin Newsom said July 26. Unvaccinated healthcare employees will also be required to wear appropriate personal protective equipment. The policy will take effect Aug. 9 and employees will have until Aug. 23 to fully comply.
Truman Medical Centers/University Health in Kansas City, Mo., said July 26 that vaccination will be a requirement for staff members, according to KMBC. The deadline to be vaccinated is Sept. 20.
Mayo Clinic in Rochester, Minn., said all health system staff must be fully vaccinated by Sept. 17. Those who do not meet the deadline will be able to keep their jobs. However, they will be required to complete a formal refusal process, which includes watching education modules, wearing face masks and maintaining social distancing while on campus.
The Department of Veterans Affairs is mandating COVID-19 vaccinations for 115,000 of its front-line healthcare workers, the first federal agency to do so. Starting July 28, those workers have eight weeks to get fully vaccinated or face penalties, including possible removal.
Rush University Medical Center in Chicago is requiring its workers, contractors and volunteers to get the shot. They must be fully vaccinated by Oct. 1.
HonorHealth in Scottsdale, Ariz., said July 23 that it will require vaccination as a condition of employment. Employees must submit proof of vaccination by Nov. 1.
Sanford Health in Sioux Falls, S.D., said July 22 that all employees across its 46 hospitals and hundreds of other medical facilities will be required to be vaccinated by Nov. 1. More than 90 percent of clinicians and 70 percent of nurses are already vaccinated, the health system said. Those who do not get vaccinated will not be working, but a final decision on a furlough has not been decided.
Duke University Health System, a three-hospital health system based in Durham, N.C., is requiring vaccination for employees. The deadline for employees is Sept. 21, news station ABC11 reported July 22.
Cone Health in Greensboro, N.C., said July 22 that it will require vaccination for workers, effective July 30. The mandate will apply to employees, medical and dental staff, professional students and volunteers. The deadline for compliance is Oct. 1.
UNC Health said July 22 that it will require teammates at UNC Medical Center, UNC Rex Healthcare, Chatham Hospital, Johnston Health, UNC Health Southeastern, UNC Rockingham Health Care, UNC Physicians Network Practices and UNC Health Shared Services locations to get vaccinated. The deadline for employees at the Chapel Hill, N.C.-based health system is Sept. 21.
Wake Forest Baptist Health said July 22 that the Winston-Salem, N.C.-based organization is requiring teammates to be fully vaccinated or obtain an approved medical or religious exemption. The mandate applies to remote workers, physicians, medical residents, faculty, fellows, trainees, contractors, students/visiting students, members of the medical staff, temporary workers and volunteer staff.
Novant Health is requiring team members to be fully vaccinated, the Winston-Salem, N.C.-based health system said July 22. Workers must be vaccinated by Sept. 15.
Atrium Health is making vaccination mandatory for all teammates, the Charlotte, N.C.-based health system said July 22. Teammates, including remote workers, physicians, medical residents, faculty, fellows, trainees, contractors, students/visiting students, members of the medical staff, temporary workers and volunteer staff, must be fully vaccinated or obtain an approved medical or religious exemption by Oct. 31.
Arkansas Children’s in Little Rock is requiring that its leaders (managers, directors, vice presidents, senior vice presidents and executive vice presidents) receive a first vaccine dose as a condition of employment, according to a message sent July 22 from Marcy Doderer, president and CEO. Leaders must receive their first dose by Aug. 20 and be fully vaccinated by Sept. 30. Beginning Aug. 16, all new Arkansas Children’s new hires will also be required to receive a first shot by their start date and a second one within 30 days of employment, said Ms. Doderer.
OSF HealthCare, a multistate health system based in Peoria, Ill., said July 21 that it will require all employees to be vaccinated against COVID-19 by the end of September. The requirement does not apply to Michigan Nursing Association bargaining unit members. OSF HealthCare has 150 locations in Michigan and Illinois.
Banner Health will require COVID-19 vaccination as a condition of employment for its roughly 52,000 team members, the Phoenix-based health system said July 20. The deadline for employees to be fully vaccinated is Nov. 1, with limited exceptions.
Southcoast Health, a three-hospital health system offering services in southeastern Massachusetts and Rhode Island, said vaccines will be mandated for all employees, staff and providers once at least one of the vaccines receives full FDA approval, The Standard-Times reported July 20. Employees will be able to request exemptions if they have documented medical and religious reasons, or if they are pregnant or intend to become pregnant.
Valley Health, a Winchester, Va.-based health system with 6,300 employees and affiliated physicians, said July 19 that it will add COVID-19 vaccination to its list of required vaccinations for all employees, medical staff members and contractors. Health system officials said the standard is effective immediately for new employees, who must provide evidence of vaccination or complete the vaccination series two weeks before beginning work. Employees who are managers or above and medical staff members must provide evidence of prior completion of the vaccination series or receive their first dose by Aug. 16. Remaining staff have until Nov. 1 to either obtain an exemption or be fully vaccinated.
