During the COVID-19 pandemic, home health aides have been on the frontlines of the crisis, providing direct care to thousands of New Yorkers. 

"They've just been amazing health care givers throughout the pandemic, just at the heroic level," said Al Cardillo, the president of the Home Care Assocation of New York. 

But New York's other looming vaccine mandate could spell trouble for those who rely on services from home health aides and be even less easier to replace than many health care workers.

Cardillo's organization in a survey of 189 home care agencies found as many as 894 registered nurses are expected to resign or leave their jobs ahead of the Oct. 7 deadline. At the same time, it's estimated 10,500 home health aides and personal care aides, as well as hundreds of support and administration staff, will leave their jobs.

Patients, many of whom are physically vulnerable, could struggle as a result, Cardillo said. 

"Those individuals in which there are thousands in the state cannot go a day without care," he said. "They must have their care and support."

A similar vaccination mandate for health care workers already in effect has led to dismissals and suspensions. On Thursday, Gov. Hochul says she was not going to budge on the issue. 

"It was the right thing to do. I will stand with that," Hochul said during a news conference. "It was hard to do though. It's hard to force people to do something you'd wish they would do voluntarily."

Hochul and her administration have pointed to a rise in vaccination rates among health care workers in the last month before the deadline took effect this week. The state is also trying to supplement the loss of health care workers through the National Guard, retired workers and nursing students. 

"We are encouraged by the increase in hospital and nursing home staff who got vaccinated in the weeks and days leading up to their vaccine mandate deadline and we expect the same of those health care workers who will be required to receive at least one vaccine dose by October 7," the Department of Health said in a statement. "It is critical for all health care workers to get vaccinated to protect themselves and our most vulnerable populations, and we will continue to work with providers and stakeholders to ensure this deadline is met and minimize any disruptions in care."

It's not clear how many people have been suspended or left their jobs because of the vaccination mandate in New York, nor did the state have numbers for how many people have provided replacement services. Overall, Hochul's office reported 92% of health care workers have received at least one dose of the vaccine. 

But Cardillo says home health aides are not as easily replaceable, and often need highly specific training. 

"If you've got a bariatric patient, they're 250, 300 pounds, and now the worker who is otherwise assigned to transfer that person from the bed to the shower to the toilet, you can't just replace that person with somebody else," he said. 

He says a compromise is possible, essentially giving home health aides more time to get their shots while still providing care. 

"There really is an opportunity to vaccinate at the highest rates possible, and if there does need to be replacement," Cardillo said, "it gives time in order to get there."