The first federal, state and city COVID vaccine and testing mandates are here

It feels like a big shift has begun to force unvaccinated people to get their shots or be asked to be constantly tested for COVID-19. Some might lose their jobs. 

The push is on at the federal, state and local government level. Government workers at the Department of Veterans Affairs, state workers in California and city employees in New York must now either get vaccinated or undergo weekly COVID-19 tests. Two more cities issued mask mandates that a state attorney general says he will try to block.

Key questions today include “How much will workers resist?” and “Is the dam breaking for other government agencies and private employers to require vaccinations?” 

At the same time, dozens of top professional associations for doctors and nurses are demanding that all health care workers be forced to get their vaccinated.

The VA orders vaccinations for workers

The Department of Veterans Affairs says it is giving its 115,000 front-line workers eight weeks to get vaccinated. It is the first federal government department to require vaccinations, something even the Department of Defense has not yet insisted on.

Veterans Affairs Secretary Denis McDonough said in a statement, “Whenever a Veteran or VA employee sets foot in a VA facility, they deserve to know that we have done everything in our power to protect them from COVID-19.”

Military Times reports:

Officials said the move is designed “to keep the veterans (VA) serves safe.” The mandate has been discussed as a possibility in recent weeks, but the recent nationwide surges in the Delta variant of the virus pushed leaders to enact the change now.

All Title 38 employees — including physicians, dentists, podiatrists, optometrists, registered nurses, physician assistants, expanded-function dental auxiliaries and chiropractors — who work in Veterans Health Administration facilities or provide direct care to veterans on VA’s behalf will have eight weeks to be fully vaccinated.

Military Times also puts the announcement in perspective:

Nearly 20,300 VA employees have contracted coronavirus since March 2020, 190 in the last month alone. At least 145 staffers have died from complications related to the illness. More than 227,000 veterans in VA care have contracted coronavirus in the last 15 months, and nearly 12,500 have died from complications related to the sickness. 

States and cities begin vaccination requirements

California went where no state has gone before in pushing what amounts to a COVID-19 vaccine requirement for state workers.

California Gov. Gavin Newsom announced:

The requirement, which begins Aug. 23, applies to more than a quarter of a million California state employees and health care workers.

The California Health and Human Services Agency, which oversees hospitals and other public and private care facilities, is pushing private employers to require vaccinations or implement weekly COVID-19 tests.

In New York City, the testing or vaccination requirement will be in effect before schools open in mid-September. It applies to 340,000 municipal workers, including police, fire and rescue workers and teachers.

“We’re just not going to tolerate unvaccinated city employees doing the wrong thing,” New York City Mayor Bill de Blasio said. “Let’s be blunt: If you’re a city employee and you’re unvaccinated, you must wear a mask indoors at work. We will not tolerate any decision to do otherwise because this is about protecting people’s health and well-being.”

City workers who are unvaccinated and refuse to wear a mask will not be allowed to enter the workplace and will not be paid, the mayor said.

St. Louis also issued an indoor mask mandate Monday, and it applies to everyone over age 5 in public areas and mass transit.

CNN reports, “About 41% of … Missouri’s population is fully vaccinated, according to data from the Centers for Disease Control and Prevention. St. Louis has fully vaccinated just 35.4% of its residents, the most recent dashboard by the state shows.”

Missouri Attorney General Eric Schmitt says he will sue to block the order:

The city of Provincetown, Massachusetts, ordered a mask mandate this week after hundreds of COVID-19 cases surfaced there in recent days. WCVB reports:

Massachusetts Department of Public Health is reporting that at least 430 confirmed COVID-19 cases are associated with the Provincetown cluster. Of these cases, 342 are Massachusetts residents and 153 of those people reside in Provincetown. The remainder of those who tested positive reside in other states.

Cases associated with the cluster among Massachusetts residents are found to be predominantly symptomatic (71%) with 69% of affected individuals reporting that they are fully vaccinated against COVID-19.

“The unvaccinated, they were probably much rarer, actually, than the vaccinated, and yet, they make up a third of the infections,” said Dr. Shira Doron, the hospital epidemiologist at Tufts Medical Center in Boston.

In a sort of equal and opposite reaction, New Hampshire Gov. Chris Sununu just signed a bill that says New Hampshire residents can’t be required to be vaccinated against COVID-19 in order to access public facilities, benefits or services. There are some exceptions, including the state psychiatric hospitals and other government hospitals. And jails and prisons can also require vaccinations if COVID-19 is a threat.

In Chicago, Mayor Lori Lightfoot says the city plans to go on with its massive music festival, Lollapalooza, which will draw hundreds of thousands of people. The city even loosened its requirements that attendees present proof of negative COVID-19 tests.

Doctors, nurses and researchers demand all health care workers be vaccinated

57 groups, including the American Medical Association and the American Nurses Association, issued a joint statement calling for mandatory COVID-19 vaccinations for all health care workers.

The statement says, in part:

Unfortunately, many health care and long-term care personnel remain unvaccinated. As we move towards full FDA approval of the currently available vaccines, all health care workers should get vaccinated for their own health, and to protect their colleagues, families, residents of long-term care facilities and patients. This is especially necessary to protect those who are vulnerable, including unvaccinated children and the immunocompromised. Indeed, this is why many health care and long-term care organizations already require vaccinations for influenza, hepatitis B, and pertussis.

We stand with the growing number of experts and institutions that support the requirement for universal vaccination of health workers. While we recognize some workers cannot be vaccinated because of identified medical reasons and should be exempted from a mandate, they constitute a small minority of all workers. Employers should consider any applicable state laws on a case-by-case basis. Existing COVID-19 vaccine mandates have proven effective.

