51 Pima County workers face firing for not complying with COVID vax policy

Pima County will soon terminate 51 employees who have refused to get vaccinated against COVID-19, flouting a policy for local government staffers who work with vulnerable people. That includes 22 members of the Pima County Sheriff's Department, and is far fewer than an earlier tally of hundreds of non-compliant county workers who would have been fired under the shot mandate.

Supervisor Matt Heinz attempted to rebuke Supervisor Steve Christy for downplaying the outbreak here, saying during a Tuesday meeting that "unvaccinated members of this community are actually killing people."

During that Board of Supervisors meeting, Acting County Administrator Jan Lesher said that 51 employees who work with "vulnerable communities" had not received their vaccinations by a Dec. 31 deadline, and would face dismissal. Another 89 employees work with vulnerable people and have not been vaccinated, but Lesher said they will not face termination because they're on military leave, family-medical leave, or have a medical exemption.

Last month, there were 427 county workers who were covered by the policy and remained unvaccinated, leading officials to forecast that hundreds of local government workers could be fired for refusing their shots.

"These numbers have been changing rapidly," Lesher told the supervisors Tuesday, adding that those currently on leave have told county officials if they return to the workforce, "they will continue to work with the Sheriff's Department to make sure that they are vaccinated."

'Junk science' — Heinz

As officials outlined the current state of the COVID-19 pandemic in Pima County during the meeting, Supervisor Christy complained about "herd immunity" and sought to delay the implementation of the county's vaccination policy, prompting a harsh rebuke from Supervisor Heinz, a medical doctor, who complained that Christy was espousing "junk science."

"Make no mistake: unvaccinated members of this community are actually killing people," said Heinz, who has worked treating patients with COVID throughout the pandemic.

In October, the supervisors voted 4-1 to require employees who work with children or the elderly, as well as corrections officers in the Pima County jail and juvenile detention facility to get vaccinated before Jan. 1, 2022. In a memo to the board, Lesher wrote that out of 6,240 employees, nearly 87 percent, or 5,455 were vaccinated against COVID-19. Among those who work with vulnerable people there are 2,069 employees. 

When the county began reviewing vaccination records around 427 employees had not been vaccinated, but that as of Tuesday, that number had dwindled to just 51, Lesher said.

"So we've had considerable progress moving in that area," Lesher said, adding that outside of the Sheriff's Department, there are 29 employees who have not been fully vaccinated, and the "largest chunk" is in the County Attorney's Office. "We've been doing a very good job at making sure that our population stays safe," Lesher said.

While numbers released by county administration have shown that hundreds of corrections officers and sergeants at PCSD's jail have not gotten their shots, Sheriff Chris Nanos has told the Tucson Sentinel for weeks that the numbers he has show most of those staffers are complying with the policy.

The shot deadline set by the Board was December 31, but in a memo last week, Lesher wrote that she would give her departments until Jan. 7 to issue final paperwork for the firings.

Among all staff, nearly 87 percent of county employees received a vaccination, and another 63 were able to receive an exemption from the mandate. 

More than a dozen departments had a vaccination rate of 100 percent, but the Sheriff's Department's overall rate was at 75 percent. Among the staff who work with vulnerable people, about 79 percent were vaccinated, leaving 111 employees unvaccinated at the county jail, including 105 full-time employees and 6 part-time staffers, Lesher wrote. 

"Again, I will note that this is a very fluid situation with data coming in hourly," wrote Lesher in a memo to the supervisors on Monday. "While unvaccinated employees working with vulnerable populations will not be permitted in the work environment, delaying the issuance of the final paperwork will ensure that each affected employee was given the full opportunity to comply with the vaccination directive," she wrote. "As such, more definitive numbers of actual terminations will be forthcoming early next week."

Motion to limit mandate fails  

After Lesher presented her findings, Supervisor Steve Christy reiterated an argument he made previously, asking if county employees who have ignored the new policy are "bad employees." 

"We are proceeding with terminating career-minded hard-working public service servants employed by Pima County," he said, adding that this was coming during what he called an "acute staffing shortage of corrections officers in the Pima County jail system." 

"My question then is the same one that I have today—why are we doing this?" asked Christy, the sole Republican on the board, who has been a vocal opponent of many of the public health measures taken by the county.

He argued that the county might have to release some "less-hardened inhabitants" at the county jail, and that by reducing the jail population, this would leave "more bad guys locked up." 

