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Methodist anti-vaxxers appeal lawsuit dismissal

As expected.

A group of Houston Methodist employees who sued the hospital system over its COVID-19 vaccine requirement have appealed a ruling dismissing the case.

Over the weekend, U.S. District Judge Lynn N. Hughes tossed the lawsuit, calling it “reprehensible” to compare the vaccine requirement to Nazi Germany’s medical experiments.

“Equating the injection requirement to medical experimentation in concentration camps is reprehensible,” Hughes said. “Nazi doctors conducted medical experiments on victims that caused pain, mutilation, permanent disability, and in many cases, death.”

[…]

Although the lower court judge thought the case had no merit, Woodfill could get traction from the 5th U.S. Circuit Court, known as one of the most conservative appeals courts in the country. On several recent occasions, the 5th Circuit has dealt blows to Hughes, a historically stubborn 79-year-old Reagan appointee.

The appeals court ordered him to re-sentence a defendant in a terrorism case who was accused of supporting ISIS overseas. After Hughes re-sentenced the man to the same abbreviated sentence, 18 months, which did not consider a sentencing enhancement, the government appealed and the 5th circuit removed the sentencing from Hughes’ court.

The 5th circuit also admonished Hughes for remarks he made on the record about female employees of the federal government. Hughes later barred the Houston prosecutor from appearing at the jury trial involved in that case.

More than half of frontline medical workers nationwide have received at least one dose of the COVID-19 vaccine, according to a survey from the Kaiser Family Foundation, a Washington, D.C.-based think tank. But as of April, nearly one in five said they did not plan on receiving a COVID-19 vaccine.

See here for the previous entry. It’s true that Judge Hughes can be a crank, but I kind of doubt that any of those previous instances will weigh on this case. For some analysis of the lawsuit and subsequent dismissal, this WaPo story has some good information.

Valerie Gutmann Koch, co-director of the University of Houston’s Health Law & Policy Institute, called the decision “another step in demonstrating the legality of these mandates, particularly in a health crisis like this.”

“There isn’t much there to rely on to argue these mandates should be illegal,” she said.

[…]

Akiko Iwasaki, an immunologist at Yale University, characterized the lawsuit’s claims as “absurd” in recent remarks to The Washington Post, noting that tens of thousands of people participated in the vaccine trials. The suit also repeats misinformation circulated widely online about the shots altering DNA.

The inoculations are seen as key to a return to normalcy, yet most employers have shied away from mandating them, concerned about the thorny politics and previously untested legal issues. Colleges and universities, along with Houston Methodist and a handful of other health-care institutions, are the exception.

Koch said the ruling shows “employer mandates of the covid-19 vaccine, particularly in the health care arena, are absolutely legal.” She said she expects to see more legal battles around vaccination mandates but noted she has “always predicted that they have very thin legal legs to stand on.”

There is precedent for vaccine requirements, she said, such as when health-care institutions require vaccinations during particularly bad flu seasons. Koch said she was “encouraged by the fact that this was dismissed as quickly and expeditiously as it was.”

Veronica Vargas Stidvent, executive director at the Center for Women in Law at the University of Texas School of Law, said the ruling is based on employment law in Texas, so the extent to which it sets a precedent for other jurisdictions is not clear.

“At least here in Texas, under this ruling, it’s pretty clear employers can require employees to get vaccinated,” she said.

Yeah, I don’t think it should be a surprise that Texas employment laws are much more favorable to employers than to employees. As Reuters notes, Judge Hughes wrote that “Texas law only protected employees from being fired for refusing to commit an illegal act and that the requirement is consistent with public policy.” I’ll be more than a little surprised if the Fifth Circuit decides that this is the place to take a stand in favor of the workers.

Lawsuit over Methodist Hospital vaccination mandate tossed

That was quick.

A federal judge has tossed a lawsuit against Houston Methodist over its policy to terminate workers who refuse to get the COVID vaccine, calling it “reprehensible” that plaintiffs compared the requirement to those made under Nazi Germany.

In the lawsuit on behalf of 117 Houston Methodist employees, lawyers likened the vaccine requirement to the Nuremberg Code, a set of medical ethics standards created at the end of World War II following medical experiments by the Nazis on German citizens.

U.S. District Judge Lynn Hughes heavily criticized the comparison in a decision Saturday.

“Equating the injection requirement to medical experimentation in concentration camps is reprehensible,” Hughes said. “Nazi doctors conducted medical experiments on victims that caused pain, mutilation, permanent disability, and in many cases, death.”

