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Methodist Hospital System

More proof that vaccine mandates work

In the end, most people just get the damn shots. The rest is sound and fury.

Protests, lawsuits and national media coverage surrounded Houston Methodist Hospital in June when it became the country’s first major health system to require a COVID-19 vaccine as a condition of employment.

Now, as other Houston healthcare providers begin to enforce similar mandates, the drama has faded into the background. Hospitals are not facing the same pushback, officials say, and only a small portion of employees are holding out on the vaccine.

“There is a lot of noise around (mandates), and the anti-vaxx movement has been vociferous, but this is more of an outcry from the community rather than when it comes down to the brass tacks in facilities,” said Carrie Kroll, vice president of advocacy, quality and public health at the Texas Hospital Association.

Texas Children’s Hospital and Baylor College of Medicine were the first to reach their vaccine mandate deadlines following Methodist.

Baylor required its roughly 9,000 faculty and staff members to be fully vaccinated by Sept. 15. Those who did not attest to receiving their vaccine were subject to “progressive discipline,” which includes a series of warnings that ends in firing, according to a statement. The vast majority of employees complied, while about 3 percent were granted an exemption, according to numbers provided by the school.

One employee resigned. Another five will be fired after facing warnings.

[…]

Texas Children’s Hospital also passed its first-dose deadline on Sept. 21. Its doctors are employed by Baylor and already covered by the school’s mandate. In a statement, the hospital said “a very small number of employees did not receive the vaccine and therefore chose to leave the organization.”

Texas Children’s spokesperson Natasha Barrett said the hospital could not disclose a specific number of people who left or whether any exemptions were granted.

See here, here, and here for some background. A lawsuit by the (very small number of) fired Methodist employees was dismissed, though it is being appealed. There’s growing evidence from around the country that this is what happens pretty much everywhere that there’s a vaccine mandate – lots of loud whining and complaining and threats to quit, followed by near-universal compliance. This is why I’m happy for the San Antonio ISD vaccine mandate fight to move slowly through the courts, because regardless of outcome it’s going to cause people to get the damn vaccine. And don’t anyone tell Greg Abbott, but Southwest Airlines is doing a mandate now, too. The more, the very much better.

COVID rate slows a bit, but ICUs still full

The good news.

So far, the delta variant has fueled a month of Houston-area COVID hospitalizations over 3,000, according to the Texas Department of State Health Services.

But Texas Medical Center records show positive case rates may be slowly declining. According to TMC’s daily report, 1,939 people tested positive Tuesday in the Greater Houston area, a decline that may be related to COVID testing site closures as a precaution before Hurricane Nicholas.

Also Tuesday, the medical center admitted 310 new COVID-19 patients compared to the average 328 per day last week. Hospitals in the TMC remain at 90 percent capacity.

Dr. Wesley Long, a microbiologist and medical director of diagnostic microbiology at Houston Methodist, has been tracking and analyzing the virus and its variants through the hospital’s COVID-19 genome sequencing operation.

While Long sees the increase slowing, he hesitates to say Houston is passed the peak of the surge.

“It’s like cresting the top of the wave, you don’t know what the backside of the wave is going to look like,” Long said. “In the beginning of this fourth wave, there were some people hopeful it would go up quickly and come down quickly. That’s not the case.”

The fourth wave’s peak has been broader than previous waves, which spiked and declined within about 25-30 days, Long explained. The big question with the delta wave is whether it will plateau at a high rate of hospitalizations or have a slow decline.

“It’s hard to know how other things like holidays and school will affect the case count,” he said. “It’s really important to keep masking, social distancing and staying home if you’re sick because it’s important to bring the fourth wave under control.”

Another way to look at it:

The not so good news.

COVID-19 hospitalizations have been declining across Texas and the Houston region, but the virus is still keeping a high number of people in ICUs, prolonging the strain on patients waiting for critical care beds.

Last week, the number of available adult ICU beds in Texas sunk below 300 for the first time in the pandemic, with 270 beds available on Sept. 8 and 279 available on Sept. 9, according to the Texas Department of State Health Services. There were 326 beds available this Wednesday, including 65 in the nine-county region surrounding Houston, the data show.

Texas Medical Center ICUs for weeks have been hovering around 90 percent full with “Phase 2” surge plans — which add 373 ICU beds to the 1,330 available in Phase 1 — activated.

[…]

ICU data is a lagging indicator of the virus’s impact, [Dr. Syed Raza, vice president of medical operations at CHI St. Luke’s Health-The Woodlands Hospital] said, because the sickest patients need care for a longer period of time. He said it is the “natural course of the pandemic” for ICUs to remain high after hospitalizations decline.

Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine, said the hospital strain appears to be easing overall. The number of COVID patients in ICU beds likely peaked at the end of August, when they took up 49 percent of all critical care beds, he said. As of Wednesday, that number dropped to 45 percent.

He said he is cautiously optimistic that “we’ll continue to see this trend move in right direction.” He compared the current ICU situation to flooding during hurricane.

“We are no longer stuffing towels under the door” to stop the water, he said. “But the water is still over our threshold.”

