“It’s a really, really tough situation here,” Dr. Emily Landon, the executive medical director of infection prevention and control at UChicago Medicine, told Crain’s on Jan. 20 during the omicron surge. “Everybody is short-staffed. Our regular, everyday workers are getting COVID at an alarming rate.”

Hospitals across the country and in Illinois have lost workers since the pandemic began, according to the US Bureau of Labor Statistics. The number of US hospital employees has dropped 2% from 5.24 million in March 2020 to 5.13 million in December 2021. In Illinois, the number of hospital workers has dropped about 4% from about 241,500 in March 2020 to 232,700 in December 2021.

More evidence of labor issues turned up in a recent survey from Chicago-based American College of Healthcare Executives that polled 310 executives and shows personnel shortages are hospital CEOs’ top concern.

“The hospital systems, like other employers—because of the labor shortage, they are following the CDC guidance,” says Margo Wolf O’Donnell, an attorney specializing in employment law at Benesch Friedlander Coplan & Aronoff. “In some instances, they don ‘t want to exceed what is required in order to ensure there is enough staffing to meet the needs of the patient population right now.”

In accordance with state and federal requirements, Sinai Chicago, Chicago’s largest safety net hospital, required employees have two COVID-19 doses by Dec. 31. About 99% of its 3,200 caregivers have complied, with a small number of deferrals and just 14 terminations , spokesman Dan Regan says.

While Sinai says it is strongly encouraging caregivers to get boosted, it’s not yet a requirement. But more than 40% of the staff has received a booster.

“Given this response and the fact that there is not yet a state or federal requirement for boosters, we have not yet decided to make boosters mandatory,” Regan says.

Unlike some other states, including New Jersey, New York, California and New Mexico, Illinois has yet to require that all healthcare workers be boosted, though it does require the first two doses. Gov. JB Pritzker’s office didn’t answer questions about boosters for healthcare workers. But now with COVID restrictions set to ease in Illinois and around the country, it’s possible government will never mandate boosters, says Amanda Sonneborn, a Chicago-based lawyer at Atlanta law firm King & Spalding.

“I am doubtful if you will see (new mandates), based on the fact that much of the government is rolling back requirements, not adding new requirements,” Sonneborn says.

Whether or not boosters are ever required for Illinois healthcare workers, some are still opting to get boosted. James Kerridge, the assistant chief nursing officer at Sinai Chicago, got his booster shot in November. Since then, he’s urged co-workers to get the third dose.

“We have an obligation as healthcare professionals to recommend that people get vaccinated and boosted,” Kerridge says. “But the organizational leader in me understands that mandates can be tricky.”

This story first appeared in our sister publication, Crain’s Chicago Business.