Delta Surge On Decline As More Businesses Mandate Vaccines : Consider This from NPR Cases, hospitalizations, and deaths are all on the decline in the U.S. — with September marking a turning point in the delta surge.

Vaccination rates continue to tick up and will be helped along by more workplace vaccine rules, including one from the Department of Labor. That rule, which has yet to be released, will be enforced by the Occupational Safety and Health Administration. NPR's Andrea Hsu reports on the small agency with a big task.

Vaccine rules have been implemented successfully at big companies like United Airlines and Novant Health, where the vast majority of employees have gotten their shots. But in smaller workplaces, vaccine rules present a different challenge. Katia Riddle reports from Malheur County, Oregon.

In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.

Email us at considerthis@npr.org.

The U.S. Has Passed Its Delta Peak — With More Vaccine Rules Coming

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AUDIE CORNISH, HOST:

September is officially behind us, and so is the peak of the delta surge in the U.S.

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ROCHELLE WALENSKY: We're beginning to see cases and hospitalizations decrease from their peaks in late August and early September.

CORNISH: CDC Director Rochelle Walensky said late last week, September was a month of declines in cases and hospitalizations. Deaths from COVID-19, a lagging indicator, are falling, too. And that's even with more and more students going back to school and college in person. The bad news?

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WALENSKY: Deaths remain substantially higher in states with low vaccine coverage.

CORNISH: And those deaths pushed the U.S. past a brutal milestone over the weekend - 700,000 people are dead from COVID-19. That's according to data from Johns Hopkins University. But there's evidence our national vaccine rate may continue to go up as more vaccine rules take effect.

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BILL DE BLASIO: Mandates work. They make us safer. I would urge every mayor in America, do it now. Get those vaccine mandates...

CORNISH: New York City Mayor Bill de Blasio told MSNBC just last week that vaccinations went up 45% after the city began to require them for indoor dining. And when it comes to the city's vaccine mandate for school staff, de Blasio said last week that 93% of teachers had gotten a first dose ahead of a Monday deadline to do so.

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DE BLASIO: There's so much noise when you put a mandate forward. But whether it's the one we did for schools or the one we did for indoor dining, the bottom line is when the dust settled, a huge number of people went out and got vaccinated.

CORNISH: CONSIDER THIS - across the country, the number of cases from the delta surge is falling, while the number of cities, states and businesses with vaccine rules is on the rise. Coming up, more on how those rules are playing out.

From NPR, I'm Audie Cornish. It's Monday, October 4.

It's CONSIDER THIS FROM NPR.

Now we should note here that just because the U.S. is coming out of the delta surge does not mean the worst of the pandemic is automatically behind us.

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ANTHONY FAUCI: We certainly are turning the corner on this particular surge. The way to keep it down is to get people vaccinated. When you have 70 million people...

CORNISH: Dr. Anthony Fauci told ABC News on Sunday there are still 70 million eligible Americans who have not gotten the vaccine yet. At the same time, a growing number of them are subject to vaccine rules in their place of work. And so you may be hearing more about those rules and stories like this.

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UNIDENTIFIED REPORTER #1: What is next for Novant Health? That is the question we're asking today after 175 employees were fired for refusing to get the COVID-19 vaccine.

CORNISH: This past week, a hospital system in North Carolina was in the news after it fired employees who did not comply with its vaccine policy. The headlines were about the 175 people who did not get vaccinated, not about the ones who did.

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UNIDENTIFIED REPORTER #2: Currently, Novant Health has more than 35,000 employees across the state.

CORNISH: And of those 35,000?

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UNIDENTIFIED REPORTER #3: Ninety-nine percent of Novant Health's employees are in compliance with the vaccine mandate.

CORNISH: That means, at Novant Health, the vaccine holdouts made up a fraction of 1% of the workforce. It's a similar story at United Airlines.

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UNIDENTIFIED REPORTER #4: Tonight, nearly 600 United Airlines employees losing their jobs.

CORNISH: Now, that was the headline last week after a deadline passed for United workers to show proof of vaccination. By Thursday?

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UNIDENTIFIED REPORTER #5: The company says after it announced that 593 employees would be fired for not complying, that number dropped by nearly half.

