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New vaccination mandate targets nursing homes and hospitals

A shot at normalcy
Vaccine hesitancy “is keeping the virus alive. It’s looking at us, and just laughing at us.” — Dr. Mark Hirko, Sharon Hospital

Hospitals and nursing homes in the Northwest Corner and around the state now have a new tool in their arsenal in the fight against the newly dominant and highly contagious delta variant of COVID-19: mandated vaccines of workers. 

An order by Gov. Ned Lamont on Aug. 6 requires that staff at nursing homes, long-term care facilities and residential care homes be vaccinated by early September. That edict, which imposes a fine of $20,000 per day to facilities that fail to comply, follows on the heels of a recent announcement by the state’s hospital association that all Connecticut hospitals will soon require COVID-19 vaccinations for their workers.

The mandates have been met with support by hospital and nursing home leaders in rural northwest Connecticut, who said they are prepared to impose those orders, even at the risk of losing employees who will quit rather than get the shot.

Nursing homes were among the hardest hit by earlier surges of the novel coronavirus, and Kevin O’Connell, CEO of Geer Village senior community in North Canaan, said it is a move that must be taken. “My attitude is that no one wants to go through the pain and suffering of another outbreak. There really is no other solution. The sooner we all get on board, the better off everyone will be.” 

Unvaccinated staff tested positive

O’Connell is well aware of the risk of losing staff because of the state mandate, particularly during an already challenging hiring climate, “but we will survive and get through it. The job market will stabilize even if people decide to seek employment elsewhere.”

“We have already seen that since hospitals announced plans to mandate staff vaccinations that there are some people who have quit” to take positions at other facilities, including nursing homes, where immunization was not mandatory. But no more. “We are all going to feel the pain of this,” noted O’Connell.

Geer announced on Aug. 3 that one unvaccinated staff member tested positive for COVID-19 at its nursing and rehab unit, and in response all residents and staff have been tested. As of Aug. 4, results of rapid testing conducted for nursing center residents and staff were negative, said O’Connell, and additional testing at three of the facility’s four centers came back negative. “I anticipate we will not have any other positives. It looks like it was just this one staff member.”

Geer’s CEO added that there is no reason for anyone to question the impact vaccines have in reducing illness and preventing death in those infected with the virus. “The reality is that information is out there on the safety and efficacy of vaccines, and if you want to make an informed decision there is absolutely no reason not to have the information you need.” 

‘There will be no safe haven’

Sharon Hospital President Dr. Mark Hirko said some hospitals that have begun mandating vaccines have seen a 10% to 12% resignation rate among staff, which is an added burden at a time when employees are hard to find. Many health-care workers are leaving their jobs at hospitals and seeking employment where vaccines are not required. “But pretty soon, there will be no safe haven,” as a growing number of private employers start requiring that workers roll up their sleeves.

Hirko said Sharon Hospital is currently “firming up the details” of the mandate, which will include medical and religious exemptions. “We know this is the right thing to do to keep the community safe and in order to provide high-quality health care.

“We worked very hard as a community and as a health care system to mitigate all the problems with this virus when it first came out and, you know what? We controlled it. But things became lax and now we can’t get out of our own way.” Vaccine hesitancy, said Hirko, “is keeping the virus alive. It’s looking at us, and just laughing at us.”

“You can have all the technology you want,” noted Hirko, but it all boils down to vaccines. “Too many people are refusing to get vaccinated so that the virus can burn itself out.” 

Evidence of that has materialized with the current, fourth wave of COVID-19. As of Aug. 6, there were no admissions of patients with COVID-19, said Hirko, but based on the uptick in cases, that could change soon.

The coronavirus, said the Sharon Hospital administrator, “is an opportunist and will find the most vulnerable”— meaning the unvaccinated, including children. 

Historically, as with prior diseases such as measles and chicken pox, he said, “that’s the most susceptible population toward the end of these epidemics.”

CDC: indoor masking advised

With the new delta variant spreading around the country, the U.S. Centers for Disease Control (CDC) has updated its masking guidelines for fully vaccinated people. 

The CDC advises that all individuals who live in a place with “substantial” or “high” coronavirus transmission should wear their masks indoors, whether or not they are vaccinated. All five counties in Connecticut are currently labeled areas of “substantial” transmission.

“If we are not careful, we could find ourselves back where we were” at the height of the pandemic, noted Hirko. 

At Noble Horizons, Molly Tanner, director of nursing at the 91-bed senior community in Salisbury, reported on Aug. 6 that one staff member has tested positive for the virus, and there have been zero positive cases among residents. The worker, she said, had no direct contact with residents. “We are still COVID-free,” said Tanner, who noted that between 80 and 85 percent of staff have received the COVID-19 vaccine.

Referring to the current spike in community transmission, she said, “We are concerned about what is out there, and as the rate continues to climb throughout the country, we are tightening things up again,” with heightened infection control practices and rules on visitation. 

“People have become more lenient with mask use, which has fueled the spread.”

Tim Brown, spokesman for Athena Health Care Systems, the owner/operator of Sharon Health Care center, reported on Aug. 6 via email: “The staff and residents at Sharon Health Care Center have been very fortunate to not experience any cases of COVID-19 for some time now. We continue to perform temperature checks and health screenings each shift on our staff and follow CDC and Connecticut DPH guidance on infection prevention.”

Since the COVID-19 vaccines became available, the Sharon facility has advocated and educated staff, residents and families to obtain the vaccine. “Vaccination remains the most important defense against illness and hospitalization from COVID-19,” he said, noting that Athena will continue to monitor implementation of vaccine mandates in Massachusetts in accordance with an Aug. 4 executive order from Gov. Charlie Baker. Connecticut’s mandate came hours after Brown’s email.

‘We are going to be OK’

Dr. James Shepherd, an infectious disease consultant at Yale-New Haven Hospital who lives in Sharon, said that while the delta variant is rapidly spreading, those who have been vaccinated are experiencing less-severe symptoms.

“Vaccinations are progressively ‘uncoupling’ infection from hospitalization and death,” said Shepherd, who referred to a chart from the UK showing the second wave from last fall where the rising case rate produced a rising death rate. 

The third wave from May/June with the delta variant shows a similarly rising case rate but a very low and steady death rate. 

“This is the impact of vaccinating around 70% of adults,” said Shepherd, who noted that the situation is similar in Connecticut, where about 70% of adults are immunized, “so we are going to be OK.”

The situation, he explained, pertains to the UK, Israel, Germany and the northeastern United States, “which have been quite efficient in vaccination distribution and where the levels of hesitancy have been around 30%.” 

However, noted Shepherd, places like Tennessee, Missouri and Louisiana, where only 35 percent of adults have been vaccinated, “will still see hospitalizations and deaths rising as delta variant spreads.”

The take-away? “The virus may spread, particularly variants like delta that are more transmissible, but they won’t cause the same spread of disease and health-care pressure as they did last year. Vaccines,” he said, “are the key.”

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