Declaring that “our patience is wearing thin” with Americans who refuse to be vaccinated against COVID-19, President Biden announced sweeping new plans to implement vaccine mandates on Thursday.
Businesses that employ more than 100 people must require their employees to get vaccinated or face weekly COVID testing, federal workers and contractors must be vaccinated or face disciplinary measures, and all healthcare organizations that receive Medicare or Medicaid funds must ensure 100 percent employee vaccination as a condition of continued participation in those federal payment programs. The healthcare component of the mandate will impact about 17 million workers, including those at hospitals, surgery centers, dialysis facilities, and home health agencies. The Centers for Medicare & Medicaid Services (CMS) already requires nursing home workers to be vaccinated, and yesterday announced plans to release a new regulation by October 1st, implementing the expanded mandate. According to Fierce Healthcare, at least 172 hospital systems have already announced some form of vaccine mandate, but others have expressed concerns that forcing workers to get vaccinated might exacerbate labor shortages and result in employees seeking work elsewhere.
Responding to President Biden’s announcement, the American Hospital Association (AHA) echoed those concerns, citing “the critical challenges that we are facing in maintaining the resiliency of our workforce.” In our view, that concern pales in comparison to the imperative to protect patients by reducing the potential for exposure by unvaccinated caregivers. If anything, the national healthcare mandate should provide cover for those hospitals and care providers that have shied away from mandates, letting other organizations take the lead. Once universal healthcare mandates are implemented, vaccine resistant workers will find few employment alternatives left, significantly dampening the risk of widespread resignations. If you don’t want to take the necessary precautions to keep patients safe, you shouldn’t be working in healthcare in the first place. Yesterday’s mandate announcement, while aggressive, is overdue.
An EMT directs an ambulance outside the emergency room of the East Los Angeles Doctors Hospital.
Not a typo:Unvaccinated people are 11 times more likely to die of COVID than those who’ve gotten the shot, the CDC found.
By the numbers: Of 37,948 hospitalizations in 13 jurisdictions studied between April and July, 2,976 patients— or about 8% — were vaccinated, Axios’ Noah Garfinkel reports.
Of 6,748 deaths, 616 — or about 9% — were people who were fully vaccinated.
The three vaccines “showed continued robust protection for all adults — greater than 82 percent — for hospitalization, emergency room and urgent care trips,” The Washington Post reports.
Another study found the Moderna vaccine most effective against Delta. But Pfizer and J&J also worked.
David and Bill wrote that we should do this because it would save many lives. Perhaps this is all that needs to be said. We also argued that the U.S. stood to benefit if we could substantially reduce the number of global covid cases. This would reduce U.S. coronavirus exposure and slow the rate of evolution of new coronavirus variants. The economic cost to the U.S. of a more severe pandemic could easily be greater than the cost of making and distributing the vaccine. If so, the global vaccination effort would pay for itself.
There is, however, another moral argument for global vaccination, this one tied to 9/11 and the ensuing global war on terror. Since 9/11, the U.S. has engaged in 20 years of warfare in countries across the world.
At least 801,000 people have been killed by direct war violence in Iraq, Afghanistan, Syria, Yemen, and Pakistan… The U.S. post-9/11 wars have forcibly displaced at least 38 million people in and from Afghanistan, Iraq, Pakistan, Yemen, Somalia, the Philippines, Libya, and Syria. This number exceeds the total displaced by every war since 1900, except World War II.
Of course, much of that violence was committed by al-Qaeda, ISIS, or the Syrian government. Some of the civil wars that have followed 9/11 might have happened anyway. Nevertheless, Americans failed to limit their 9/11 response to the specific individuals who carried out the attacks. This was a principal cause of the ensuing death and displacements.
So now, the U.S. is known not only for baseball and democracy but also for drone strikes and torture. If we led an effort to vaccinate the world, it would be one of the largest humanitarian actions in history. We should do this to set an example and balance the effects of the global war on terror.
