Some New York hospitals curtail service as vaccine mandate triggers staff crunch

By Maria Caspani and Nathan Layne

NEW YORK (Reuters) -New York hospitals were preparing to fire thousands of healthcare workers for not complying with a COVID-19 vaccine mandate taking effect on Monday, with some in the upstate region curtailing services to cope with staffing shortfalls.

The Erie County Medical Center (ECMC) in Buffalo has suspended elective inpatient surgeries and will not accept intensive-care patients from other hospitals as it prepares to fire about 300 unvaccinated employees, a spokesperson said.

Catholic Health, one of the largest healthcare providers in Western New York, had said it would postpone some elective surgeries on Monday as it works to boost its vaccination rate, which reached 90% of workers as of Sunday afternoon.

Peter Cutler, a spokesman for ECMC, said the decision to curtail some operations would put a big dent in the hospital’s revenue, as elective inpatient surgeries bring in about $1 million per week, in addition to inconveniencing patients.

“Financially, it’s a big deal,” Cutler said.

New York’s state health department issued an order last month mandating that all healthcare workers receive at least their first COVID-19 shot by Sept. 27, triggering a rush by hospitals to inoculate as many employees as possible.

New York Governor Kathy Hochul said on Saturday she was considering bringing in National Guard and out-of-state medical workers to fill likely staffing shortages, with 16% of the state’s 450,000 hospital staff, or roughly 72,000 workers, not fully vaccinated.

The inoculation push comes amid a broader battle between state and federal government leaders seeking to use vaccine mandates to help counter the highly infectious Delta variant of the coronavirus and workers who are against such requirements, many claiming religious grounds for their objections.

The Delta variant drove a surge in COVID-19 cases and hospitalizations in the United States that peaked in early September and has since fallen, according to a Reuters tally. Deaths, a lagging indicator, continue to rise with about 2,000 lives lost on average a day for the past week.

NYC HOSPITALS ‘FULLY FUNCTIONAL’

New York City Mayor Bill de Blasio told a news conference on Monday that hospitals in the city were not seeing major impacts from the mandate, but that he was worried about other areas of the state, where vaccination rates are lower.

Of the 43,000 employees at the city’s 11 public hospitals, about 5,000 were not vaccinated, Dr. Mitchell Katz, head of NYC Health + Hospitals, said at the news conference. Katz said 95% of nurses were vaccinated and all of the group’s facilities were “open and fully functional.”

It was not immediately clear how pending legal cases concerning religious exemptions would apply to the state’s plans and what recourse might be available to fired employees. A federal judge in Albany temporarily ordered New York state officials to allow religious exemptions for the state-imposed vaccine mandate on healthcare workers.

At St. Peter’s Health Partners in the Albany region, about 400 employees are at risk of losing their job for failing to show proof of vaccination or intent to be inoculated, said Dr. Thea Dalfino, chief medical officer for SPHP Acute Care.

She warned that some services including elective surgeries may need to be halted due to staffing issues at their hospitals. The unvaccinated workers will be suspended without pay and given until Oct. 8 to comply or be fired, a spokesperson said.

Others have made greater progress with their vaccination drives.

New York-Presbyterian, the largest private network of hospitals in New York City, gave its employees until Sept. 22 to get a shot. Only 250 out of 48,000 total employees chose not to be vaccinated and were terminated, a spokesperson said.

Rochester Regional Health, which oversees a network of nine hospitals in upstate New York, said on Monday that nearly 99% of its employees had either received one dose or had been granted an exemption.

The mandate has also thrown up new staffing challenges for nursing homes and other long-term care facilities, many of which had struggled to retain workers even prior to the pandemic.

Stephen Hanse, who heads a statewide long-term care association, said he supports the vaccine mandate but worries it could exacerbate such staffing problems, hindering the capacity for nursing homes to accept hospital patients upon discharge.

(Reporting by Nathan Layne in Wilton, Connecticut and Maria Caspani in New York; Editing by Bill Berkrot)

France suspends 3,000 health staff as Europe targets vaccine refusal

By Matthieu Protard and Ingrid Melander

PARIS (Reuters) -Hospitals, care homes and health centers have suspended around 3,000 workers across France for failing to comply with mandatory COVID vaccination, the government said on Thursday, as countries around Europe weigh how far to go to combat the pandemic.