I mean, it could be worse. It’s still not good, and it’s going to continue to not be good for awhile, but it could be worse. Keep up with the precautions, they’re our best hope in the short term as more people get vaccinated.

Hospital systems have no excuse for not mandating COVID vaccines now

So get on with it already.

Local hospitals reacted Friday to President Joseph Biden’s sweeping vaccine mandates directed at the health care workers, who make up much of the Houston workforce.

In a move that overrides Gov. Greg Abbott’s executive order barring public institutions from issuing their own COVID-19 restrictions, the administration said it would require vaccinations for employees at health care facilities that accept Medicare and Medicaid reimbursement.

Baylor College of Medicine’s dean of clinical affairs, Dr. James McDeavitt, said Thursday he supported the new measures.

“It is the right thing to do,” he said.

Still, he wished the plan had come sooner. “It is not going to help us with the current delta surge,” he added.

[…]

Five Houston hospital systems already require a vaccine. In June, Houston Methodist became the first hospital in the nation to announce it would require its staff to be fully vaccinated, a move that met months of resistance, including a lawsuit by some employees. Memorial Hermann and Baylor College of Medicine enacted their own vaccine mandates in July; St. Luke’s Health and Texas Children’s Hospital announced similar plans in August.

Thursday’s executive order will bring similar mandates to the city’s remaining health systems.

Until now, Harris Health System and UTHealth had encouraged worker vaccinations but were unable to require it under the governor’s order.

But on Friday, Harris Health System said it “fully intends to embrace the vaccine mandate” for workers at its two hospitals, 18 community health centers and 10 clinics serving the greater Houston area. The system has not yet set a date.

UT Health said it would wait for guidance from the Centers for Medicare & Medicaid Service, expected in October. It had not instituted a mandate as of Friday afternoon.

St. Joseph Medical Center and UTMB Galveston said they are still evaluating Biden’s plan.

While Kelsey-Seybold Clinic said in August it was waiting for full vaccine approval from the U.S. Food and Drug Administration before asking employees to provide proof of immunization, the clinic has not announced a mandate since the Pfizer-BioNTech vaccine gained full U.S. Food and Drug Administration approval late last month.

See here for the background. I agree that the mandate coming out now will have little to no effect on the current surge, given that it takes a few weeks to get both shots and the full effect of them, and that it will take time for these hospital systems to get their programs going. It would still be nice if some of them had more of a sense of urgency about it. This is still by far the best thing we can do for the medium to longer term, and at the very least these hospital systems should be setting a better example. Get it done already, y’all. The Trib has more.

Fired Methodist employees file another lawsuit

In state court this time, in what should be one of the friendliest venues available to them.

A new lawsuit filed Monday in Montgomery County against Houston Methodist claims the hospital wrongfully terminated 62 employees over their COVID-19 vaccine requirement.

The suit, filed by attorney Jared Woodfill, alleges the hospital’s COVID vaccine mandate goes against Gov. Greg Abbott’s statement that the government can’t mandate vaccine passports in Texas, that breakthrough infections pose a problem with the current COVID-19 vaccines available and that there was no exception for people who have not been vaccinated because they previously caught COVID-19 as a result of their employment.

In June, a federal judge tossed a lawsuit filed against Houston Methodist Hospital over its COVID-19 vaccine requirement, finding that the mandate “was not coercion.”

Houston Methodist became the first hospital in the nation to require a COVID-19 vaccine as a condition of employment. The health system’s human resources policy required employees to be fully vaccinated by June 7, or risk suspension and eventual termination.

[…]

Woodfill, the former Harris County GOP chairman who is representing the 62 plaintiffs, noted in an interview that Abbott has repeatedly said vaccines will not be mandated by the state.

Specifically, he noted Abbott’s most recent order, in which the governor said Texans “have the individual right and responsibility to decide for themselves and their children whether they will wear masks, open their businesses and engage in leisure activities.”

Woodfill said Abbott’s order “articulates or identifies a public policy for the state of Texas, that you can’t just force people to comply with.”

In the first lawsuit filed against Houston Methodist, Woodfill and more than 100 plaintiffs argued the vaccine requirement was unlawful. The complaint likened the vaccine requirement to a violation of the Nuremberg Code, the set of medical ethics created following World War II in response to Nazi atrocities.

U.S. District Judge Lynn Hughes called the comparison “reprehensible” in his June ruling tossing the lawsuit. Woodfill and the plaintiffs have appealed the ruling.

More than 170 employees at Houston Methodist were fired after not receiving the COVID-19 vaccine by the June deadline, according to the hospital.

Houston Methodist CEO Marc Boom said Monday he was “not surprised” by the complaint.

“It just seems to completely rehash the other lawsuit, which was very clearly and definitively overturned and dismissed by Judge Hughes,” Boom said. “We would expect the same thing in this case.”

See here, here, and here for some background on the federal lawsuit. While Montgomery County is likely to be as pro-COVID a location as Jared Woodfill could find for this nonsense, the fact remains that Texas is a strongly pro-employer state, and that will be a high hurdle to overcome. As the story notes, multiple other hospital systems including (finally) Texas Children’s and St. Luke’s have initiated similar mandates, so there doesn’t seem to be any fear of the legal risk on their part. I expect this will get swatted back, but with Montgomery County you can never be too sure. We’ll keep an eye on it.