Houston Methodist is one of the first hospitals in the nation to require employees to be vaccinated. The hospital system allows employees to opt out of the vaccine requirement if they provide a medical or religious exemption.

[…]

Jennifer Bridges, a Houston Methodist Baytown nurse who originally circulated a petition in April asking the hospital’s executives to reconsider the policy, said the plaintiffs plan to appeal.

“This will go all the way,” Bridges said. “This is only the beginning.”

Occupational Safety and Health Administration officials issued guidance on Thursday outlining new COVID-19 precautions and procedures to prevent the spread of the virus in health care workplaces. Under the new rule, health care employers must provide paid time off for workers to receive COVID-19 vaccinations and recover from the side effects. Federal regulators in May issued guidance allowing employers to require proof of vaccination as a condition of employment.

Hughes wrote in the dismissal order that the vaccinate mandate “was not coercion.”

“Methodist is trying to do their business of saving lives without giving them the COVID-19 virus,” the judge wrote. “It is a choice made to keep staff, patients and their families safer.”

He also denied a request for a temporary restraining order to block the hospital from suspending the 178 employees who have not received a shot.

See here for some background – the policy was announced in late April, the lawsuit was filed shortly afterwards. As of the last day before the suspensions, all but 178 employees out of 25,000 had been vaccinated, and 27 of those 171 had since received a first shot. The nurse who has acted as the spokesperson for the holdout employees has insisted this isn’t about vaccine skepticism but about not wanting to rush things and so on, but as the Chron editorial board noted over the weekend, her rhetoric has veered more into conspiracy theory land as this has progressed. Plus, there’s the whole “hiring Jared Woodfill as their attorney” thing, which is something you never do if you want to be taken seriously. Anyway, my guess is that they will get no joy from the appeals courts, who I suspect will be more pro-employer than pro-not-getting-vaccinated, but we’ll see. The Press has more.

Will Methodist fire its unvaccinated workers?

In two weeks, if they haven’t gotten vaccinated, the answer is Yes.

Dozens of cheering supporters gathered outside the Houston Methodist Baytown campus Monday evening as several medical workers who refused to get a COVID-19 vaccine ended their last shifts working for the hospital system.

The act of protest was aimed at what workers said was the hospital’s decision to suspend employees for two weeks without pay and then fire them for failing to immunize themselves.

Jennifer Bridges, a nurse who effectively lost her job at the Baytown facility for deciding not to be inoculated, said the goal was to stage a walkout but that did not go as planned. Participating employees who refused the vaccine’s first dose were told not to gather or linger on the hospital grounds after ending their shift, she said.

“The hospital wouldn’t let us do it,” Bridges said.

She got out of work early, emptied her locker and gathered with others on a grassy medium near the ambulance entrance to the hospital. Bridges fished a paper out of a backpack — a suspension report — that she had been asked to sign. She refused, she continued.

About 117 employees in May filed a class action lawsuit against the health system for requiring its workers to be vaccinated against COVID-19. Bridges said the plaintiffs in the suit are a mix of those who want more trial data to emerge on the long-term effects of the vaccine before taking it, and those who simply don’t want any shots.

Sorry, I’m with Methodist on this. I cannot see any reason why health care workers – who by the way were already required to get a flu shot every year – should be able to opt out of this. If the concern is that we still don’t know enough about the potential negative effects of the vaccines, which at this point have emergency authorization from the FDA and not full clearance yet, all I can say is that over 300 million doses have been administered so far, with basically zero serious negative effects. There’s no way that the risk analysis comes out more favorably for not being vaccinated. Hiring Jared Woodfill as your attorney for that class action lawsuit doesn’t say much for one’s commitment to science, either.

In the end, it’s a pretty small number of employees who are affected.

While nearly 25,000 Houston Methodist workers are now vaccinated against COVID-19, 178 employees are now suspended without pay for not receiving a shot.

In a Tuesday memo to hospital staff, Houston Methodist CEO Marc Boom said 27 of the 178 workers who have not been fully vaccinated have received at least one dose of the vaccine. If they comply, they will not face termination.

“I wish the number could be zero, but unfortunately, a small number of individuals have decided not to put their patients first,” Boom said.

More than 600 employees were granted deferrals or exemptions for medical or religious reasons, the hospital said.

The hospital will have a final number of employees fired for not complying with the vaccine mandate in two weeks. Houston Methodist also requires its workers to get an annual flu shot.

That’s 0.7% of the Methodist workforce that was affected, and some of them have already decided it wasn’t worth getting fired over. Good for them. All of these folks did have a choice, and they made it. That there are consequences is just how life is sometimes. Erica Greider and the Press have more.

