|THIS WEEK AT GIST—ON THE ROAD
What we learned this week from our work in the real world.
It’s an unsafe time to be in the hospital
This week we caught up with the physician director of the emergency department at a large urban hospital. The hospital’s COVID admissions were up 60 percent compared to last month, but that was just one of his concerns. The emergency department is swamped every day, and staffing shortages are at critical levels. While this is nothing new, he said, it felt for the first time that the combination of unrelenting volume and short staffing were perceptibly affecting the quality of care. “It’s not just that we’re super busy and short staffed,” he shared, “it’s that there is no consistency in our staffing anymore.” When he would work a shift in the past, he was usually “on” with the same team of doctors, nurses, and techs—and those teams worked together like a well-oiled machine, anticipating each other’s needs, knowing how to expedite processes. Now a quarter of the nurses on some shifts come from travel agencies: “Thank God they’re here, but we’ve lost a lot of our speed and agility. I think it’s a very unsafe time to be in the hospital, not just for COVID, but for anything.”
This mix of challenges is almost certain to intensify over the next month, as Americans head out on holiday travel just as the Omicron variant is taking hold. We still don’t know how the severity of Omicron will compare to prior COVID waves. A recent article in The Atlantic summarized the potential impact well: “The variant’s threat is far greater at the societal level than at the personal one.” Those of us who are vaccinated and boosted will hopefully be spared severe disease, but given the variant’s sky-high transmissibility, hospitals could still find themselves overwhelmed, even if a smaller portion of patients require admission. The impact on staffing could be even more dire. In the weeks following Omicron’s emergence in South Africa, 20 percent of the country’s healthcare workers contracted COVID. US hospitals could find themselves in a similar position in early January, flooded with patients while experiencing a record number of staff under quarantine themselves. And we are starting from a position today where the system is already overwhelmed; in the words of one expert, “the level of care that we’ve come to expect in our hospitals no longer exists”. Anyone coming to the hospital, for any reason, may have their care adversely impacted. Managing this surge will require not just vaccines, but for Americans to push through pandemic fatigue and resume masking, distancing and other precautions—working for the collective good, not just our individual benefits.