More on the Memorial Hermann and Baylor vaccination mandates

Memorial Hermann: Get your shots or get out.

Memorial Hermann on Monday said it will require all employees to be vaccinated by Oct. 9, becoming the third Houston healthcare institution to do so.

The hospital system follows Baylor College of Medicine, which announced its employee vaccine requirement last week, nearly two months after Houston Methodist reached its vaccination deadline.

Managers and other leaders across the organizations must be compliant by Sept. 11. The deadline is Oct. 9 for all other employees, including the system’s affiliated providers and volunteers.

About 83 percent of Memorial Hermann’s workforce is fully vaccinated, including 87 percent of bedside staff, 95 percent of managers and above and all executive leaders, according to the hospital system. Memorial Hermann employs more than 29,000 people.

Exemptions will be made for those who are unable to be vaccinated due to medical or religious reasons. Employees who are not exempt and refuse the vaccine “will be deemed to have voluntarily resigned their position,” said Dr. David L. Callender, Memorial Hermann President and CEO.

He said spiking hospitalizations and COVID cases prompted the move.

“We’ve been waiting a little bit just to make sure the circumstances fully warrant moving forward, and we think they do now, “ Callender said Monday. “We’re seeing the impact of the very aggressive delta variant, a significant spike in new cases and hospitalizations, and about 50 percent of Houston’s population remains unvaccinated, which means the community continues to be at risk.”

See here for the background. I don’t think that justification needs any further explaining. By the way, the Memorial Hermann CEO wrote an op-ed in March, just as we were starting to hear about some scary variants out there, begging Greg Abbott to leave mask mandates in place. We know how that went.

Here’s Baylor, from about a week ago, with a somewhat less punitive approach.

Baylor employees have until Sept. 15 to become fully vaccinated or they may be subjected to discipline, said Dr. James McDeavitt, senior vice president and dean of clinical affairs at the medical school. However, he believes termination will be a “rare event.”

“We thought it was important to make a statement,” McDeavitt said. “As an organization, we are committed to vaccination, and we have been involved in all stages of the pandemic, from the development of vaccines, testing, clinical trials of medications and critical care of patients. (Requiring vaccines) was a necessary step for us to close that loop.”

Baylor’s vaccine policy had been in the works for some time, McDeavitt said, but the spike in cases was a catalyst for releasing the policy this week. “The spreading of the delta variant had a role in the timing of the release of this,” he said.

The policy, which was sent to employees Wednesday, details requirements for annual influenza and COVID-19 shots, except for people who have religious beliefs or a medical condition that would preclude them from becoming immunized.

So far, employee feedback has been positive, he said.

“I haven’t gotten any negative pushback to date,” McDeavitt said.

Baylor looked to Houston Methodist’s example when developing its policy, McDeavitt said. Methodist was the first health system nationwide to require vaccinations for employees in early June. More than 150 hospital employees resigned or were fired over the new policy — fewer than 1 percent of Methodist’s 25,000 employees.

“We will roll this out differently than Houston Methodist did. If someone flat-out refuses to become vaccinated, we don’t intend to jump to termination,” McDeavitt said.

For employees who are vaccine-hesitant, there will be a human resources process to further encourage them to take the shots. McDeavitt hopes no one is terminated over the new vaccination policy.

We’ll see how that works for them. I don’t care either way, as long as it gets the desired result. There’s no indication in that story of how many BCM employees are already vaccinated. MH’s 83% is not bad, but obviously it can – and will – be better. I wish they had done this sooner, but at least they are doing it. Texas Children’s, where are you on this?

More hospital systems to require vaccines

About time.

Memorial Hermann officials are finalizing details on its mandatory vaccine policy for employees.

During a radio interview Wednesday, Dr. David L. Callender, president and CEO, said the system will soon announce the timeline for its employees to become fully vaccinated.

The new measure comes as a fourth wave of the virus spreads across the state, due in large part to the ultra-transmissible delta variant. On Friday, the Department of State Health Services reported 13,871 new confirmed COVID cases, the largest single-day count since last winter’s surge and more than 12 times the number of cases confirmed on July 1.

“We think it’s very important for health care workers across the country to be vaccinated as vaccination is really the only way to stop this pandemic,” Callender said on the Houston Public Media radio show. “We’re working on (the policy), and will be making an announcement early next week.”

As of Friday morning, no details were made available on a vaccination deadline for employees or what type of discipline they may face if they do not comply with the new policy.

[…]

Memorial Hermann follows Baylor College of Medicine, which this week became the second Houston-area health care facility to require vaccines for employees, nearly two months after Houston Methodist reached its vaccination deadline.

Baylor employees have until Sept. 15 to become fully vaccinated or they may be subjected to discipline, said Dr. James McDeavitt, senior vice president and dean of clinical affairs at the medical school. McDeavitt expects most of the system’s employees will comply, and he believes firings connected to the policy will be rare.