Houston Methodist tells its employees to get vaxxed or else

I’m okay with this.

Four out of five Houston Methodist employees are vaccinated against COVID-19. The sliver who are not will be suspended or fired if they refuse the shot, according to company policy.

The hospital required managers to be vaccinated by April 15 and all other employees — about 26,000 workers in total — by June 7, said Stefanie Asin, a Houston Methodist spokesperson.

With 84 percent of the staff vaccinated, the hospital is close to herd immunity, CEO Marc Boom wrote in a letter to employees this month.

“As health care workers we’ve taken a sacred oath to do everything possible to keep our patients safe and healthy — this includes getting vaccinated,” Boom wrote.

A little more than 4,100 employees have not received at least a first dose of the COVID-19 vaccine. The hospital does not know yet how many employees potentially will be suspended or terminated because of the mandatory vaccination policy.

Since 2009, a hospital policy has mandated its workers receive the flu vaccine each year, unless they have a medical or religious objection qualifying them for exemption.

[…]

Several nursing homes in Houston are requiring COVID-19 vaccinations of their workers, while other hospitals in the Texas Medical Center have not yet followed suit.

“UTMB is not mandating vaccination,” said Christopher Smith Gonzalez, senior communication specialist for the hospital. “But, in view of the high contagiousness of the some of the SARS-CoV-2 variants, UTMB has implemented enhanced respiratory precautions for all unvaccinated individuals caring for or evaluating patients for COVID.”

While 80 percent of Texas Children’s Hospital employees are vaccinated against COVID-19, the hospital does not require inoculation. St. Luke’s Health has vaccinated “thousands of our staff,” vaccinations are not mandatory, according to the health system.

But some are considering it to cut back on health hazards for employees and patients.

“As a provider of health care services, Baylor College of Medicine currently requires vaccination for employees for a variety of infectious diseases,” said Dr. James McDeavitt, senior vice president of Baylor College of Medicine. “For example, flu vaccination for employees has been mandatory for several years. With appropriately defined exemptions (medical contraindications, religious beliefs), we support mandatory vaccination for COVID-19. We do not yet have this requirement in place, but it is under active consideration.”

Memorial Hermann will make COVID-19 vaccines mandatory after it relaxes some of its COVID-19 protocols, such as mask-wearing and social distancing. However, it has not set a deadline for employees to receive the vaccine, said Drew Munhausen, a Memorial Hermann spokesperson.

This all makes sense to me. They’re health care workers, which not only makes them at high risk for catching COVID, it means they’re in very close contact with a lot of extremely vulnerable people as well. The story notes a recent incident in a Kentucky nursing home, where an unvaxxed worker was the cause of an outbreak. While most of the residents, who had been vaccinated, had only mild symptoms, one of them died. None of that should have happened. State law requires that health care facilities have a policy about vaccinations, but doesn’t require that they mandate them; federal law allows employers to require vaccinations, but also doesn’t mandate it. I for sure would want to know that the doctor or nurse or physician’s assistant who is giving me medical assistance, as well as all of the support staff, have been vaccinated for COVID. I understand that some of the employees may be hesitant about the vaccine, and I have some sympathy for them, but only so much.

There is also this:

Houston Methodist was one of several companies to offer incentives for its workers to get a COVID-19 vaccine. The hospital is granting $500 bonuses to anyone who worked during the pandemic and received the vaccine.

“Already we’re seeing positive results as the number of employee infections has dropped inversely with the number of employees receiving the vaccine,” Boom wrote.

Paying people to get vaxxed has its merits. One of the hesitant Methodist employees from the story says that some of her fellow hesitators are thinking about getting the shots to keep their jobs. Clearly, incentives work. Maybe that’s a lesson for us for the broader issue.

No flu

I would never say that there was any such thing as a silver lining to the COVID pandemic, but it is true that basically nobody died from the flu this year because of masking and social distancing.

What medical officials worried would be a “twindemic” at the end of last year — the concurrence of influenza and COVID-19 sicknesses overwhelming Houston’s hospitals — turned out surprisingly well.

At Memorial Hermann, just three patients tested positive for influenza during the 2020-2021 flu season, compared to 983 patients during the 2019-2020 flu season. Doctors test for both flu and COVID-19 as a precaution.

The same public health measures that prevent SARS-CoV-2 from spreading — masks, social distancing and regular hand-washing — kept influenza strains from sickening people.

“When we were looking internally, we just weren’t seeing flu,” said Dr. James McCarthy, chief executive physician at Memorial Hermann.