While Italy is set to announce later on Thursday that proof of vaccination or a negative test will be compulsory for all workers, going further than any other country in the region, the Netherlands plans a similar step – but only to go to bars or clubs.

Britain, meanwhile, says it is highly likely to require front-line health and social care workers in England to be vaccinated as part of a plan to contain the virus during winter.

In France, President Emmanuel Macron’s decision in mid-July to require a similar health pass to go anywhere from restaurants to gyms and museums, and make the jab mandatory for health workers, has massively increased vaccination take-up.

With the mandate for workers in hospitals and care homes taking effect on Wednesday, its very concrete impact – unvaccinated staff forbidden to work – started to be felt.

According to local daily Nice Matin, nearly 450 health workers – out of 7,500 – have been suspended in just one hospital in the city of Nice, in southern France.

The government, however, shrugged off the impact.

“It hasn’t been chaos, far from it,” Health Minister Olivier Veran told French RTL radio, adding there were 27 million workers in the sector.

There have been a few cases where it has affected care, he said, like the use of an MRI being briefly complicated, but most suspended staff work in support roles, limiting the impact.

“Most of the suspensions are only temporary … many have decided to get vaccinated as they see that the vaccination mandate is a reality,” Veran said.

But unions warn of likely disruptions to care, and just a few absentees in a team is enough to trigger a crisis, Emmanuel Chignon, a care home manager in Bordeaux told Reuters this week, pointing to how hard it was to hire staff in the sector.

“If we can’t replace the carers who leave, the work will fall on the others, and I fear an unvirtuous circle, with tiredness, exhaustion and an increase in absenteeism,” he said.

MANDATORY

In Italy, where vaccination for health workers was made mandatory at the end of March, some have been suspended, but with numbers nowhere near those seen in France.

As of Sept. 16, some 728 doctors in all of Italy had been suspended for failing to be vaccinated, the Italian doctors’ federation said.

Italy is now set to go much further and announce on Thursday that a “Green pass” – showing someone has received at least one vaccine dose, tested negative or recently recovered from the virus – will be mandatory for all public and private sector workers. Failure to have a Green Pass will result in workers being suspended and losing their pay.

In other countries, like the Netherlands, opinion polls show a majority of the public favoring mandatory vaccination for health workers, with the workers themselves mostly opposed to it, and the government has said it will not take such measures.

However a pass showing proof of vaccination or a recent negative coronavirus test is set to be required there as of Sept 25 to go to bars, restaurants, clubs or cultural events.

Although polls have shown that a majority of the Dutch support the measure, the pass is strongly opposed by the around 30% of the population who have so far refused to be vaccinated. Critics say the measure is meant to force people to get the jab.

(Reporting by Blandine Henault, Matthieu Protard and Ingrid Melander in Paris, Crispian Balmer and Francesco Zecchini in Rome, Bart Mejier in Amsterdam; Writing by Ingrid Melander; Editing by Alex Richardson, William Maclean)

Overwhelmed Philippines hospitals hit by staff resignations

By Neil Jerome Morales and Karen Lema

MANILA (Reuters) -Exhausted by the COVID-19 workload, Loui quit her job as an intensive care unit nurse at a private hospital in the Philippines earlier this year.

The 30-year-old, who declined to give her last name for fear of reprisals, is among thousands of medical workers who have resigned during the pandemic, complaining of low pay and poor working conditions. Others have sought better jobs abroad.

“We can’t even take a proper day off because we are often called back to cover for other staff who were in quarantine or resigned,” said Loui, who was earning 20,000 pesos ($394) a month, including overtime, before she quit in March.

Hospitals fear the desertions have reached a critical point just as the Delta variant sends the number of cases soaring, as it has done elsewhere in Southeast Asia and worldwide.

The Private Hospitals Association of the Philippines (PHAPi)estimated that 40% of private hospital nurses resigned last year, but more followed new waves of infections this year. Public hospitals are facing similar challenges.

“If we want to increase bed capacity, that is easy, but the problem is the nursing component,” PHAPi’s president, Jose Rene de Grano, told Reuters.

