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Health care workers must get vaccinated or tested

Governor Kate Brown has announced that health care workers in Oregon have until the end of September to get a COVID-19 vaccine or face weekly tests. Andy Van Pelt, Executive Vice President of the Oregon Association of Hospitals and Health Systems, joins us to talk about what the new requirements mean for hospitals in the state.

This transcript has been created by a computer and edited by a volunteer.

Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. Yesterday, Oregon Governor Kate Brown announced that healthcare workers who are not vaccinated against COVID-19 by September 30th will have to be tested weekly. It’s an executive level work around for a 30 year old law that is unique to Oregon. The law prevents healthcare systems from requiring vaccines as a condition of employment, but it doesn’t prevent the state government from doing so. For more on this new requirement, I’m joined by Andy Van Pelt. He is the Executive Vice President of the Oregon Association of Hospitals and Health Systems. Andy Van Pelt, welcome to Think Out Loud.

Andy Van Pelt: Thanks, Dave. Appreciate you having me.

Miller: Your organization, the largest organization of hospitals in the state, had been pushing for the state to end the prohibition on requiring healthcare workers to be vaccinated as a condition of employment and to end that prohibition either by rule at the Oregon Health Authority or having the Legislature do it, which they didn’t do. But neither of those have happened yet because the announcement yesterday was a kind of middle ground. How do you feel about this compromise?

Van Pelt: Every step forward is a positive step. COVID is unique to all of us. There’s no playbook. We’ve been in this build mode in terms of a user manual of COVID for over a year now. This is one positive step to make sure that we get the largest community we possibly can vaccinated, and our healthcare workers. And it’s a very broad definition. It’s way beyond hospitals in terms of healthcare workers only that will fall under this rule. We think it’s a really positive step. We’ll continue to work on the existing law, as we have in the past, with the legislature and the Governor as she is committed to in 2022.

Miller: I should say that when you look at the state, the Oregon Health Authorities’ page showing vaccination rates for different people who are licensed healthcare workers, just to underline what you just said, there really is it’s a wide variety. It includes massage therapists, chiropractors, naturopaths, occupational therapists, pharmacists, dentists, and then people who work in emergency medical services. And then the kinds of healthcare workers you associate more with the hospital, doctors and licensed nurse practitioners and registered nurses and on and on. There are different vaccination levels for those different groups that we make get into, if we have time. What have you heard from the various members of your organization since this rule change was announced? And I imagine as it was being worked out with the governor’s office?

Van Pelt: It’s a positive step in terms of it’s consistent across the state. It gets to be a challenge when there’s lack of consistency in terms of how rules are implemented or laws are implemented in a public health emergency. As we’ve heard repeatedly, this virus doesn’t stop at the county border, and so we have to respond to be one step ahead of that virus in terms of how can we put up barriers for it to slow the spread. Yesterday, with over 422 COVID people in the hospital, it’s an increase of 43 patients from the day before. We are kind of entering a perfect storm in terms of our COVID infections are dramatically increasing to compete with our highest peak in the fall. And we have a worker shortage, in terms of just burn out, in terms of a multitude of things. Not the healthcare industry alone, but up and down Main Street you see help wanted signs and that then puts a further capacity on the system in terms of getting appropriate access to healthcare. So this is one tool statewide to help and it has options. We know vaccinations are a very personal issue. Unfortunately, they have become a political issue. The science backs up their efficacy. Today, a report was just released that at the six month mark of both Pfizer and Moderna, they’re still in the mid 90% effective. And that’s really promising. We know, though, that not everybody will want to go down the vaccination route. So the weekly testing is the other proven way to try and block COVID from entering our communities and being aware.

Miller: Will hospitals have other tools at their disposal if, say, an OR Nurse refused to get vaccinated? Could their hospitals say, ‘well, we can’t legally fire you because you’ll get tested every week, but we’re not going to let you take part in surgeries.’ Is that the kind of thing the hospitals might do?

Van Pelt: There’s not going to be a blanket approach [to] how hospitals or various health systems across the state, or the country for that matter, respond to individual circumstances. I would say hospitals and health systems have a full suite of options, including masking, including possible reassignment away from direct patient care settings, and even potentially those folks who don’t work in the patient care settings of hospitals might be able to work remotely for a period of time. But those are all going to be unique to the specific employee and the specific hospital that that employer works.

Miller: The Governor, in her announcement, said it’s going to be up to health care settings, hospitals or whatever, to actually figure out how payment for weekly tests is going to work. What have you heard from hospitals about what their plans are? And do you think they’ll make unvaccinated employees themselves pay for their weekly tests?

Pelt: I would hope we don’t create a barrier to access with payment, just like the federal government and the state government stepped up to pay for the vaccinations. I would expect under this new rule that something like that would apply. The devil’s in the details. We haven’t seen the final rule and all the language that the OHO or the health agency is apparently going to put out either later this week or within the next week and that is really going to tell us how this is going to be implemented. We are committed, hospitals are committed to working with the Governor and the agency to make sure we don’t have any unintended consequences of this policy. And we have a bit of a runway in terms of figuring that out. As we know, policies have to be in place by the end of August and then compliance by the end of September.

Miller: Let me ask you about that runway, because as you mentioned, we’re in the middle of the surge right now with worrisome numbers of cases and hospitalizations, as you mentioned, increasing. Why wait for almost two months for this to fully kick in?

Pelt: That’s a great question. And I don’t have an answer to that. I would redirect that back to the Governor’s office and some other stakeholder groups in terms of why the delay. We are ready to move in terms of implementing these protocols. As you’ve seen over the past couple of days, there are several health systems in the state that are moving faster, so I don’t know actually why the 56-day runway to implement something when the COVID is spreading dramatically and our hospitals are feeling the capacity crunch.

Miller: Just briefly, on this note, the Governor’s office said that this time is going to quote ‘give currently unvaccinated health care workers time to become fully vaccinated.’ We’re talking here about, by definition, people who work in health care settings. How hard is it going to be for the majority of them to get access to a vaccine?

Pelt: The supply chain issue that we faced at the very beginning of the vaccination rollout is not what it is today. Vaccination availability is abundant, especially this population in terms of health care workers. So access shouldn’t be a barrier in terms of meeting that. As we know, one shot in a two shot series is better than nothing. You get into the 60-70% of efficacy after your first shot. So I don’t know if we should let perfection be the evil of good in terms of waiting 57 days to complete this because we know that before that period we will have a protected health care workforce.

Miller: Andy Van Pelt, thanks very much for joining us today.

Van Pelt: I appreciate it. Thank you very much.

Dave Miller: That’s Andy Van Pelt, the Executive Vice President of the Oregon Association of Hospitals and Health Systems talking to us about the new requirement that was announced yesterday for health care workers in Oregon. They now have until the end of September to either get a COVID-19 vaccine or face weekly tests.

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