A hospital in Lewiston, Maine has closed its neonatal intensive care unit and has plans to reduce ICU beds by 50 percent as well as medical surgical beds by 40 percent. This isn’t because the hospital is overrun with COVID-19 patients but because, at the end of this month, unvaccinated hospital staff will be terminated.
The result will be restricted access to care and longer wait times. In a word: rationing.
The term “rationing” seems like something that only happens during times of war. But in reality, medical resources are often rationed when demand outpaces supply. Policymakers would be wise to consider how to offer the greatest supply of healthcare services to the greatest number of patients, even if that means offering flexibility around mandates to get the COVID-19 vaccine.
Since the early months of the pandemic, we have seen rationing of health care — from a lack of doctor-patient telemedicine infrastructure to other medical services (tests, procedures, and surgeries) delayed or rescheduled because they were deemed “elective” or “nonurgent.”
These policies, which often led to further patient suffering and worse conditions, were utilized again with the rise of the Delta Variant in summer 2021. COVID-19 lockdowns and restrictions also led to delays in diagnosis, treatment, and worse outcomes for cancer patients.
“Rationing” is continuing, and the latest development relates to the COVID-19 vaccine.
After the vaccine was fully approved in August 2021 by the Food and Drug Administration, many medical organizations (including the American Medical Association and 60 others), states, and hospitals have started to require the vaccine for personnel.
As the Kaiser Family Foundation (KFF) recently reported, 39% of all hospitals in the U.S. are mandating that their employees get the COVID-19 vaccine. This summer alone, the Houston Methodist Hospital fired or accepted the resignation of over 150 healthcare staff who did not want to get the vaccine.
Dozens of hospital systems are losing staff due to vaccine mandates. Some polls indicate that as many as 50% of unvaccinated healthcare workers would quit or look for a new job rather than comply with the vaccination requirement.
What is the result? Healthcare staff shortages and ultimately more rationing of care.
For a long time, our nation has experienced medical staffing shortages, from doctors to home health aides to nurse practitioners. With the rise of COVID-19 in fall 2020, the situation worsened: hospitals in 25 states reported a lack of nurses, doctors, and other staff. Additionally, there is an increase in burnout and practitioners going on stress or medical leave.
Vaccine mandates also apply to respiratory techs, nursing assistants, food service employees, billing staff, and other healthcare workers. These professionals are also already in short supply. As one hospital administrator put it, “You may have the finest neurosurgeon, but if you don’t have a registration person everything stops… We’re all interdependent on each other.”
Regardless of one’s perspective on the COVID-19 vaccine, it’s clear that vaccination requirements are exacerbating healthcare shortages.
Some states like New York, which may lose thousands of healthcare workers over its vaccine mandate (including 1,400 recently fired from the state’s largest healthcare provider), are looking into using the National Guard for staffing shortages. However, some regional health care systems don’t qualify for National Guard staffing assistance. Reliance on outside assistance from other burdened states or countries or enlisting the National Guard is not a silver bullet.
Instead, there needs to be robust flexibility.
One potential area for compromise is testing. With widespread COVID-19 testing available and in convenient ways, this should be leveraged for flexibility for our healthcare professionals. For example, Oregon allows for weekly testing for the unvaccinated.
Furthermore, we are learning more about natural immunity.
Over 15 studies demonstrate the power of immunity by previously having the virus. A recent Cleveland Clinic Study deduced that, of those studied, front-line healthcare staff who got the virus did not get reinfected. Additionally, the study’s researchers concluded “individuals who have had SARS-CoV-2 infection are unlikely to benefit from COVID-19 vaccination.”
Healthcare systems and nursing homes that develop flexibility for workers with previous COVID-19 infections will have a competitive advantage.
Due to demographics and other factors, America was facing a healthcare shortage even before the COVID-19 pandemic. The pandemic, unfortunately, made things worse. We should now avoid burdening our healthcare system with additional pressure toward rationing.
A potential decline in COVID-19 cases is on the horizon. Until the pandemic is behind us, policymakers and bureaucrats, including in hospital systems, must continue to weigh COVID-19 precautions against other risks. The risks imposed by healthcare rationing are real, to our liberty and to our health.