COVID-19 and the Health Workforce 8/24-09/07

08/24-09/07 Updates

Vaccine Information

Vaccine mandates are being used competitively to recruit staff in urban areas, while a lack of mandates is being used as a strategy to retain health workers in rural and regional areas.

As vaccine mandates become increasingly commonplace, staffing shortages are being exacerbated in certain health professions with lower vaccination uptake.

New research looks at the initial distribution of COVID-19 vaccines among health care workers and common symptoms reported by workers following vaccination.

Vaccine Information

(08/31/21) Lack of a Vaccine Mandate Becomes Competitive Advantage in Hospital Staffing Wars
This article explains that mandating COVID-19 vaccines has become a serious challenge for small, rural hospitals. As workforce shortage has continued since the COVID-19 pandemic, hospitals have oscillated between the risk of COVID-19 and losing their workers due to a vaccine mandate. While urban, bigger hospitals have implemented vaccine mandates and used them as a selling point to recruit staff and patients, this has become a hard choice for other rural, regional hospitals as cases surge again.

(08/31/21) Vaccine Mandate Complicates California’s Nursing Shortage
The COVID-19 pandemic is causing staffing shortages in several California hospitals. The state’s new COVID-19 vaccination requirement for healthcare workers complicates matters. Some visiting nurses refuse to work in California because they fear being vaccinated.

(08/29/21) About 1 in 8 Nurses Hasn’t Gotten a COVID-19 Vaccine or Doesn’t Plan to Get One, a New Survey Finds, Setting Up the Potential for More Staffing Shortages at Hospitals
According to a survey, one out of every eight nurses has not had or plans to get the COVID-19 vaccination. Nearly 5,000 nurses from throughout the United States were polled by the American Nurses Association. Hospitals are debating whether or not to mandate coronavirus vaccination for its employees. In December, healthcare professionals in the United States were eligible for the COVID-19 vaccination, months before the rest of the country. According to the CDC, 52.3 percent of Americans were completely vaccinated at the time of reporting, while 61.6 percent had gotten at least one dose.

(08/27/21) Initial Distribution of COVID-19 Vaccines to Front-line Hospital Workers and Community First Responders—A Prospective Descriptive Study
This article published in Journal of Healthcare Risk Management presents the demographic and side-effects of COVID-19 vaccines among front-line healthcare workers. The results suggest that pains and fatigues are the most common types of side effects resulting in missed time from work among front-line healthcare workers.

(08/24/21) 11 States Banning COVID-19 Vaccine Mandates & How They Affect Healthcare Workers
This article from Becker’s Hospital Review highlights the eleven states that have signed bills in efforts to restrict COVID-19 vaccine mandates. While some states have prohibited COVID-19 vaccination mandates altogether, most states have only restricted employers from mandating vaccination as a condition of employment.

Access to Care

Surge capacity in hospitals continues with COVID-19 hospitalizations reaching record levels in some parts of the United States.

A hospital describes efforts to reach those who traditionally struggle to access care in a digital environment: the elderly and individuals in poverty.

Access to Care

(08/31/21) Delta Cutting ‘Like a Buzzsaw’ Through Oregon-California Border Counties
Kaiser Health News details the issues with surge capacity occurring among the nine counties on the Oregon-California border, with the major hospitals in the area requesting field hospitals to be established in an effort to stem the tide of COVID-19 patients in the intensive care unit beds.

(08/24/21) Oregon, Once a Virus Success Story, Struggles with Surge
This article from the Associated Press covers the ways in which new surges of transmission of the coronavirus delta variant has turned what was seen as an initially successful curbing of the pandemic into a difficult time for the state. Low COVID-19 vaccination uptake in some counties and low supply of hospital beds even pre-pandemic are fueling the struggles.

(08/24/21) Arkansas COVID Patients on Ventilators Reaches New Record
Arkansas is reporting record levels of patients on ventilators as the COVID-19 pandemic continues to ravage the state. Arkansas has among the lowest levels of vaccination for COVID-19 in the United States, and is struggling to meet surge capacity with COVID-19 patients taking up more than half of all ICU beds and few beds remaining open.

(08/24/21) To Boost Covid-19 Vaccine Uptake, One Health System Hunts For Patients Who Fell Through The Cracks
This article published by STAT describes the efforts by a health system in North Carolina to reach patients for vaccination who were most likely to be missed: those without digital accounts and access to the internet. While traditional strategies use community-level data as a substitute for patient-level data and utilize digital services such as electronic health records and email, these strategies can miss those who have difficulty accessing digital records, such as elderly and poorer individuals.

State Workforce Strategies

In an effort to make further progress on vaccination rates among health care workers, New York has removed religious exemptions for vaccinations.

A new issue brief looks at the use of Medicaid Emergency Authorities from various states during the COVID-19 pandemic.

State Workforce Strategies

(08/27/21)New York State Removes Religious Exemption From COVID-19 Vaccine Mandate
This article from Becker’s Hospital Reviewdiscusses New York state’s newly approved emergency regulations for health care workers which will supersede previous requirements. The previous emergency regulations permitted health care workers to receive medical and religious exemptions from the vaccination requirement. However, religious exemption from the vaccination requirement was removed and additional institutions were included in the mandate. Health care workers at hospitals and nursing homes are still expected to receive their first COVID-19 vaccination dose by September 27, 2021, but workers at newly added institutions have until October 7, 2021.

(08/26/21) How Have States Used Medicaid Emergency Authorities During COVID-19 and What Can We Learn?
This brief from the Kaiser Family Foundation summarizes how states have used Medicaid emergency authorities in efforts to address the COVID-19 public health emergency. All 50 states and D.C. were approved to authorize temporary regulatory changes to their Medicaid state plans which impacted providers, beneficiaries, and long-term services and supports. Subsequently, states implemented policy changes to facilitate expanded access to Medicaid coverage, expand benefits for beneficiaries, and increase reimbursement for provider.


As relaxation of laws governing telehealth begin to lapse across the US, issues are arising with providers offering care to patients across state lines.


(8/31/21)Telehealth’s Limits: Battle Over State Lines and Licensing Threatens Patients’ Options
This jointly-published article from Kaiser Health News and Time discusses the repercussions of the coming changes to regulations about medical appointments across state lines through telehealth services. As emergency pandemic-related exemptions expire, many providers are left unable to continue to provide care remotely to patients as they have been able to throughout the pandemic.

Regulatory Flexibility

New executive orders issued in Missouri allow some flexibilities, namely for telehealth among physicians and pharmacists, while the state allows hundreds of previous flexibilities to expire.

Regulatory Flexibility

(08/30/21)Missouri Reduces State of Emergency Guidelines to Focus on Health Care
Missouri Governor, Mike Parson, has issued a new executive order which focuses on continued assistance for the state’s health care system. The previous executive order held more than 600 regulatory waivers, however, the number of waivers were reduced to 163 under the new order. The new executive order includes ongoing waivers allowing an expansion of telemedicine for physicians and pharmacists among other regulatory flexibilities.