ALBANY COUNTY — “It is truly a crisis,” said Dennis McKenna, president and chief executive officer of Albany Medical Center, of a staff shortage — but the crisis predates a vaccination mandate for health-care workers, he said.
McKenna, at a Tuesday morning press conference, thanked Governor Kathy Hochul for issuing an executive order on Monday night that will allow out-of-state and out-of-country nurses and medically trained National Guard members to fill in for needed health-care workers. The order also expands the role of emergency medical technicians and lets retired health-care workers re-enter the workforce.

Hochul declared a 30-day statewide disaster emergency due to health-care staffing shortages anticipated as some workers won’t get vaccinated.

According to a regulation issued by the state’s health department, all health-care workers in New York State, at hospitals and nursing homes, are to have been vaccinated against COVID-19 with the first dose received by Monday, Sept. 27, and staff at other covered entities including home care, hospice, and adult care facilities are to be vaccinated by Oct. 7.

The state’s labor department has said that workers who are terminated because of refusal to be vaccinated are not eligible for unemployment insurance absent a valid doctor-approved request for medical accommodation.

As of Sept. 27, the governor’s office reported, 92 percent of all hospital employees in the state had received at least one dose of vaccine while 85 percent are fully vaccinated. Also as of Sept. 27, eighty-nine percent of staff at all adult-care facilities and 92 percent of all staff at nursing home facilities in New York State had received one dose.

Currently, 98 percent of Albany Med workers are vaccinated, McKenna said on Tuesday.

He said that 204 of the center’s 11,456 workers have not received at least one shot of a COVID-19 vaccine. The clock starts on Friday, he said, for unvaccinated workers who will be suspended without pay for seven days and then let go if they do not get vaccinated.

Additionally, 29 Albany Med workers have religious exemptions and a small number have medical exemptions; they must wear masks and be tested weekly for COVID-19, he said.

Of the 204, which McKenna stressed is a fluid number, 48 are nurses, 29 are patient-care associates, 10 are physicians, and six are students, among other categories.

In early August, Albany Med joined with other area hospitals to sign a consensus statement that COVID-19 vaccination would be mandated for workers.

“COVID-19 is a serious disease that can lead to hospitalization and death ...,” the statement said. “Requiring a COVID-19 vaccine demonstrates our commitment to protect the safety and health of our patients, many of whom already have weakened immune systems, as well as visitors, co-workers, and our own families. Highly transmissible variants of COVID-19 are increasing in the community and causing increased case rates which may affect our patients, visitors, and staff.”

When Albany Med first required workers to be vaccinated against flu, McKenna said, some workers left. “I don’t see the COVID [vaccine requirement] as being different,” he said, noting the flu shot is an annual requirement for hospital workers.

McKenna made the point that the COVID-19 vaccine limits serious illness by going over current figures: 37 patients — 35 adults and two children — are now hospitalized at Albany Med with COVID-19; twenty-five are on the the floor and 12 are in intensive-care units with four of those on ventilators.

All of the patients on ventilators are unvaccinated, he said, and, of the 26 COVID-19 patients admitted last week, 81 percent were unvaccinated.

All of the samples of COVID-19 that Albany Med has sent to the state’s Wadsworth Laboratory recently have been the Delta variant, McKenna said.

The Capital Region, in the last several weeks, has plateaued with its COVID-19 cases, he said.

Coming and going

The staffing crisis is “a much bigger issue” than the exodus of unvaccinated workers, McKenna said; the crisis has been looming for years, he said.

A month ago, Albany Med set up an incident command so that hospital leaders can work on recruitment and retention. “We need to inspire a new generation,” said McKenna, noting the aging of health-care workers.

Plans include adjusted wages, $1,000 bonuses for nurses who bring on a new nurse who stays a year, $500 bonuses for support staffers who do likewise, and $250 per pay period for perfect attendance, which amounts to $1 million per pay period.

McKenna pointed out Albany Medical Center’s unique position in the region as the only Level 1 trauma center in 25 counties, as having the area’s only children’s hospital, and as the only Level 4 neonatal intensive care unit.

He said patients come to Albany Med in three ways: through the emergency room, because of surgery or other procedures, and as transfers.

It is “unclear right now when we will have to cancel elective surgeries,” McKenna said. Out-patient staff may have to be re-deployed, he said.

McKenna also said that Albany Med typically accepts 16,000 transfers from other hospitals every year but is now “having serious conversations on whether or not we can say yes.”

When patients leave Albany Medical Center, they typically go home, go to a rehabilitation center, or go into a skilled nursing facility, McKenna said.

Nursing homes, he noted, have been having trouble getting all of their workers vaccinated against COVID-19.

If nursing homes close beds, McKenna said, hospitals will become congested.

For hospital patients returning home, care may also be a problem.

On Tuesday, the Empire Center, a nonpartisan, not-for-profit think tank based in Albany, reported on a September survey by the Home Care Association of New York State, a subset of 189 agencies projected that more than 12,000 of their workers would quit rather than accept vaccination for COVID-19.

Since there are about 1,500 home care agencies across the state, the industry-wide losses would be several times higher, the association said.

Among agencies that responded to the survey, the average vaccination rate for home health aids was 63 percent, almost 20 points lower than the 82.3 percent rate for all eligible New Yorkers. The average rates for other home-care workers were 87 percent for therapists, 79 percent for nurses and 72 percent for administrative staff.

Newest numbers

On Tuesday morning, Albany County Executive Daniel McCoy reported 106 new cases of COVID-19 in his daily release.

Between Sept. 19 and 25, a total of 529 new COVID-19 infections were identified by the Albany County Health Department. Of those analyzed, 236 were fully vaccinated; 252 were not; and, for 41 cases, the vaccination status was unknown or the individual declined to respond.

There are now 503 active cases in the county, down from 505 on Monday. The number of Albany County residents under quarantine decreased to 768 from 879. 

Albany County’s infection rate, as of Sept. 26, as a seven-day average is 3.9 percent; statewide, the rate is 2.7 percent.

There were five new hospitalizations since Monday, and a total of 32 county residents are still hospitalized with the virus – unchanged from Monday. There are now nine patients in intensive-care units, a net increase of three.

Albany County’s COVID-19 death toll remains at 402.

“We continue to see the majority of those who are hospitalized with COVID are unvaccinated,” said McCoy in the release, echoing McKenna’s analysis. “Of the 32 residents in the hospital right now, 56.2 percent have not gotten a single shot, 3.1 percent are partially vaccinated, and 40.6 percent are fully vaccinated.

“And, when you look at the combined data over the last month of our reporting, nearly 66 percent of all hospitalizations were unvaccinated individuals and 31 percent were fully vaccinated.

“The data is clear — the more people that get the shot, the fewer the people that will get sent to the hospital with potentially life-threatening complications.”

According to the state’s vaccine tracker, 71.3 percent of Albany county’s 307,117 residents have received at least one shot of vaccine as have 82.4 percent of residents aged 18 or older.

Statewide, 70.9 percent of New Yorkers have received a first dose as have 83.7 percent of New Yorkers 18 and older.

At the same time, 63.4 percent of New Yorkers have completed a vaccine series as have 75. 1 percent of New Yorkers 18 and older.