‘We need all hands on deck’: Amid crisis, hospitals pause employee vaccine mandate

As Idaho hospitals approach a worst-case scenario due to an influx of unvaccinated COVID-19 patients, St. Luke’s Health System and Saint Alphonsus Health System have paused their vaccine mandates for staff.

On July 8, the state’s largest health care provider, St. Luke’s, announced it would require all employees at its facilities to have received at least one shot of a vaccine by Sept. 1, or face termination. Saint Alphonsus, another major hospital system in the Treasure Valley, announced on the same day as St. Luke’s that employees would be required to be fully vaccinated by Sept. 21.

But because of the dire situation at overwhelmed hospitals, where some patients are being treated with ventilation devices in non-monitored settings and providers are reducing supervision of patients’ vital signs, both systems have changed their plans.

“While we are leading with safety and safety is our North Star here … we need all hands on deck,” Sandhee Gehrke, chief operating officer at St. Luke’s, told the Idaho Statesman in a video interview. “So we are going to extend that time frame for our team members.”

Last week, St. Luke’s sent letters of “corrective action” to the 2% of employees who are still not compliant with the company’s policy, Gehrke said. Of the hospital’s staff, 98% has either been fully vaccinated or received an approved exemption on medical or religious grounds. The hospital has nearly 17,000 employees, according to spokesperson Taylor Reeves, meaning that around 350 employees are not compliant.

The situation is similar at Saint Al’s.

“While we remain committed to our vaccine requirement policy, we are pausing the deadline for our Idaho colleagues while crisis standards of care have been activated,” said Mark Snider, a spokesperson for Saint Al’s, by phone. “We anticipate very few of our colleagues will be out of compliance, but right now the decision was reached because we want our staff to focus on patient care.”

While both hospitals have paused their requirements indefinitely, starting on Oct. 1, Gehrke said that unvaccinated employees will be required to take a COVID-19 test twice a week in order to come to work. Saint Al’s has not announced a similar requirement, according to Snider.

As of Friday, St. Luke’s had more than 400 employees out due to COVID-19-related illnesses. About 45% of those employees have tested positive for COVID-19, while others are awaiting test results, quarantining because of a known exposure, or staying home with COVID-19-like symptoms despite having tested negative, Gehrke said. About 60% of those not working are from the hospital’s non-clinical team — positions like cleaning staff, or food workers — while the rest work in clinical positions.

Gehrke said the hospital has not tracked what percentage of those workers out sick are unvaccinated.

“If we continue on this course over the next several weeks, St. Luke’s Health System will become a COVID health system,” said Chris Roth, president and CEO of St. Luke’s, on Thursday, while adding that nearly every COVID-19 patient in the hospital is unvaccinated. “We will consume every single bed and every single resource we have with COVID patients in our hospital.”

Just under 50% of adult intensive care patients at St. Luke’s have tested positive for COVID-19, according to Gehrke. In addition to the influx of COVID-19 patients, the hospital — and others in the state — are experiencing unusually high numbers of patients needing other types of care.

Nurses and other staff members are being paid overtime or extra bonuses to take on more shifts, Gehrke said.

On Thursday, the state Department of Health and Welfare activated a measure allowing hospitals to ration care.

The move was made at the request of St. Luke’s, while facilities at Saint Al’s are operating at the “most extreme contingency standards,” which is a level below the rationing standards, according to Dr. Steven Nemerson, chief medical officer.

The shift, called crisis standards of care, means that instead of offering traditional care, overburdened hospitals may begin providing the best care to patients with severe conditions based on who is most likely to survive.

St. Luke’s has hundreds of open nursing positions listed on its website. In the last two months, the health system has hired over 800 providers and is working with close to 400 travel nurses, according to Roth.

“But I can tell you, that’s not going to be enough staff to support the crushing demands that we’re currently seeing,” Roth said. “We will do and are doing everything possible to ensure we’re providing safe and effective care, but the standard of care is being eroded.”