More than a year and a half into the pandemic, reported coronavirus infections in the Philippines have soared to more than 1.75 million, the second highest in Southeast Asia, while deaths have exceeded 30,000.

‘DEMORALIZED’

Philippine Nurses Association President Melbert Reyes said he feared that hospitals could see even more nurses quit if their demands for better benefits and conditions went unmet.

“A lot of our nurses are demoralized,” Reyes told Reuters.

Union leaders in several hospitals in virus hot spots last week threatened to strike, while a nursing group warned that dozens could resign over unpaid allowance and benefits.

The state auditor last week flagged “deficiencies” involving 67.3 billion pesos, casting doubts on the regularity of related transactions in the health ministry’s pandemic response.

“But to the issue of whether the money has been stolen, that is pure bullshit,” Philippines President Rodrigo Duterte said in a weekly national address late on Monday.

The lure of better paying jobs abroad is also making it harder to fill nursing vacancies, said Donnel John Siason, president of the union at the University of Santo Tomas hospital.

This year nearly 7,000 nurses have moved abroad, including to the United States and Britain, joining hundreds of thousands of other Filipino nurses already working abroad.

Dave Santos, a 39-year old nurse at the Quezon City General Hospital, said he hoped to leave the Philippines too.

“We are giving our best,” said Santos, a father of three. “But we are just people who get tired and we have needs.”

($1 = 50.7150 Philippine pesos)

(Reporting by Karen Lema; Editing by Matthew Tostevin, Gareth Jones and Jonathan Oatis)

Over 71% of Lebanon’s population risks losing access to safe water – UNICEF

BEIRUT (Reuters) – The United Nations warned on Friday that more than four million people in Lebanon, including one million refugees risked losing access to safe water as shortages of funding, fuel and supplies affect water pumping.

“UNICEF estimates that most water pumping will gradually cease across the country in the next four to six weeks,” a statement by the U.N. body said.

Lebanon is battling an economic meltdown that has propelled more than half of its population into poverty and seen its currency lose over 90% of its value in less than two years.

The financial crisis has translated into severe shortages of basic goods such as fuel and medicine as dollars run dry.

UNICEF said that should the public water supply system collapse, water costs could jump by 200% a month as water would be secured from private water suppliers.

The U.N. agency said it needed $40 million a year to secure the minimum levels of fuel, chlorine, spare parts and maintenance required to keep critical systems operational.

“Unless urgent action is taken, hospitals, schools and essential public facilities will be unable to function,” UNICEF Representative in Lebanon, Yukie Mokuo, was quoted as saying in the statement.

(Reporting By Maha El Dahan; editing by Grant McCool)

Fully vaccinated people can shed masks in most places and travel -U.S. CDC

By David Shepardson

WASHINGTON (Reuters) -The U.S. Centers for Disease Control and Prevention (CDC) on Thursday advised that fully vaccinated people do not need to wear masks outdoors and can avoid wearing them indoors in most places, updated guidance the agency said will allow life to begin to return to normal.

The CDC also said fully vaccinated people will not need to physically distance in most places. The agency also hopes the guidance will prod more Americans to get vaccinated.

President Joe Biden emerged at the White House for remarks without a mask. “I think it’s a great milestone, a great day,” he said.

“If you’re fully vaccinated and can take your mask off, you’ve earned the right to do something that Americans are known for all around the world: greeting others with a smile,” he said, flashing a brief smile himself.

CDC Director Rochelle Walensky said the new guidance just two weeks after its most recent update, was based on a sharp reduction in cases, expansion of vaccines to younger people and vaccine efficacy against coronavirus variants.

“We followed the science here,” Walensky said adding, “a coalescence of more science that has emerged just in the last week.”

Biden earlier shed his mask during a meeting with lawmakers, Republican Senator Shelly Moore Capito told reporters. “We heard all about it. The president took his off too,” she said.

Some journalists at the White House also shed their masks.

The CDC had faced criticism, even from public health officials, that it has been too cautious in its guidance. Critics have said people need to see more benefit of getting vaccinated in terms of returning to normal activities.

