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Healthcare

How New York's Vaccine Mandate Could Impact The Pandemic

NOEL KING, HOST:

Health care workers in New York state had until yesterday to get vaccinated for COVID or lose their jobs. The problem is, as NPR has reported, that many hospitals say staff are resigning rather than get the vaccine. New York's governor, Kathy Hochul, has talked about changing the state's licensing requirements to allow out-of-state health care workers to practice in New York. She's even talked about deploying medically trained members of the National Guard.

With us now via Skype is Dr. Leana Wen. She's a public health professor at George Washington University and a former Baltimore health commissioner. Good morning, Dr. Wen.

LEANA WEN: Good morning, Noel.

KING: Let's get right to it. Is this a good strategy, what New York is doing - get vaccinated, or find a new place to work?

WEN: Look. I think we need to level set and say that health care professionals take an oath when we decide on our profession. And that oath is always to put the health and well-being of our patients first. This is the reason why we are required to get all kinds of other vaccines for our job. We are required, for example, to get the influenza vaccine every year. We have to show proof that we got hepatitis and measles and chicken pox and rubella and other vaccines because one of the basic elements of our work is not infecting our patients. And we're in the middle of a global pandemic. And so it just - it makes so much sense that anyone working with patients or with nursing home residents, who are the most vulnerable, should be vaccinated. And frankly, the COVID vaccine should not be seen as being any different than all the other vaccines that we have.

I also think, by the way, that it is important to have an across-the-board vaccine requirement for health care workers in the country because, otherwise, people might be worried that - or health care systems might be worried that they will lose their workers to other places. And so if it's something that is across the country, it actually levels the playing field for hospitals.

KING: Maryland and Illinois, to give two examples, have vaccine mandates, but health care workers can opt out if they get tested for COVID regularly, which gives them a choice. And a lot of people say, just give us a choice, and we'll get it done. What do you think about that?

WEN: I think that testing is an important layer of protection. And it is something that I think we should have a lot more of, as in there are other countries that have rapid testing available for free for all of their residents. Canada is giving free tests for businesses. The U.K. makes available enough free tests for people so that they could be tested twice a week. I definitely think that we need more testing. But testing itself is not an exact replacement for vaccination. Testing picks up cases of people who are already infected. And so I think at the end of the day, people have to make a decision about what our values are.

And by the way, I know that there is a loud minority that is very vocally opposed to vaccine requirements, but there is a large, mostly silent majority that's in favor. Recently, the American Medical Association, the American Nurses Association, American Hospital Association and about a hundred other major health care professional organizations signed a letter saying that they are in favor of vaccine requirements for health care workers.

KING: Officials - public health officials in New York state say about 84% of state workers are fully vaccinated - health care workers. But thousands of them refuse to do it. Now, we've spoken to doctors on this show who say when people resign, our standards of care fall. We simply cannot attend to patients the way we want to if we are missing doctors and nurses. How do you manage that problem?

WEN: It's really tough. And frankly, we already have rationing of care that's happening all over the country. I think a lot of people somehow think that rationing of care is an on and off switch that once you reach this critical level, that's when rationing occurs. But actually, if a nurse normally takes care of five patients but now has to care for 10 or when we're in the emergency department and patients are boarding there, meaning that there's no bed in an ICU and there's no bed on a nursing or surgical floor, they're in the emergency department for 20, 30 hours, that impacts care for everyone. So I completely, of course, agree that we really need to solve many of our problems with overwhelmed hospitals and that staff shortage is a major issue.

We also have to remember, though, that if people - if health care workers do not get vaccinated, they are also much more likely to be out of work. They are more likely to get COVID-19. Also, if an unvaccinated person gets exposed to somebody known to be infected, they need to be out of work completely for usually at least seven, probably up to 14 days, as opposed to somebody who is vaccinated and exposed. They don't need to be out of work. And so I think there are also - and of course, the individual who - an employee who ends up getting infected is also more likely to be hospitalized themselves and to transmit in the community. And so I think it's a difficult trade-off, but one that, again, at the end of the day, we as a society and certainly institutions need to say, what is it that we stand for, and how can we best serve in this time of a global pandemic?

KING: What more can public health officials be doing to break down vaccine hesitancy among health care workers? I know a lot of people are surprised that this group of people in particular is so vaccine hesitant. Something seems to be going wrong here or not adding up. What is it?

WEN: I actually don't think that it's health care professionals in particular that are vaccine hesitant. When you look at physicians, for example, even back just a couple of months into the pandemic, I believe that there was an American Medical Association poll done that found that well over 90% of physicians had already gotten vaccinated. I think what we're seeing in techs, in nurses, in some other professions is that they are reflecting the community around them. And this disinformation and misinformation doesn't just affect the average person in the population; it very much affects our health care professionals as well. And so we need to do more education. But we also need to see that vaccine mandates are important, they are legal, and they work.

KING: Dr. Leana Wen is a public health professor at George Washington University. Thank you for being with us this morning, Dr. Wen.

WEN: Thank you, Noel. Transcript provided by NPR, Copyright NPR.

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