Simultaneously, we recognize the historical mistrust of health care institutions, including among many in our own health care workforce. We must continue to address workers’ concerns, engage with marginalized populations, and work with trusted messengers to improve vaccine acceptance.

The signatories include:

• Academy of Managed Care Pharmacy (AMCP)
• American Academy of Ambulatory Care Nursing (AAACN)
• American Academy of Child and Adolescent Psychiatry (AACAP)
• American Academy of Family Physicians (AAFP)
• American Academy of Nursing (AAN)
• American Academy of Ophthalmology (AAO)
• American Academy of PAs (AAPA)
• American Academy of Pediatrics (AAP)
• American Association of Allergy, Asthma & Immunology (AAAAI)
• American Association of Clinical Endocrinology (AACE)
• American Association of Colleges of Pharmacy (AACP)
• American Association of Neuroscience Nurses (AANN)
• American College of Clinical Pharmacy (ACCP)
• American College of Physicians (ACP)
• American College of Preventive Medicine (ACPM)
• American College of Surgeons (ACS)
• American Epilepsy Society (AES)
• American Medical Association (AMA)
• American Nursing Association (ANA)
• American Pharmacists Association (APhA)
• American Psychiatric Association (APA)
• American Public Health Association (APHA)
• American Society for Clinical Pathology (ASCP)
• American Society for Radiation Oncology (ASTRO)
• American Society of Health-System Pharmacists (ASHP)
• American Society of Hematology (ASH)
• American Society of Nephrology (ASN)
• American Thoracic Society (ATS)
• Association for Clinical Oncology (ASCO)
• Association of Academic Health Centers (AAHC)
• Association of American Medical Colleges (AAMC)
• Association of Rehabilitation Nurses (ARN)
• Council of Medical Specialty Societies (CMSS)
• HIV Medicine Association Infectious Diseases Society of America (IDSA)
• LeadingAge National Association of Indian Nurses of America (NAINA)
• National Association of Pediatric Nurse Practitioners (NAPNAP)
• National Council of State Boards of Nursing (NCSBN)
• National Hispanic Medical Association (NHMA)
• National League for Nursing (NLN)
• National Medical Association (NMA)
• National Pharmaceutical Association (NPhA)
• Nurses Who Vaccinate (NWV)
• Organization for Associate Degree Nursing (OADN)
• Pediatric Infectious Diseases Society (PIDS)
• Philippine Nurses Association of America, Inc (PNAA)
• Society of Gynecologic Oncology (SGO)
• Society for Healthcare Epidemiology of America (SHEA)
• Society of Hospital Medicine (SHM)
• Society of Interventional Radiology (SIR)
• Texas Nurses Association (TNA)
• The John A. Hartford Foundation Transcultural Nursing Society (TCNS)
• Virgin Islands State Nurses Association (VISNA)
• Wound, Ostomy, and Continence Nurses Society (WOCN)

No vaccination, no bars

European countries are flat-out telling unvaccinated people that they soon will not be able to enter bars or restaurants. In the U.S., Dr. Jonathan Reiner, professor of medicine and surgery at George Washington University, kept it concise, “What I would say bluntly is: If you are not vaccinated right now in the United States, you should not go into a bar, you should probably not eat at a restaurant. You are at great risk of becoming infected.”

At our current rate of vaccination, it will take another eight months to cover 75% of the U.S. population.

The latest data shows cases increasing in every state, and stubborn southern states are the worst.

As you look at those charts, you can see that Florida and Arkansas are part of a grim COVID-19 fraternity. All counties in both states have earned the Centers for Disease Control and Prevention’s label of having “high” levels of COVID-19. Johns Hopkins data shows in the last week, Florida averaged 10,452 new cases a week, which is triple the rate of two weeks ago. Triple in two weeks.

Missouri, Louisiana, Mississippi and Alabama have the same “high” listing in almost every county.

In fact, 46% of all counties in America are listed today as “high” rates. Look at the chart.

To earn a “high” rate, a county must have 100 or more cases of COVID-19 per 100,000 residents, or a test positivity rate of 10% or higher in the past seven days.

The pandemic accelerated the decline of friendship

The pandemic may have heightened interest in friendship, but the newest polling from the 2021 American Perspectives Survey shows that “Americans report having fewer close friendships than they once did, talking to their friends less often, and relying less on their friends for personal support.”

The pandemic didn’t cause this trend but it did seem to accelerate it.

Another factor for why we do not have as many close friends is our increased mobility. We lose touch with others as we move from place to place. The survey also found, “American parents are spending twice as much time with their children compared to previous generations, crowding out other types of relationships, including friendships. And Americans are working longer hours and traveling more for work, which may come at the cost of maintaining and developing friendships.

Look at the next chart for a clearer look at the long-term trend. One in 10 Americans say they have no close friend other than a relative. One in three Americans has two or fewer friends. Thirty years ago, a third of Americans said they had 10 or more close friends. Now only 13% can say that.

Considering these numbers, you might think we are unhappy about losing all of our close friendships, but not really. More than half of women say they are fine with the number of friends that they stay in touch with. And two-thirds of Americans say they have a childhood friend they stay in touch with.

The report says, “Childhood friendships are particularly prevalent among Black Americans. Nearly eight in 10 (78 percent) Black Americans report having a friend whom they have known since childhood. These types of friendships are significantly less common among White (66 percent) and Hispanic Americans (64 percent).”

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