Flu infections are down nationwide, with a hospitalization rate of 0.7 per 100,000 people, according to the Centers for Disease Control and Prevention. During the last flu season, the rate was nearly 100 times higher — 66.1 per 100,000 patients. Pediatric deaths also decreased, from 189 last year to one this year.

[…]

Researchers wondered whether being infected with the coronavirus would wipe out the chances of getting the flu, and say it may be a factor that contributed equally to declining flu rates.

“Part of it is because we had a worse virus that was spreading faster,” McCarthy said.

Knowing to wear masks and get a flu vaccine could be a huge step toward eradicating deadly flu seasons. But will people continue to practice those public health measures? Doctors don’t know.

“We’re recognizing that not only can we protect our friends and loved ones from COVID, but we can also do it from influenza with precautions for medically vulnerable folks,” McCarthy said.

I’ve gotten a flu shot every year for as long as I can remember, and as far as I know I’ve never gotten the flu. I will certainly continue to get those vaccines as before, and I’d strongly consider wearing a mask during the flu season going forward when doing things like grocery shopping. Hard to see any reason why not to at this point.

The weather effect

Maybe a little bit of hope. We’ll see.

Communities living in warmer places appear to have a comparative advantage to slow the transmission of coronavirus infections, according to an early analysis by scientists at the Massachusetts Institute of Technology.

The researchers found that most coronavirus transmissions had occurred in regions with low temperatures, between 37.4 and 62.6 degrees Fahrenheit (or 3 and 17 degrees Celsius).

While countries with equatorial climates and those in the Southern Hemisphere, currently in the middle of summer, have reported coronavirus cases, regions with average temperatures above 64.4 degrees Fahrenheit (or 18 degrees Celsius) account for fewer than 6% of global cases so far.

“Wherever the temperatures were colder, the number of the cases started increasing quickly,” said Qasim Bukhari, a computational scientist at MIT who is a co-author of the study. “You see this in Europe, even though the health care there is among the world’s best.”

The temperature dependency is also clear within the United States, Bukhari said. Southern states, like Arizona, Florida and Texas, have seen slower outbreak growth compared with states like Washington, New York and Colorado. Coronavirus cases in California have grown at a rate that falls somewhere in between.

The seasonal pattern is similar to what epidemiologists have observed with other viruses. Dr. Deborah Birx, the global AIDS coordinator in the United States and also a member of the Trump administration’s coronavirus task force, said during a recent briefing that the flu, in the Northern Hemisphere, generally follows a November to April trend.

The four types of coronavirus that cause the common cold every year also wane in warmer weather.

Birx also noted that the pattern was similar with the SARS epidemic in 2003. But she stressed that because the virus outbreaks in China and South Korea began later, it was difficult to determine whether the new coronavirus would take the same course.

[…]

It will take another 4 to 6 weeks before health officials will have a clearer picture of how weather patterns shape the trajectory of the coronavirus, said Jarbas Barbosa, assistant director at the Pan American Health Organization, the regional office of the World Health Organization that focuses on the Americas.

The fact that local transmission is happening across the global south signals that this virus may be more resilient to warmer temperatures than the flu and other respiratory viruses. That is why World Health Organization officials still urge countries to act urgently and aggressively to try and contain the virus while case numbers are relatively low and close contacts can easily be traced and quarantined.

“One of the big perils in assuming that the virus is less dangerous in warmer temperatures, among particular ages or for any specific group is complacency,” said Julio Frenk, a physician who served as health minister in Mexico and is now president of the University of Miami. “If people fail to heed the warnings and recommendations of public health professionals, the results will be disastrous.”

But because high humidity and heat only align perfectly during mainly July and August in some parts of the Northern Hemisphere, Bukhari cautioned that the effects of warmer weather on reducing transmissions might only last for a brief period in some regions.

This is all very, very preliminary, and the effect may end up being limited in a number of ways. Even if coronavirus does behave like the cold and flu viruses in this way, that doesn’t mean it’s gone away, or that existing precautions like vigilant hand-washing are less necessary. It just means maybe our hospitals will get a break, and maybe give us some headway in getting a better handle on it. Maybe. If we’re lucky. In the meantime, stay socially distant. Kevin Drum has more.

Please get a flu shot

It’s always a good idea, even if it’s more effective in some years than in others.

The flu vaccine may not be very effective this winter, according to U.S. health officials who worry this may lead to more serious illnesses and deaths.

Flu season has begun to ramp up, and officials say the vaccine does not protect well against the dominant strain seen most commonly so far this year. That strain tends to cause more deaths and hospitalizations, especially in the elderly.