“In the past couple of weeks, we have seen additional data to show these vaccines work in the real world, they stand up to the variants, and vaccinated people are less likely to transmit the virus,” the agency said in a news release.

It added, “We needed to take the time to review the full body of evidence to get this right, and that’s how we came to this decision.”

‘NEED A REWARD’

Dr. William Schaffner, an infectious disease doctor at Vanderbilt University Medical Center, said he supports the new guidance that many had been calling for.

“People in state health departments and infectious disease doctors have been saying this for some time because they’re so impressed with the effectiveness of the vaccine, and also, they have the feeling that people who are vaccinated need a reward,” he said.

Republican Senator Susan Collins had been critical of the CDC’s delay in revising the guidance.

“Today’s announcement on masks, while overdue, is certainly a step in the right direction,” she said in a statement. “If people find they cannot do anything differently after a vaccine, they will not see the benefit in getting vaccinated.”

The revised guidance is a major step toward returning to pre-pandemic life, but the agency still recommends vaccinated people wear masks on planes and trains, and at airports, transit hubs, mass transit and in places like hospitals and doctor’s offices.

The U.S. government last month extended mask requirements across transportation networks through Sept. 13. Walensky said the CDC plans to soon issued updated guidance for transit.

The new guidance says vaccinated Americans can resume all travel, do not need to quarantine after international trips and do not need to be tested for COVID-19 if exposed to someone who is COVID-19 positive but asymptomatic.

However, Americans still face some international travel restrictions, including non-essential trips to Canada.

Masks became a political issues in the United States with then-President Donald Trump resisting mandating masks while President Joe Biden embraced masks and mandated them for transit hubs. Some U.S. states issued aggressive mask mandates while others declined or dropped them months ago.

The CDC said fully vaccinated people should still wear masks where required by federal, state, local, tribal or territorial laws, and abide by such rules and regulations, including from local businesses and workplace guidance.

In late April, the CDC said fully vaccinated people can safely engage in outdoor activities like walking and hiking without wearing masks, but recommended continuing to use face-coverings in public spaces where they are required.

Walensky said on Thursday immune-compromised individuals should consult doctors before shedding masks and emphasized people who have not been vaccinated should continue to wear them. She added vaccinated people who have COVID-19 symptoms should put masks back on.

(Reporting by David Shepardson; Additional reporting by Steve Holland in Washington and Julie Steenhuysen in Chicago; Editing by Franklin Paul and Bill Berkrot)

Polish hospitals under strain as coronavirus cases hit 2021 record

WARSAW (Reuters) – Poland reported a record number of new coronavirus cases on Wednesday just shy of 30,000, as the pandemic cripples hospitals in some parts of the country and the government mulls sending patients to different regions to help cope.

Poland has been hit very hard by a third wave of cases and a highly contagious variant of the virus first discovered in Britain. The regions of Silesia in the south and Mazowiecki, where the capital Warsaw is located, in particular have struggled.

The government has faced criticism for failing to support the healthcare system as cases rise, while it has called on the public to observe current restrictions more closely.

“Poland’s eyes are focused on Silesia,” Health Minister Adam Niedzielski said on Wednesday, adding that the government was considering moving patients from the south to the east, where more beds are available.

In Silesia, Tuesday data showed that of 305 available respirators, 257 were occupied, while 2,894 of 3,723 hospital beds were occupied.

Doctors said the whole country’s healthcare system was struggling, however.

“We are lacking beds everywhere, let’s not fool ourselves. This is an all-Poland situation,” immunologist Pawel Grzesiowski told Reuters.

On Wednesday the number of occupied beds rose to 26,511 from 26,075, while occupied ventilators rose edged up to 2,537. The ministry said it has 35,444 hospital beds available for COVID-19 patients and 3,366 ventilators.

Poland reported 29,978 new infections on Wednesday and 575 daily coronavirus-related deaths, a record in 2021.

The country has reported 2.12 million confirmed cases overall and 50,340 deaths.

The government ordered theatres, shopping malls, hotels and cinemas to close last week as cases rose.

More restrictions loom ahead of the Easter holidays, typically marked by packed church services and family gatherings in the deeply Catholic country.

