By Maria Caspani and Nathan Layne

NEW YORK (Reuters) -New York hospitals were preparing to fire thousands of healthcare workers for not complying with a COVID-19 vaccine mandate taking effect on Monday, with some in the upstate region curtailing services to cope with staffing shortfalls.

The Erie County Medical Center (ECMC) in Buffalo has suspended elective inpatient surgeries and will not accept intensive-care patients from other hospitals as it prepares to fire about 300 unvaccinated employees, a spokesperson said.

Catholic Health, one of the largest healthcare providers in Western New York, had said it would postpone some elective surgeries on Monday as it works to boost its vaccination rate, which reached 90% of workers as of Sunday afternoon.

Peter Cutler, a spokesman for ECMC, said the decision to curtail some operations would put a big dent in the hospital’s revenue, as elective inpatient surgeries bring in about $1 million per week, in addition to inconveniencing patients.

“Financially, it’s a big deal,” Cutler said.

New York’s state health department issued an order last month mandating that all healthcare workers receive at least their first COVID-19 shot by Sept. 27, triggering a rush by hospitals to inoculate as many employees as possible.

New York Governor Kathy Hochul said on Saturday she was considering bringing in National Guard and out-of-state medical workers to fill likely staffing shortages, with 16% of the state’s 450,000 hospital staff, or roughly 72,000 workers, not fully vaccinated.

The inoculation push comes amid a broader battle between state and federal government leaders seeking to use vaccine mandates to help counter the highly infectious Delta variant of the coronavirus and workers who are against such requirements, many claiming religious grounds for their objections.

The Delta variant drove a surge in COVID-19 cases and hospitalizations in the United States that peaked in early September and has since fallen, according to a Reuters tally. Deaths, a lagging indicator, continue to rise with about 2,000 lives lost on average a day for the past week.

NYC HOSPITALS ‘FULLY FUNCTIONAL’

New York City Mayor Bill de Blasio told a news conference on Monday that hospitals in the city were not seeing major impacts from the mandate, but that he was worried about other areas of the state, where vaccination rates are lower.

Of the 43,000 employees at the city’s 11 public hospitals, about 5,000 were not vaccinated, Dr. Mitchell Katz, head of NYC Health + Hospitals, said at the news conference. Katz said 95% of nurses were vaccinated and all of the group’s facilities were “open and fully functional.”

It was not immediately clear how pending legal cases concerning religious exemptions would apply to the state’s plans and what recourse might be available to fired employees. A federal judge in Albany temporarily ordered New York state officials to allow religious exemptions for the state-imposed vaccine mandate on healthcare workers.

At St. Peter’s Health Partners in the Albany region, about 400 employees are at risk of losing their job for failing to show proof of vaccination or intent to be inoculated, said Dr. Thea Dalfino, chief medical officer for SPHP Acute Care.

She warned that some services including elective surgeries may need to be halted due to staffing issues at their hospitals. The unvaccinated workers will be suspended without pay and given until Oct. 8 to comply or be fired, a spokesperson said.

Others have made greater progress with their vaccination drives.

New York-Presbyterian, the largest private network of hospitals in New York City, gave its employees until Sept. 22 to get a shot. Only 250 out of 48,000 total employees chose not to be vaccinated and were terminated, a spokesperson said.

Rochester Regional Health, which oversees a network of nine hospitals in upstate New York, said on Monday that nearly 99% of its employees had either received one dose or had been granted an exemption.

The mandate has also thrown up new staffing challenges for nursing homes and other long-term care facilities, many of which had struggled to retain workers even prior to the pandemic.

Stephen Hanse, who heads a statewide long-term care association, said he supports the vaccine mandate but worries it could exacerbate such staffing problems, hindering the capacity for nursing homes to accept hospital patients upon discharge.

(Reporting by Nathan Layne in Wilton, Connecticut and Maria Caspani in New York; Editing by Bill Berkrot)