CORNISH: Meaning, in total, a little more than 300 United employees may lose their jobs, but that's in a workforce of 67,000 people, meaning their vaccination rate is 99%.

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JEFF ZIENTS: The data is clear. When organizations implement vaccine requirements, vaccination rates soared in 90% or greater.

CORNISH: White House COVID coordinator Jeff Zients cited United and Novant last week when he called on more companies to require vaccines. In recent days, three other major airlines did just that. American, Alaska Airlines and JetBlue will require their employees to be vaccinated. Two other big companies, Procter & Gamble and AT&T, also announced vaccine rules last week. And this is all happening before the Biden administration's federal vaccine rule for workers is in place, a rule that's still being written. The administration says it'll be out soon and will require all private businesses with more than a hundred workers to have a vaccine rule or a testing option.

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CORNISH: Now, once that rule goes into effect, it will apply to some 80 million Americans and their workplaces. Enforcing it? Well, that will be the job of a relatively small government agency, one that's not exactly flush with resources. NPR's Andrea Hsu has more.

ANDREA HSU, BYLINE: About a month ago, a question went viral on the internet. It started on Twitter and then migrated to TikTok.

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UNIDENTIFIED PERSON #1: Would you all report your unvaccinated co-workers for $200,000?

HSU: That was the question - would you report your unvaccinated co-workers for an insane amount of money? Well, here were some of the answers. I would report my co-workers for a bag of Flamin' Hot Cheetos.

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UNIDENTIFIED PERSON #2: I would report them to get out of work five minutes early. I'd report them to get out of work two minutes early.

HSU: Others said they'd do it for a basket of Shake Shack fries, a tangled-up slinky.

ARIANNY MERCEDES: I'd do it for free. I'd do it for a Starbucks gift card. I'd do it for a trip to Target. I was not expecting this.

HSU: That's Arianny Mercedes, who came up with the original post. She's a public policy major at the University of Virginia. And she has a career-consulting business on the side. As entertaining as those responses are, the idea of snitching on co-workers is not actually that far from reality. Workers do have a role to play in enforcing workplace rules.

RICH FAIRFAX: If an employee files a complaint, and if they allege a serious hazard, then OSHA wants to get out there as soon as possible.

HSU: Rich Fairfax is a safety consultant who spent more than three decades at OSHA, the Occupational Safety and Health Administration. It's the federal agency that sets workplace safety rules and enforces them. He says employees' eyes and ears are crucial because OSHA simply does not have enough inspectors. Nationwide, there are fewer than 2,000 federal and state inspectors.

FAIRFAX: And there's - what? - 8 or 9 million workplaces, so you can do the math.

HSU: It would be impossible for them to enter every workplace. So in addition to responding to complaints, Fairfax thinks OSHA will just add COVID-related items to inspectors' to-do lists when they're out doing what they normally do - checking up on safety hazards or following up after an incident.

FAIRFAX: You know, I think all the OSHA inspectors will be directed to look into the vaccination status and see what the employer has done.

HSU: And if a violation is discovered - say, there are no vaccination records on file or no testing program set up - well, OSHA can issue a fine up to $13,600-some for a serious violation, 10 times that for a willful or repeated violation. But more than the threat of fines, Jordan Barab says it's the threat of bad publicity that gets employers to comply. He was acting head of OSHA under President Obama.

JORDAN BARAB: Actually, employers told us, you know, OSHA penalties are generally not very much. They're really just part of doing business. What we really don't like is having our names in the press.

HSU: OSHA issues stern press releases when they discover a company is violating safety rules. Imagine what that might look like. Such-and-such a business fails to keep its workers safe from COVID-19. Not a good look when the whole country is trying to get past the pandemic. Barab believes the vast majority of companies will comply with the federal vaccine rule once it's rolled out. But still, he says, this is a big moment for OSHA.

BARAB: You know, they've been kind of this small agency that nobody noticed much. And suddenly, they're thrown into the spotlight with an extremely controversial policy.

HSU: A policy they hope will soon be less controversial, given how many workers have now gotten the shots.

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CORNISH: Andrea Hsu is NPR's labor and workplace correspondent.

