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Houston Methodist Hospital’s action occurs as the spreading of the COVID-19 Delta variant catches the eye of health care officials in the United States.
Even before the approval of the first COVID-19 vaccine in the United States, the issue of whether hospitals could legally mandate that employees get vaccinated loomed. Most medical experts who spoke to Infection Control Today® (ICT®) about this said that the fact that the COVID-19 vaccines had been granted under emergency use authorization (EUA) by the Food and Drug Administration would likely prevent hospitals from being able to mandate COVID-19 vaccinations for employees. Infection preventionists (IPs) would have to use their powers of persuasion to convince their fellow health care professionals to get the COVID-19 vaccine.
This issue might surface, said experts, but not for a long while. Well, it surfaced in a big way yesterday when Houston Methodist Hospital suspended 178 employees without pay for 14 days for refusing to get vaccinated, as Axios reports this morning. Marc Boom, MD, the hospital’s CEO, reportedly sent a message to staff saying that “I know that today may be difficult for some who are sad about losing a colleague who’s decided to not get vaccinated. We only wish them well and thank them for their past service to our community, and we must respect the decision they made.”
The hospital is being sued by 117 of the suspended employees, some of whom rallied outside the facility on Monday, according to the Washington Post.
The standoff between the hospital’s employees and administrators occurs at a time when another concern darkens the mostly positive news about health care’s battle against COVID-19 leading the reemergence of normal times in the United States. At a press conference yesterday, Rochelle Walensky, MD, the director of the Centers for Disease Control and Prevention (CDC) listed some of those highlights:
“This is great news but there is more work to be done,” Walensky said.
That work involves stemming the rise of the Delta variant—B.1.617.2—in the United States. As Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board wrote on Monday: “Over three weeks, the percentage of genomic testing which was comprised of the Indian Double Mutation Variant, or Delta Variant, jumped from 1% to 7% in the U.S. The data was derived from Outbreak.info, a website operated by Scripps Research and funded by the NIC, the Centers for Disease Control and Prevention (CDC) and National Center for Data for Health.”
NPR yesterday also sounded the alarm over the Delta variant, reporting that the variant now accounts for “more than 6% of all infections in the United States, according to the CDC. And this highly transmissible variant may be responsible for more than 18% of cases in some Western states.”
At yesterday’s White House press conference, Walensky introduced Anthony Fauci, the National Institute of Allergy and Infectious Diseases, who wasted no time expressing his concern about the Delta variant. He pointed to the United Kingdom, where the Delta variant spread so quickly that it’s now the dominant strain, causing more than 60% of infections in the U.K.
Fauci added that the newer variant underscores even more the need to get as many people vaccinated as possible. Fauci said that while the COVID-19 vaccines are effective against variants such as the 617 and the B1.1.7., they don’t seem to be as effective against B.1.617.2. Fauci cited data from Public Health England, saying that “two weeks after the second dose of the mRNA Pfizer-BioNTech, it was 88% effective against the 617 and just like we’ve shown multiple times, over 93% effective against the B1.1.7….. Three weeks after one dose, both vaccines, the AZ and the Pfizer-BioNTech were only 33% effective against symptomatic disease from Delta. Clearly important about why a second dose is so important…. We want to get to and above the goal of 70% of the adult population receiving at least one dose by the 4th of July.”
This also may possibly explain why Houston United Methodist administrators suspended employees who refused to get vaccinated. In a press release issued in February, Houston United Methodist underscored just how closely it tracks COVID-19 variants and how those variants might plunge the country into another surge.
“Identifying and tracking the emerging variants in this way is becoming critical, because we’re now in a potentially dangerous phase where the virus is mutating in ways that may help it to survive,” the press release states. “These variants are coming about as the virus tries to find strategies to evade our immune systems, which are now in the process of being primed to fight the virus as humans gain immunity through vaccinations or natural infections.” The hospital uncovered 28 cases of coronavirus variants in its latest batches of virus genomes sequenced from patients.
A study in March by investigators with Houston United Methodist states: “Since the beginning of the SARS-CoV-2 pandemic, there has been international concern about the emergence of virus variants with mutations that increase transmissibility, enhance escape from the human immune response, or otherwise alter biologically important phenotypes…. Based on our extensive genome sequencing program involving 20,453 virus specimens from COVID-19 patients dating from March 2020, we report identification of all important SARS-CoV-2 variants among Houston Methodist Hospital patients residing in the greater metropolitan area.”
Contacted this morning by ICT®, Kavanagh expressed concern with how the CDC’s going about informing the public about the COVID-19 variants. “The CDC's government webpage on variants still lags behind the CDC/NIH funded Scripps research site of outbreak.info,” Kavanagh said. “Even today the Delta Variant was not included in the CDC Website Table Listing Variants of Concern and state specific data on this variant is absent. The latest data which you can obtain by a mouse over on the bar graph lists the prevalence of the Delta Variant as 2.5%. This is much less than the data in the NPR story of over 6% and less than the outbreak.info listing of 19%”
There’s little doubt as to which side of the Houston Methodist Hospital debate Kavanagh comes down on. The headline for an article published on the ICT® website on April 22 sums it up: “Viewpoint: Health Care Professionals—Get Vaccinated or Get Out.” In it, Kavanagh wrote that “if you work in a health care facility, you need to be vaccinated against SARS-CoV-2. If you choose not to become vaccinated, then you should choose not to be working in a health care setting.”