Why the Vaccine Mandate Does Not Violate the Tenth Amendment

For your reference, here’s the announcement, and here’s the Tenth Amendment.

The mandate is broken into three big pieces, which will be addressed individually: government employees, health care workers, and employees of large employers.

Government Employees:

The Federal Government is acting as an employer, not as the government. The courts have long held that it’s ok for an employer to say “no smoking” or “we don’t cover birth control pills.” The courts have also said it’s ok to have requirements for a job. Schools — a specialized “employer” — have required certain vaccines since before I was a small child. That ship has sailed.

Health Care Workers:

The Feds are using their authority under the Centers for Medicare/Medicaid Services Conditions of Participation. They are in essence saying “If you want our money, you must do these things.” Since at least 99% of hospitals receive money from Medicare, Medicaid, or both, effectively all hospitals will be finding ways to comply with this rule once the actual rules are finalized (it’s already a done deal in some states like California). This is another case where the courts spoke years ago and the ship has long since sailed.

There are a few places that think they can legislate or make executive orders to make this go away. Florida’s governor appears to be backing down about a half step, only vowing to fight the mandate for businesses. Texas’s governor not so much. There are teams of hospital lawyers girding up for battle, because hospitals want to get paid and federal regulations overrule states.

The one aspect of this I find interesting is that the mandate as announced (no word on implementation yet) does not appear to have a loophole to regularly test employees that have legitimate medical contraindications to the vaccine. I do have a horse in this race. My building could lose employees if there’s not a loophole. However I’m the sucker who is going to be running a lot of COVID tests if there is.

Large Employers:

Here’s where stuff gets interesting. The rule would require employers with 100 or more employers to mandate vaccines. And there’s a testing loophole. This falls under OSHA. Fun thing about the law creating OSHA, the OSH Act. There’s a part of it called Section 18 that allows states to have their own OSHA rules. There’s your Tenth Amendment compliance right there. Done. However, those rules have to be at least as strong as the federal rules. You can have your state rules, but only if those state rules also include stuff like the vaccine mandate.

The Vaccine Mandate doesn’t violate the Tenth Amendment, stop saying it does.

The Actual “Far Left” Agenda

There’s been a great deal of scare talk about the “far left” and how they’ll create chaos and turn everything evil in this country. I thought I’d share what I believe the actual left stands for. I think you’ll find it not so terrifying. Heck, you might even agree with some of these points.

Getting health care shouldn’t cause bankruptcy.

Full time work should earn a living wage. Particularly for “essential workers,” now that we can agree who they are.

Infrastructure — things like safe drinking water, school buildings, roads, and bridges that won’t fall down — is important and we really need to spend money on it.

Police departments don’t need tanks. They don’t need rubber bullets. Defunding means no tank and rubber bullet money. They need to knock and announce themselves before trying to bust your door down. And they should refrain from shooting black people and dogs under the pretext of being scared.

We only have the one planet and we should try to take better care of it. Heck, even Jesus would want us to do that.

Speaking of What Would Jesus Do: don’t want an abortion or a gay marriage? Don’t have one. Want to prevent abortions? Advocate for better access to birth control, birth defect prevention, and rape prevention.

Almost nobody actually seriously wants to take guns away from law abiding citizens! Yeah, there’s a few crackpots among the left (and among the right too). We do want responsible gun ownership by people who follow and respect both the law and safety rules. That specifically excludes most of the nuts out there showing off or even aiming their weapons in public.

The rule of law is important. Lawmakers who actually work for their constituents are important.

Nobody wants anarchy. Trust me on this. I hope you find this guide helpful.

Brave New Day

Yesterday, I received notification that COVID-19 data would be reported to the Department of Health and Human Services instead of the CDC. That change is effective today. This abrupt change was sent to me from the Association for Professionals in Infection Prevention, then confirmed about a half hour later by email from the CDC itself. As an Infection Preventionist, my duties include reporting regularly to the CDC’s National Healthcare Safety Network. Until today, this was the single largest and most accurate repository of infection information in the United States.

Some hours later, the various news services got wind of the change.

I am deeply concerned about the possibility that this could mean COVID-19 data may be buried or even falsified. While no evidence yet exists that this is the case, it is no secret that the Trump Administration and the CDC have disagreed about COVID-19 on many fronts. This administration does have a history of attempting to hide unflattering information.