The Centers for Disease Control and Prevention (CDC) announced results from a study Friday that found unvaccinated individuals were 11 times more likely to die from COVID-19 than fully vaccinated people.
The research, spanning more than 600,000 people in 13 jurisdictions, also determined that unvaccinated populations were over 10 times more likely to be hospitalized — figures that underscore COVID-19 vaccines protect recipients from deaths and hospitalizations.
The study also showed that unvaccinated people were 4 1/2 times more likely to contract COVID-19 than the fully vaccinated.
The studies come just one day after President Biden announced a new rule that would require private companies with 100 employees or more to mandate vaccinations or frequent coronavirus testing.
The Biden administration as a whole has pushed for the use of vaccines as the best way to combat the pandemic.
CDC Director Rochelle Walensky on Friday made the case for vaccines yet again, citing the study along with two others and stating that COVID-19 shots still work to protect recipients from the worst of the disease amid the rampant spread of the delta variant.
“As we have shown study after study, vaccination works,” Walensky said during the briefing. “CDC will continue to do all we can do to increase vaccination rates across the country by working with local communities and trusted messengers and providing vaccine confidence consults to make sure that people have the information they need to make an informed decision.”
“The bottom line is this: We have the scientific tools we need to turn the corner on this pandemic,” Walensky said. “Vaccination works and will protect us from the severe complications of COVID-19. It will protect our children and allow them to stay in school for safe in-person learning.”
The agency and Biden administration are promoting the data behind the vaccine effectiveness in their bolstered push to get the unvaccinated shots.
The U.S. has made progress with vaccinations, reaching 75 percent of adults who have had at least one dose earlier this week.
But the portion of unvaccinated people continues to affect the U.S.’s trajectory in the pandemic, with the unvaccinated making up almost all of the growing hospitalizations and deaths.
The other two studies in the CDC’s Morbidity and Mortality Weekly Report (MMWR) released Friday focused on the vaccine’s effectiveness against hospitalization.
One involving five Veterans Affairs Medical Centers found the mRNA vaccines’ overall effectiveness against hospitalization reached 86.8 percent.
Another similarly calculated that effectiveness at 86 percent among patients in emergency departments, urgent cares and hospitals across nine states.
However, the studies also provided some evidence that the effectiveness of the vaccines are starting to wane among the older population, prompting the researchers to call for further investigation.
For the patients in emergency departments, urgent cares and hospitals across nine states, the effectiveness among those aged 75 and older was 76 percent, while among those aged 18 to 74, effectiveness reached 89 percent.
But researchers urged caution, with the report saying “this moderate decline should be interpreted with caution and might be related to changes in SARS-CoV-2, waning of vaccine-induced immunity with increased time since vaccination, or a combination of factors.”
The study involving Veterans Affairs facilities determined that the mRNA vaccine effectiveness among those aged 65 and older was 79.8 percent, compared to 95.1 percent among those aged 18 to 64.
More than 82 percent of those aged 65 and older are considered fully vaccinated, according to CDC data.
Surgeon General Vivek Murthy said Friday the administration is aiming to get “as close to 100 percent as possible” through expanded outreach.
“We know that every senior matters in terms of getting them vaccinated as a potential life saved,” he said, adding that booster vaccinations “will likely be helpful” for the older population.
The Biden administration had announced it planned to start administering additional shots to recipients on Sept. 20 beginning eight months after their second shot.
But the plan led to criticism from some experts who said the administration was getting ahead of the review process at the Food and Drug Administration (FDA), although officials say the strategy depends on FDA approval.
Howard Stern was reflecting this week on the coronavirus deaths of four conservative talk-radio hosts who had espoused anti-vaccine and anti-mask sentiments when he took aim at those who have refused to get vaccinated.
“I want my freedom to live,” he said Tuesday on his SiriusXM program. “I want to get out of the house. I want to go next door and play chess. I want to go take some pictures.”