In mid-December, Pima County Attorney Laura Conover said that her office would decline to charge people arrested for simple drug possession, paraphernalia, or related personal-use incidents, "in order to prevent transporting them to the Pima County jail and risking their health, the health of jail staff, and the health of the interior jail population."

Those arrested on drug charges would be sent to drug treatment programs. However, Conover limited her policy to those arrested on simple drug charges, adding that arrested for an additional felony offense could still face being booked into the jail and charged. 

Supervisor Matt Heinz followed Christy by asking Lesher if there were any "anticipated releases" from the jail as a result of the termination of 22 corrections officers. "Is there a plan to mass release anyone in the jail at this point?" he asked. 

Lesher replied that "no one will be released from the jail." 

"And the sheriff has been consistent in stating that he can ensure the safety of not only the entire community, but the people who was in his jail with the staff that he has," Lesher said. 

She added that while the county's Human Resources Department showed that 111 employees at the Sheriff's Department had not gotten vaccinated, many of those employees had "extenuating circumstances," including one employee who is pregnant and was told by her doctor not to receive the vaccine. 

Christy also argued that instead of dismissing employees who had refused to be vaccinated, the county should test people to see if they have "natural immunity," referring to people who have previously been infected by COVID-19 and might be less vulnerable to a second infection. "Why don't we suggest to these folks that aren't going to be vaccinated, but they get tested to see if they were immune, we can keep them in the corrections officers community, and they could provide the protection to the community by saying on the job." 

There are significant questions about whether someone who infected by COVID-19 remains immune to the virus. Data from the CDC and others shows that people's immunity declines over the weeks and months following an infection, and thus far, the CDC has recommended that people who were sick with COVID-19 seek vaccinations and even boosters. And, the game has changed since November when South African researchers identified the new Omicron variant of COVID-19, which is significantly more virulent than its predecessors and appears more robust against both vaccinations and treatments. 

In recent weeks, the number of cases because of Omicron has spiked, and the CDC said last week that Omicron represented more than half of all cases of COVID-19, outpacing both the Delta variant and the original form of COVID-19. A few cases of Omicron have appeared in Pima County based on samples from county residents, and the University of Arizona identified several cases on campus in December. 

While the county seeks to dismiss unvaccinated employees, new data shows that COVID-19 cases are increasing significantly. In a memo submitted to the board, Pima County Health Department officials wrote that in November 2021 the county reported 15,943 new cases, or about 2,000 additional cases compared to November 2020. 

Weekly cases have increased from a low of 243 cases in May 2020 and peaked last week with 4,587 cases, county officials wrote. They also noted that the overall rate of positive COVID-19 tests is elevated at 17 percent, while the number of ICU beds available remains "scarce." 

"Although the trend has improved through the third week in December likely signaling that the Delta variant is subsiding, the cases been seen during the final week of last month may be indicative of what it to come," officials wrote. "Although there have been a relatively small number of Omicron cases in Pima County, it is clear that we have not yet been substantially impacted by the wave of this new variant Omicron that is sweeping the east coast and Midwest." 

Data from the Arizona Department of Health Services shows a massive spike in cases over the holiday weekend, with 9,203 cases 

"Omicron appears to be substantially more transmissible that previous circulating variants, and although not any more morbid, the sheer volume of cases is overwhelming hospitals and public health infrastructure in many of the large metropolitan areas," they wrote. "Pima County is not yet experiencing the full impact of the Omicron related surge. Regardless, vaccination (including boosters), staying home when sick, masking in indoor public settings, maintaining a physical distance of 6 feet or more, and hand-washing are the most important evidence-based interventions which individuals can undertake to protect themselves even in the face of the emerging variants." 

"Additionally, the improved availability of therapeutics adds another needed tool to protect hospital capacity in this community," they wrote. 

Dr. Francisco Garcia, the county’s chief medical officer, threw cold water on Christy's notion, telling the Board of Supervisors that "from a practical standpoint, that is not a practical solution." 

"What I can tell you is that today, there is not settled science on what level of antibody protection is," Garcia said. "The other piece to understand is that even being able to measure a level of antibody protection in an individual does not tell you how long that that protection would persist for. " 

"We don't know exactly whether the vaccine immunity toward one variant offers cross protection for instance, or some early preliminary data that say that that folks who have who are experiencing Omicron may have a greater degree of protection against other variants," Garcia said. "However, the opposite is not true." 

Christy also pushed for the county to wait until the Supreme Court decides on a case involving a federal mandate that requires vaccinations or test mandates for businesses with more than 100 employees. 