“We have to suffocate the third wave. That’s why we will announce new restrictions…that will be enforced during the week before and the week after the (Easter) holidays,” Prime Minister Mateusz Morawiecki told a news conference on Wednesday.

Those restrictions are expected to be announced on Thursday.

(Reporting by Agnieszka Barteczko, Joanna Plucinska, Alicja Ptak and Pawel Florkiewicz; Editing by Andrew Heavens and Hugh Lawson)

France reports 4,246 COVID-19 patients in intensive care, new 2021 high

PARIS (Reuters) – The number of people in intensive care units in French hospitals with COVID-19 rose by 27 to 4,246, the highest so far this year, the health ministry reported on Thursday.

The number of new positive cases also remained on a steadily increasing trend, up by 34,998 to 4.18 million in the second-biggest increase in absolute numbers this year, following an increase of 38,501 on Wednesday.

Compared with last Thursday, the case count was up by 4.8%, the 10th consecutive increase week-on-week, but remained well below week-on-week increases in the range of 20 to 30% ahead of a second lockdown in November.

The virus’s cumulative death toll rose by another 268 to 91,679, ministry data showed.

The government will detail further confinement measures at a news conference at 1800 GMT.

(Reporting by GV De Clercq; Editing by Benoit Van Overstraeten and Alex Richardson)

Portugal’s daily COVID deaths hit record high as hospitals struggle

By Catarina Demony and Miguel Pereira

LISBON (Reuters) – Portugal, initially praised for its swift response to the coronavirus pandemic, recorded a record number of COVID-19 related deaths on Monday as its hospitals struggled to cope.

The Portuguese government, facing concerns over low compliance with lockdown measures brought in last week, also introduced further rules to try to curb the spread of the coronavirus among its population of 10 million people.

Portugal posted 167 COVID-19 related deaths over the last 24 hours, bringing the total to 9,028 since the pandemic began.

“After so many cases, and so many deaths, nobody can … think COVID-19 only happens to others,” Portugal’s Prime Minister Antonio Costa told reporters.

Under the new rules, those not able to work remotely will have to carry an employer declaration and people will not be allowed to travel between municipalities over the weekend.

“You see a lot of people not following (the rules) during this new lockdown,” Anabela Ribeiro, 55, said as she left a busy train station in the heart of the capital Lisbon.

“Stricter measures are needed,” Ribeiro added.

Hospitals are struggling to cope with the soaring number of infections, with Portugal now the country with the highest rolling average of new cases over the last seven days per million inhabitants, ourworldindata.org said.

Portugal also reported a record 664 coronavirus patients in intensive care, just below the 672 maximum allocation of ICU beds out of a total of just over 1,000, health authorities said.

With 6,702 new cases the cumulative tally of infections in the country has now reached 556,503.

“The impact is huge because the number of beds doesn’t increase, the walls are not expandable and health workers are not multiplying,” Antonio Pais de Lacerda, a doctor at Lisbon’s biggest hospital, Santa Maria, said.

Portugal has already nearly doubled the number of ICU beds since the start of the pandemic, when it had just 528 critical care beds and Europe’s lowest ratio per 100,000 inhabitants.

(Reporting by Catarina Demony and Miguel Pereira; Additional reporting by Victoria Waldersee and Patricia Vicente Rua; Editing by Andrei Khalip, Timothy Heritage and Alexander Smith)

No work without COVID test in central Slovakia as hospitals overflow worst-hit region

PRAGUE (Reuters) – Slovaks in the country’s central Nitra region would not be allowed to work unless they have tested negative for the coronavirus as the area’s main hospital was inundated with COVID patients and deaths were high, officials said on Tuesday.

The central European country of 5.5 million has seen record numbers of new cases and hospitalizations in the past days, with 3,146 people in hospitals as of Monday, despite a partial national lockdown.

People from the Nitra region of about 160,000 would not be allowed to attend work as of Monday without a negative test, Prime Minister Igor Matovic told a televised news conference from the central Slovak city.

“The situation in Nitra is so dramatic that only voluntary testing would not be enough,” Matovic said. “This is a better way to protect workers, companies, the health of the people.”

Slovakia has limited movement of people to necessary work commutes, shopping and nature walks within their district, but new cases have remained high, with around 10,000 found on Monday through PCR and antigen testing.

