Amid an uptick in COVID-19 cases and hospitalizations, California Gov. Gavin Newsom announced July 26 that health care workers and state employees must be vaccinated or undergo weekly testing and wear masks.

Employees of hospitals, nursing homes, dentists' and doctors' offices and other health care settings will have to comply with the requirements by Aug. 23. In addition, all employees of state agencies will be subjected to a verification process that will be mostly in place by Aug. 2, according to state officials.

Exactly what the new policy means for vaccination efforts in Humboldt County — where about 55 percent of the population is vaccinated and thousands of residents are employed by the state and local healthcare providers — remains unclear.

Tory Starr, executive officer of Open Door Community Health Centers, Humboldt County's largest healthcare provider, said in an email to the Journal that 87 percent of staff is already vaccinated and vaccination is required for all new hires.

"We recognize that the best preventative measure to ensure patient and staff safety is to be vaccinated," Starr wrote. "At some point in the near future we will require staff to be vaccinated as a condition of employment unless a valid health or religious exemption exists."

Attempts to reach St. Joseph Health, Humboldt County's second largest provider, for comment were not successful by deadline.

Short of a vaccination mandate, the new policy comes as the Delta variant has become the dominant strain in California — approximately 80 percent of the COVID-19 cases sequenced were of the Delta type, according to the state. Experts say the Delta variant is highly contagious and poses a serious threat to unvaccinated people.

More than 3,000 people infected with COVID-19 were hospitalized in California — including 16 in Humboldt County — as of July 27, which is comparable to late October 2020, before the vaccine was available. 

"We are at a point in this pandemic where individuals' choice to not get vaccinated is now impacting the rest of us in a profound, devastating and deadly way," Newsom said during his announcement. 

The California Hospital Association voiced strong support for the governor's order, calling the requirements "important and necessary steps that must be taken in this extraordinary situation." 

But one of the state's largest health care unions declined to comment directly on the new policy. The union prefers "education and outreach" over mandatory vaccination or testing, said Renee Saldana, press secretary for SEIU-UHW, which represents about 100,000 California health care workers, including certified nursing assistants, respiratory therapists, hospital cooks and janitors.

Saldana also declined to comment on what the union would do if health care providers require mandatory vaccinations for workers, as some hospital systems have done.

The American Medical Association and the American Nurses Association, along with about 60 other medical groups, signed a joint statement July 26 calling for the mandatory vaccination of health care workers. And the Veterans Affairs Administration said it would require COVID-19 vaccinations for some of its workers, including doctors and nurses. It is the first federal agency to do so.

Assemblymember Buffy Wicks, an Oakland Democrat, said she is exploring legislation to clarify that employers can mandate that their workers get shots. Experts say it's a tough ask, but not impossible or illegal. Employers can require vaccines, but cannot discriminate against people who aren't vaccinated because of a disability or religion, according to the state's Department of Fair Employment and Housing.

Wicks said she's heard from small businesses owners who are interested in mandating vaccines among their employees but are afraid of being sued. 

"Beyond legislation, I think what we need is a cultural shift around this idea of proof of vaccination," Wicks said. "Our education leaders, our religious leaders, they should say, 'we're going to require this'...same thing with gyms, that's an obvious place we should be doing it."

California eliminated its colored-tier system for businesses when it reopened on June 15. An analysis by the San Francisco Chronicle estimated that about a dozen counties — including Humboldt — would be in the most restrictive "purple" tier if those rules still applied. 

"The idea that we would be in a purple tier, which means schools and indoor dining would be closed, to me that was very alarming, it was a wake up call," Wicks said. "We need to consider further measures to ensure people are getting vaccinated." 

Shira Shafir, an epidemiology professor at UCLA, said from a public health perspective, it is extremely valuable for employers to require their workers to get vaccinated.

"Given the risk of transmission, it is really important to use all public health prevention measures we have at our disposal," she said. "Vaccines protect against the Delta variant, but they only work if people get them."

Requiring — or in the case of the state, strongly encouraging — health workers to get vaccinated helps protect people who are immunocompromised or older because even if vaccinated, their bodies may not be able to build strong protection, Shafir said. It also helps protect children under 12 who cannot yet be vaccinated.

About 5.3 percent of all COVID-19 tests are coming back positive as of today; about six weeks ago, the state reopened its economy with a positivity rate under 1 percent. (Humboldt County, meanwhile, had recorded a 12.2 percent test-positivity rate over the seven-day period before this edition of the Journal went to press.)

Conversations around stricter vaccination policies and mandates in the workplace have been gaining traction in California. At least two Bay Area counties, San Francisco and Santa Clara, had already announced plans to require vaccination among county workers. San Francisco is also requiring that workers in high-risk settings including hospitals, nursing homes and jails, be vaccinated by Sept. 15. 

Last week, three public health officials in the Bay Area announced their support for private employers to also require vaccination among their workers. In Humboldt County, Health Officer Ian Hoffman has said it is something that could move the needle on vaccination rates locally, though he's stopped short of openly advocating for such requirements.

Another large employer, the University of California system, including UC Health hospitals and clinics, recently finalized its vaccination policy, which will require that students, staff and faculty be fully vaccinated before the start of fall classes or by Sept. 1 for those not on an academic calendar. 

Barbara Feder Ostrov and Thadeus Greenson contributed to this report.

CalMatters is a nonprofit, nonpartisan newsroom dedicated to covering California politics and policies.