Needed: Vaccine Mandates

Last week I had my 4th vaccine. I felt I needed to because my doctor had told early on to get the first booster and since I got it early in July, I was worried its protective properties were getting weaker. A couple days after #4, though, my doctor called with some good news. The hospital had been allocated 250 doses of Tixagevimab plus Cilgavimab (Evusheld), a new anti-COVID antibody and that she had applied for me to get one and that I had been approved.

One dose of Evusheld, administered as two separate consecutive intramuscular injections (one injection per monoclonal antibody, given in immediate succession), may be effective for pre-exposure prevention for six months.

New cases where I live, in California-- still just 67% fully vaccinated-- are spiking... as are hospitalizations. Los Angeles County hospitalizations are up 54% in the last 2 weeks and the state's rate is a ghastly 127% up in the same period. There are 9 California counties with less than 50% of their residents fully vaccinated and seemingly on mass suicie missions:

• Lassen- 36% fully vaccinated (74.5% Trump)-- 14-day case increase- 391%

• Tehama- 40% fully vaccinated (66.6% Trump)-- 14-day case increase- 357%

• Del Norte- 41% fully vaccinated (56.4% Trump)-- 14-day case increase- 500%

• Kings- 43% fully vaccinated (54.9% Trump)-- 14-day case increase- 309%

• Shasta- 48% fully vaccinated (65.5% Trump)-- 14-day case increase- 220%

• Yuba- 49% fully vaccinated (59.3% Trump)-- 14-day case increase- 281%

• Merced- 49% fully vaccinated (43.3% Trump)-- 14-day case increase- 426%

• Kern- 49% fully vaccinated (53.9% Trump)-- 14-day case increase- 218%

• Tulare- 49% fully vaccinated (52.8% Trump)-- 14-day case increase- 278%

Some Trumpist hellholes like Modoc (71.2% Trump), Plumas (57.2% Trump), Sierra (58.6% Trump), and Mariposa (57.9% Trump) refuse to report vaccination rates but Modoc has reported a 52% increase in cases in the last 2 weeks, while Plumas is up 183%, Sierra is up 285% and Mariposa is up 697%.

This morning, the NY Times reported that in the cities that were hit with Omicron early, like New York, Boston and Chicago, "hospitals are seeing more patients testing positive for Covid-19 than at any time last year. Because of the sheer infectiousness of the Omicron variant, many who arrive at the hospital for other ailments test positive for the coronavirus. Some doctors have also said that patients who do have Covid as a primary diagnosis are faring better than during previous waves. Even so, the number of Covid-19 patients who need intensive care or mechanical ventilation is approaching levels not seen since last winter. And the sheer number of patients is overwhelming to hospitals, where staffing shortages are putting healthcare workers under immense strain. Healthcare workers were already quitting their jobs in record numbers before the Omicron wave. Now, many more are out sick with the hugely transmissible variant. With fewer staff members available to care for them, even a smaller number of patients can overwhelm emergency departments and intensive care units. Since vaccines became available, those who are vaccinated have been far less likely to be hospitalized with severe Covid-19 than those who are unvaccinated. Early data from New York City shows that the vaccination gap in hospitalizations became even wider during the first weeks of the city’s Omicron surge. Vaccinated patients are more likely to experience milder disease, doctors have said, and a vast majority of Omicron patients who require intensive care are unvaccinated or have severely compromised immune systems."

Glenn Altschuler's column for The Hill this morning, How to hold unvaccinated Americans accountable, may help conservatives understand why the unvaccinated are a threat to the whole country and how to push more of them towards stepping up and getting the jabs. They have the right to commit suicide by COVID if they want to but these are the folks overwhelming hospitals and ICUs, "reducing services available to people who have non-COVID related medical issues." Nearly 90% of these unvaccinated people indicate they will not change their minds. And a number of governors, most notably sociopaths like DeSantis and Abbott, "are fighting the Biden administration vaccine mandates and thwarting vaccination requirements by schools and private employers in their states."

Altschuler is advocating holding the unvaccinated "accountable for putting themselves and others at risk: make them pay more for health insurance through surcharges and eliminating paid time off when they are sick, while offering financial incentives (including lower deductibles) for fully-vaccinated Americans who enroll in wellness programs.

There is ample precedent for doing so. Smoking is exempted from federal laws restricting discrimination in premiums based on health status. Insurance companies can place a surcharge up to 50 percent (subject to limitations imposed by states) for anyone who uses a tobacco product four or more times per week. Carriers rely on the honor system, but misrepresentation constitutes fraud, and in some states is a felony. Employers providing health insurance often require routine medical examinations, in which nicotine can be detected through samples of blood and urine.

And many driving infractions result in substantial increases in automobile insurance rates: driving under the influence (DUI) can raise rate 65.5 percent; refusal to submit to a chemical test, 63.5 percent; reckless driving, 61.1 percent; at-fault accidents resulting in more than $2,000 in damages, 45.2 percent; passing a school bus, 28.4 percent; speeding, 23.8 percent; failure to stop at a red light, 22.6 percent; texting while driving, 21.6 percent; failure to use a seat belt, 5.6 percent.

This fall some employers began requiring unvaccinated workers to pay more for their health insurance. Delta Airlines (which, on average, has been paying $50,000 for each COVID-related hospital stay) imposes a surcharge of $200 per month for its unvaccinated staff. Delta also limits salary protection for those who miss work to workers who have been vaccinated and have had “breakthrough” infections. Since these policies took effect on Nov. 1, 2021, it’s worth noting, the vaccination rate among Delta employees has risen to 94 percent.

Mercy Health, whose 7,000 employees work in hospitals and clinics in Wisconsin and Illinois, has introduced a “risk pool fee,” in which $60 per week is deducted from the wages of workers who have not been vaccinated. After the policy was announced in September, vaccination rates rose from 70 percent to 91 percent.

As Omicron rages, health care workers are exhausted, frustrated, and disheartened. In a sentiment shared by many of her colleagues, Sarah Rauner, a chief nurse practitioner in Troy, Mich., declared, “So much of what we see on a daily basis is preventable.” A few days before Christmas, Sue Wolfe, a nurse in Madison, Wis., wondered why unvaccinated people “did this, why are they doing this to me … This is my second 16-hour shift this week. Came in at 2 o’clock in the morning and it’s now 7 at night. I got my 20-minute break. It gets hard. I am 61 years old and I am doing this.” Wolfe pleads with the unvaccinated to get vaccinated: “Do it for the people that you care about, that perhaps are susceptible to getting really sick because of the virus that you’re carrying.”

Last summer, an exasperated Gov. Kay Ivey (R-AL) told reporters, “Folks are supposed to have common sense. But it’s time to start blaming the unvaccinated folks, the regular folks. It’s the unvaccinated folks that are letting us down.”

Two-thirds of Americans now say they are angry at the unvaccinated.

Two years into a pandemic that has claimed over 800,000 lives, blaming and shaming are unlikely to persuade the vast majority of those remaining to take a safe and effective vaccine, for themselves, people they care about, or strangers they encounter in grocery stores or restaurants.

But if the unvaccinated can’t be reached through their hearts or minds, we can-- and should-- require them to pay at least some of the financial costs they are forcing the rest of us to bear.

A weak Biden administration doesn't have the political will to do any such thing and the political elites are unable to see past their own career trajectories to come together for the good of the country. As of this morning there were nearly 860,000 death in the U.S. That number will have to double-- or reach 2 million-- before anything like what Altschuler is proposing is implemented by the federal government, especially if-- as seems likely-- a hyper-partisan right-wing Supreme Court starts striking down what pandemic mandates there already are.