Are Alaska’s hospitals short-staffed over COVID-19 vaccination mandates? Not yet.

An as-yet-unknown number of nurses and other health care employees are either considering leaving their jobs or facing termination as vaccine requirements go into effect at hospitals around Alaska.

Hospitals say vaccinated employees help prevent the spread of COVID-19 and are far less likely to get sick with the virus.

Some public officials, including Anchorage Mayor Dave Bronson, blame mandates for the ongoing staffing shortages straining hospitals as COVID-19 cases remain near the highest levels seen during the pandemic.

That is categorically not true, say Anchorage hospital leaders: The current problem is being caused by a combination of factors, including burnout and COVID-related absences.

A more realistic concern is the possibility that mandates could worsen already compromised staffing levels, health care observers say.

The issue is contentious. No nurses interviewed for this story were willing to go on record.

Two hospitals already have vaccine mandates in place: Fairbanks Memorial Hospital and PeaceHealth Ketchikan Medical Center, where a combined 25 employees have left or been placed on leave.

Eleven workers — or just over 0.5% — of 1,850 employees with Foundation Health Partners, which operates Fairbanks Memorial, decided to leave the organization rather than get vaccinated or submit a medical or religious exemption, Foundation Health Partners said late Friday, the day the hospital’s vaccine mandate went into effect.

Mandates went into effect at the end of August in Ketchikan, where even employees who received religious or medical exemptions aren’t allowed on campus if they’re not vaccinated.

About 14 caregivers or just under 3% of 500 employees across the hospital and clinics operated by PeaceHealth Ketchikan either resigned or are on administrative leave for “noncompliance with vaccine policies,” according to hospital spokesperson Kate Govaars.

Workers who got exemptions are allowed to work remotely if their position allows, or are placed on case-by-case administrative leaves if not to avoid any risk of COVID-19 transmission to patients, Govaars said. She wasn’t able to say if the leaves are paid.

The situation is not leading to staffing shortages at Ketchikan, Govaars said.

“Vaccine requirements are working across the country,” she said. “From a public health standpoint, it’s absolutely the best thing we can do for patient safety. Vaccination has been proven to be the most effective strategy in reducing long-term illness and death from this virus.”

[Alaska reports over 1,000 COVID cases Friday as ANMC shifts care standards, gets help from Outside workers]

‘Quite a bit of angst’

Until future vaccine deadlines come and go at Anchorage’s large hospitals, the broader effect of any health worker departures — and how many actually happen — remains to be seen.

The state’s largest hospital, Providence Alaska Medical Center, announced last month it will require all caregivers to be fully vaccinated by Oct. 18 or have an approved medical or religious exemption.

The hospital isn’t releasing any information about exemption requests before that deadline, spokesperson Mikal Canfield said Friday. About 85% of the workforce is in compliance with the Providence vaccination policy, a statistic that doesn’t reflect employees who’ve had only the first dose of a vaccine.

Two of the state’s largest tribal health organizations, the Alaska Native Tribal Health Consortium and Southcentral Foundation, announced in July that staff would be required to get vaccinated or face termination by Oct. 15.

The organizations co-manage Alaska Native Medical Center, which is considering only medical exemption requests.

As of Friday, fewer than 80 Alaska Native Tribal Health Consortium workers — out of 3,020 full-time employees — have asked for exemptions, and about half were granted, according to a spokesperson. The remaining employees who don’t get vaccinated and don’t resign before the deadline will be involuntarily terminated.

Alaska Regional Hospital and Mat-Su Regional Medical Center aren’t requiring vaccination at this point. Representatives of both say hospital administrators are following federal recommendations. Final guidelines have not been released yet.

It’s likely that an influx of nurses, respiratory therapists and other contracted health workers from Outside who started arriving in Alaska this week could dilute any immediate effects of mandate-related job losses. The state is bringing up as many as 470 people through a federal contract to help critically understaffed facilities.

The Fairbanks hospital operator, for example, expects to get 20 temporary employees, officials there say. Another 70 existing employees signed up for the labor pool to provide COVID-19 relief as needed.

It’s possible, too, that some workers could leave jobs at vaccine-mandating facilities but stay within the health care industry at other facilities that aren’t.

Still, the prospect of getting vaccinated or losing their jobs is “causing quite a bit of angst” for the small number of unvaccinated nurses in the roughly 1,100-member Alaska Nurses Association, according to president Jane Erickson, an RN at an Anchorage ICU. The union represents nurses at hospitals in Anchorage, Soldotna and Ketchikan.

“They have their own reasons as to why they are not getting the vaccine,” said Erickson, who wore an N-95 mask and face shield throughout a recent 12-hour shift. “They wear their masks and their shields whenever they deal with their patients. They feel that they should be able to just sign the declination form and continue to work. I don’t see a problem with that.”