I mean, Houston Methodist was doing this back in April, before any of us had ever heard of the Delta variant. They prevailed in a lawsuit, which is now under appeal, so the legal precedent is there for Memorial and Baylor. I honestly don’t know what has taken them so long, but better late than never. Now I’m wondering about other hospital systems – when I went to the Memorial Hermann Twitter page to get their logo for the embedded image, they suggested Texas Children’s Hospital, and now I’m wondering what their policy is. A Google search did not answer that question for me, which suggests the answer is No. Get it together, Texas Children’s!

The fourth wave

We’re not ready.

One local hospital is reinstating visitor limits and Harris County Judge Lina Hidalgo is mulling a change to the county’s threat level amid a wave of COVID-19 variant cases that medical leaders warned Tuesday could overwhelm area hospitals and wreak further havoc as schools reopen next month.

The warning came amid massive spikes in hospitalizations across the Houston region, which Hidalgo’s office is closely monitoring to decide if the county needs to raise its emergency threat level from yellow to orange — or moderate to significant.

“We’re watching this very, very closely,” Hidalgo spokesperson Rafael Lemaitre wrote in an email. “The trends are moving in the wrong direction again and we are in a high-stakes race against the delta variant of this virus. Our message to the community is simple and clear: If you haven’t been vaccinated, take action now.”

In May, Hidalgo lowered the threat level from red — where it had been for nearly a year — to orange, then yellow a few weeks later, as COVID cases waned statewide.

But this month, hospitalizations across the state have more than doubled, ballooning from 1,591 on July 1 to 3,319 as of Tuesday, according to the Texas Department of State Health Services. The state’s hospitalization count peaked in January at 14,000.

Texas Medical Center CEO William McKeon said he fears the closing of many testing centers will make it more difficult to gauge the extent of COVID’s spread in the coming weeks.

“As this fourth wave begins in force, our radar is down,” Texas Medical Center CEO William McKeon said in a Tuesday conference call with reporters. “We have only a fraction of the testing…. We’re going to be running much more blind to the spread of delta variant in our community.”

[…]

Memorial-Hermann Health System plans to readopt visitor restrictions this week, and will test all patients for COVID, regardless of their vaccination status, said Dr. Annamaria Macaluso Davidson, vice president of employee health medical operations.

The hospital system had about 100 confirmed COVID cases on July 4; by Tuesday, there were more than 250.

We’ve been discussing this, and you know how I feel. The hospitalization numbers are still relatively low, but that’s a sharp increase, and there’s no reason to think there won’t be more. And I hadn’t even thought about the drastic reduction in testing facilities – I don’t know how big an effect that may have, but it’s not going to help.

I drafted this a couple of days ago, and before I knew it, Judge Hidalgo had already taken action.

Harris County’s emergency threat level was raised to orange — or “significant” — on Thursday and County Judge Lina Hidalgo called for resumed mask wearing amid a fourth wave of COVID-19 that has already caused hospitalizations to spike across the region.

“It’s not too late,” Hidalgo said. “But if we don’t act now, it will be too late for many people…. We are at the beginning of a potentially very dangerous fourth wave of this pandemic.”

The guidelines for the orange threat level are voluntary, and urge residents — namely those who are not vaccinated — to avoid large gatherings and businesses with poor safety procedures.

Hidalgo also said “everyone” should resume wearing masks to protect the County’s population who are not fully vaccinated. Currently, about 2.1 million county residents are fully vaccinated — 44 percent of Harris County’s total population.

She noted the county’s positivity rate is now doubling about every 17 days, quicker than any other point in the pandemic.

Get your masks back on, and hope for the best. I trust Judge Hidalgo to do everything she can to ameliorate this situation, but as we know, there’s not a lot she can do. Greg Abbott has seen to that.

One thing that could help is if more places of business begin putting in their own vaccination requirements, mostly for employees but also possibly for customers or business partners, depending on the situation. Putting some limits on what one can do as an unvaccinated person is one of the few effective ways to compel people to get their shots. That will have to come from the private sector, because it sure won’t come from the state. The FDA giving final approval to the Pfizer and Moderna shots will help, too. I just don’t know how long we can wait.

Methodist anti-vaxxers officially fired

I have three things to say about this.

More than 150 Houston Methodist Hospital employees resigned or have been fired as of Tuesday over a recent policy that required hospital employees to be vaccinated against COVID-19 by Monday.

All told, 153 people are no longer employees of the Houston health care chain, Methodist spokesperson Patti Muck said. The hospital has about 25,000 employees, nearly all of whom have abided by the policy, Methodist leaders have said previously.

The firings follow a contentious few weeks in which hospital employees staged protests and filed a lawsuit against the hospital, claiming the policy, announced in April, violated their rights. Methodist was one of the first large health care providers in the country to announce vaccine requirements.

“I’m so happy and relieved,” Jennifer Bridges, the lead plaintiff in the suit, said Tuesday. “I don’t want any part of Methodist.”

Earlier this month, a federal judge tossed the lawsuit filed by more than 100 Methodist employees, most of whom were not doctors or nurses. In it, the plaintiffs argued Methodist’s policy violated the Nuremberg Codes, a World War II-era agreement that bans involuntary participation in medical trials.

