The most extensive health care systems in Georgia — Piedmont Healthcare, Wellstar Health System and Emory Healthcare —told staff that unless they were vaccinated against COVID-19 by midnight last Friday, they’d be out of a job.

That deadline came and went. But the three systems now are mum about exactly how many employees quit or were terminated for failure to meet the mandate.

Piedmont said only that its staff loss was “minimal.” Wellstar said it had vaccinated “an overwhelming majority” of its staff and was extending its deadline for full vaccination to Nov. 1 for those who had received at least one shot by the original deadline. Emory gave no description of its loss.

None of the systems addressed the question of how many employees were granted religious or medical exemptions.

Their responses reflect the sensitivity of the issue for hospitals throughout Georgia and the rest of the country. All tout their commitment to promoting vaccination. But critical shortages of nurses, respiratory therapists and other frontline health care workers have made many hospitals wait for other providers to make the first move, to see if the mandates prompt an exodus of workers.

“We have concerns about the impact on staffing,” said Dr. Phillip Coule, Augusta University Health System’s chief medical officer. “For example, whether or not we could lose staff over a mandate who, for whatever reason, have been misinformed about the safety and efficacy of the vaccine.”

Reports from other states with vaccination requirements for hospital workers have yielded a wide spectrum of results. At a large Texas hospital, nearly 25,000 workers met the deadline while 153 employees resigned or were fired for refusing vaccination. But a small New York town near the Canadian border made national headlines after it lost a dozen workers and had to suspend delivering babies.

Hospitals fear staff loss

The scant information about the impact of the Atlanta-area mandates doesn’t help other systems trying to make their own decisions.

Among those hesitating, for now, to impose vaccination mandates are Northside Hospital and Children’s Healthcare of Atlanta.

Grady said it will impose a requirement, but for now the Atlanta metro area’s biggest safety net hospital has only required its executives and higher-level staff clinicians to be vaccinated. A Grady spokeswoman, Denise Simpson, said “one or two” of those covered by the mandate were expected to leave as a result, but the system would not be able to confirm that until mid-week. Most of Grady’s doctors come from Morehouse and Emory universities and are all vaccinated, she said.

A vaccination mandate is approaching for the Veterans Affairs hospital in Atlanta. Friday is the deadline for all workers to get vaccinated or be at risk of losing their jobs. The VA did not respond to requests for comment. The union that represents its nurses, National Nurses United, said in a statement that it strongly believes all eligible people should be vaccinated, while respecting the need for medical and religious accommodations.

In rural Georgia, where vaccination rates tend to be significantly lower, a prevailing sentiment among hospital executives is fear of what might happen if they order staff to be vaccinated, said Monty Veazey, who represents many rural Georgia hospitals as a lobbyist.

And right now, there is a sense that they are too overwhelmed with COVID-19 cases to organize a mandate, he said.

“They’re short of help now,” Veazey said. “They’re too busy to fool with it, I guess. And they’re afraid of losing help. I talked to one (hospital) CEO Thursday, he was down in the ER rolling carts because they’re so short handed.”

But it’s a catch-22. The more staff who aren’t vaccinated, the more staff are vulnerable to catching COVID-19 and being absent from work.

At Northeast Georgia Health System on Monday, 103 staff were out due to coronavirus infection or exposure. NGHS spokesman Sean Couch pointed out that was out of about 10,000 staff systemwide. NGHS does not have a mandate.

Augusta University Medical Center faces the same problems, but Coule is afraid a mandate could make the shortage worse than it already is.

Phoebe Putney Health System in southwest Georgia has mandated vaccination for upper-level employees. And the system will also require all new hires to be vaccinated. But with only about 73% of Phoebe’s current staff vaccinated, the system has adopted a new policy covering the rest of its 5,470 employees and contract workers. They can choose either to be vaccinated or to undergo weekly COVID-19 tests. The tests start Tuesday.

“Since we announced our policy, only a handful of employees have mentioned the vaccine requirements as playing any role in their decision to leave our organization,” Phoebe Putney CEO Scott Steiner said in a prepared statement.

National mandate coming

Some nurses have reported staff who are unhappy with vaccination mandates being encouraged to transfer to hospitals without mandates.

The health worker job website Vivian Health maintains on its website a partial list of hospitals that have vaccination mandates; Vivian says it has no data on how many nurses use the information to avoid a job requiring vaccination.

Veazey, the hospital lobbyist, said a vaccination mandate for all hospitals is what it may take so hospitals don’t fear losing staff to a facility next door.

It’s in the pipeline. The U.S. Department of Health and Human Services is drawing up the rules now, and a draft is expected this month. It will require staff at all hospitals that are reimbursed by Medicaid and Medicare to be vaccinated.

Coule said he is concerned a government mandate will harden opposition among staff who are suspicious of government, and that some might retire rather than comply. But he agrees it will stop the concern about job-hopping, and that efforts in play now are not producing full vaccination.

Stakes are high in deciding whether or not to mandate, Veazey said .

“As long as we’re not vaccinated, (the virus is) here to stay, so you’re playing Russian roulette,” he said.