COVID-19 Update September 30

On Wednesday, September 29, there were 3,388 new cases of COVID-19 reported in Arizona and 39 new COVID-19-related deaths. Deaths are reported by actual date of death. For intensive care unit beds, only 8% remain available statewide, with 30% of ICU beds occupied by COVID-19 patients.

This information can be found on the Arizona Department of Health Services (ADHS) COVID-19 data dashboard.

Overloaded Arizona hospitals have rural health networks pleading with larger hospital networks across the state for patient transfers, but this week rural hospitals have compounding concerns. According to NPR, many rural health providers are concerned that their overloaded practices may experience an even greater worker shortage when the federal vaccine mandate for healthcare workers goes into effect.

The Centers for Medicare and Medicaid Services (CMS) is finalizing the details of the new requirement which is expected to go into effect next month. The plan is to withhold Medicare and Medicaid funding from facilities that do not comply with the mandate. Administrator Chiquita Brooks-LaSure has explained some of the reasoning for the mandate, according to Becker’s Hospital Review:

We did not undertake this decision lightly.

Ms. Brooks-LaSure acknowledged hospitals’ concerns but said unvaccinated healthcare workers who become sick also contribute to the dire shortages. She cited specific situations in which workers threatened to quit but did not following vaccine mandates on the state level.

Many individual hospitals and health systems across the country have already imposed vaccine mandates for their employees, and most health system leaders are supportive of the federal requirement, according to Fierce Healthcare. And while there are a handful of organizations concerned about potential loss, industry figures are also pushing back on fears of staffing shortages due to the mandate. Ezekiel J. Emanuel, M.D., vice provost for global initiatives at the University of Pennsylvania, said the systems with mandates already in place have shown little workforce loss:

If you look at healthcare systems that have actually mandated this, they’ve retained over 99% of their workforce. Their workforce does go along when the employer requires it.

In a press conference Wednesday, Banner Health CMO Dr. Marjorie Bessel said that Banner’s deadline for vaccination is still November 1, and the health system is not concerned about the potential of losing employees.

We continue to work with our employees, who are potentially going through a process, to request a medical or religious exemption, as well as with those employees who have not yet been vaccinated, or those employees who are partially-vaccinated. I expect that in November, we will be 100% compliant with our policy and will be happy to share that number with you when we get to our deadline.

The Biden administration’s plan to increase the number of vaccinated Americans, called the “Path Out of the Pandemic: President Biden’s COVID-19 Action Plan,” will also extend to any business with 100 or more employees. Despite confusion over the constitutionality of the law, the plan is to enforce the mandate as a protection for workers’ health, and will be enforced through the Occupational Safety and Health Administration (OSHA).

The National Law Review published a preliminary advisory on the enforcement of the new rule, including which businesses will fall under the requirement and how to best prepare for compliance, based on the information currently known about the imminent rule.

Booster Shots

On September 24, ADHS announced that the state of Arizona would follow guidance from federal officials recommending that Arizonans 65 and older, residents of long term care facilities and other adults with underlying medical conditions get a booster dose of the Pfizer COVID-19 vaccine if they are six months past their second shot. Furthermore, the Centers for Disease Control and Prevention (CDC) extended the recommendation to those aged 18 to 64 with underlying medical conditions. From Don Herrington, interim director of ADHS:

Rest assured there is plenty of Pfizer vaccine in Arizona to accommodate not just those needing booster doses but those who need their first doses. Our primary focus remains helping unvaccinated Arizonans make the lifesaving choice to take advantage of safe, free, and highly effective COVID-19 vaccines.

Stakeholder groups were quick to applaud the decisions by the Food and Drug Administration (FDA) and CDC to extend booster shots to vulnerable groups including frontline healthcare workers. From the American Hospital Association:

We welcome Dr. Walensky’s decision to recommend the booster shot for frontline health care workers, which aligns with the FDA’s Emergency Use Authorization for booster shots that includes health care workers and others whose occupations increase their risk of exposure to COVID-19. Health care workers were among the first to receive the vaccines, and many workers are now nine months out from their initial vaccine series.

Full details on the recommendation for the Pfizer booster shot can be found at the U.S. Department of Health and Human Services website.

And the American Medical Association:

Given that we are in the midst of a global pandemic that continues to cause widespread illness and death, we must do everything we can to protect our frontline health care professionals. We believe this recommendation is a critical step to preserve our nation’s health care capacity and prevent illness among those who have continued to put their own health and safety at risk to care for patients.

COVID-19 Rapid Tests

According to the New York Times, over a dozen testing sites owned by the start-up company GS Labs regularly bill $380 for rapid tests. The lab is able to charge this much due to language in the CARES Act of 2020 that sought to keep Americans from becoming financially liable for getting tested. The language states that insurers must pay whatever the “cash price” of tests is listed online by the laboratories providing them. While many insurers have flat out refused to pay GS Labs’ fees, arguing the lab is price-gouging, a Blue Cross plan in Missouri has filed a lawsuit over the prices.

Community Advocacy

Many children are suffering compounding effects of experiencing COVID-19 related illnesses, according to AZCentral. One teenager from Goodyear, Nicholas Hernandez, is in physical therapy to regain muscle he lost while hospitalized with COVID-19 and also in counseling to cope with the trauma of a near-death experience. This issues are causing parents to speak out against anti-mask mandates in schools, and to push for vaccination mandates in order to protect vulnerable populations like children.

The National Academy of Medicine (NAM) released a video encouraging Hispanic Americans to get vaccinated for COVID-19, highlighting the safety and efficacy of the vaccine and reinforcing their role in bringing families together safely. The video features 11 Latino members of NAM and includes a letter signed by 21 Latino NAM members affirming their confidence in the vaccine.