Hundreds of sought-after nurses are leaving some U.S. hospitals that have established vaccine requirements for all employees, involving some protests and legal opposition. But most workers, especially at large hospital chains, appear to be complying with the policies.
New York hospitals and nursing homes are grappling with the state’s Monday deadline for workers to have received at least one coronavirus vaccine dose, with thousands of workers remaining unvaccinated and at risk of being fired. Several other states and cities have also imposed mandates for health care workers, with deadlines approaching.
All are also facing a looming federal vaccine mandate for hospital and nursing home staff that President Biden ordered, though its exact scope and timing has yet to be announced.
The departures, especially of nurses, have compounded major staffing shortages over the course of the pandemic. The situation has become acutely difficult these past few months, particularly in regions where the Delta variant has overwhelmed hospitals and caused new spikes in Covid cases among nursing home staffs and residents. In one instance, a hospital in upstate New York said it briefly had to stop delivering babies after six of its employees left rather than get vaccinated.
At Novant Health, a large hospital group based in North Carolina, 375 workers were suspended after not meeting the system’s vaccination deadline this month. Another 200 agreed to comply, increasing the vaccination rate to over 99 percent of its more than 35,000 employees, according to Novant.
Yet the loss of some employees “is going to be the cost of doing business in a pandemic,” said Dr. Saad B. Omer, the director of the Yale Institute for Global Health, who has studied vaccine mandates. “I’m not seeing any widespread disruptive effect,” he said.
Dr. David H. Priest, an infectious-disease specialist and senior executive at Novant, said he believed that the hospital would persuade most of its workers by addressing their concerns. The hospital has “been working on this for weeks on end,” he said, by holding webinars and sending emails to help educate employees about the benefits of being immunized.
How the nation’s hospitals are handling the holdouts varies widely, and many facilities are waiting for federal guidelines. Others have set deadlines later this year.
Many hospitals are not establishing sharp cutoffs for when they might eventually fire someone.
UNC Health, another North Carolina group, said that it was confirming the status of about 900 employees. About 70 employees have left as a result of the system’s mandate, and the group has granted about 1,250 exemptions for medical or religious reasons. About 97 percent of its work force have complied. Those who still need to be vaccinated or qualify for an exemption have until Nov. 2, providing what UNC described as “a last chance to remain employed.”
At Trinity Health, one of the first major hospital chains to announce a vaccine mandate, the percentage of its vaccinated staff has increased from 75 percent to 94 percent, said the group, which operates in 22 states.
SSM Health, a Catholic hospital group based in St. Louis, also adopted a mandate but said that few of its workers had left because of its requirement.
Hospitals and nursing homes have raised concerns about their ability to find workers if they impose strict requirements. The situation may be worse in rural areas, where limited numbers of workers are available. But healthy vaccinated workers may also ease staffing shortages.
At Houston Methodist, where 150 employees left from a work force of about 26,000 people, the hospital said that there had been little lasting effect on its ability to hire people. And when Texas was hit with rising numbers of Covid cases over the summer, the hospital found that fewer of its workers were out sick.
“The mandate has not only protected our employees, but kept more of them at work during the pandemic,” a hospital spokeswoman said in an email.
ChristianaCare, a hospital group based in Wilmington, Del., said on Monday that it had fired 150 employees for not complying with its vaccine mandate. But the group emphasized that over the last month it had hired more than 200 employees, many of whom are more comfortable working where they knew their colleagues were vaccinated.
Spain’s health ministry said on Wednesday that fans would be allowed to fill soccer stadiums again, the latest step toward a general removal of restrictions after the country’s coronavirus infection rate fell to its lowest level in over a year.
Starting on Friday, stadiums will no longer have to limit the number of spectators at soccer matches and other outdoor events. For indoor stadiums hosting basketball and other competitions, the limit will be 80 percent of capacity.
Fans will still have to wear face masks, including in outdoor stadiums, and a ban on food service remains in place.
The Spanish authorities agreed in August to reopen stadiums after the summer break, but they initially limited capacity to 40 percent for outdoor stadiums and 30 percent indoors. As the pandemic numbers continued to improve — and after the country announced that 70 percent of the population had been fully vaccinated as of the end of August — the stadium capacity thresholds were raised to 60 percent outdoors and 40 percent indoors.
Many of the main restrictions in Spain have now been significantly eased or lifted altogether. In the capital region of Madrid, restaurants and bars were allowed this month to stay open as late as their licenses allow, and shopping malls, cinemas and theaters no longer have to apply limits on capacity.
On Tuesday, Spain registered 2,290 new cases of Covid-19 — its lowest daily number in more than a year. The 14-day infection rate fell to 62 registered cases per 100,000 inhabitants. (The infection rate had reached almost 700 during July, and 400 during August.)
The rate remains above 100 in just two Spanish enclaves in North Africa: Ceuta and Melilla.
