POST 198. September 15, 2021. CORONAVIRUS. A pundit said “The most elegant policy riposte to the anti-vaxxers… is to refuse to allow Medicare or Medicaid to pay their medical bills in the event they become seriously ill. Private health insurers might also follow suit.” (but is making our hospitals become the bill collectors right?)

Faced with this avoidable catastrophe, President Biden is right to order tighter vaccine rules, which he did for roughly two-thirds of the nation’s work force on Thursday. “We’ve been patient,” Mr. Biden told vaccine holdouts. “But our patience is wearing thin. And your refusal has cost all of us.”…

for links to POSTS 1-198 in chronological order highlight and click on

“President Joe Biden on Thursday imposed stringent new vaccine rules on federal workers, large employers and health care staff in a sweeping attempt to contain the latest surge of Covid-19.

The new requirements could apply to as many as 100 million Americans — close to two-thirds of the American workforce — and amount to Biden’s strongest push yet to require vaccines for much of the country…

At the center of Biden’s new plan is directing the Labor Department to require all businesses with 100 or more employees ensure their workers are either vaccinated or tested once a week, an expansive step the President took after consultation with administration health officials and lawyers. Companies could face thousands of dollars in fines per employee if they don’t comply.

US Postal Service workers would fall under that rule, a senior administration official told CNN, and employees will be required to be vaccinated or face mandatory weekly testing. The Postal Service, a quasi independent agency, employees more than 640,000 people.

Biden also signed an executive order requiring all government employees be vaccinated against Covid-19, with no option of being regularly tested to opt out. The President signed an accompanying order directing the same standard be applied to employees of contractors who do business with the federal government.

He said 300,000 educators in federal Head Start programs must be vaccinated and called on governors to require vaccinations for schoolteachers and staff.

And Biden announced he would require the 17 million health care workers at facilities receiving funds from Medicare and Medicaid to be fully vaccinated, expanding the mandate to hospitals, home care facilities and dialysis centers around the country.

“We have the tools to combat the virus if we come together to use those tools,” Biden said at the outset of what was billed as a major speech to tackle the latest phase of the Covid-19 pandemic.”  (A)

“Experts say Mr. Biden has the legal authority to impose vaccine requirements on the private sector, through laws that require businesses to comply with evidence-based federal health safety standards. OSHA, which enforces workplace safety, has already imposed other pandemic precautions, such as a rule in June requiring health care employers to provide protective equipment and adequate ventilation and ensure social distancing, among other measures. Robert I. Field, a law professor at Drexel University, said that OSHA had the authority to protect workers’ safety, keeping them from being exposed to a potentially deadly virus, by requiring vaccinations.

Lawrence O. Gostin, a Georgetown University law professor who specializes in public health, added: “The president’s plan is bold, audacious and unprecedented. But I do think it’s entirely lawful. He’s on extremely strong legal ground.”..

“When you have 75 to 80 million people who are eligible to be vaccinated, who don’t get vaccinated, you’re going to have a dynamic of continual smoldering spread of the infection,” Mr. Biden’s top medical adviser for the coronavirus pandemic, Dr. Anthony S. Fauci, warned in an interview, adding, “It’s very frustrating, because we have the wherewithal within our power to be able to actually suppress it.”…

One thing Mr. Biden cannot do is require all Americans to be vaccinated; in the United States, vaccinations are the province of the states. But Mr. Gostin said the president could also dangle the prospect of federal funding to prod states to require their own workers to be vaccinated, and his administration could offer technical guidance to states that want to develop so-called vaccine passports for people to provide digital proof of vaccination.”  (B)

“If a conflict at one New York hospital over vaccine mandates for health care workers is any indication, the Biden administration’s new effort to mandate vaccines for millions of workers could be in for an uphill battle…

In New York, where former Gov. Andrew Cuomo mandated that all health care workers in the state get a vaccine, employees at hospitals and long-term care facilities need to get their first dose by Sep. 27.

At one local hospital in upstate New York, dozens of staff members walked away from their jobs after refusing to get vaccinated. The move has seriously disrupted care in the process.

Lewis County General Hospital in Lowville, N.Y., announced Friday that it is pausing maternity services later this month because dozens of staff members quit rather than get COVID-19 vaccines.

The hospital will be “unable to safely staff” its maternity department and newborn nursery as of Sept. 25, according to Lewis County Health System CEO Gerald Cayer. He added that other departments in the hospital are at risk as well if workers don’t get vaccinated.

As of Friday, 30 employees had resigned from Lewis County General Hospital. At least 464 people in the Lewis County Health System have been vaccinated — a 73% immunization rate among employees.” (C)

“The Equal Employment Opportunity Commission has already clarified that employers can require their staffs to get vaccinated, so long as they provide accommodations for workers who say they can’t get the shot because of their religious beliefs or a disability. Businesses can tell workers to stay home if they can’t be vaccinated for one of those reasons, and workers could be fired if their employer is unable to accommodate remote work, attorneys say.” (D)

“It’s true that courts have upheld vaccine mandates in certain circumstances: In a 1922 case, the Supreme Court famously ruled that a city ordinance could deny admission to students who failed to get the smallpox vaccine. But the assertion that a public official can completely sidestep the legislative process and enact a much farther-reaching vaccine mandate via administrative action should elicit skepticism from even those who vigorously support vaccination.

There are other ways to nudge the populace in the right direction. Rather than punishing the unvaccinated, the government could create an incentive for vaccination by lifting restrictions for the vaccinated. This was the approach initially taken by the C.D.C., which said this year that since the vaccinated were well protected, they could almost always safely discard their masks. Unfortunately, the more transmissible Delta variant spooked federal health officials, and the C.D.C. reversed course. Some municipalities, including Washington, then reimposed mask mandates, even though the science hasn’t actually changed: The vaccinated are still well protected from Covid.

