Denver Mayor Michael Hancock announced on August 2, a COVID vaccine mandate for all city employees and private sector healthcare workers. The latter includes doctors, nurses, and other medical staff working in anything from a hospital to a private office to a nursing home.
What does this mean? What are the implications? This is not a commentary on the vaccines themselves, but on the mandates and potential intended or unintended consequences.
Colorado is one of the mostly vaxxed states with 55 percent of the total population fully vaccinated. For Denver County, the vaccination rate is higher with 62 percent fully vaccinated and most importantly 81 percent of the most vulnerable over age 65 population.
Vaccination is one path to herd immunity, the other being natural infection, with the former a generally lower risk path to immunity. How long vaccination immunity lasts or how well it protects against present and future variants is up for debate. But in a healthcare setting, most patients for obvious reasons have medical issues and are health compromise to some degree, meaning that any measure to mitigate that risk is important and worthwhile.
So, it’s a no brainer. Everyone who works in healthcare should be vaccinated or find a new line of work. Not so fast. What are some of the potential unintended consequences?
What about those who refuse the jab? A Monmouth University poll earlier this year found 25 percent of Americans unwilling to be vaccinated. A Newsweek poll showed that number a bit lower at 18 percent refusing the jab.
How many vaccine resisters are in healthcare and how many will quit rather than accepting vaccination against their will? How would that play out?
There is already a shortage of workers in Denver. For many, unemployment benefits combined with a COVID bonus of $300 a week incentivizes many to stay home and collect a healthy pay check, close to or in some cases even more than they earned while working.
Many healthcare workers are burnt out by the stresses of the past 2 years of COVID, masks and mandates, restrictions and distancing, choosing to take time off or find a new job for their sanity and mental health.
I recently received an email from a local hospital needing 80 nurses to combat “the most difficult labor market” in recent times. A vaccine mandate will likely raise that number if the vaccine hesitant, perhaps 10 to 20 percent of workers, take a hike rather than take a needle, exacerbating the healthcare labor shortage.
This could lead to a repeat of last year when elective procedures were cancelled, not over COVID concerns like last year but over a lack of staff. How many screening colonoscopies or mammograms will be delayed or cancelled? What about cardiac stress tests or catheterizations?
What happens when treatable medical conditions are missed, or treatment delayed? Will heart problems or cancer patiently wait until the labor market stabilizes? What happens to elderly patients in understaffed nursing homes?
As the saying goes, the road to hell is paved with good intentions. Will the health enhancing good intentions of vaccine mandates lead to health damaging consequences of exacerbating a healthcare labor shortage? Hopefully Denver officials are modeling vaccine mandates out beyond news headlines, not causing more harm than good. We will know the answer this fall.