Most experts attribute the improvement in Spain to the speeding up of vaccinations. The immunization rate — 77 percent on Tuesday — translates to 36.5 million residents, one of the largest fully inoculated populations in Europe.
And more than 90 percent have now received at least one dose of a Covid-19 vaccine, including about three-quarters of adolescents.
Rubel, a 30-year-old roofer from Bangladesh, is among more than 300,000 migrant workers currently living under lockdown restrictions in Singapore that essentially prevent them from doing anything other than going from their crowded dorms to work and back to their dorms again.
When the pandemic began, Rubel shared a single room with about 30 people, he said, and there were 10 bathrooms for the 100 people in his building — conditions that he has tolerated because he can take in 28 Singapore dollars a day (about $20), plus overtime, which he sends home to his wife and young son.
But the toll on his mental health is growing.
“While we are grateful for many things, I can’t breathe,” he said.
Singapore’s pandemic restrictions on migrant workers began in April 2020. The country’s Ministry of Manpower said they were targeted for lockdowns because “the vast majority” of coronavirus infections in the country were coming from the dormitories where such workers live.
Now, more than 90 percent of migrant workers in the dorms are fully vaccinated against the coronavirus. And despite that high inoculation rate, the strict regulations have remained in place, effectively trapping the workers inside crowded, uncomfortable and unsafe conditions.
“I really hope that we can get permission soon go to outside, as it really has been very long,” Rubel said.
Two weeks ago, the government introduced a pilot program to allow up to 500 vaccinated workers a week to visit predetermined locations for up to six hours — a move that Alex Au, the vice president of Transient Workers Count, Too, an organization that works with migrant workers in Singapore, described as “madness.”
“It would take 600 weeks, or 12 years, to give all the migrant workers a chance to go outside,” he said, adding that the pilot program also did not meet the workers’ emotional and social needs.
Jeremy Lim, a professor at the National University of Singapore’s Saw Swee Hock School of Public Health, said the lockdown had taken a tremendous toll on the workers’ mental health.
Both Professor Lin and Mr. Au said there had been an increase in suicides among migrant workers in Singapore, though the government has denies any increase. And a study by Yale-N.U.S. College found that restricted movement for people living in the dorms was associated with higher levels of stress and depression.
“From a public health point, there is no danger of letting the workers out of their dorms,” Professor Lin said.
The government and other organizations have created telephone lines to help migrant workers deal with mental health issues. But Professor Lim said the best solution was to let migrant workers move more freely so that they can reintegrate into society and reestablish social connections.
As for Rubel, he said he had a plan for what to do when he is allowed to move freely around Singapore, where 79 percent of the population is fully vaccinated.
“I need meet my friends and sit outside,” he said.
After a bruising 18 months of the pandemic, this fall represented a fresh start for the apparel company Everlane. It was preparing to release a slew of new products, with September marking the beginning of an ambitious marketing campaign around its denim.
Instead, Everlane has spent this month scrambling just to get jeans out of Vietnam, where a surge in coronavirus cases has forced factories to either close or operate at severely reduced capacity with staff living in on-site bubbles.
“At this point we have factories in 100 percent lockdown,” Michael Preysman, Everlane’s chief executive, said in an interview. “Do we fly things over? Do we move things? Do we adjust in the factory? It’s a nonstop game of Tetris.”
The crisis in Vietnam is the latest curveball to be tossed at the retail industry, which has been battered by the pandemic. And it comes after Vietnam made it through the first part of the pandemic relatively unscathed. But now the Delta variant is on a rampage, highlighting the uneven distribution of vaccines globally and the perils that new outbreaks pose to the world’s economy.
Harvard Business School said on Monday that all first-year and some second-year graduate students would temporarily revert to remote learning after a recent surge in breakthrough coronavirus cases driven by the Delta variant.
The shift to remote learning for the school will last through Sunday, said Mark Cautela, a spokesman for the business school.
“In recent days, we’ve seen a steady rise in breakthrough infections among our student population, despite high vaccination rates and frequent testing,” he said in a statement.
As of Sept. 22, 95 percent of students and 96 percent of employees at Harvard were fully vaccinated, according to data from the university.
“Contact tracers who have worked with positive cases highlight that transmission is not occurring in classrooms or other academic settings on campus,” Mr. Cautela said. “Nor is it occurring among individuals who are masked.”
The university has asked students to avoid unmasked indoor activities, group travel and gatherings with people outside their household.
The business school will begin testing all students three times a week, regardless of their vaccination status, Mr. Cautela said. Previously, unvaccinated students were being tested twice a week, and vaccinated students once a week, he said.
Graduate students have accounted for most of the recent positive cases at Harvard, according to the university’s Covid-19 dashboard. Over the past seven days, graduate students have made up 51 of the 66 positive cases at the school.
Massachusetts has some of the highest vaccination rates in the country, with 77 percent of its population at least partly vaccinated and 68 percent fully vaccinated. New cases in the Boston area have been falling since a recent spike in mid-September.