September 13, 2021

Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

President Joe Biden says all federal employees will have to be vaccinated and weekly tests are not an option to get out of taking the shot. But one big group of people who get paid out of the federal treasury won’t have to get vaccinated: Congress.

The thing to remember is that the president controls the executive branch of government but can’t tell the legislative branch what to do, so Congress can make its own rules about vaccine requirements.

House Speaker Nancy Pelosi said back in April there would not be a vaccine requirement for members of Congress and their staff.

USA Today says that while the number is not certain, the best estimate is that about one in five members of Congress is not vaccinated. But the figure could be different from that:

Disclosure of member’s vaccination status has relied solely on an honor system, so an exact vaccination rate is hard to pin down. CNN reported 97 House Republicans refused to disclose their vaccination status, indicating the number is likely higher than 81%.

The Associated Press says some big employers who clearly will be covered by the mandate have some decisions to make about whether they will require vaccinations. For example, Google says it is undecided about whether it will allow employees to work remotely and be unvaccinated. An AP story says some businesses are happy that Biden issued the mandate because it takes the heat off the employer:

“The business community is really going to appreciate this,” said Angela B. Cornell, a clinical professor at Cornell Law School, who focuses on labor law. “This shift will make it a lot easier for employers to push those individuals who have been on the fence or who have been opposed.”

Companies won’t have to worry about being sued, since it’s a government mandate and not one from the employer, she said. It could also help level the playing field for employers of hourly workers, many of which didn’t mandate vaccinations for fear that they could lose employees during a tight job market.

You can now get your flu shot and COVID vaccination at the same time

The Centers for Disease Control and Prevention once advised people to take flu shots separate from COVID-19 vaccinations, but the CDC just changed its guidelines and says it is fine to take them at the same time. That will be important as we all will line up soon for booster shots.

I just got my annual flu shot. I take it every year. The CDC says there are lots of reasons to do so, especially in a pandemic:

  • Fewer influenza cases mean fewer people needing to go to hospitals and doctor offices that are already overburdened with covid cases.
  • Avoiding the flu means you won’t mistake flu symptoms for covid symptoms.

The CDC says the flu vaccine works best if you get it before the end of October. By now, you probably know that vaccines need some time to become fully effective because they stimulate your body’s immune system to produce antibodies. Getting the flu vaccine weeks before the height of flu season gives your body enough time to be ready to protect you.

The 2020 flu cycle produced far fewer cases than normal because we were not around each other much last year. But this year the flu may make a comeback, partly because we are more social and partly because we have been socially distanced and may have lost some immunity.

Keep an eye on a new rise in British cases

Pedestrians wearing face masks enter Oxford Street tube station in London, Friday, Aug. 6, 2021. (AP Photo/Alastair Grant)

Time and again, we have seen the trends that show up in the U.K. show up in the U.S. a few weeks later. We saw the delta variant rise there, then here. A month or so ago, the British infection rate dropped and there is reason to hope this week’s numbers in the U.S. might, too. The 14-day new case average was down 6% over the weekend.

But now the U.K. is seeing a new unexpected rise in new cases.

The Guardian reports:

More than 8,000 people in the UK were in hospital with Covid on Wednesday — the highest figure for nearly six months — leading to fears of a resurgence in the virus’ ability to cause serious illness and death among the population.

By the way, the U.K.’s health secretary said yesterday that his country will not turn to vaccine passports to gain entry to restaurants, shops or bars. That’s a big change from the government’s plans.

The stigma of dying with COVID: grief mixed with shame and denial

NPR produced an overdue story about how unvaccinated people die from COVID-19 but their families often do not mention the cause of death out of shame or denial.

The story included Reading, Pennsylvania, funeral director Mike Kuhn:

His chain of three funeral homes has helped bury hundreds of people who died from the coronavirus. He says about half of those families asked that COVID-19 not be mentioned in obituaries or death notices.

“You know, I’ve had people say, ‘My mother or my father was going to die, probably in the next year or two anyway, and they were in a nursing home, and then they got COVID, and you know, I don’t really want to give a lot of credence to COVID,’ ” Kuhn says.