If you want accurate COVID-19 information, I urge you to keep track of your local health district — my colleagues and I are still required to report to them too. Here’s links to help you find them. And don’t forget that Johns Hopkins still has data available.

Droplet vs Airborne: Different and Important

Sometimes professionals use words in very specific ways that aren’t obvious. Just the other day I realized that is what happened with those two words. My Facebook friends have seen me very carefully point out articles like these, which suggest than COVID-19 is airborne, rather than droplet. I did this carefully because before yesterday, the WHO and CDC staunchly denied any such thing and today the WHO merely confirms that there is “emerging evidence.” Today I want to explain why it’s different, and a really big deal, in fairly simple terms.

I work in a hospital, as an Infection Preventionist. Just as the name suggests, I help keep people from getting sicker in the hospital. We used to be called “Infection Control Nurses,” and it’s a tradition that literally goes all the way back to Florence Nightingale. Hospitals use different kinds of precautions — safety measures — to prevent the spread of disease. These measures are based on how the disease itself can move from person to person.

Standard precautions are what we do to protect everybody at all times. This includes keeping your hands clean, using disposable gloves, and changing those gloves between patients. Hand washing is still the most important thing you can do to keep from getting or transmitting any disease. It’s so important the CDC has an entire section on it.

When we know a person has certain infections that could spread, we use Contact precautions. This is for fairly heavy organisms that can survive for a while on surfaces, and that we can inadvertently transport to a new victim on our hands or clothing. One such organism you may have heard of is MRSA, Methicillin Resistant Staphlycoccus Aureus. We also use Contact for more mundane bugs like head lice. For Contact, we make sure to use gloves, treatment gowns to cover our clothing, and we are extra sure to wash our hands after taking our gear off.

Now for the meat of this discussion. Droplet precautions are for organisms that can move in droplets we create when we talk, cough, or sneeze. These droplets can go maybe 6 feet or so (that’s where the 6 feet apart for social distancing comes from) before they go SPLUT! onto a surface. Droplet precautions always includes Contact precautions. That surface can be somebody else’s face, which is why the protective gear for Droplet precautions includes a facemask and ideally eye protection, in addition to gloves and gown. The most common organism for which we use Droplet is the Flu. Remember, up until yesterday, the WHO insisted this was all we needed to protect ourselves from COVID-19. And as of this moment — subject to change without notice — the CDC still does.

By contrast, Airborne precautions are for organisms that can float in the air a long ways and a long time. Much farther than 6 feet. And to do this, they are very small and very lightweight. Examples include Measles, Tuberculosis, and Ebola. These bugs are small enough to get through and around normal surgical masks. These patients should be cared for in a special “negative pressure” hospital room — the HVAC system is designed to create lower air pressure than in surrounding areas while still having fresh air move in and out, so germs aren’t likely to go into the rest of the hospital. To care for these patients, you need special masks, such as N95 or a powered respirator, and they need to fit correctly to prevent germs getting around the edges. That’s over any above gloves, gown, shoe covers, hair covers, and eye/face protection.

As you can see, there’s actually a huge difference between droplet and airborne transmission. And although many experts have privately held that COVID-19 is airborne, its a huge step for the WHO to admit that. I hope the CDC joins them shortly.

A few words about masks

Masks in public has become the new normal. So let’s talk about this for a few minutes.

Masks are a whole lot like condoms: they do work; they only work if you use them, and use them correctly; they don’t work with holes cut in them; and they are not foolproof — you and the people around you are safer if you’re all doing something to prevent the spread of disease.

Nor are masks a substitute for things like quarantining the sick, isolating those who are known to have unprotected exposure, washing your hands, or social distancing. Hand hygiene is still the number one thing you can do to keep from getting almost any disease — it will even stop you from accidentally making somebody else sick. That last point is really important, because people can spread COVID-19 two days before they feel sick, and worse yet they can spread it and never feel sick at all.

Again, just like condoms, masks are only one tool to prevent the spread of disease.

We haven’t got a cure or a vaccine for this thing yet. Prevention is literally all we’ve got to prevent more people from getting sick and possibly dying.

Now for those of you who like actual research results: here’s the Mayo Clinic; Journal of the American Medical Association (JAMA); some research from Hong Kong; and The Lancet. For those of you who are total data nerds, here’s some more fine studies.

Wear the damn mask, people. There’s nothing “unconstitutional” about it. Your “rights” end when you interfere with the rights of others, such as when your selfishness accidentally spreads disease.