The shock jock, who advocated for the coronavirus vaccine to be mandatory, then turned his attention to the hesitancy that has played a significant role in the U.S. spread of the virus, leading to what Rochelle Walensky, director of the Centers for Disease Control and Prevention, has called a “pandemic of the unvaccinated.”He pointed to unvaccinated people who are “clogging” up overwhelmed hospitals, calling them “imbeciles” and “nut jobs” and suggesting that doctors and nurses not treat those who have not taken a coronavirus vaccine.
“I’m really of mind to say, ‘Look, if you didn’t get vaccinated [and] you got covid, you don’t get into a hospital,’ ” he said. “You had the cure and you wouldn’t take it.”
Stern’s comments come after several other celebrities expressed to their large social media audiences their frustration with the ongoing lag in vaccinations when hospitals are being pushed to their limits by the highly transmissible delta variant.
More than 185,000 coronavirus infections were reported Wednesday across the United States, according to data compiled by The Washington Post. Nearly 102,000 people are hospitalized with covid-19; more than 26,000 are in intensive care units. A slight decline in hospitalizations over the past week has inspired cautious optimism among public health leaders.
While there is not a nationwide vaccine mandate, President Biden is expected to sign an executive order Thursday requiring that all federal employees be vaccinated, without an alternative for regular coronavirus testing to opt out of the mandate, The Post reported. The order affecting the estimated 2.1 million federal workers comes as Biden plans to outline a “robust plan to stop the spread of the delta variant and boost covid-19 vaccinations,” the White House said.
Health officials, doctors and nurses nationwide have urged those still hesitant to get vaccinated — and some have gone a step further. Jason Valentine, a physician in Mobile, Ala., informed patients last month that he would not treat anyone who was unvaccinated, saying there were “no conspiracy theories, no excuses” preventing anyone from being vaccinated. Linda Marraccini, a doctor in South Miami, said this month that she would not treat unvaccinated patients in person, noting that her office would “no longer subject our patients and staff to unnecessary risk.”
The summer surge also has led celebrities to use their platform to either call on unvaccinated people to get vaccinated or to denounce them for not doing so. Actor and activist Sean Penn said the vaccine should be mandatory and has called on Hollywood to implement vaccination guidelines on film sets. Actors Benicio Del Toro and Zoe Saldana were part of a vaccine video campaign this year to help debunk misinformation about coronavirus vaccination. When actress Melissa Joan Hart revealed her breakthrough coronavirus case last month, she said she was angry that the nation “got lazy” about getting vaccinated and that masking was not required at her children’s school.
Late-night talk host Jimmy Kimmel suggested Tuesday that hospitals shouldn’t treat unvaccinated patients who prefer to take ivermectin — a medicine long used to kill parasites in animals and humans that has soared in popularity despite being an unproven covid-19 treatment and the subject of warnings by health officials against its use for the coronavirus. After noting that Anthony S. Fauci, the chief medical adviser to Biden, warned that some hospitals might be forced to make “tough choices” on who gets an ICU bed, the late-night host quipped that the situation was not difficult.
“That choice doesn’t seem so tough to me,” Kimmel said. “Vaccinated person having a heart attack? Yes, come right in; we’ll take care of you. Unvaccinated guy who gobbled horse goo? Rest in peace, wheezy.”
Stern has featured front-line workers on his show and has advocated for people to get vaccinated against the coronavirus. In December, the host interviewed Cody Turner, a physician at the Cleveland Clinic, about how the front-line doctor struggled with his mental health while treating infected patients when a vaccine was not widely available.
“We are drowning and we are in hell, and people don’t understand, not only what’s happening to people, you know, but patients across this country,” Turner said.
Stern was a fierce critic of President Donald Trump’s response to the pandemic, saying last year that his former friend was “treasonous” for telling supporters to attend large rallies, despite the risk of infection, in the run-up to the presidential election.
On his eponymous program this week, Stern referred to four conservative talk-radio hosts who bashed the vaccine and eventually died of the virus: Marc Bernier, 65; Phil Valentine, 61; Jimmy DeYoung, 81; and Dick Farrel, 65. In the weeks and months leading up to their deaths last month, all four men had publicly shared their opposition to mainstream public health efforts when coronavirus infections were spiking.
