Hospital staffing losses from state vaccine mandate ‘much lower than what we feared’

Two weeks after the vaccine mandate for health care workers went into effect, the state’s hospitals have barely felt a pinch.

Hospital leaders had predicted that the hospitals on the eastern side of the state — where vaccination rates have tended to be lower — might lose so many workers that they would have to cancel services, such as dialysis.

However, this has not been the case.

“There has been some impact, but it’s been much lower than what we all feared that it could be,” said Beth Zbrowski, senior vice president of communications and engagement for the Washington State Hospital Association during the group’s regular briefing this week. “We’ve had a couple hospitals that have had to curtail a service or two, and they’ve been working on getting those patients care elsewhere.”

Taya Briley, executive vice president of WSHA, explained that no hospital has had to cut off an entire type of service.

“We’ve been managing much better than we thought we might, and where there are limitations on services, it’s more like folks can’t take as many patients as they might have been able to, but they aren’t having to shutter services altogether,” Briley said.

But while the vaccine mandate has not led to any prominent staffing losses, hospitals are still dealing with the ongoing staffing shortages that they have been seeing for months due to exhaustion and burnout. Besides the long hours and extra shifts, health care practitioners have told KIRO Radio that seeing the suffering of COVID patients during the fifth wave was especially emotionally draining because most of the people hospitalized were unvaccinated.

“Taking care of any sick patient is not easy, but when you see it in younger and younger patients, it really, really hurts your soul in a way that is difficult to describe,” said Dr. Karthikeyan Muthuswamy with Virginia Mason Franciscan Health in Lakewood.

He said he has seen more young people in critical care during the pandemic than in the entirety of his medical career — and most of these patients were unvaccinated.

That emotional burden is twofold.

“It’s been very difficult for health care providers who are dealing with this pandemic to feel like we have two battlefronts,” said Dr. Mary Fairchok, a pediatrician at Mary Bridge Children’s Hospital in Tacoma. “We have the battle in the hospital and the clinic every day, and we have the battle of misinformation.”

Hospitals have been able to help fill the void with traveling nurses and federally-contracted health workers. But there is still the worry that if cases start to rise again, hospitals could land right back in the scenes of August and September — when the combination of the state’s largest COVID surge and staffing challenges meant that, in some cases patients with appendicitis and strokes had to wait for care.

Unfortunately, while cases and hospitalizations have dropped significantly since then, the decline appears to have stopped. Briley is nervous that a plateau could be a precursor to an increase in cases again — and if that happens, we are not starting from a low number.

“We don’t like where we are plateauing,” Briley said. “Right now, COVID-19 hospitalizations are around 1,000 in Washington state on any given day, compared to 300 and 350 last June and July.”

She explained that numbers like that are equal to last winter’s third wave — which, until the delta variant came along, was the largest surge the state had seen.

“One-thousand hospitalizations per day was the peak of the surge that we had in December of 2020,” she said. “And at that time, we introduced significant additional mitigation measures to try to get the COVID-19 numbers under control.”

During the December 2020 surge, as restaurants went back to takeout only and stores limited capacity, health officials advised families not to get together for the holidays. This year, with the availability of vaccines, the recommendations are a little more flexible.

“It’s so hard for me to tell people two years in a row, ‘Don’t go see your family for Christmas and Thanksgiving,’” said Muthuswamy. “So, just, please be careful, take the right precautions, and keep the gatherings as small as possible.”

Muthuswamy, along with the CDC, advises that any family members getting together for holidays who are eligible for vaccines — including not just the COVID vaccine, but the booster and a flu shot — get them well in advance of gathering. That recommendation also extends to children ages 5 to 11, who are expected to become eligible for the Pfizer vaccine within the next week or two.

Doctors expect to see the most vaccine hesitancy yet from parents as the 5-to-11-year-olds become eligible.

“Although it may be tempting to dismiss the idea of vaccinating the [5]-to-11-year-old age group because they are the group at the lowest risk for things like hospitalizations and death, we shouldn’t be minimizing that,” Fairchok said.

She explained that Mary Bridge saw a large increase in children hospitalized with COVID during the summer’s delta surge, including 45 children with the COVID complication multisystem inflammatory syndrome. This rare but serious side effect of COVID tends to affect kids and can cause dangerous heart and lung problems; Fairchok said most of those Mary Bridge patients who had it ended up in the ICU.

“[COVID-19] was still the sixth leading cause of death for 4-11-year-olds during Delta. Kids at this age are not supposed to die,” Fairchok said. “So they still are dying of coronavirus, they still are being hospitalized. We still have the problems with the [multisystem ifnlammatory syndrome], around 7-8% of them are experiencing long COVID. "

Dr. John Hawes, a pediatrician with Swedish Medical Center, assured parents that the vaccine is safe.

“It’s been tested on several thousand kids in this age group and there hasn’t been a single serious side effect in the children age 5 to 11,” Hawes said.

While there have been extremely rare cases in adolescents of myocarditis — the inflammation of the heart muscle — after receiving the vaccine, Fairchok explained that that has mostly been in teenage boys, and was not once seen in the children’s vaccine trials. And even in this higher-risk group, she said, the rate of heart complications from COVID is four times higher. Multisystem inflammatory syndrome is just one example of the serious problems that kids can get from COVID.

“If we’re refusing to use a very effective weapon against it, it’s like trying to fight the virus with one hand tied behind our backs, and why would we want to do that?” Fairchok said. “I shudder to think what delta would have been like had we not had the vaccination.”

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