Wash. Hospital Exec: COVID Vax Mandate Will Help Staffing

Tri-City Herald (Kennewick, Wash.)

A requirement that most health care workers in Washington state be fully vaccinated against COVID-19 by Monday Oct. 18 could actually help with Kadlec Regional Medical Center staffing issues, said its chief executive, Reza Kaleel.

Kaleel talked about Kadlec, the largest hospital in the Tri-Cities, at a Monday news briefing of the Washington State Hospital Association.

As of Monday morning, well over 90% of Kadlec employees met state requirements to either be fully vaccinated against COVID-19 or have been granted a religious or medical exemption, Kaleel said.

When vaccination was previously voluntary, the number of Kadlec health system employees getting the vaccine had stalled despite the Richland hospital's efforts to encourage staff, he said.

"Having the mandate has really moved up our vaccine compliance quite a bit," he said.

Kadlec may lose a small number of employees who don't comply with the state mandate, but having more employees vaccinated could reduce the number who are unable to work because they must quarantine at home after a possible exposure, he said.

Dr. Tim Dellit, chief medical officer for UW Medicine in the Seattle area, said unvaccinated people have a nine-fold chance of infection, a 50-fold likelihood of hospitalization and a 60-fold likelihood of dying, based on King County data.

He said he's hopeful that having more employees vaccinated will mean fewer of them not out on a daily basis.

Kadlec does have a policy to put employees who have not complied with the vaccine mandate on leave rather than firing them.

Cassie Sauer, president of the Washington State Hospital Association, said other states with vaccine mandates that took effect earlier have seen people put on leave for not complying and then starting the process of becoming fully vaccinated.

She estimated that in Washington state 2% to 5% of hospital employees will not meet the state vaccine mandate, although that estimate could be high if there's last-minute compliance.

Employees at long-term care facilities, such as nursing homes, and first responders, such as firefighters licensed as paramedics, are likely to have lower compliance with the vaccine mandate, she said.

Hospital Staffing Shortages

The hospitals that have the lowest compliance in Washington state are small hospitals in rural Eastern Washington, she said.

They could cap admissions, close some services or delay non-urgent and outpatient procedures, she said.

Dr. Andrea Carter, chief medical officer of Samaritan Healthcare in Moses Lake, said at the briefing that the hospital was losing nearly all of its materials management employees because of the vaccine mandate. Those employees purchase, deliver and stock supplies.

The relatively small number of employees that Kadlec could lose pales in comparison to the number who have left the hospital during the pandemic, Kaleel said.

Nearly a quarter of Kadlec's intensive care unit staff have left, he said.

"And everyone's in the same situation with the hospitals virtually all competing with each other now across the country for staff," Kaleel said.

Some Kadlec staff have left health care, but others have remained in the profession, just not in their current jobs.

Some hospital employees have taken lucrative traveler assignments, working for companies that send health care workers to hospitals that are short of staff for a premium price. However, some have returned to Kadlec after finding traveler jobs more stressful than anticipated.

Some staff have looked for work in locations, at least for now, that do not have vaccine mandates. Others retired, and some changed assignments, such as leaving the ICU.

The pandemic played at least a part in most resignations, Kaleel said.

The biggest challenge he hears from staff is the emotional burden they carry, he said.

Kadlec has admitted a little over 3,200 patients with COVID-19 since the start of the pandemic, and 260 have died at the hospital.

"That's folks who our staff and team have unfortunately had to help say goodbye to without families present for most of those, or at least, (only) virtually," he said.

Fewer COVID Patients

Kadlec is treating fewer COVID-19 patients than last month. Then it had as many as 85 patients daily, or about a third of its 240 to 250 total daily patients, he said.

That had dropped to 30 as of Monday, he said.

But the rate of new COVID-19 cases remains high in Eastern Washington and Kadlec is seeing more deaths in younger patients, he said.

Kadlec usually serves the Mid-Columbia as a resource for patients needing higher level medical care that may not be available elsewhere in the region, particularly in rural hospitals.

But it is accepting more transfer patients now than last month, when a combination of high patient counts and staff who were at home due to COVID-19 infections made ICU and some other hospital beds difficult to find across the Northwest.

Statewide 1,025 patients were hospitalized due to COVID-19 Monday compared to 1,101 the previous Monday, Sauer said.

"It is a decline but we wish it was more quick," she said.

However, there were 184 patients on ventilators compared to 185 the week before.

"Once patients are on a ventilator... their chance of survival goes down pretty significantly," she said.