Amanda Kostroski, a 911 dispatcher in Madison, Wisconsin, leaves busy work once a week to go to the county health clinic to be tested for COVID-19.

Since Dane County required all employees to be vaccinated or tested every week in late September, she has been driving 15 minutes from get off work. The test is free, and she usually resumes work within an hour.

Kostroski is one of the 10% of county employees who have not been vaccinated and are tested weekly. She chose not to get the vaccine because she thought the vaccine was too new and worried about side effects.

Kostrowski said she did not understand the necessity of vaccinations, nor did she understand why vaccinated people were not tested because they sometimes spread the virus. “I don’t think it makes any sense,” said Kostromski, 34, whose test results have been negative. Colleagues who had been vaccinated told her that they felt burdened to help those who were tested.

Denmark is one of dozens of counties, cities and states that require workers to be vaccinated against COVID or undergo regular testing. County officials said that although some employees complained about the policy, it helped to ensure workplace safety through moderate interference. They also said that vaccinated workers do not need to be tested because they are unlikely to be infected, and if they are infected, they are also unlikely to be infected with a serious COVID case. But it is costly and usually requires the government to use federal COVID relief funds they would rather spend elsewhere.

Some private employers have adopted similar policies. Starting from January 4, the Biden government will require private employers with 100 or more workers to insist on injections or weekly testing.

But among some workers, unions, and conservative leaders, opposition to these mandates is deeply ingrained. More than two dozen Republican state attorneys have sued the government, arguing that the federal government lacks authority. The Federal Court of Appeals agreed with them and temporarily blocked the order, and the case may eventually be submitted to the Supreme Court for trial.

Nonetheless, these early efforts by state and local governments give us insight into what Biden’s rules mean for the wider private sector, as the company needs to deal with the establishment and payment of tests, and then monitor the results. Even in places like Dane County where nearly 90% of adults are at least partially vaccinated, the program adds more work to government managers.

According to data from the Centers for Disease Control and Prevention, approximately 81% of adults nationwide are at least partially vaccinated against COVID, although the vaccination rates vary widely from state to state.

Jurisdictions managed by conservative officials tend to have low vaccination rates and are unlikely to require workers to be vaccinated or tested-this means that the experience so far does not reflect strong opposition to vaccines and other COVID requirements .

The local and state governments that accept testing options do so because they cross the line between creating a safe working environment and providing reluctant employees with a way to opt out of the vaccine without losing their jobs.

Blair Bryant, deputy legislative director of health for the National Association of Counties, said: “It is too early to give a clear answer on its progress, but so far [we have] Did not hear any major issues. “

Counties rely on free COVID testing in the community, pay through federal COVID relief funds, or have their health insurance company pay the bill.

Local governments have various policies on who should comply with vaccine or testing requirements and how to implement them. For example, all unvaccinated employees in San Diego County, California who are not working in a health care facility are required to provide their supervisor with a certificate of weekly testing, said spokesperson Michael Walkman.

Miami-Dade County’s policy only applies to non-union workers, accounting for approximately 9% of its 29,000 employees. Approximately 380 are tested every week. Florida County is still negotiating with the union to increase the requirements.

The Virginia Department of Corrections requires unvaccinated employees working in crowded environments to be tested every three days and every 7 days for the rest of the time. Still have expenses? The department tested 442 staff in two days in October and spent nearly $7,000. The state is using federal COVID relief funds to cover testing costs.

It can be difficult to secure scarce test supplies. The Virginia State Police had to wait more than a month to start the test program, partly because of delays in delivery.

Although the Biden administration hopes its rules will inspire more people to get vaccinated, the results have been mixed in the counties.

Officials in Fairfax County, Virginia, located outside of Washington, DC, said that since the mandatory injection policy took effect in October, there has been no significant increase in the number of employees submitting vaccination verification. More than 80% of employees in the county have been vaccinated.

Spokesperson Dawn Nieters said the county distributes and pays for self-administered tests for its 2,300 employees who need testing. The cost ranges from US$35 for a rapid test to US$53 for a PCR test, and is considered the gold standard for COVID detection.

Mecklenburg County, North Carolina, including Charlotte, did see the needle moving. Employees there are responsible for conducting their own tests. One month after the requirement was implemented in early September, the vaccination rate jumped from 62% to 85%.

George Dunlap, chairman of the Mecklenburg County Commission, said that he prefers vaccine or test requirements rather than just vaccinations because “you have to allow human behavior that may be different from yours.” But he is not sure whether the policy is Will encourage more workers to get vaccinated.

“The people I personally know who have decided to be tested are still being tested. They have not changed their views on vaccination,” he said.

Some health experts question the value of testing as a backup and instead support mandatory injections.

“Vaccine and/or testing policies are sub-optimal,” said Jeffrey Levy, professor of health management and policy at George Washington University. “Testing policy can detect problems early. It cannot prevent problems, and vaccination requirements help prevent problems.”

The chief executive of Montgomery County, Maryland, on the outskirts of Washington, Marc Elrich, theoretically supports the vaccination-only rule, but fears that imposing such a rule will cause workers to go to neighboring jurisdictions without similar requirements. Area work.

“I hope the federal government can impose [vaccine-only] Authorized because if the FBI does this, there will be no job portability,” Elrich said. Almost all other police departments are here.”

Robb Pitts, chairman of the Atlanta Fulton County Committee, also wants to cancel the test option. “But I don’t think my colleagues will agree with this,” he said. About one-third of county employees chose testing instead of vaccinations.

“Why should I compromise? Because I think, well, we have to do something,” Pitts said. “Many times, politics is the art of compromise.”

According to the Pitts office, Fulton County has seen the largest increase in vaccination volumes since the implementation of the vaccine or testing policy in September and May. The vaccination rate is now hovering around 72%.

Kaiser Health News is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.