A New Kind of Shortage in COVID Responses: Health Workers

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States of Crisis with Dan Vock
A New Kind of Shortage in COVID Responses: Health Workers
By Daniel C. Vock • Issue #23 • View online
Today is Election Day, but it will likely also be a day when the United States sets yet another record for the most new coronavirus cases since pandemic began.
While the number of deaths per day is thankfully down from this spring’s peak, the massive caseload is straining health care facilities around the country.
That’s the story this week, as health officials and administrators scramble to provide services with a limited number of doctors and nurses to call on…
Welcome back to “States of Crisis,” where we try to give you a glimpse of what’s next in state policy during these tumultuous times.
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Onto the news…

Donna Edwards
Tonight, we light the Governor’s Mansion blue to recognize all of our first responders and health care workers, our heroes on the frontline of the COVID-19 crisis. God bless and thank you all!! 💙 #LightItBlue https://t.co/X8HQ5Oprd9
Short-Staffed and Under Duress, Health Workers Confront Biggest COVID Surge Yet
When the coronavirus first arrived in the United States this winter, governors and other officials scrambled to find all sorts of medical equipment they would need to deal with the outbreak, from ventilators to latex gloves and hand sanitizer.
But now, as the outbreak flares like never before, they may be looking for something even more essential: health workers.
As hospital beds fill up, administrators are scrambling to make sure there are enough doctors, nurses and other staff to handle the influx.
“All the beds in the world are worthless without skilled, experienced health care workers to staff them and to provide care,” Kris Ehresmann, director of infectious disease for the Minnesota Department of Health, recently told the St. Paul Pioneer Press.
Things are so precarious in Helena, Montana, that Dr. Shelly Harkins, the chief medical officer of St. Peter’s Health there, told Kaiser Health News that administrators have to worry about the health of every one of their staff members. “Just one more person out and we wouldn’t be able to keep the surgeries going,” she said.
In a small town, administrators have to keep their staff lean to keep costs down, she explained, but that means they don’t have much slack if a specialist gets sick or goes into quarantine, she explained.
The fact that the latest surge of COVID-19 cases has reached nearly all corners of the country, also means that it is harder for hospitals to bring in workers from other areas.
The number of COVID-19 cases nationwide jumped by 45 percent in just the last two weeks. The Midwest and interior West are especially hard-hit, but new cases are already high and staying high in 40 states, plus Guam and Puerto Rico, according to The New York Times.
So even hospitals in a big metropolitan area like Chicago have trouble bringing in back-up. “Every state around Illinois is surging,” Danny Chun, a spokesman for the Illinois Hospital Association, told the Daily Herald. “Look at Wisconsin. Look at Missouri. Look at Iowa. They’re all surging. There’s a limited pool of health care professionals.”
But the stress on health personnel isn’t just about the current workload. Doctors, nurses, public health administrators and front-line workers have been scrambling to respond to the pandemic for eight months now.
While much of society is trying to deal with “covid fatigue,” the health care workers are bearing the brunt of it.
Six percent of known cases of COVID-19 in the first three months of the outbreak in the United States were of health care workers, the Centers for Disease Control and Prevention recently reported. A quarter of those workers were hospitalized and 4 percent died.
Advocates say the official tally may be an undercount. The National Nurses United, a labor union of registered nurses, estimates that more than 1,700 health care workers – including more than 200 registered nurses – died of COVID-19 in the United States through mid-September.
The nurses union said many health care workers had been infected because of a lack of personal protective equipment and unsafe working environments. It called on states and the federal government to require hospitals and other health care facilities to provide more detail about infections in their workplaces.
“There is widespread resistance on the part of health care employers to transparently provide information on nurse and other health care worker COVID-19 infection rates and fatalities,” the group said in a release. “Meanwhile, federal, state, and local governments have failed to compel health care facilities to provide this data. If hospitals are not widely required to publicly disclose their deaths and infection rates, they have no incentive to avoid becoming zones of infection.”
The recent uptick in coronavirus infections has also renewed worries that local health facilities won’t have enough PPE and other equipment to handle the influx in cases.
In Michigan, the amount of equipment on hand varies greatly from one hospital to the next, the Detroit Free Press reported. “While some hospital systems have amassed at least 90 days of critical PPE supplies, the volume at other hospitals is so low, they’ll be exhausted within a week,” the paper wrote.
Meanwhile, one of the most basic pieces of protection for health care workers from the virus – the N95 mask – remains relatively hard to find, the Washington Post noted.
“As the weather cools and the death toll climbs, America’s health-care workers fear that when winter comes, they still won’t have enough respirators. And the longer the shortage lasts, the longer N95s will remain largely out of reach for millions of others who could be protected by them — teachers and day-care workers, factory employees and flight attendants, restaurant servers and grocery store clerks,” the Post warned in September.
Health officials threatened
After eight months, it may be hard to remember the early days of the coronavirus outbreak when residents rallied to support health care workers by banging pots at dusk, while skyscrapers and sports stadiums were bathed in blue light to honor their work. Americans tuned in to watch their governors and public health officials brief the public on the spread of the virus, and what was being done to stop it.
These days, it seems as if front-line workers have been forgotten as Americans debate the wisdom of opening schools, closing bars or postponing sports seasons instead.
Public health officials, though, now confront new dangers. Even Dr. Anthony Fauci has to run with a security detail.
Three men – one of them armed – confronted a team of workers conducting random COVID testing in Minnesota this September, forcing the team to turn back. In Ohio this summer, armed protesters showed up at the home of Amy Acton, who at the time was the director of the state department of health. Acton later resigned.
Threats and attacks on public health officials have become so common, in fact, that the Journal of the American Medical Association (JAMA) ran a piece from public health experts calling on state and local leaders to intervene. They noted that public officials, from President Donald Trump to state lawmakers and supreme court judges have fanned the hostility toward health officials.
“Instead of attacking their health officials, elected leaders should provide them with protection from illegal harassment, assault, and violence,” the JAMA authors wrote.
“States and the federal government should investigate all credible threats, provide security details as warranted, and prosecute those whose harassment crosses legal lines. Without protection and support, the already scarce supply of qualified individuals willing to serve in health officer roles will decline further.”
Two weeks ago, Illinois Public Health Director Dr. Ngozi Ezike paused during a briefing about the resurgence of COVID-19 cases in the state.
“Since yesterday, we lost an additional 31 lives – for a total of 9,418 deaths,” she started. “These are people who started with us in 2020 and won’t be with us at the Thanksgiving table.”
“To date,” she continued, her voice wavering, “we are reporting 3,874 new cases, for a total of 364,033 confirmed cases, since the start of this pandemic. Excuse me, please.”
Ezike turned away from the cameras, apparently in tears. She took a tissue before returning to the lectern.
“If you’re talking about Covid fatigue from having to keep wearing a mask,” she said later, “think about the Covid fatigue for health care workers, respiratory therapists, who are going to have to go through this whole episode again, of trying to fight for people’s lives because we couldn’t figure out how to control this virus by doing some of the simple measures that have been prescribed.”
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Daniel C. Vock

A pandemic. Recession. Civil unrest. State leaders are grappling with several enormous crises all at once. We explore how they're responding.

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