Tidelands Health in Georgetown, S.C., said July 16 that it will mandate vaccination for employees, employed providers, volunteers, learners and contractors. Employees have until Sept. 7 to comply, and the health system is providing an attestation and declination process for those who cannot get vaccinated for medical or religious reasons. Tidelands Health said employees who have previously tested positive for COVID-19 may also choose to decline the shot.
Hackensack Meridian Health, a 17-hospital system based in Edison, N.J., will require its staff to be fully vaccinated against COVID-19, NorthJersey.com reported July 15. A memo to employees cited by NorthJersey.com gave Nov. 15 as the deadline for the mandate. Workers, including physicians and nurses, must receive at least one dose of the Pfizer, Moderna or Johnson & Johnson shots by Oct. 1 and a second dose of Pfizer or Moderna by Nov. 15. The deadline to request an exemption is Aug. 16.
Beacon Health System in South Bend, Ind., said July 15 that it will require employees and others who work regularly at a Beacon facility to be fully vaccinated by Oct. 1. Employees may request an exemption.
Vanderbilt University Medical Center in Nashville, Tenn., will require its entire staff to get the vaccine, according to an employee newsletter distributed July 15. All hospital leaders must get the first dose or achieve a medical exemption by Aug. 15 They must fully be vaccinated by Sept. 15. The deadline for all employees is under consideration.
The University of Mississippi Medical Center in Jackson said July 15 that it will implement a new vaccination policy requiring those who work or learn in a medical center-controlled space to be fully vaccinated against COVID-19, with limited exceptions, or wear an N95 mask while at any medical center facility. Medical center officials said those who are fully vaccinated will only be required to wear a mask of their choosing or as determined according to the clinical situation in patient care areas. The policy will be phased in over three months, with all who work in a medical center-controlled space required to be fully vaccinated or wearing an N95 mask at all times on or by Nov. 1.
Hartford (Conn.) HealthCare said July 14 that it will require COVID-19 vaccination for its employees. Health system officials said employees may apply for an exemption, but those without an approved exemption must show proof of vaccination by the end of September.
St. Jude Children’s Research Hospital said July 14 that the Memphis, Tenn.-based hospital and its foundation partner, ALSAC, are requiring that St. Jude and Memphis-area ALSAC employees be vaccinated against COVID-19 by Sept. 9. In a memo, St. Jude President and CEO James Downing, MD, told employees they must have their final dose scheduled and administered by the deadline, or, if vaccinated outside of St. Jude, have the documentation to the hospital by the deadline date.
University of Chicago Medicine will require its workers to be vaccinated against COVID-19, according to a July 13 memo to students, faculty and staff. The mandate will apply to employees of University of Chicago Medical Center and to medical center volunteers and contractors at both the Hyde Park campus and other medical center sites, health system leaders wrote. They added that the mandate may be subject to discussion with unions representing workers.
Piedmont Healthcare in Atlanta said June 12 it is requiring leaders, physicians, providers and new employees to be fully vaccinated against COVID-19, with plans to eventually extend the mandate to all its more than 23,000 workers. As of Sept. 1, the mandate will apply to that initial group and to the rest of Piedmont’s employees in “the near future,” following Sept. 1.
Virtua Health in Marlton, N.J., will require its more than 14,000 workforce members to be fully vaccinated against COVID-19. Virtua employees must be fully vaccinated by Sept. 15. Virtua said July 12 that all employees, regardless of vaccination status, will continue to maintain COVID-19 safety protocols per CDC guidelines, and it will consider employee requests for exemptions based on religious beliefs or disability/medical condition.
Inova Health System in Falls Church, Va. informed its 18,000 employees that they will have to be vaccinated by Sept. 1.
Trinity Health in Livonia, Mich., will require its 117,000 employees across 22 states to get the COVID-19 vaccine after the number of employees who received at least one shot stagnated at 75 percent.
St. Luke’s Health System in Boise, Idaho, will require its employees to be vaccinated against COVID-19, according to a memo sent to employees July 8 from Chris Roth, president and CEO of the health system. St. Luke’s will require all employees, providers, volunteers and contractors to receive their first vaccine dose by Sept. 1.
Mercy in St. Louis will require its 40,000 employees across 44 hospitals and healthcare facilities to receive the COVID-19 vaccine, health system officials said on July 7. All employees will be required to be vaccinated by Sept. 30.
University Hospital in Newark, N.J. will require all of its employees to be vaccinated, according to a June 30 report.
Yale New Haven (Conn.) Health officials said in a June 30 press conference that all health system employees will be mandated to get the vaccine, however, the deadline is still being determined.
Connecticut Children’s Medical Center in Hartford will require all employees to be fully vaccinated against COVID-19. The hospitals’ CEO and president, Jim Shmerling, PhD, said hospital employees will have until Sept. 30 to get vaccinated, according to a June 29 letter to employees.
Henry Ford Health System in Detroit, which employs more than 33,000 people, said June 29 it will require its workforce to be vaccinated, effective Sept. 10. The requirement applies to team members, students, volunteers and contractors.
SSM Health in St. Louis said June 28 it will require its nearly 40,000 employees, providers and volunteers to be fully vaccinated by late September. Team members can request a medical or religious exemption.