Earlier, we spoke about the relatively high vaccine rates at some very big companies, but there are workplaces where the denominator is much smaller. Reporter Katia Riddle has this story from Oregon, and that's where some rural workers say they won't comply with a state vaccine order to be vaccinated by mid-October. And if those workers leave, there are not a lot of options to replace them.

KATIA RIDDLE, BYLINE: Even before the pandemic, this southeastern corner of Oregon was thin on emergency services. Now some say the vaccine mandates could devastate their small workforce.

SAMANTHA CHAMBERLAIN: We were just counting today. There are only, like, 10 of us that are vaccinated.

RIDDLE: Samantha Chamberlain supervises EMT ambulance drivers. She works out of the small town of Vale.

CHAMBERLAIN: That's 17 people that we lose.

RIDDLE: More than half of your staff.

CHAMBERLAIN: More than half of our staff, yes.

RIDDLE: The order threatens debilitating fines for employers with unvaccinated health care workers, even if they're volunteers, like most of this team. EMT Matthew Kabush commutes an hour each way to his shift at this small station that houses fire and ambulance services.

MATTHEW KABUSH: My dad's a firefighter. My - two of my two brothers are firefighters.

RIDDLE: His mom was also in the business. Volunteer emergency services are commonly a family affair around here. Kabush says many feel a responsibility to protect their rural community, and thousands of people who live and pass through here are dependent on them to cover a lot of ground - 2,500 square miles.

KABUSH: And down there at the 78 junction, that's 90, almost 100 road miles.

RIDDLE: Kabush and Chamberlain, who are both vaccinated, look together at a map of their territory.

CHAMBERLAIN: Actually, yeah, I think pretty...

KABUSH: If you include the off-road curves.

RIDDLE: With truck drivers traveling through regularly over icy stretches, EMTs here, like Chamberlain, have responded to some horrific accidents. And if the vaccine mandates handicap them, county officials warn lifesaving measures could be delayed by hours.

CHAMBERLAIN: I think what makes me the most upset is the fact that my community is going to suffer, and there's nothing I can do about it.

RIDDLE: Suffer as the county could lose essential emergency workers.

MARTA STODDART: So we're not going to get the shot. We're just not going to do it.

RIDDLE: Marta Stoddart is a volunteer EMT in an even more remote part of the county called Jordan Valley. She and her husband are ranchers when they're not driving ambulances. She'd rather let the county cope without emergency services than get vaccinated.

STODDART: Then I guess we won't have our service down there, and the county will have to figure stuff out.

RIDDLE: Stoddart worries the potential side effects of the vaccine are so serious that getting the shot could mean risking her life.

STODDART: Well, if something happens to us, what's going to happen to our bills? What's going to happen to our kids?

UNIDENTIFIED PERSON #3: This is your vaccination card.

RIDDLE: At the Malheur County Fairgrounds, cars roll in passed the horse stables - one line for testing, one for vaccination. Someone who says the mandate did bring him in, reluctantly, is Matthew McClain.

MATTHEW MCCLAIN: A lot of people I've talked to aren't so much opposed to the vaccine. They're opposed to the mandate.

RIDDLE: McClain works for the Department of Corrections. He's here getting the shot with his wife. They were both going to do it eventually, but he's still irritated.

MCCLAIN: Being told that you have to put something in your body is kind of a shocking thing to a lot of people.

RIDDLE: Some facilities have reported a recent increase in vaccination rates, with staff scared of losing their jobs. According to the state, Malheur County has only about 50% of health care workers vaccinated.

SARAH POE: There are people who are going to say no to a vaccine and be at risk because of the mandates.

RIDDLE: Sarah Poe is the director of Public Health in Malheur County. She says in this conservative part of the state, when an order comes down from a liberal governor, people have a knee-jerk reaction to it.

POE: Really, I think that the politicians need to stay out of it.

RIDDLE: Poe says local public health officials who know the community are more compassionate and effective ambassadors for vaccination.

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CORNISH: Reporter Katia Riddle in Malheur County, Ore.

It's CONSIDER THIS FROM NPR. I'm Audie Cornish.

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