Bridges said Tuesday that she and others planned to protest outside Methodist on Saturday, and that conspiracy theorist Alex Jones will be in attendance.

See here and here for the background. My three things:

1. I strongly suspect Methodist would say that the feeling is mutual, Jennifer.

2. Inviting Alex Jones to your protest really makes one question the previous statements made about how these folks are not anti-vaccine, just super cautious about this particular vaccine.

3. As Methodist cardiovascular technician Deedee Mattoa says in this story, the real surprise here is not that Methodist followed through, but that Memorial Hermann and Baylor College of Medicine, which have made public promises to require COVID-19 vaccines but have not set deadlines for when staff will need the shots, have not yet followed suit. What are you guys waiting for? The Trib has more.

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’s hospitals are still busy

Interesting.

While local hospital leaders aren’t sounding the alarm about capacity concerns, we heard a similar story from leaders at St. Luke’s and Houston Methodist: hospital beds and emergency rooms are regularly filling up as both health systems continue to manage coronavirus patients on top of all the folks finally heading to the hospital for care they may have delayed due to the pandemic, all while the number of patients coming into local emergency rooms is already hitting pre-COVID levels.

Roberta Schwartz, Executive VP of Houston Methodist Hospital in the Texas Medical Center, told the Press that it wasn’t surprising to hear that the Houston Methodist ER in Sugar Land was recently so busy it had to turn away ambulances temporarily.

“The emergency rooms and the hospitals are very full,” Schwartz said.

When we asked Dr. Brad Lembcke — Chief Medical Officer at St. Luke’s — about the current status of his hospital system’s bed count and ER capacity, he said “We’re full, I guess is probably the two-second version.”

[…]

Lots of Schwartz’s colleagues around the country have told her their hospitals are seeing lower numbers of emergency room visits than they did before COVID. “That is not the case at Houston Methodist,” Schwartz said, “and seems not to be the case in Houston.”

St. Luke’s is also seeing a similar trend of ERs packed with more patients than in other parts of the United States, Lembcke said. While “a lot of places report only recovering to about 80 percent of what their prior volumes were,” he said, St. Luke’s main downtown hospital is now seeing ER numbers that have “just about reached the pre-COVID states.”

Even though coronavirus hospitalizations have fallen after the winter surge, local hospitals continue to deal with steady numbers of COVID-19 patients. At Houston Methodist, the number of coronavirus hospitalizations has plateaued in recent weeks, and at a level higher than where that patient count leveled-off at after the first two surges in the spring and summer of 2020.

Schwartz said that after the first surge last spring, coronavirus hospitalizations at Houston Methodist fell to around 50. Following the summer surge, they averaged “about 100 COVID patients on a daily basis.”

“When we came down from this latest surge in December and January, we’re settling in at about 180 to 200,” Schwartz said.

“If you had a normal load of patients, and you add on 200, that would put some stressors to the system, and I think that you’re seeing that across Houston. And this comment on saturation is not just us, it’s lots of hospitals,” she said.

Lembcke said that St. Luke’s average number of coronavirus hospitalizations these days is “maybe a little higher” than what they saw right after the summer surge. “But it’s more consistent. It’s been pretty stable over the last month or so.”

When asked about why Houston’s hospitals are still so full, Schwartz said she and her colleagues have a few educated guesses.

“We do know for sure — 100 percent, this is documented in many papers — that people have delayed their care in many cases, and are coming in with later stage illnesses,” many of whom whose conditions got bad enough that they needed emergency care, Schwartz said. Some of those patients “were people who said ‘I don’t want to get COVID from going to the hospital or to the doctor.’ We know that.”

They note also that a lot of nurses have retired or left the industry due to burnout from the previous high volume of COVID cases, and that they are seeing a lot more younger patients with serious COVID issues, as is “needing a lung transplant”-level of seriousness. I certainly hope we’ll get back on a downward trajectory as more people get vaccinated, but this is a reminder both that we really need to get as many people vaxxed as we can, and that even as the overall numbers have dropped we’re still not out of the red yet.

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.

We’ve got all kinds

Not the kind of distinction you want.

Houston is the nation’s first city to record every major variant of the novel coronavirus — many of which are more contagious than the original strain.

“The numbers of the major variants we have identified in our large sequencing study are disquieting,” said Dr. James Musser, who leads the team of experts at Houston Methodist Hospital behind the new finding. “The genome data indicate that these important variants are now geographically widely distributed in the Houston metropolitan region.”

It comes barely a week after the ever-evolving virus’ death toll in the United States passed the half-million mark, a grim figure that Musser and other experts believe will continue to increase unless Americans double-down on social distancing, masks and vaccination efforts.

Since the virus was first detected in the Houston region nearly a year ago, Musser’s team has sequenced more than 20,000 genomes of COVID-19. The most recent batch of roughly 3,000 genomes sequenced from patients who had tested positive for COVID-19 included variants from the United Kingdom, South Africa and Brazil.

Experts are still researching the new strains and the effectiveness of the Moderna and Pfizer vaccines. But there’s no reason to panic, said Dr. Wesley Long, a Methodist infectious disease expert who assisted with the study.