Some families wanted to have their loved one’s official death certificate changed so that COVID-19 was not listed as the cause of death, Kuhn adds. Death certificates are official state documents, so Kuhn couldn’t make that change even if he wanted to. But the request shows how badly some people want to minimize the role of the virus in a loved one’s death.

The NPR story quotes Ken Doka, “who works for the Hospice Foundation of America and has written books about aging, dying, grief and end-of-life care,” as saying when a person dies of something controversial, like COVID-19, it becomes a “disenfranchising death,” meaning people do not feel comfortable talking about the cause of death. You probably think of drug overdoses or suicides as similar “disenfranchising” causes of death. AIDS used to be such a cause that some people didn’t discuss.

Sociologist and grief specialist Holly Prigerson told NPR:

If people believe the pandemic is a hoax, or that the dangers of the virus are overblown, then “anything, including the death of a loved one from this disease … they compartmentalize it,” Prigerson says. “They’re not going to process it. It gives them too much of a headache to try to reconcile.”

Prigerson says trying to fight someone’s cognitive dissonance rarely works. People double down on their beliefs when they are challenged, a concept known as the “backfire effect.”

A lesson that we can take from this is that it’s useless to shame people who have gotten infected. Make it safe for people to get vaccinated, no matter how long it takes for them to come to that decision.

If you care, there is a fair amount of scientific study about social stigmas and infectious disease, like COVID-19.

How millions of people will avoid vaccine mandates

Biden’s order that companies with more than 100 employees be required to mandate employees be vaccinated or regularly tested won’t affect the millions of workers who are employed by independently owned franchises. For example, lots of fast-food restaurants are not corporately owned and have fewer than 100 workers. The corporation could require all franchises to require vaccinations, but CNN talked with Brian Kropp, chief of research at consulting firm Gartner’s HR practice, who said that is not likely:

With a record number of job openings and not enough job seekers to fill them, “the war for talent is intense right now,” Kropp said. “If McDonald’s does [require vaccinations] and Wendy’s doesn’t, those employees who don’t want to get vaccinated are going to walk out the door to go over to Wendy’s.”

Many other large companies hire independent contractors, rather than employees, to interact with the public, including Uber, Lyft and other major delivery services such as DoorDash and Instacart.

In addition to their need to hang on to workers, those companies have a bigger issue at play — imposing a vaccine mandate on drivers could complicate future legal battles over whether they should be considered employees rather than independent contractors, Kropp said.

“If the mandate were to apply to them, it makes it more likely in future legal cases for drivers to say, ‘We’re treated the same way as employees,’” said Kropp.

The net effect is that the federal mandates will increase the number of people who are vaccinated but it will still be easy to come in contact with unvaccinated people away from the job.

Is weekly COVID testing for unvaccinated people going to help?

If a workplace requires workers to get vaccinated or take weekly COVID-19 tests, does that protect you from the virus? Think of it this way: Let’s say a coworker gets infected over the weekend and tested on Monday. They might show up negative but turn positive on Tuesday. It will be another week before the coworker is tested again. By then, you may have been infected along with your whole office/assembly line/workgroup.

Politico says weekly tests are not useless but “a test every seven days is well short of a coronavirus stopper.” The Politico story continues:

Three tests a week would be more reliable (and rapid tests are fine) to identify active infection and prevent spread, said Céline Gounder, an infectious disease specialist and epidemiologist at NYU and Bellevue Hospital who advised the Biden transition team. Weekly testing can still be helpful for surveillance, Gounder added, helping track how much virus is circulating in a given place, maybe triggering a temporary closure of an office or school.

Some data suggest that a weekly testing requirement can change behavior, making people more likely to get vaxxed. Behavioral economists might think of it as a nose nudge. “People don’t want to get something up their nose every week,” said West Virginia Health Commissioner Ayne Amjad. When they’ve had enough of those swabs, they get the shot.

