Fall Surge
In the Midwest in the fall and winter, where cases were spiking, hospitals were filling up and taxing ICUs. “Our ambulatory practice has, just as in the springtime, decreased office visits and increased telehealth visits,” said Dr. Pensak. “Transitional units are being brought online, and we’ve begun to limit elective surgeries requiring postsurgical hospitalization.” While staffing hasn’t been an issue so far at the University of Cincinnati College of Medicine, they are relying on an increasingly limited pool of nursing travelers, according to Dr. Pensak.
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January 2021There are big differences between the spring and winter surges, however. “The things we learned during the first wave will definitely help us in these next waves, but we have to be nimble and understand there’s a set of circumstances for winter that are different from the first time around, some of which will impact us positively and some of which will impact us negatively,” said Dr. Devaiah.
Occupation Type Of Healthcare Personnel (HCP) With COVID-19 — Six Jurisdictions,* FEB. 12–July 16, 2020
| Characteristic (no. with available information) | No. (%) |
|---|---|
| Healthcare support worker** | 1,895 (32.1) |
| Nurse*** | 1,742 (29.5) |
| Administrative staff member | 581 (9.8) |
| Environmental services worker | 330 (5.6) |
| Physician | 190 (3.2) |
| Medical technician | 135 (2.3) |
| Behavioral health worker | 128 (2.2) |
| First responder | 113 (1.9) |
| Dietary services worker | 113 (1.9) |
| Dental worker | 98 (1.7) |
| Laboratorian | 68 (1.2) |
| Occupational, physical, or speech therapist | 65 (1.1) |
| Pharmacy worker | 62 (1.1) |
| Respiratory therapist | 44 (0.7) |
| Phlebotomist | 25 (0.4) |
| Physician assistant | 13 (0.2) |
| Other | 311 (5.3) |
*Alaska, Kansas, Michigan, Minnesota, North Carolina, and Utah.
**Includes nursing assistant (1,444), medical assistant (123), and other care provider or aide (328)
***Specialty not specified.
Source: CDC. “Update: Characteristics of Health Care Personnel with COVID-19 — United States, February 12–July 16, 2020,” Sept. 25, 2020.
The positives include a better understanding of infection risk and control and greater access to PPE, both of which help both the general population and healthcare workers to avoid infection. Other pluses are the medications, procedures, and protocols that have been found to mitigate the effects of COVID-19 should patients need to be hospitalized.
The negatives boil down to pandemic fatigue: People have grown weary of wearing masks and social distancing nine months into the pandemic. “We should be understanding of the fact that dealing with COVID-19 is difficult, but we should also be vigilant about not taking shortcuts or dropping our guard,” said Dr. Devaiah.
In the Operating Room
Staff absences can particularly hurt in the OR. Dr. Pensak said the OR staff at his hospital are extremely taxed and the hospital has had to cut back on paid time off. “Indeed, staff availability will be the rate limiter for both the amount and quality of care provided,” he said.
At NYU, all elective surgeries resumed in May, with precautions to keep staff and patients safe. According to Dr. Roland, all staff in the OR are cross trained on many different kinds of cases to maintain good coverage should staff be out sick. NYU has also trained internal staff to fill potentially necessary roles should New York City have a second drastic COVID-19 wave.