Asked how many nurses she thinks might leave, Erickson said it’s hard to say.

“I don’t know how many there are,” she said, adding the impact also depends where the nurses work. “If any are nurses in the ER or ICU, that would be significant. If they’re nurses over in mother-baby, it probably wouldn’t unless it was the majority of the staff.”

Alaska’s precarious position

A unique urgency colors the hospital vaccine debate in this state with a health care system made vulnerable by isolation.

Alaska’s seven-day per capita case rate is higher than any other U.S. state and any country in the world. Short staffing and high numbers of COVID-19 patients are straining hospitals in Anchorage, Mat-Su and rural parts of the state.

Alaska enabled crisis standards of care last week, a worst-case scenario allowing health care providers to enact protocols to ration care when they have more patients than staffing, beds or equipment to treat them.

Providence had already enacted crisis-care mode on Sept. 11. At least four additional facilities — Fairbanks Memorial, Alaska Native Medical Center, the Bethel hospital operated by Yukon-Kuskokwim Health Corp., and Providence’s Valdez Medical Center — have started using crisis standards in some form.

The Biden administration earlier this month ordered sweeping new federal vaccine requirements for up to 100 million Americans, including health care workers as well as private-sector employees, to curb the surging COVID-19 delta variant that’s driving up case counts and hospitalizations.

The Occupational Safety and Health Administration hasn’t yet released guidelines to provide specifics. That’s expected next month.

[In policy shift, Alaska Air requires COVID-19 vaccine for employees]

Firings and departures over vaccine mandates are making headlines everywhere, from at least five Bethel city employees including a police officer to Major League Baseball executives and scouts. Two days after United Airlines announced plans to fire nearly 600 workers over COVID-19 vaccine mandates, almost half submitted proof of vaccination, Forbes reported Thursday. Another 320 are expected to lose their jobs.

Nationally, a growing list of hospitals and health facilities is requiring COVID-19 vaccinations for employees, according to Becker’s Hospital Review.

Some studies show some vaccine-hesitant workers don’t quit after saying they plan to. Several surveys indicated up to half of unvaccinated workers said they’d quit before getting the shot, but a study published in Scientific American found the actual number who do resign is much smaller than the survey data suggest.

Still, job losses are real. A North Carolina provider this week fired 175 workers after they refused to get vaccinated. Vaccine ultimatums took effect this week in New York, California, Rhode Island and Connecticut, sparking fears some employees would quit or let themselves be fired or suspended rather than get the vaccine.

About 20 people employed in the medical field testified they expect to lose their jobs over vaccine mandates at a 4 1/2 hour invite-only “listening session” on Sept. 18 organized by Anchorage Assembly member Jamie Allard and attended by Anchorage Mayor Dave Bronson and numerous administration members.

The Daily News was not invited to the meeting, which can be viewed on the mayor’s YouTube page.

Much testimony referred to broadly circulating misinformation, false claims or unsubstantiated medical treatments like using “frequencies” to kill the virus.

But a similar theme emerged from many of the health workers who spoke: They don’t want to get vaccinated at this time, didn’t qualify for religious or medical exemptions, and don’t want to be forced to choose between vaccination and their jobs after working long hours through a pandemic.

Dean Robinson, a 16-year family nurse practitioner at a Southcentral Foundation clinic, said he’s been told his choice to remain unvaccinated amounts to “a form of voluntary resignation.”

Robinson praised his fellow care providers and said he’s fully endorsed the clinic’s mission and vision until now, given his employer’s mandate.

“I will no longer be working there as of Oct. 15 because .. I have chosen not to get the vaccine. I believe that’s a personal decision,” he said. “I feel like they have lost sight of where the organization ends and I begin.”

‘Without any carrot or stick’

Health care workers are a diverse group. Like the general population, not all of them want to get vaccinated. But most do.

As of Friday, about 40% of all eligible Alaskans remained unvaccinated. That statistic is probably lower among doctors and nurses, people in those fields say.

The Alaska State Hospital and Nursing Home Association initially expressed concerns that the federal policy might cut into staffing at nursing homes in a state with fewer beds than any other.

Some individual facilities probably remain anxious about losing employees, association president and CEO Jared Kosin said recently. But Alaska nursing homes have a relatively high rate of vaccination for workers and Kosin said generally he’s not hearing concerns on a larger scale.

“I appreciate people speaking up. On the larger scale, we’re not hearing that,” Kosin said. “We’re all in uncharted waters in Alaska’s health care system.”

All of the roughly 90 members of The Alaska Hospitalist Group, which includes hospitalists and intensive-care physicians, say they are fully vaccinated, according to group president Dr. Tim Bateman. That number also includes nurse practitioners and office staff.

“It’s an important message,” Bateman said. “The people who are taking care of the dying patients with COVID are all 100% vaccinated, without any carrot or stick.”

Reporter Annie Berman contributed to this story.