“Four of them were like ranting on the air — they will not get vaccinated,” Stern said Tuesday. “They were on fire … they were all dying and then their dying words were, ‘I wish I had been more into the vaccine. I wish I had taken it.’ ”
After he played a clip of Bernier saying he would not get vaccinated, Stern suggested that the coronavirus vaccine be considered as normal as a measles or mumps vaccine.
“When are we going to stop putting up with the idiots in this country and just say it’s mandatory to get vaccinated?” he asked.
More than 73% of those ages 12 to 18 have received one shot, while 92.4% of those older than 65 have received at least one dose.
The U.S. hit a new milestone this week as 75% of adults over the age of 18 have received at least one dose of a COVID-19 vaccine as of Tuesday, according to data from the Centers for Disease Control and Prevention.
Among the over-18 set, almost 194 million Americans have received a first dose, while close to 165 million people are fully vaccinated, good for 64.3% of that population.
The percentages increase the older the population subset. Slightly more than 73% of those ages 12 to 18 have received one shot (with 62.3% fully inoculated), while 92.4% of those older than 65 have received at least one dose. Among that age group, 82.1% are fully vaccinated.
The data also highlighted which states are faring better in terms of total doses administered per 100,000 people. Vermont leads the nation, with other New England states – Maine, Massachusetts, Rhode Island and Connecticut in particular – following closely behind.
The South and Midwest show the lowest rates of vaccination.
The Pfizer-BioNTech vaccine, which was the first to receive full approval from the Food and Drug Administration, leads the pack in terms of total doses administered with more than 214 million shots delivered as of September 7. Moderna comes in second with 147 million-plus doses administered, followed by Johnson and Johnson, which has seen more than 14.5 million total doses administered.
The vaccine hierarchy holds true when examining the number of people fully vaccinated, with Pfizer at almost 96 million, Moderna at about 66 million and J&J at roughly 14 million.
WHAT’S THE IMPACT?
The numbers should come as some encouragement to the nation’s hospitals and health systems, which have been beleaguered by an influx of coronavirus patients, driven in large part by the highly transmissible Delta variant.
These new surges are once more resulting in operational pressure for nonprofit hospitals in the U.S., which will likely affect margins in the near term, according to an August analysis from Fitch Ratings.
Operations and resources in these new coronavirus hotspots are being stretched more than at any prior time during the pandemic, according to the ratings agency, with hospitalization rates exceeding prior peaks and ICU beds at full capacity in some states.
And while some areas are worse than others, there are no regions that are unaffected: Hospitalizations are trending upward in all states.
What this means for hospitals, and nonprofits in particular, is that additional staffing and supplies will be needed to handle the new influx of COVID-19 patients. The greater number of patients is resulting in a self-induced postponement of nonemergent surgical cases, resulting in lower hospital revenues.
Additionally, hospitals and skilled nursing facilities are competing for a limited supply of nurses, including more expensive contract nursing staff.
The vaccine has been approved for the prevention of COVID-19 for those 16 years old and older. The vaccine also continues to be available under emergency use authorization, including for those 12 to 15, and for the administration of a third dose in certain immunocompromised patients.
Just last week, Moderna submitted data to the FDA for evaluation of a booster shot for its mRNA vaccine.
The yet-to-be peer-reviewed data comes from a study of 344 individuals who received a third dose of the Moderna vaccine six months after their second shot. Moderna found that their antibodies had “waned significantly” before getting the booster shot, but the additional jab increased antibodies to an even higher level than the previous round.
Heightened protection was observed across age groups, but particularly in adults over the age of 65, according to Moderna. It also offered protection against “all variants of concern,” including the Delta variant.
Moderna’s vaccine received emergency use authorization last December and showed to be 94.1% effective in preventing symptomatic COVID-19 in its clinical trial.
HENRY KOTULA 