There is evidence that the Brazilian strain is more contagious and can infect those who have received the Pfizer or Moderna vaccines, Musser said.

But Long said the variations in vaccine effectiveness are minor and don’t detract from the overall goal of vaccines: to prevent severe illness, hospitalization or death.

“It doesn’t mean that (current vaccines) are useless,” he said. “That doesn’t mean that (the new strains) go through walls or defeat masks or that they change the way they are transmitted. All of the rules that we’ve used against COVID still apply.”

His advice: Continue to social distance and wear masks and get vaccinated as soon as possible — regardless of which brand is available.

Go tell that to Greg Abbott. He won’t listen, but at least you can say you tried.

More COVID restrictions are about to happen in Harris County

Blame Greg Abbott and the virus, in whatever order you prefer.

Houston and its surrounding communities on Tuesday became the latest region to require new emergency restrictions after seven straight days of ballooning coronavirus hospitalizations.

The rollback, mandated under Gov. Greg Abbott’s emergency protocols, includes restaurants dropping to 50 percent occupancy from 75 percent, and bars that have not reclassified as restaurants closing immediately. The restrictions remain in place until the region drops below 15 percent COVID-19 hospitalizations for seven straight days.

As of Monday, the latest day of available data, the Houston region was at 19.9 percent, up from just over 13 percent a week earlier. Infections and hospitalizations have been rising steadily in recent weeks, following spikes in other parts of the state and amid holiday gatherings.

All but four of the state’s 22 hospital regions were over 15 percent as of Monday.

Texas Medical Center Hospitals in Houston announced earlier Tuesday that they were putting a hold on certain elective surgeries to save resources for coronavirus patients. Under the governor’s protocols, hospitals are required to postpone elective surgeries that would deplete COVID-19 resources.

“The best thing we can do is take this threshold as a wakeup call,” Harris County Judge Lina Hidalgo said in a news conference Tuesday afternoon. “This is the time to take this for the red alert that it is. We are only going to get through this if we are able to quickly stem the tide of hospitalizations.”

More here.

The rollback comes as Texas Medical Center hospitals already had begun deferring certain elective procedures or readying such a managed reduction strategy, the same one they deployed during the summer when patient censuses spiked. The reduction is not the wholesale delay of elective procedures all Texas hospitals invoked in the spring.

Hospital leaders said Tuesday their systems will continue some elective procedures but suspend those non-urgent cases whose demands on staff and space detract from resources better used to treat COVID-19 patients. Procedures such as mammography and colonoscopy will continue because they don’t tax needed hospital resources, for instance, but some procedures like heart catheterizations might be better delayed.

[…]

The surge of COVID-19 hospitalizations has been relentless. The number of admitted COVID-19 patients in the Houston region has increased for 13 straight weeks, and the 25-county area anchored by Harris County had more than 3,100 hospitalizations on Monday, the highest since July, the peak of the first wave in Texas.

Houston Methodist was just short of 700 COVID-19 patients on Monday. Methodist CEO Dr. Marc Boom emailed employees that if this trend holds the system will surpass its peak July numbers in a matter of days.

“This may well be among the most challenging few weeks we’ve experienced during this pandemic,” Boom wrote in the email to employees Monday. “Together, we will get through this, but it will be difficult.”

Dr. James McCarthy, chief physician executive at Memorial Hermann, said his system exceeded 800 patients and should eclipse July numbers by the third week in January. The system’s number of patients has increased three-fold over the last month, he said.

[…]

The COVID-19 positive test rate statewide is now at 20.53 percent. Methodist’s is nearly 32 percent.

Porsa said said Harris Health is about to enter Phase 3 of its surge plans, which involves closing some of its clinics in order to deploy its nurses and other staff at Ben Taub and Lyndon B. Johnson hospitals, both of which are near capacity. He said the leadership is currently determining which clinics to start with.

Hospital officials said they are encouraged that ICUs aren’t being overloaded with COVID-19. They said their staffs have gotten much better, thanks to better treatment options and nine months of experience with the disease, at getting patients discharged faster now compared to early summer.

But with the Houston area now averaging more than 3,300 new COVID-19 cases a day — compared to roughly 2,330 such cases at the pandemic’s height in July — it appears the peak won’t come before late January or February, hospital officials said. They also worry a more contagious strain — not yet identified in Houston but maybe already here — poses an even greater threat ahead.

“January and February are shaping up to be our darkest days, given these record numbers,” said William McKeon, CEO of the TMC. “Hospitals lag behind in feeling the effects of increases in cases so expect the numbers to keep going in the wrong direction before things get better.”

We’re already passing the levels we had seen at the worst of it in July, and we’re probably a few weeks out from hitting the peak this time around. Remember all this next year, when it’s time to vote for our state government.

It’s still not too late to prevent a big spike in COVID infections

But it will be soon.

A rise in COVID-19 cases has health care officials and government leaders pleading with Houstonians: Act now to prevent, or at least minimize, a third wave of infections across Greater Houston.

“This feels a lot like late May, early June when we saw the early warning signs that things were beginning to increase,” Dr. Marc Boom, president and CEO of Houston Methodist, told the Chronicle on Tuesday, “and then things slipped out of our control.”