Only 48 percent of the 85 samples of H3N2 influenza viruses that have been tested since Oct. 1 are closely related to the strain that was picked for the vaccine distributed in North America, according to the agency.

“Though we cannot predict what will happen the rest of this flu season, it’s possible we may have a season that’s more severe than most,” said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, at a news conference Thursday.

CDC officials think the vaccine should provide some protection and still are urging people to get vaccinated. But it probably won’t be as good as if the vaccine strain was a match.

Flu vaccine effectiveness tends to vary from year to year. Last winter, flu vaccine was 50 to 55 percent effective overall, which experts consider relatively good.

[…]

Current flu vaccines are built to protect against three or four different kinds of flu virus, depending on the product. The ingredients are selected very early in the year, based on predictions of what strains will circulate the following winter.

The ingredients always include a Type A H3N2 flu virus. The most severe flu seasons tend to be dominated by some version of that kind of flu bug. The three most deadly flu seasons of the last 10 years – in the winters of 2003-2004, 2007-2008, and 2012-2013 – were H3N2 seasons.

In March, after the H3N2 vaccine strain was vaccine production was underway, health officials noted the appearance of a new and different strain of H3N2. “This is not something that’s been around before,” Frieden said.

But health officials weren’t sure if the new strain would become a significant problem in the United States this winter until recently, they said. Lab specimens from patients have shown that the most commonly seen flu bug so far is the new strain of H3N2. Specifically, about 48 percent of the H3N2 samples seen so far were well matched to what’s in the vaccine, but 52 percent were not, the CDC said.

Not perfect, but your odds are still a lot better with the vaccine than without. As the story notes, in an average year about 24,000 Americans die from the flu. I’ll have to check my math on this, but I’m pretty sure that’s more than the number of Americans that die from Ebola. (Which we still need to fight against as well, but Congressional Republicans have lost interest in Ebola since it’s not generating scary cable news stories any more.) So don’t fall for the hysteria. Please put the odds in your favor and get a flu shot, OK? Thanks.

Some things you can vaccinate against

Saying dumb things isn’t one of them.

CM Jack Christie

As the council considered a proposal Wednesday to accept $3.1 million in federal funding for childhood immunizations, Councilman Jack Christie voiced his opposition to the measure, apparently conflating it with flu vaccinations.

“I’m going to vote against this,” Christie said before the 15-1 vote. “You don’t die from the flu.”

Christie backed down somewhat from his comment on Friday. What he meant to say, he said, was that “People should not die from the flu.”

“First of all, that’s $3 million that the federal government doesn’t really have,” Christie said of the funding proposal. “It’s borrowed money we eventually have to pay back. But more important is the media’s embellishment of the extreme fear of encouraging flu vaccinations.

“Every year there’s going to be a flu,” he said, “and vaccines create synthetic immunity, which does not trump natural immunity to disease.”

Christie, who said he has never taken a flu shot, suggested the medical community should focus more attention on prescription drug abuse that claims thousands of lives annually in the U.S.

Dr. Joshua Septimus, associate professor of internal medicine at Methodist Hospital in the Texas Medical Center, called Christie’s comments irresponsible.

“That is totally wrong,” he said. “The flu kills anywhere from a few thousand to tens of thousands in the U.S. alone. There is very good evidence that the flu shot reduces deaths from the flu. That flu vaccine is a very low risk and with very high potential benefits.”

So much here to deal with. First, the idea that not accepting this funding is fiscally responsible is ludicrous. This money has already been appropriated. Not accepting it doesn’t mean it magically gets transmuted from a liability to an asset on the federal budget balance sheet. It means it gets to be granted to some other city. There are sometimes good reasons to turn down federal funding, but this is money for childhood immunizations. Spending money to keep kids healthy is about the best spending we can do. It’s an investment with a big payoff, both in terms of spending less later on sick kids, and the greater lifetime earnings potential of kids who grew up healthy and in some cases who got to grow up at all.

Second, the bit about the medical community needing to focus more on prescription drug abuse is a complete non sequitur. Last I checked, the medical community was big enough to handle more than one thing at a time. It’s also unlikely to change its priorities based on one screwball City Council voting down a grant for childhood immunizations. If you want to send a message to the American Medical Association, writing a letter to them is probably the better approach.

Finally, and not to put too fine a point on it, but even Helena Brown voted to accept these funds. Let me say that again: Even Helena Brown voted to accept these funds. When you’re off on an island that even Helena Brown isn’t inhabiting, you need to check your coordinates, know what I mean?