Health care workers protest being forced to get a COVID-19...

Health care workers protest being forced to get a COVID-19 vaccination outside the New York State Office Building in Hauppauge on Aug. 27. Credit: Newsday/Alejandra Villa Loarca

Tens of thousands of home health care workers across the state were projected to be terminated Friday as the state's COVID-19 vaccine mandate went into effect, creating a looming workforce shortage, according to trade associations representing the industry.

Long Island could lose thousands of nurses and home health care aides who declined to take a vaccine by Thursday's deadline, but the region, which has a higher vaccination rate than other parts of the state, will escape the worst of the crisis, officials said.

"Long island is in good shape overall as compared to other parts of the state," said Kathy Febraio, president and chief executive of the New York State Association of Health Care Providers.

A complete count of how many home health care workers were terminated because of the mandate is ongoing and will not be available until next week, she said.

The latest mandate comes as New York announced Friday that 85% of adults have had at least one dose of the vaccine, state health officials said.

Thousands could be terminated

Al Cardillo, president and chief executive of the Home Care Association of New York State, which represents some, but not all, of the same agencies as Febraio's group, said the layoffs would likely impact "thousands" of Long Island workers.

For example, Cardillo said he spoke to an agency with a 96% vaccination rate that serves Long Island and New York City. But the remaining 4%, who were terminated Friday, accounted for 175 employees, he said.

"We support the governor one hundred percent in the goal she laid out for the state and the health care system, but the issue is that the application of the mandate is being done as a cliff," said Cardillo, who is calling for a phased-in application of the mandate. "You're in today and you're gone tomorrow."

The mandate covers adult care facilities, home health agencies, long-term home health care programs, AIDS home care programs, hospice care, and diagnostic and treatment centers.

State Health Department spokeswoman Jill Montag said although employers are required to implement and enforce the mandate, they can determine what happens if their employees did not comply.

"Some have furloughed employees; some have placed them on indefinite leave, and some have terminated employees," Montag said. "The regulation allows, but does not require termination. The mandate also does not require employers to report their enforcement actions to the state."

'No viability'

Cardillo recently sampled 189 of his agencies to determine the vaccination status of their workers. The survey found 10,500 home health care aides, 894 nurses and 1,000 physical therapists and other staff would leave their job before taking the vaccine, he said. If the sample was magnified over the state's 1,500 home health care agencies, the layoffs could effect 84,000 aides, more than 7,000 nurses and 8,000 other staffers.

And the number could grow next week when a lower Manhattan court is expected to rule on health care workers refusing to take the vaccine, citing a "religious exemption." The court issued a temporary restraining order last week, blocking enforcement of the mandate for those workers.

In the interim, home health care cases will be transferred to vaccinated staff, who will be asked to work overtime, Febraio said. Out-of-state and foreign workers also could be brought on, Cardillo said.

But they agree the shortages are not sustainable.

"The workforce is already stretched beyond capacity in what we are already doing," Cardillo said. "The problem is going to create not only issues for patients but systemically. Home care is where hospitals turn for post-surgical discharges. Individuals with catheters and those with ongoing rehab and recovery needs … There is no viability with that kind of plan to actually meet the needs that would be displaced in this workforce."

Linda Taylor, chief executive of the Visiting Nurse Service & Hospice of Suffolk, said she was forced to terminate six of the Northport agency's 200 employees Friday who refused to get vaccinated. They include two nurses, two home health aides, one physical therapist and one social worker.

"All were encouraged to return to VNSHS should their vaccination status change as all were employees in good standing and we would welcome them back," Taylor said.

David Nemiroff, president and chief executive of Long Island FQHC, which has seven facilities in Nassau County as well as three school-based centers, said three workers who declined to take the vaccine resigned, and three more are on leave. Seven others are citing religious exemptions.

"We are down to a very small number of individuals," he said.

Breakthrough cases rising

With the rapid spread of the delta variant and the effectiveness of the vaccine waning slightly over time, Long Island has seen an uptick of breakthrough infections of fully vaccinated individuals, a pair of local doctors said during a Newsday Live panel Friday.

But they said the overwhelming majority of those cases appeared to be mild infections and rarely resulted in hospitalization or death.

"When the vaccines are working as well as they can, people who get breakthrough infections often do not know or have symptoms so mild they don't see to get tested," said Dr. Chidubem Iloabachie, associate chair, emergency medicine, at Long Island Jewish in Valley Stream.

Dr. Luis Marcos, an infectious disease specialist at Stony Brook University Hospital, said vaccinated individuals who contracted COVID-19 also had a decreased chance of spreading the virus to others.

"You may block the virus against transmission if you're fully vaccinated," Marcos said.

State Health Department data shows there have been 95,146 confirmed breakthrough cases, representing 0.8% of fully vaccinated adults. Only 6,567 of those individuals were hospitalized, the data shows.

The statewide positivity rate dropped to 2.4% Thursday, while the seven-day average was 3.1%, according to Health Department figures.

Long Island's infection rate was 2.7%, with the region now going a week with cases below 3%. Nassau reported 316 new cases, while Suffolk had 427, the data shows. The virus claimed the lives of 42 New Yorkers on Thursday, including seven in Suffolk and one in Nassau.

Gov. Kathy Hochul heralded the 85% vaccination rate as an important milestone.

"We are one step closer to finally putting an end to this pandemic and getting our lives back to normal," Hochul said. "While this is a momentous achievement, we still have communities lagging behind in vaccinations."

Meanwhile, the Nassau Coliseum announced that it would not require proof of vaccination or negative COVID-19 test for Saturday’s Dude Perfect concert. The show will seat fewer than 5,000 guests and therefore is not subject to the state’s guidelines as a condition of entry, but venue officials say precautions are recommended.

Future shows at the county-owned venue in Uniondale, including the Michael Bublé concert on Oct. 15, will require proof of vaccination and/or a negative test result for attendees 5 years and older.

With Candice Ferrette

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