Washington state hospital leaders on Monday urged people to stay as healthy as possible as the deadline for the state’s health care workers to get COVID-19 vaccinations approaches. They say workers who are not vaccinated and have to quit could affect staffing levels.

Monday was the last day most unvaccinated health care workers could get a COVID-19 vaccine, the single-dose Johnson & Johnson shot, to comply with the mandate that they be fully vaccinated by Oct. 18.

Several health care systems have reported a high level of vaccination among their staffs but worry understaffed hospitals could be further stressed by patients sick with COVID-19 and those sick with seasonal respiratory illnesses, like the flu.

The immunization rate among health care workers in Washington is fairly high, said Taya Briley, executive vice president of the Washington State Hospital Association, during a Monday morning news briefing.

Hospitals are also battling the effects of delayed care for patients unable to receive treatment during the recent COVID-19 peak, Briley said.

“And these folks get sicker,” she said. “When they need to access care, they are sicker and require a higher level of care, so we’re concerned about the impact of those patients and their health status.”

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The hospital association won’t know how many Washington health workers are fully vaccinated until next week, though some health care systems do have some data. Health care workers with a religious or medical exemption won’t be required to get vaccinated.

Swedish Health Services is reporting 92% of its workers are fully vaccinated, with more on the way, said chief nursing officer Kristy Carrington. At Tacoma-based Multicare Health System, vaccination rates were also a little over 90% as of Monday morning, said Dr. Michael Myint, the hospital’s physician executive for population health.

Most services are expected to remain open even if hospitals lose some staffers, though some rural hospitals might have to temporarily limit patient admissions if cases and hospitalizations surge, Briley said. Overall, however, the state is seeing improvements in its COVID-19 trends, she added.

Hospitalizations continue to decline. This week, the state counted 1,124 hospitalized COVID-19 patients compared to last week’s 1,277, Briley said. Of those, about 207 are intubated, whereas last week 239 patients were on ventilators. Deaths are also seeing a decrease, with 15 reported in the past week. In the hospital association’s report last week, 29 people had died due to the virus, Briley said.

“It’s a decrease we’re glad to see, but it’s still a sobering number,” she said.

In the past week, hospitals have also reported record high levels of patients who are ready to discharge to long-term care facilities but can’t get a spot, despite efforts the state is making to move patients to appropriate facilities.

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“If long-term care facilities cannot accept the patients who are ready for discharge, our hospitals will then be unable to accept patients in need of true acute care,” Briley said.

Fortunately, she said, there’s good news about the state’s supply of monoclonal antibodies — a treatment shown to be effective in preventing hospitalization among people with mild to moderate COVID-19 if given within seven to 10 days after symptoms appear. The supply has again started to stabilize, after weeks of reports that the state’s stockpile was low.

“We’re really happy we’re going to get increased access in these lifesaving drugs for our patients,” she said.

There’s also a new antiviral pill from drugmaker Merck that’s headed to the U.S. Food and Drug Administration for approval, Briley said, adding that a COVID-19 vaccine is the “first and best defense” against the virus.

Even if the delta wave continues to ebb, however, Myint said his hospital system is anticipating a very busy winter season.

“We are concerned about the coming months,” Carrington said. “… COVID if anything has shown us that you can’t predict the future. It really is dependent on human behavior.”