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Marita Smith runs a nursing home in Seattle, and Janet Snipes runs a nursing home in Denver. They share years of experience in the industry and painful memories of Covid-19, but differ sharply on a new federal policy that would make vaccinations mandatory for all nursing home workers.

In Ms Smith’s view, unvaccinated people should not be caring for a vulnerable population that has already been hit hard by the pandemic. While none come close to last year’s highs, the industry is again experiencing rising infection rates and deaths among residents, and the mission is intended to cause another surge.

st. Ms. Smith, director of the Mother’s Nursing and Rehabilitation Center, said “wonderful” and described the policy as “a pretty big deal” that would “eliminate healthcare professionals who shouldn’t be in healthcare.”

It’s precisely these kinds of breakups that worry Ms. Snipes, executive director of the Holly Heights Care Center in Denver. He also wants to see all nursing home workers vaccinated, but not at risk of losing employees who don’t comply amid labor shortages in an already high turnover industry.

Of the 1.5 million nursing home staff in the United States, 540,000 — 40 percent of the workforce — are unvaccinated. Their fate could be directly affected by a policy announced by President Biden on Wednesday that requires all nursing home workers to be vaccinated, and the rules are likely to go into effect in September. Facilities that fail to meet this target may face fines or qualify for federal reimbursement, a vital source of income for many.

The practical effect of the policy is that workers must be vaccinated or lose their jobs. Ms. Snipes said several employees told her they could leave. One she describes as her best nurse said she was “very, very scared” of the vaccine because she was partly black and was concerned about the medical experiments of the past.

“Getting vaccinated is the safest thing for our residents and staff, but we feel strongly that it should be mandatory for all healthcare settings,” Ms Snipes said of President Biden. “We cannot afford to lose our staff to hospitals and assisted living facilities.”

Several major hospice chains and some states, already required vaccination. Industry officials said vaccines were highly recommended, but their stance on the new policy was the same as that of Ms.

“We’re going to lose tens of thousands, maybe hundreds of thousands of workers,” said Mark Parkinson, the company’s president and CEO. American Health Association, a large nursing home trading group. He said he hoped for policy changes, and about them Dr. He said he had already spoken to Lee A. Fleisher. Centers for Medicare and Medicaid Services, and was looking for a meeting with Xavier Becerra, secretary of health and human services.

The main change sought by the industry is a signal from management that a mandate will eventually be implemented in all healthcare settings so nursing home workers understand they have nowhere else to go. “Delegate for everyone,” said Mr. Parkinson.

In fact, nearly 2,000 hospitals have already issued vaccination guidelines, reducing job options for unvaccinated healthcare workers.

Dr. Fleisher said CMS and the Centers for Disease Control and Prevention have seen an association in recent data between increased infections in nursing homes and unvaccinated staff.

Dr. “The higher the percentage of unvaccinated staff, the higher the percentage of cases we see in those homes,” Fleisher said. “There was a strong relationship.”

Currently, 60 percent of nursing home staff nationwide have been vaccinated, well below the industry’s previous target of 75 percent by the end of June.

Mr Parkinson said the industry is also lobbying the government to launch a “much more intense media campaign to influence workers” that vaccines are safe and effective. The trade organization also wants the government to create a grace period for unstable personnel.

Geriatrician and medical director of a nursing home in Philadelphia, Dr. Joshua Uy said he already saw the staffing difficulties and was “ecstatic about the task”.

“I’m tired,” he said. “A vaccine is like a small fortress around the most vulnerable, even if a fire breaks out outside, those inside stay safe.”

The mission aims to avoid an increase in Covid cases and deaths in an extremely vulnerable population.

Nearly one-fifth of the 625,000 Covid deaths in the United States to date – 133,700 – are nursing home residents, according to HKM

And a recent CDC survey of 4,000 nursing homes found that: Efficiency of Pfizer and Moderna vaccines dropped among nursing home residents As the delta variant became more common, it increased from 75 percent in the spring to 53 percent by mid-summer. “The findings highlight the critical importance of the Covid-19 vaccine for staff, residents and visitors,” the study’s authors said.

Public health experts are concerned that unvaccinated workers could bring Covid-19 to a nursing home and infect residents. More than 80 percent of nursing home residents nationwide have been vaccinated, but cases are already increasing in this population. In the week ending August 15, 354 nursing home residents died from Covid-19, the highest figure since mid-March, and 3,585 tested positive, according to the CDC.

The CDC found that more staff members also fell ill. The week ending August 15 saw 5,810 nursing home workers contract Covid-19, five times more than in the previous month, and 25 staff died.

Earlier this month, the Good Samaritan Society, which operates 142 nursing homes nationwide, announced that all 15,000 employees must be vaccinated by November 1. The company’s CEO, Randy Bury, who has argued in the past that such authorizations will create safe and desirable workplaces, said staffing levels have remained stable so far.

But he argued that the Biden administration’s new policy is misguided unless implemented across the entire healthcare industry. “What’s the difference in a long-term care facility or hospital?” said Mr Bury. “They are susceptible to the virus if they come into contact with unvaccinated personnel.”

LeadingAge, a nonprofit that represents 2,000 nursing homes and has previously called for postings in individual homes, has criticized Biden’s policy for its narrow focus.

“Management is right,” said Katie Smith Sloan, LeadingAge president and CEO. in a statement published. “We are in a time of war. It would be a tragic misstep to defend carers who continue to fight on the front lines.”

Ms. Snipes, director of Holly Heights in Denver, said she spent months training staff and promoting vaccination. He said most of his unvaccinated employees agreed to follow the instruction, but he did mention three people he feared might leave. Someone said he didn’t want to put anything foreign in his body. One second, who is Catholic, said he didn’t want an mRNA vaccine for religious reasons and got a letter of support from his bishop.

Miss Snipes, the third, was the Black nurse who “looked the most frightened of all the people I spoke to”. “I want to save him as an employee.”