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Understaffed Hospitals Fear Overcrowding This Winter As Flu Mixes With COVID: Gunshots

Understaffed Hospitals Fear Overcrowding This Winter As Flu Mixes With COVID: Gunshots

  • October 9, 2021

Nurse Christie Lindog works in the Cardiovascular Intensive Care Unit at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California on September 2nd.

Apu Gomes / AFP via Getty Images

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Apu Gomes / AFP via Getty Images

Nurse Christie Lindog works in the Cardiovascular Intensive Care Unit at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California on September 2nd.

Apu Gomes / AFP via Getty Images

With a second pandemic winter approaching, there are promising signs that the worst delta surge has come to an end, but relief could be short-lived in America’s hospitals – which are already understaffed and overworked by the COVID-19 summer flood be. lived.

Many look to a tough spell in the colder months, with the threat of a potentially dire flu season, an influx of patients trying to catch up on late treatment, and an exhausted workforce with little, if any, time to break out of this latest Wave to regroup of coronavirus infections.

“It’s like a perfect storm, isn’t it? High volume, high sharpness and few staff, ”says the emergency doctor Gregg Miller, who is the Chief Medical Officer of the Vituity Healthcare Personnel Group. “Winters are already tough for hospitals and emergency rooms.”

And while some of the leading COVID-19 models suggest the U.S. will be spared another major coronavirus onslaught during the holiday season, recent history has shown hospitals that nothing is predictable about this virus.

“We have to be prepared that we always have some people infected with COVID in our hospitals who need acute care,” says Dr. Amy Williams, Executive Dean of the Mayo Clinic Practice.

A big flu epidemic?

The dreaded “thread wave” of influenza and coronavirus did not occur last winter, likely in part due to the social distancing and masking people have undertaken in response to the coronavirus.

However, some experts fear that last year’s remarkably mild flu season has now set the stage for a big recovery in the months ahead as fewer people have built up immunity.

“It could be really bad, and it could be really bad at a time when our hospitals are still pretty much filling up with COVID-19,” says Dr. Mark Roberts, Director of Public Health Dynamics Laboratory at the University of Pittsburgh.

In recent flu seasons – not counting last year – there have been an average of around 300,000 to 400,000 hospital admissions for influenza, he says. Two recent studies von Roberts and colleagues suggest that this season could bring an additional 100,000 to 400,000 flu hospital admissions. Research on previous flu seasons did According to estimates, it was between 18,000 and 96,000 Intensive care unit shots related to the flu, depending on the time of year.

Flu season is difficult to predict, and it is possible that these worst-case scenarios will not occur, but that depends on the prevailing flu and people’s behavior.

“There’s quite a chessboard in the United States to contain COVID, so that depends on how much influenza you see and how many people get the flu vaccine,” says Roberts.

Also, COVID-19 is not going away entirely, even with optimistic predictions.

Modeling by the Centers for Disease Control and Prevention and others shows that there could be a steady decline in cases nationally, but there could very well be enough coronavirus to fuel regional outbreaks and keep some hospitals busy.

“I still expect some surges,” says Stephen Kissler, a research fellow at Harvard TH Chan School of Public Health. “I think we’re not quite out of the woods yet.”

The combination of even a mild to moderate flu season and the remnants of this current COVID-19 wave is likely to drain valuable ICU resources, says Dr. Greg Martin, President of the Society for Intensive Care Medicine.

“The delta climb isn’t going away as quickly as anyone would like, and that long tail creates a lot of uncertainty and fear,” he says.

Catching up on the need for long-term care

Patients tend to show up sicker in hospital as early as the winter, and this could be especially true this year after the massive disruptions in access to health care caused by COVID-19 resulted in a backlog in delayed care.

Some patients were forced to postpone much-needed surgeries and inpatient treatments while others dropped out of routine doctor appointments that may have had a growing health problem before it got too serious, Vituity’s Miller says.

“We’re already dealing with a baseline of sicker patients, so what if it’s colder and people slip and fall? he says.

Many hospitals have tried to avoid shutting down much-needed medical procedures for other types of patients during this recent wave of COVID-19, but this has not necessarily been possible in some severely affected states.

In Washington state, the MultiCare health system was “very, very full before the delta wave hit and really drove our cases up,” says Dr. Michael Myint, Senior Public Health Physician at MultiCare.

Myint anticipates that given the current demands of COVID-19, MultiCare will work through deferred care in its hospitals for a while.

“We are still at the level we achieved last winter and the last breathing season,” he says.

Personnel problems

Healthcare workforce is stagnating after a sharp surge in COVID-19 patients, with many parts of the United States facing major staff shortages at the same time.

“The crisis we have in this country right now is the inability to provide the right staff to the patients who need care,” says Dr. Omar Lateef, CEO of Rush University Medical Center in Chicago.

This loss of health care providers is particularly pronounced in the nursing sector, and many hospitals are competing fiercely for the same limited pool of travel nurses to fill the gaps. There are also concerns that COVID-19 vaccine mandates could further undermine the workforce, although Lateef says that’s not causing their staffing issues.

“It really has to do with supply and demand,” he says. “And the difference from previous years is that we will have this increase in patient volume nationally, while at about the same time we will have a decrease in health care providers.”

It’s not just a numbers problem. Hospitals are seeing “an exodus” of their most experienced healthcare workers, says Dr. Thomas McGinn, Executive vice president of medical companies for CommonSpirit Health, a nationwide healthcare system.

“Instead of retiring in a year or two, they are retiring now,” he says. “A lot of these seasoned people teach the younger people when they come in, so there’s this tension of losing older people and losing those who would train on the job.

And that couldn’t come at a worse time. With all the factors getting worse, health care workers fear the coming onslaught of patients this winter.

“People are tired in health care and there is a burnout that we have not seen in this country [before]”says Lateef.” This, in combination with the increased volumes that we expect in winter, creates the conditions for even more burnout in the future and even more personnel problems. “

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