If you had Stage 4 cancer, were immuno-compromised, and were receiving your chemotherapy in-home to avoid potential infection would you want unvaccinated healthcare workers treating you and visiting your home during a pandemic?
I’m assuming the answer to that question would be a very firm “no” for most people, but this is the dilemma our business faces as we wrestle with the current confusion, mixed messages, supply issues and lack of clear direction regarding mandatory vaccinations for healthcare workers.
Over the course of the pandemic many State and Territory governments introduced mandatory COVID-19 vaccination for specific high-risk employees and contractors such as those working in quarantine facilities and designated COVID-19 areas within hospitals.
The Federal Government has in the past few days also introduced mandatory COVID-19 vaccination for aged-care workers.
However there has been little conversation around the COVID-19 vaccination status of healthcare workers more generally, and the ethical dilemma we now face.
Healthcare workers work in hugely diverse working environments and with clients and patients at vastly different risks from COVID-19.
The recent “super-spreader” party in West Hoxton, NSW, showed that the vaccinated health and aged-care workers were able to avoid infection. But an unvaccinated student nurse may have been infectious during their time in two major NSW hospitals, putting staff and patients at risk.
Disregarding the difficulty all community members, including healthcare workers, are having getting vaccinated, healthcare workers include conscientious objectors to vaccination, those who cannot be vaccinated for medical reasons and the vaccine-hesitant.
So, what is our duty of care to our clients and patients?
Should unvaccinated healthcare workers be allowed to work in direct client and patient contact with specific at-risk patients such as cancer patients, those on treatment which modifies the immune system and those with compromised immune systems?
We are in, thankfully, a fortunate position.
More than 80 per cent of our direct care team are vaccinated.
Even so, we have had to make some tough decisions over the past weeks.
Decisions that are supported (where possible) by legislation, but above all, decisions that protect our vulnerable patients as these are the only decisions we can morally live with.
We must also respect the rights of the clients and patients.
We believe that clients and patients should be able to request to be treated by only vaccinated healthcare workers.
In fact, we believe they should expect their healthcare worker to be vaccinated.
How are workplaces to manage unvaccinated healthcare workers without clear direction from health authorities?
We don’t want to have to choose between offering a service with an unvaccinated healthcare worker (if there is no other option available) or offering no service at all. But we, and other healthcare providers are facing such choices.
Additionally, employers are facing decisions based on sometimes lacking or even contradictory employment law considerations, including the Fair Work Act and Work Health and Safety Act, in tandem with their own ethical values and morally held duties of care.
We wish we were not in this situation.
We wish the rollout of the vaccine had been sufficient to ensure our vulnerable patients were well protected through being able to access their own COVID-19 vaccinations and the herd immunity provided by a vaccinated community would be enough to extend protection to the unvaccinated among us.
But this is not the situation we find ourselves in.
Instead, we faced a lock-down extending over half of our country, and an unknown number of healthcare workers remaining unvaccinated.
What we do to manage this growing risk among healthcare workers is critical.
It’s time for our leaders in government and the health sector to address this elephant in the room.
Written by Julie Adams, Co-founder and Director of View Health Chemo@home for The West Australian.