Medical University of South Carolina Health employees were provided a final deadline of June 30 to be vaccinated, or to obtain a medical or religious exemption, as part of the Charleston-based health system’s mandate. The health system fired five out of about 17,000 employees for noncompliance.
Mass General Brigham will require employees to be vaccinated, the Boston-based health system said June 24. The requirement will apply to Mass General Brigham’s 80,000 employees once one of the three vaccines being distributed in the U.S. is fully approved by the FDA. The health system said employees will be able to request exemption if they are pregnant or intend to become pregnant. Employees may also request an exemption for medical and religious reasons. A deadline for the mandate will be determined after FDA approval.
Beth Israel Lahey Healthin Cambridge, Mass., said June 24 it plans to require all physicians and staff to be vaccinated against COVID-19 and the flu as a condition of employment. Flu vaccination will be required later this year, and COVID-19 vaccination for employees will be required after one of the vaccines is fully approved by the FDA.
Wellforce in Burlington, Mass., which includes Boston-based Tufts Medical Center, will require vaccination for employees, the system said June 24. The requirement takes effect after full FDA approval of one of the vaccines, which is expected later this year.
Dana-Farber Cancer Institute in Boston said it will require employees to be vaccinated, The Boston Globe reported June 24. Dana-Farber will wait until after the FDA fully approves a vaccine.
The Connecticut Hospital Association said June 24 it has adopted a consensus, statewide policy reflecting a commitment by the state’s hospitals and health systems to implement mandatory vaccination for employees and clinical staff. The association will develop best practices for implementation.
Meritus Health in Hagerstown, Md., said June 16 it will require vaccination for employees. The requirement applies to employees, medical staff members, volunteers, contractors and partners. As of Aug. 1, new employees must be vaccinated before starting work, the health system said. And as of Sept. 1, all employees, medical staff, volunteers, contractors and partners must be vaccinated or will need to be tested every 14 days. Meritus Health is providing medical and religious exemptions.
BJC HealthCare in St. Louis will require employees to be fully vaccinated beginning in the fall, according to a June 15 statement from the health system. Employees and those who work in BJC facilities must comply with the mandate by Sept. 15 or receive a medical or religious exception.
San Francisco will require personnel in high-risk settings such as skilled nursing facilities, acute care hospitals, homeless shelters and jails to be vaccinated, the city said June 14. The requirement takes effect once one of the vaccines being distributed in the U.S. receives full FDA approval.
University of California Health will require COVID-19 vaccines for faculty, staff, academic appointees and students accessing University of California campuses this fall, the system said June 14.
NewYork-Presbyterian in New York City said all employees, physicians, students, clinical rotators, volunteers and vendors must have received their first dose no later than Sept. 1. For two-dose vaccines, workers must complete the vaccination process on the prescribed timeline. Newly hired employees also must follow a vaccination or exemption process.
Community Health Network in Indianapolis is requiring employees to be fully vaccinated by Sept. 15 unless they receive exemptions for religious or medical reasons, according to a June 10 news release. The requirement applies to vendors, contractors and volunteers who work at Community’s hospitals and care sites.
The District of Columbia Hospital Association, said June 9 that hospitals in Washington, D.C., signed a consensus statement to mandate vaccination for their workers. Each of the 14 hospitals will set their own vaccination deadline.
University of Maryland Medical System in Baltimore announced June 9 that it will require vaccination for current and new employees. The 13-hospital health system said teammembers and partners who remain unvaccinated will be required to get tested weekly, and health system leaders at the manager level and above will have until Aug. 1 to be vaccinated or comply with weekly testing. Beginning Sept. 1, all teammembers will be required to get inoculated or participate in weekly testing.
The Maryland Hospital Association said June 7 that hospitals and health systems in the state signed a consensus statement to mandate vaccination for their workers. Each organization will set their own vaccination deadline.
Indiana University Healthin Indianapolis is requiring employees to be fully vaccinated, The Indianapolis Star reported June 1. Employees must be vaccinated by Sept. 1 or obtain an exemption.
University of Louisville (Ky.) Health is requiring team members and providers, including residents, fellows and rotating students, to be fully vaccinated by Sept. 1, according to a May 26 news release.
RWJBarnabas Health in West Orange, N.J., is requiring supervisors and employees ranked above them to be vaccinated no later than June 30 and said May 20 that it plans to extend the mandate to all employees.
University of Pennsylvania Health System in Philadelphia said May 19 that it is making the vaccine mandatory for all employees and clinical staff by no later than Sept. 1. New hires must provide proof of at least one dose two weeks before beginning work.
Benefis Health System in Great Falls, Mont., said May 19 it made the vaccine mandatory for about 250 employees working in senior services. Employees who are not exempt are required to get their second doses by July 1.
Houston Methodist rolled out its mandatory vaccination policy March 31, with April 15 as the deadline for managers to receive at least one dose or get an exemption. All employees had a deadline of midnight June 7 to get the COVID-19 vaccine as part of the health system’s mandate. The count as of June 8: Nearly 100 percent compliance with 24,947 workers being fully vaccinated.
HENRY KOTULA 