With COVID-19 resurgent in its Delta variant form, hospitals in San Bernardino County along with the rest of California may be in for a challenge as the state government’s September 30 deadline for all healthcare workers to be vaccinated against the coronavirus looms.
A majority of health workers have evinced faith in the medical field that employs them, and a majority have consented to receiving the Janssen/Johnson & Johnson, Moderna or Pfizer vaccine.
As of last month, however, nearly one quarter of the state’s healthcare employees, ranging from janitors to clerical staff to orderlies to candy-stripers to licensed vocational nurses, to registered nurses to nurse practitioners to physician practitioners to doctors of osteopathic medicine to medical doctors have balked at getting vaccinated.
From the outset of the coronavirus crisis in the United States, California and San Bernardino County, there was resistance by some to what were at first suggested precautions and then mandates intended to slow or preclude the spread of the disease, consisting of social distancing, masking, isolation and quarantining and ultimately vaccination.
In the late fall and early winter of 2020, the original form of the malady peaked locally, shortly after which a not-fully-tested vaccine became available.
By and large, a significant portion of the population went along with being vaccinated, and, as the immunity this gave against COVID-19 took hold, it seemed as if one of the most challenging health threats of the Third Millennium was behind humankind. On June 1, 2021, California averaged just two new COVID-19 cases for every 100,000 people.
According to health experts, that was a chimera. The Delta variant of COVID-19 – a fast mutating from of the disease first detected in India in December 2020 – had made its way to California by early March. With some 50 percent of the state’s population at that time unvaccinated, the Delta variant spread at first slowly and then more quickly throughout the population and progressed on a parallel but still different pathway, overpowering much in its way. Those who were unvaccinated and those who had not previously contracted COVID-19 were particularly vulnerable. With the mutation came increased infectability, such that even those who were presumed to be relatively immune – those vaccinated and those who had survived a go-round with the original COVID-19 virus – were contracting the Delta variant, in some cases at an alarming rate.
By July 24, the previous month’s average of just two new cases for every 100,000 people in the Golden State had escalated to 15.2 new cases per 100,000 people.
On July 26, Governor Gavin Newsom issued a mandate that all state workers and workers in the healthcare profession and any situation where there are concentrations of people either show proof of full vaccination or be tested once per week for infection with the virus.
Having a full complement of hospital workers at the state’s and San Bernardino County’s various medical centers and hospitals is now as critical as ever.
Last fall, virtually every available bed in San Bernardino’s hospitals was occupied by patients with normal or routine conditions as well as with the symptoms of COVID-19. It is anticipated that after summer shifts to fall this year, hospitalizations will again increase. Indeed that number may be increasing exponentially already. On June 15, 2021, there were 1,156 COVID-19 patients hospitalized throughout California. The last week of July, that number had climbed to 3,947. The number this week is believed to have exceeded 5,200.
With somewhere between one fifth and one-fourth of the state’s healthcare workers unvaccinated, a crisis is likely to descend upon most hospitals throughout the state. With so many trained and ready workers unable to report to work, those hospitals will be called upon to run short-staffed or fill the gap with vaccinated but most probably unskilled or poorly-trained replacements.
In some of the most prestigious hospitals in Southern California and San Bernardino County, a surprisingly large number of the health professionals employed there are unvaccinated. As of July 24 at Redlands Community Hospital, 41 percent of workers were not vaccinated. At the Mountains Community Hospital in Lake Arrowhead, precise vaccination rates among staff there are not available. One employee there who has so far refused to be vaccinated maintained that approaching 30 percent of the workers at that facility are not fully vaccinated.
Among a substantial cross section of health professionals, there is acceptance of the safety, or relative safety, of the various COVID-19 vaccines. Still the same, some health professionals – even some who have submitted to being vaccinated – say they believe the vaccine carries with it some risk.
Recently, there have been reports of myocarditis after vaccination with mRNA-based COVID-19 vaccines in people in their late teens, twenties and thirties. Out of 300 million doses of the vaccine being administered, 1,226 total cases of myocarditis – that is, inflammation and damage to the heart muscle – have been tracked. This, advocates of vaccinating point out, is an infinitesimal .00000408666 risk.
Others have objected to the presence of thimerosal – a mercury-based preservative – in the vaccines. Defenders of vaccines point out that the amount of mercury in a single shot of COVID-19 vaccine falls well below the average amount of mercury contained in a five-ounce can of tuna fish. Moreover, they point out, the mercury in the COVID-19 vaccine is in the form of ethylmercury, which is rapidly passed through the body and will not accumulate in tissues as does methylmercury.
It has been established that use of the Janssen/Johnson & Johnson COVID-19 vaccine increases the risk of an extremely rare and serious blood clotting disorder. Virtually all of those impacted by this condition are women ages 18 to 49, with the occurrence running at a ratio of 7 for every 1 million of those inoculated.
Pfizer has acknowledged that 21 cases of anaphylaxis [a severe allergic reaction] were detected after the administration of 1,893,360 first doses of Pfizer-BioNTech COVID-19 vaccine, equal to 11.1 cases per million inoculations.
Those reluctant to be vaccinated point out that an insufficient amount of time has passed since the vaccinations have become available to make conclusions about their safety, and that negative consequences from being vaccinated may take years to manifest.
Health professionals point out that medicine inherently involves the balancing of risks and benefits, and that for the vast majority of the human population, the benefits of COVID-19 vaccination greatly exceed the risks.
Some healthcare professionals have objected to vaccinations on moral or ethical grounds, pointing out that the vaccines were derived from a process dependent upon fetal cell lines incubated and cloned in laboratories over the last four to five decades from aborted fetal cells.
Some healthcare professionals who have resisted being vaccinated say they are refusing the inoculations simply on the grounds that they object to the mandates, which they say are an infringement on their constitutional rights.
Within the scope of the debate over the need for healthcare workers to be vaccinated, the risk to the healthcare professionals is not the only calculation or consideration, as the vaccine is intended to reduce the vaccinated party’s contagiosity as part of an effort to protect the patients those professionals come into contact with.
Legal challenges to the mandates have not fared well, at least in some of the cases that have been tested out so far.
Houston Methodist Hospital in Texas was among the first healthcare provider in the country to require its workers to receive COVID-19 vaccinations. When several workers there refused to comply and sued, they did so using the assertion that the hospital was, essentially, demanding that they submit to an experimental process to see if the vaccine worked and if it was safe. They lodged that lawsuit in federal court. U.S. District Judge Lynn Hughes threw the suit out in June, ruling that what the hospital was engaged in “is not coercion. Houston Methodist is trying to do their business of saving lives without giving them the COVID-19 virus. It is a choice made to keep staff, patients, and their families safer.”
Already, more than a month before Governor Newsom’s September 30 deadline, some of San Bernardino County’s hospitals have drawn the line, moving to terminate hospital workers who have made clear they will not be vaccinated.
At least two such workers at Mountains Community Hospital have been fired, the Sentinel is reliably informed, with preparations under way to fire more, which action will be staved off only if those employees knuckle under and consent to be vaccinated.
The Sentinel is informed that workers who have yet to be vaccinated at other hospitals around the county are being counseled by hospital administrators to seriously rethink their intransigence.
-Mark Gutglueck