According to a Chronicle analysis, the seven-day rolling average for newly reported cases was 1,044.2 as of Monday in an eight-county Houston area. That’s the highest since Oct. 8. In the summer, the rolling average peaked July 17 at 2,432.7.

The rate at which the virus is spreading, called the reproduction rate, reached 1.18 across a nine-county Houston area as of Monday, according to the Texas Medical Center. A number below 1, which the Houston area did report for a few weeks, means the virus is burning out. A number above 1 means that virus spread is increasing. During the COVID-19 spike this summer, Houston’s reproduction rate was in the 1.5-1.7 range when things were getting out of control, Boom said.

Finally, the seven-day average for COVID test positivity rate was 4.2 percent for TMC hospital systems as of Monday. It had been 3.4 percent last month.

For the city, Mayor Sylvester Turner on Monday reported the positivity rate was 6.5 percent as of Oct. 21. Statewide, the positivity rate was 9.42 percent as of Monday.

[…]

Houston-area case increases are not as severe as in other parts of the country and state. In the U.S., 489,769 new cases have been reported since Oct. 20. There are surges in Wisconsin and other Midwest states. In El Paso, state health officials converted a convention center into a makeshift hospital to ease the crush of patients.

Still, Shreela Sharma, an epidemiologist at UTHealth School of Public Health, knows how quickly COVID cases can climb. And she said the number of new cases in the Houston region is roughly 40 percent higher than when the summertime peak began. That means if a third wave does occur, it would start with a higher baseline.

The time is now to wear masks, practice social distancing and wash your hands.

“Our window is right now,” she said. “We could rapidly lose that window over the next few weeks.”

Yes, that is the one piece of good news. We know how to get a handle on this, and we’ve been doing it all along. Wear your mask – yes, wear it while voting, too – maintain social distancing, and avoid indoor gatherings. This week’s colder weather excepted, we’re in much better shape to handle the winter than the northern climes, because for most of our winter it’s still perfectly amenable outside for activities and dining and whatnot. Again, just don’t be an idiot. Do the things that you know you need to do. The alternatives are so, so much worse.

One more thing:

Researchers with Houston’s Health Department will monitor the wastewater flushed from 60 schools and 15 senior living homes in the city for COVID-19 in hopes of catching outbreaks before they arise in clinical testing.

City council on Wednesday unanimously approved $11.5 million in federal COVID-19 spending. Included in that was $221,000 to buy the sampling equipment needed to expand the city’s existing wastewater testing program into K-12 schools in areas with high positivity rates.

People shed the novel coronavirus through feces, regardless of whether they experience symptoms. The samplers will be installed in manholes outside the schools, and researchers will analyze them, looking for the virus.

“It’s very granular,” said Dr. Loren Hopkins, the health department’s chief environmental science officer. “We don’t expect to see any positives at all, we expect to see nothing… If we see something in a school and we see it two days in a row, then we know someone in that school is shedding the virus.”

The department would then alert the school and deploy the more traditional, clinical testing, according to Hopkins.

Don’t laugh, this is an effective method of contact tracing. It’s already been used successfully by the city. Now, if there are people who can test wastewater to see if your poop has the COVID virus in it, you can damn sure keep wearing your mask.

“On the cusp” of another COVID surge

The numbers are already trending up. You know what that means.

Cases of COVID-19 in parts of Texas surged to near catastrophic levels this summer as some hospitals were forced to put beds in hallways, intensive care units exceeded capacity and health officials struggled to stem the tide of the virus.

After peaking in late July and August, cases fell and leveled off in September, and the state’s seven-day positivity rate — or the proportion of positive tests — reached its lowest point since early June.

But health officials are now eyeing a worrying trend: New infections are rising again, and the number of patients hospitalized with COVID-19 is also ticking upward. The state reported 2,273 new cases Monday, and the seven-day average was up by 862 from the previous week. On Monday, at least 4,319 patients were hospitalized with COVID-19, far below the more than 10,000 in July, but that number has steadily risen during the last month.

“I’m no longer pondering if we’re going to see a surge,” said Dr. James McDeavitt, dean of clinical affairs at the Baylor College of Medicine. “We’re already seeing it.”

Eight months since Texas recorded its first case, experts say the state is more prepared to handle another wave, but they fear that if the state fails to control the outbreak, it could quickly spiral out of control.

“The question is whether it’ll be a modest surge, or something like we saw in July, or worse,” McDeavitt said.

[…]

At Houston Methodist, one of the region’s largest health care systems, medical staff were stretched thin this summer, said President Marc Boom. At its peak in July, the system’s staff treated nearly 850 patients with COVID-19 each day. Since then, Boom said, the medical community’s understanding of the virus has evolved, along with how to treat the disease.

Remdesivir, an antiviral medication, has shown promising results in minimizing the severity of illness, especially when administered shortly after symptoms develop. Houston Medical was the first hospital to use convalescent plasma, a therapy in which antibody-rich blood from people who have recovered from COVID-19 is administered to ill patients, Boom said.

“We’ve had tons of experience gained, better outcomes, shorter lengths of stay,” Boom said. “But this is still a serious illness.”