Jaguar Land Rover is the biggest employer in the Nitra region with around 2,800 workers.

Milan Dubaj, head of the Nitra University Hospital, said more than 10 people were dying in his COVID-19 ward every day, and called the situation “desperate”.

“We have around 200 patients, including up to 20 on ventilators, and over 10 die daily,” he told the news conference.

“I am at loss how to describe the psychological and physical exhaustion of our staff … In recent days, our urologist died, a COVID urgent care worker died and at 2 p.m. today, an internist died,” he said.

Slovakia has so far recorded around 2,600 deaths caused by COIVD-19, and over 600 more classified as “with COVID”.

(Reporting by Jan Lopatka; Editing by Steve Orlofsky)

New York, Florida tell hospitals to speed COVID-19 vaccinations or lose supply

By Carl O’Donnell and Jonathan Allen

NEW YORK (Reuters) – The governors of New York and Florida sought to accelerate the slower-than-expected rollout of coronavirus vaccines by warning hospitals on Monday that they would reduce future allocations to those that fail to dispense shots quickly enough.

In New York, hospitals must administer vaccines within a week of receiving them or face a fine and loss of future supplies, Governor Andrew Cuomo said.

“I don’t want the vaccine in a fridge or a freezer, I want it in somebody’s arm,” the governor said. “If you’re not performing this function, it does raise questions about the operating efficiency of the hospital.”

The U.S. federal government has distributed more than 15 million vaccine doses to states and territories around the country, but only around 4.5 million have been administered so far, according to data from the U.S. Centers for Disease Control and Prevention (CDC) released on Monday.

The U.S. government has fallen far short of its target of vaccinating 20 million people by the end of 2020. Officials said they expect the rollout will pick up significantly this month.

Surgeon General Jerome Adams told CBS News that there are 15 million to 20 million doses of vaccine available.

“We should be hopeful about that while acknowledging we have got to do better and we are going to keep doing better,” Adams said. “And I promise you, you will see in these next two weeks numbers increase substantially.”

The United States had reported a total of 20.5 million COVID-19 cases and 351,480 deaths as of midnight on Sunday. On a seven-day rolling average, it is reporting 210,190 cases and 2,636 coronavirus deaths per day.

In Florida, where officials have put senior citizens ahead of many essential workers for getting the vaccine, Governor Ron DeSantis announced a policy under which the state would allocate doses to hospitals that dispense them most quickly,

“Hospitals that do not do a good job of getting the vaccine out will have their allocations transferred to hospitals that are doing a good job at getting the vaccine out,” DeSantis said at a briefing.

“We do not want vaccine to just be idle at some hospital system,” he added, though he did not say they would face fines.

Florida will also deploy an additional 1,000 nurses to administer vaccines and will keep state-run vaccination sites open seven days a week, he said.

New York has dispensed about 175,000 doses of the 896,000 it has received since mid-December, according to CDC data. Florida has dispensed 265,000 of the 1.14 million doses it received.

In New York City, Mayor Bill de Blasio said obstacles were slowing his goal to have 1 million residents receive a first of two vaccine doses by the end of January. A little over 110,000 residents have received their first dose so far, according to city data.

De Blasio urged the state to broaden early eligible groups beyond healthcare workers and nursing home residents to include essential workers such as teachers, police officers, fire fighters, grocery store personnel and people who are more than 75 years old.

New York City currently has 125 vaccination sites and plans to double that by the end of the month, the mayor said.

“This has got to be a seven-day-a-week, 24-hour reality going forward,” de Blasio said.

Monday also marked the first day when some Americans were due to receive their second vaccine shot, three weeks after getting the first dose. Among them was Maritza Beniquez, a healthcare worker in Newark, New Jersey.

“I now have body armor,” she said after receiving the dose in a video posted on Facebook by New Jersey Governor Phil Murphy, who was part of a small gathering that witnessed the event.

(Reporting by Jonathan Allen, Carl O’Donnell, Rebecca Spaulding and Peter Szekely in New York; Additional reporting by Barbara Goldberg, Anurag Maan, Doina Chiacu and Susan Heavey; Editing by Bill Berkrot)