A plea for pregnant women to get vaccinated

A health worker administers the Pfizer-BioNTech COVID-19 vaccine to a pregnant woman in Montevideo, Uruguay, Wednesday, June 9, 2021. (AP Photo/Matilde Campodonico)

Mississippi State Health Officer Dr. Thomas Dobbs says his department is investigating eight pregnant women who died from COVID-19 in the past four weeks. All eight were unvaccinated.

Dobbs said his state has seen a “doubling of the rate of fetal demise, or the death of the baby in the womb after 20 weeks.” “It’s been a real tragedy,” he said.

The CDC says pregnant women are at a higher risk for severe COVID-19 symptoms, and the CDC recommends they get vaccinated.

Hospital to suspend baby deliveries because so many quit over mandatory vaccinations

WWNY tells the story in one small town that might be playing out elsewhere:

Lewis County General Hospital will stop delivering babies after September 24 because too many maternity unit workers have resigned over COVID vaccination mandates.

6 employees in the maternity unit resigned rather than get a COVID shot and another 7 are undecided.

I have seen other stories about hospitals that are forgoing mandatory vaccinations expressly to avoid losing staff. Fortune.com reports:

39% of U.S. hospitals have announced vaccine mandates, said Colin Milligan, a spokesperson for the American Hospital Association. Across the nation, hospitals are weighing more than patient and caregiver health in deciding whether to mandate COVID vaccines for staffers.

The market for health care labor, strained by more than a year and a half of coping with the pandemic, continues to be pinched. While urban hospitals with deeper pockets for shoring up staff have implemented vaccine mandates, and may even use them as a selling point to recruit staffers and patients, their rural and regional counterparts are left with hard choices as cases surge again.

“Obviously, it’s going to be a real challenge for these small, rural hospitals to mandate a vaccine when they’re already facing such significant workforce shortages,” said Alan Morgan, head of the National Rural Health Association.

Without vaccine mandates, this could lead to a desperate cycle: Areas with fewer vaccinated residents likely have fewer vaccinated hospital workers, too, making them more likely to be hard hit by the delta variant sweeping America. In the short term, mandates might drive away some workers. But the surge could also squeeze the hospital workforce further as patients flood in and staffers take sick days. Rural COVID mortality rates were almost 70% higher on average than urban ones for the week ending Aug. 15, according to the Rural Policy Research Institute.

Isn’t now the time to collect more COVID data, not less?

NPR points to big holes in the data that states are handing to the CDC:

The Centers for Disease Control and Prevention has tallied over 39 million cases of COVID-19 in the U.S., but if you want to know more detailed information, such as where patients live, whether patients were hospitalized or died, demographic details like race, gender and age, that information is gathered separately.

In that more detailed CDC data set, about 1 in 5 known cases — or 7 million people — are completely missing, an NPR analysis found. On top of that, about two-thirds of the data present aren’t usable, as health care providers marked fields as “Unknown” or simply left them blank.

Most states have voluntarily sent up whatever records they have, but a handful have not. Texas, Missouri, Louisiana, West Virginia and Wyoming have each submitted less than one-tenth of their total cases. Another handful of states, including Florida, Michigan and Kentucky, have smaller but still significant gaps in their data, each completely missing over 30% of their known cases.

I assumed that states were not sending the data that the CDC would love to have because the states didn’t want the public to know the size of the pandemic’s spread. But experts say there are other real-life reasons, including a lack of funding and data systems that don’t talk with each other. This summer, the CDC awarded $200 million of COVID-19 relief funds to six states to help them fix the blocked data pipelines. NPR says:

Texas alone now has over 3 million cases to submit, and Missouri, Louisiana, Mississippi and a handful of other states each have hundreds of thousands to work through.

There is so much work to be done. The only real solution is sustained public health funding long after the pandemic ends.

We’ll be back tomorrow with a new edition of Covering COVID-19. Are you subscribed? Sign up here to get it delivered right to your inbox.

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Al Tompkins is one of America's most requested broadcast journalism and multimedia teachers and coaches. After nearly 30 years working as a reporter, photojournalist, producer,…
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