While health authorities are better equipped to deal with new spikes, including an adequate supply of protective gear and sizable quantities of drugs like Remdesivir, a fall surge could still be equally as taxing on hospitals, said Carrie Kroll, vice president of advocacy, quality and public health at the Texas Hospital Association. As colder weather forces people inside and families gather for the holiday season, the chances for transmission increase, she said.

“We certainly have been tested, and we know the beast that it is, and have shown that we were able to make it through those first two spikes,” Kroll said. “But we don’t want to test the limit by putting patients into hospitals.”

See here for the previous update. It’s getting bad all around the country, too. Just a reminder, the July surge was bad, and it took Greg Abbott way too long to react to it. In the meantime, various assholes have decided that it’s a good use of their time to sue everyone in sight to limit the government’s ability to respond to COVID-19. I have one small bit of local optimism in that Harris County has not backed down from being at the top threat level even as the numbers were improving. Our numbers are also trending up, but they’re not as bad as other places. Yet, anyway.

“The trends are going in the wrong direction,” said William McKeon, president of the Texas Medical Center. “You hate to see the sacrifices we made and the successes we achieved lost because people let their guard down.”

Dr. Marc Boom, president of Houston Methodist, said, “We’ve definitely turned the wrong corner. The numbers aren’t growing in an out-of-control fashion, but there’s no doubt we’re in a significant growth trend that we need to stop before the holiday season.”

[…]

The Houston numbers are well below those in other parts of the country, particularly the Midwest and the West. As of Monday, 16 states had added more COVID-19 cases the past week than in any other seven-day period.

The surge is even greater in Europe. There the total of new cases in the five most-affected countries — France, the United Kingdom, Russia, Spain and the Netherlands — was nearly 42 percent greater than the U.S. increase a week ago.

Nor does Houston’s increase compare to the Panhandle and El Paso. El Paso health officials Monday reported their highest number of COVID-19 hospitalizations since the pandemic began — 449 in one day — and said just seven of the city’s ICU beds were unoccupied.

Still, increases in Houston area’s key metrics since early October are cause for concern, said local health officials. Those provided by the Texas Medical Center include:

• The rolling average of 497 COVID-19 cases reported the week ending Sunday represents a 33 percent increase from late September, when the number was 373. It increased gradually the weeks in between.

• The number of COVID-19 patients admitted to TMC hospitals exceeded 100 last week, up from the 80s the previous week and 70s the week before that.

• The TMC COVID-19 test positivity rate, 3.4 percent early in October, has been at 3.9 percent the past week, an 8 percent increase.

• The so-called R(t), or reproduction rate, the rate at which the virus is spreading, did drop to 0.99 Tuesday, but that remains a 55 percent increase over the Sept. 29 rate of 0.64, when the spread was decreasing. The rate last week hit 1.14, which means the virus’ spread was increasing.

“We’re in a yellow zone, not a red zone”, is how one doctor put it. “COVID fatigue”, they say this is. I get that, but you can see what happens when we start to take this less seriously. Until there’s a widely available vaccine, wear your damn mask, stay out of crowded indoor spaces, maintain social distancing, and hope for the best. At least our mild winter weather means we can largely stay outside. It could be worse.

No smokers need apply

Boy, is this a big can of worms.

Methodist Hospital System in Houston this month announcedit will implement a tobacco-free hiring policy on Jan. 1, joining the Texas Medical Center and Memorial Hermann Healthcare System, which have had similar policies since last year and 2010, respectively.

The policies are straightforward. Applicants who smoke or chew tobacco will not be hired. Existing employees are exempt.

A growing number of hospitals and health care institutions have adopted the policies to promote wellness, improve productivity and rein in rising health care costs, but critics say they discriminate and could lead to punitive actions against other personal habits and vices.

“We think this is an invasion of privacy and really overreaching,” said DottyGriffith, public education director for the American Civil Liberties Union in Texas. “At what point do you give up your rights and autonomy? Will they not employ those who ride motorcycles and drink alcohol?”

Dr. Marc Boom, president and CEO of Methodist Hospital System, said the policy is about company employees modeling healthy behaviors. More than 13,000 people work at the system’s five hospitals.

“This is part of a journey of wellness and making this a great place to work,” Boom said. “Employees work here to take of care patients. We can only do that if we’re leading by example.”

Methodist’s online application will warn job seekers that it is a tobacco-free employer and that urine tests will be used to detect nicotine. A job offer will be rescinded if an applicant’s results are positive. Free smoking cessation classes will be offered, giving applicants an opportunity to reapply if they have been smoke-free for 90 days.

On the one hand, it makes perfect sense for a hospital system to practice what it preaches. There’s a lot to be said for leading by example. And, though it isn’t specifically mentioned in the story, having an entirely non-smoking workforce would be great for Methodist’s bottom line, since it would reduce their own health care costs. Therein lies the rub, of course, because if having a non-smoking workforce is good for the company, then so is having a non-overweight workforce, and who knows what else. Employers have enough power over their employees already, thanks very much. Be that as it may, I have a strong feeling this will ultimately be settled in a courtroom, after someone files suit for discrimination. What do you think?