Last year, President Joe Biden ordered the Occupational Safety and Health Administration, or OSHA, to fine businesses that fail to comply with the mandates by Jan. 10. However, a string of lawsuits has turned into a widespread court fight with multiple and varying decisions between different federal courts. Now, the Supreme Court agreed to weigh on, and will hold oral arguments Friday with a decision expected soon after. 

Undaunted by Garcia's arguments, Christy pushed for a motion to hold off on the firings until the county "can explore the validity and the possibility of testing for natural immunity," and to hold off on the deadline for county employees until "we hear definitively from the Supreme Court." 

Board of Supervisors Chair Sharon Bronson sought a second for the motion, but the other supervisors remained silent, killing Christy's motion. 

'No easy outs' 

Supervisor Rex Scott focused on the county's vaccination rate, noting that county has managed to vaccinate about 73 percent of county residents, and he asked how the county would manage the future if about one-quarter of county residents refused to seek a vaccination. 

Last January, the county presented a plan to vaccinate the county-wide population, and in that plan, health officials estimated that about 20 percent of people would be resistant to the vaccine, and would wait to get the vaccine, or refuse it altogether.

Lesher told Scott that the county has sought to do "everything humanely possible" to get vaccines distributed to the county, and that overall the county is doing "very well compared to the rest of the state." 

"At some point, no pun intended, it's hard to move the needle too much further at this point," she said. "So what else do we need to do to mitigate (the virus) for the safety of the entire community?" 

Garcia told Scott and the rest of the board that Pima County Health officials were pushing hard to vaccinate school age children, noting that about 56.3 percent of children, or 107,692 kids have received their first dose. "I actually believe that we are able to nudge that percentage up significantly, especially as we reach these younger age groups." 

"I don't think we will ever be in a situation where every single person in this country is vaccinated, but I do think it is realistic to get to a 75-plus percent, fully vaccinated status," Garcia said. He added that there remains a "real wild card" in the waning of immunity, and said that boosters were necessary. However, only about one-third of Pima County residents have sought a booster, he said.  

Overall, about 62 percent of the U.S. population is vaccinated, with about 73 percent of people receiving at least one dose, according to the CDC. About 88 percent of the population over 65 is vaccinated, and about 66 percent of children over 5 are vaccinated—however, children under 5 cannot be vaccinated yet. 

Another third of the U.S. population has received boosters, but that effort is limited because children under 11 will not be eligible for the booster for months. 

Garcia added that it will be the "combination of vaccine coverage, booster and other mitigation steps"  necessary "for us to resume as much of our normal lives as possible." 

"There are no easy outs there, there are no easy choices here in terms of how we manage our response to the pandemic," he said. "What we have to do, however, is do our very best to preserve the very precious hospital resources that we have in this community," he said. 

"When can we say that we have reached a point of herd immunity," asked Scott. "At least for those who are vaccinated? Because I think we're all reaching a point of frustration and and exhaustion with with the state of things especially since a lot of the mitigation measures are in place mostly for the unvaccinated." 

Garcia responded that it was a "complicated thing" adding that herd immunity was largely dependent on the disease. For a disease like measles, that requires a vaccination rate of around 95 percent to get "herd immunity," Garcia said. However, for hepatitis, it's much lower. 

The new variant appears to be significantly more infectious than previous variants. Researchers use a calculation to measure how virulent a virus is called R0 or "r-naught," which estimates how many people one contagious person can infect on average. While researchers estimated that the Delta variant of COVID-19 was about six, researchers believe that Omicron may be closer to 10, similar to measles. 

"There just isn't an easy way for us to be able to say, geez, we've we've had enough normal infections plus the vaccine vaccinated population for us to get back to safety," added Garcia. "What I can tell you is that we will likely be facing a situation not unlike what we face with the flu, where we are on an annual basis needing to re-up our vaccinations need to pay attention to mitigation."

"I have a hard time seeing sort of going back to the way it was before," Garcia said. 

Christy argued that months ago, Pima County Administrator Chuck Huckelberry said "with great clarity, great certainty what herd immunity would actually be." 

"Now you can really see and feel the frustration that the community has," Christy complained, "When we're told at this point today right now that we have no idea what herd immunity is going to be if we're ever going to reach it if it even exists." 

"So, hopefully, my colleagues and the administration can at least try to be empathetic with the community when they express their frustration over issues such as these," he said. Christy also sought to question how hospital track COVID-19 infections, arguing that hospitals could "mischaracterize" the level of COVID-19 infections. 