Some people would probably voluntarily get the shot if they knew for certain that a vaccination card was a ticket to living a normal life once again. Regrettably, Mr. Biden’s mandate moves in the exact opposite direction, with the White House saying his plan will ensure that “strong mask requirements remain in place.” If the government is concerned about vaccine hesitancy, it should trust the vaccines and drop other restrictions. People should know that if they get vaccinated, they will be better off. Instead, the White House is sending the message that people must get vaccinated but should hardly expect things to be different afterward.” (E)

“But Dr. William Schaffner, an infectious disease expert at Vanderbilt University, said the policy was necessary, and likened it to military service in a time of war.

“To date, we have relied on a volunteer army,” Dr. Schaffner said. “But particularly with the Delta variant, the enemy has been reinforced, and now a volunteer army is not sufficient. We need to institute a draft.”” (F)

“As Americans contemplate the prospect of a second winter trapped in the grip of Covid-19, remember that it didn’t need to be this way. Vaccines were developed in record time, and have proved to be both incredibly safe and stunningly effective. Nearly two-thirds of eligible Americans have accepted these facts and done their part by getting fully vaccinated.

Yet tens of millions more have not, allowing the more contagious Delta variant to sweep across the country, where it is now killing more than 1,500 people in the United States daily. Right now, the list of the very sick and the dead is made up almost entirely of the unvaccinated. But as long as the virus continues to spread widely, it can and will evolve in ways that put everyone at risk.

Faced with this avoidable catastrophe, President Biden is right to order tighter vaccine rules, which he did for roughly two-thirds of the nation’s work force on Thursday. “We’ve been patient,” Mr. Biden told vaccine holdouts. “But our patience is wearing thin. And your refusal has cost all of us.”…

The Biden administration has already done just about everything in its power to encourage people to get vaccinated, from putting out targeted advertisements, offering financial incentives and reminding people that the shots are free. Carrots haven’t been enough. That’s why Mr. Biden’s actions Thursday were courageous: If the goal is not to pander but to lead, tighter rules ensuring more people are vaccinated were the only meaningful option left.” (G)

“Gail Collins: Well, Bret, if Biden was rounding up the non-vaxxers, having them tied down and inoculated by force — the way many Republicans seem to be drawing the picture — I’d certainly have reservations. But in effect he’s saying that they shouldn’t be allowed in certain places where infection is relatively easy to spread, like workplaces or public buildings.

This is a serious, serious health crisis and I don’t think I’d want the president to content himself with giving pep talks.

And don’t I remember a previous conversation in which you suggested the non-vaccinated didn’t deserve to be allowed in hospitals if they got sick?

Bret: Not exactly, but close. The most elegant policy riposte to the anti-vaxxers — and I mean the willful ones, not the people who simply haven’t had access to the shot or have a compelling medical excuse — is to refuse to allow Medicare or Medicaid to pay their medical bills in the event they become seriously ill. Private health insurers might also follow suit. I accept that people don’t want the government or their employer telling them what to do with their bodies. But these same people shouldn’t expect someone else to bail them out of their terrible health decisions.” (H)

“More than a year and a half into the Covid-19 pandemic, America still doesn’t agree on what it’s trying to accomplish.

Is the goal to completely eradicate Covid-19? Is it to prevent hospitals from getting overwhelmed? Is it hitting a certain vaccine threshold that mitigates the worst Covid-19 outcomes but doesn’t prevent all infections? Or is it something else entirely?

At the root of this confusion is a big question the US, including policymakers, experts, and the general public, has never been able to answer: How many Covid-19 deaths are too many?

The lack of a clear end goal has hindered America’s anti-pandemic efforts from the start. At first, the goal of restrictions was to “flatten the curve”: to keep the number of cases low enough that hospitals could treat those that did arise. But that consensus crumbled against the reality of the coronavirus — leaving the country with patchwork restrictions and no clear idea of what it meant to “beat” Covid-19, let alone a strategy to achieve a victory.

The vaccines were supposed to be a way out. But between breakthrough infections, the risks of long Covid, and new variants, it’s becoming clear the vaccines didn’t get rid of the need to answer the underlying question of what the Covid-19 endgame is.

America is now stuck between those two extremes: The country wants to reduce the risk of Covid-19, but it also wants to limit the remnants of social distancing and other Covid-related restrictions on day-to-day life.

“We’re not trying to go for zero Covid,” Ashish Jha, dean of the Brown University School of Public Health, told me. “The question becomes: When do, in most communities, people feel comfortable going about their daily business and not worrying, excessively, about doing things that are important and meaningful to them?”” (I)

“The US shouldn’t ease restrictions in place to prevent Covid-19 before the number of new coronavirus cases falls below 10,000 daily, “and maybe even considerably less than that,” Dr. Anthony Fauci said Thursday.

The US should pull restrictions gradually, after a substantial portion of Americans are vaccinated, Fauci told CNN’s Jake Tapper.

The last time the US saw fewer than 10,000 new daily cases was almost a year ago, on March 22, 2020. The number hasn’t fallen below 50,000 daily cases since mid-October, and the seven-day average on Wednesday was more than 64,000.

“We will be pulling back,” said Fauci, President Joe Biden’s chief medical adviser. “We’re now up to about 2 million vaccinations per day. That means every day that goes by, every week that goes by, you have more and more people protected.”

Fauci’s comments come as some states begin to pull back restrictions, including doing away with mask mandates, allowing businesses to fully open and increasing the number of people allowed at mass gatherings.

That is “inexplicable,” Fauci said earlier.” (J)


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