Hospitals face critical staffing shortages as COVID-19 cases spike

The spike in COVID-19 cases that pushed Alabama COVID-19 hospitalization numbers to a record high Monday has put hospitals in a critical state of alert, the president of the Alabama Hospital Association said today.

And the increased numbers don’t have anything to do with Thanksgiving holiday gatherings. The impact of Thanksgiving likely won’t begin to be felt until late this week or this weekend, said Dr. Don Williamson, the hospital association’s president who formerly was Alabama’s state health officer.

The “disturbing escalation” of COVID-19 cases and deaths and expected “tidal wave” of cases related to Thanksgiving has some hospital officials worried about their ability to keep up, said Dr. Jeanne Marrazzo, director of UAB’s Division of Infection Diseases.

“Our hospitals have the potential to be overwhelmed,” Marrazzo said. “Our ability to provide the standard of care that everybody is used to could be severely compromised.”

The number of people hospitalized in Alabama with COVID-19 climbed to a record 1,717 patients on Monday and to 1,785 Tuesday, according to the Alabama Department of Public Health.

Hospitals still have more beds for patients. According to Williamson, 23% of Alabama’s 7,981 regular hospital beds were still available as of Monday, and 11% of the 1,627 intensive care beds were still available, Williamson said.

But the biggest concern isn’t the number of beds; it’s the number of health care workers available to care for patients, he said.

There already was a staffing shortage before the COVID-19 pandemic began, with nursing vacancies that couldn’t be filled, Williamson said.

And it takes more staff to care for COVID-19 patients than the average patient, he said. For example, a normal hospital wing with 12 patients might have two or three nurses on duty at a time, but if those patients have COVID-19, it might take four or five nurses, Williamson said.

Plus, COVID-19 is knocking nurses and other health care workers out of work, either due to contracting the disease themselves or having to go into isolation due to close contact with others who became infected, he said.

While hospitals can manage the caseload at the current level, as the pandemic escalates with the 20 to 30% increase in cases expected due to Thanksgiving gatherings, “it is at that point we’re going to be extremely stressed,” Williamson said. “I believe in the next two to three weeks, we’re going to be very, very critical with staffing.”

Hospital and health officials are exploring other staffing options, such as National Guard and military health care workers, but the problem there is that many of those National Guard members already are working in health care jobs they would be abandoning if activated, he said.

Some officials are exploring the idea of working with the licensing board to make it possible for retired medical personnel to more easily come out of retirement to serve again, he said.

‘DISTURBING ESCALATION’

Marrazzo at UAB said she’s extremely concerned with the rise in cases and deaths across the country.

The United States is now averaging about 160,000 new COVID-19 cases a day, and there are more than 96,000 people hospitalized for COVID-19 and 1,400 to 1,600 people dying due to COVID-19 every day, Marrazzo said.

“This is one death a minute right now that we’re seeing,” she said. “Many of these people are dying without their families.”

The silver lining is that hospitals have improved the way they are taking care of COVID-19 patients, with fewer patients being put on ventilators, she said. But that’s meager comfort in the face of the demands on the health care system and “tragic death toll,” Marrazzo said.

Alabama added 3,376 new COVID-19 cases Tuesday, bringing the total number of cases since the pandemic began to 252,900, state data shows. There have been 161,946 recoveries but also 3,638 deaths attributed to COVID-19, including 3,280 confirmed deaths and 358 deaths probably due to COVID-19, state data indicates.

One in five people in regular hospital beds and 30% of the patients in intensive care beds are COVID-19 patients, Williamson said.

Also, one in five of people being tested for COVID-19 right now are testing positive for the disease, which is an extraordinarily high positivity rate, Marrazzo said.

The early news concerning vaccines that are on their way is very encouraging, with a 94% success rate in preventing infection and remarkable success in preventing severe infection for those who do contract the disease, Marrazzo said.

However, a big concern is that health experts still don’t have enough safety data concerning the vaccines, she said.