Garcia shot back that any patient with COVID-19 in a hospital takes up resources. "Whether that is the primary reason why they went into the hospital or not, are requiring lots of resources, lots of staffing, lots of support, lots of PPE," he said. That is an important number to understand, and that is an important number to track." 

Christy also asked if hospitals are "delineating" between deaths due to COVID and others, and Garcia noted that overall mortality figures show the problem. 

"We have more deaths occurring than we have ever had on a per capita basis," Garcia said. "That is largely due to the impact of COVID. You're absolutely right not every one of those is a COVID death, but it is the overall impact that it is having on this population." 

Heinz: 'Unvaccinated members of this community are actually killing people'

Following Christy's comments and questions Heinz laid into his fellow supervisor, and pushed back on the idea that a pregnant Pima County employee was told to hold off on her vaccination. 

"Every pregnant woman at every stage of pregnancy should be vaccinated against COVID," he said, adding that if a physician tells a pregnant woman not to be vaccinated, they should be reported to the Arizona medical board. 

Heinz said that talking about COVID-19 was "always a very frustrating subject," and he said that hearing Christie talk about COVID is "just incredibly distressing." 

"Make no mistake: unvaccinated members of this community are actually killing people," Heinz said, adding that people are not getting important surgeries and procedures, even "medically and sometimes urgently necessary procedures" because ICU beds have been packed by COVID-19 patients. 

Two weeks ago, the head of Banner Health Network said that among her hospitals in Arizona, nearly 90 percent of the COVID-19 patients in the ICU were unvaccinated, and in recent weeks, the number of ICU beds available has been at 5 to 6 percent, with between 30 to 50 percent filled by COVID-19 patients.

"If you if you need a bypass Supervisor Christy — any of us — if your spouse needs a bypass, if your kid or your grandparents need bypass surgery, you cannot have that elective procedure," Heinz argued. "Unless there's a an ICU bed waiting for you post-operatively and every day, nearly every day. "

Heinz added that vaccination "has to be required for every aspect of public life. Every aspect, going to Safeway, going to the pharmacy, everything we can do." 

"That's how we fix it," Heinz said. "And in countries where they've done this, and in states where they've done this, they've seen a huge benefit and a huge uptick in vaccination rates." 

"So I just don't want to hear any more junk science," Heinz said. "It's exhausting for all of us in healthcare," he said to have to refute, point-by-point, the "garbage that — I'm sorry, my colleague is spewing." Heinz added that Christy was "trying to trick Dr. Garcia into saying things that are confusing to the public." 

"That is killing people," Heinz said. "And I hope you will stop." 

Christy latter added that he was "very glad that he made those comments, so the entire community knows exactly what he means and what he stands on." 

Bronson admonished both men, calling them gentlemen. "Let's remember the first syllable in that word, and that is gentle. So let's be gentle with one another please." 

Heinz refused to back down, later posting to Facebook that he "firmly believe the vast majority of those who remain unvaccinated aren’t trying to harm our community – but that is in fact what they are doing."

"As we enter year three of this pandemic, the only way we will end this is if we convince them to get off the sidelines and get a shot, for themselves, for their loved ones, for all of us," he said. "The data speak for themselves: the vaccine saves lives. Of those of us who are fully vaccinated in Pima County, only 2.2% of us have subsequently developed a case of COVID, and 99.94% of us have avoided hospitalization due to COVID." 

"In Arizona, if you are not vaccinated, you are 15 times more likely to die from the virus if you get it," he said. "Elected leaders in our community have a responsibility to stop disseminating disinformation. I’m looking at you Supervisor Christy. Do you think it’s ok that people follow your lead and suffer dire consequences because of it? I do not." 

"Let’s make 2022 the year we finally put this pandemic behind us," he said. "We ALL have a role to play."

The board had planned to discuss whether to again meet in person.

Christy has been pushing the board to meet in person since September. However, while he has repeatedly argued that in-person meetings are important, he has refused to wear a mask during those meetings, at one point arguing that the other board members should meet in-person while he appears remotely. Christy's refusal to wear a mask, as required for county employees, and those who would attend an in-person meeting has prompted the other supervisors to repeatedly vote to appear virtually. 

However, this time, Grijalva moved to move the discussion to a meeting in February because of the Omicron variant, and Bronson agreed, delaying the question about in-person meetings until March.