- Oops!Something went wrong.Please try again later.
A nurse and a doctor who work in emergency medicine in Bloomington are urging people to get vaccinated as hospital staff are dealing with pandemic fatigue and a worker shortage while patient numbers are rising.
“People are acting like COVID is over ... and it’s not,” said Dr. Robert Adams, IU Health Southern Indiana Physicians Emergency Medicine provider.
Katy Howe, a registered nurse and director of emergency and trauma services at IU Health, said, “Just when we think we’ve made it through another surge (and there’s) a glimmer of hope ... then it hits again.”
Adams and Howe are adding their voices to a growing chorus of health care workers who are sounding the alarm about rising hospitalizations from motor vehicle accidents, the flu and COVID-19 amid increasing health care worker burnout and a general labor shortage.
The Indiana Hospital Association, Indiana State Medical Association and Indiana State Nurses Association this week released a joint statement to urge people to get their COVID and flu shots to relieve pressures bearing down on health care workers.
“Right now, there’s not a lot of capacity in the system,” IHA President Brian Tabor told The Herald-Times.
COVID-19 hospitalizations have risen by two-thirds in the past three weeks and are nearing 75% of the pandemic peak the state experienced last November, he said.
“We’re very concerned,” Tabor said.
The rising case numbers have pushed all but seven of Indiana’s 92 counties into the orange or red advisory, the two most serious classifications.
Since the pandemic began, the state has counted more than 1.1 million COVID-19 cases, and more than 17,000 Hoosiers have died from the disease. Nearly 89% of those who have died were older than 60. Most have underlying health conditions. The vast majority of people who become infected recover.
While hospitalizations have risen again recently, deaths, so far, have not ticked up, but they are a lagging indicator, meaning that cases rise first, then hospitalizations, then deaths.
Data provided by the Indiana State Health Department show sharply higher risks of infection and death among people who are unvaccinated.
According to the ISDH:
Cases among people who are vaccinated peaked this year at 28.5 per 100,000 people.
Cases among people who are not vaccinated peaked on Nov. 23 at 96.2 per 100,000 people.
The mortality rate among people who are vaccinated peaked this year at about 1 out of 300,000, compared to about 1 out of 100,000 for people who are unvaccinated.
Adams, who works in emergency rooms including in Bloomington, said more than 90% of the COVID patients at IU Health in southern Indiana are unvaccinated.
The state’s low vaccination rate is putting an enormous strain on the health care system, he said.
Pandemic amplifies shortage of nurses, doctors, support staff
The rising number of COVID-19 cases also has affected health care workers themselves.
“I’m struggling to keep my staff healthy,” Adams said.
While his co-workers’ vaccinations will, with a high degree of certainty, prevent severe disease, they do still have to isolate sometimes and cannot work, tightening workforce constraints that already existed before the pandemic. A 2018 study projected a national shortage of registered nurses that would exceed 500,000 by 2030.
Tabor said the pandemic has accelerated the speed and increased the magnitude of some pre-pandemic trends, including more retirements or people leaving hospitals to work in less frantic environments. Some providers struggled even before the pandemic to find short-term solutions to those long-term dynamics, and, Tabor said, doing so while dealing with surges of patients during a pandemic is an even greater challenge.
Howe said hospital employees also are seeing more verbal and physical assaults on staff, which is causing more people than normal to ask questions including, “Is this what I signed up for?”
Given the nursing shortage, she said, nurses can earn good wages outside emergency rooms, which is worsening the staffing situation in hospitals. And health care providers have fewer opportunities to replace departing employees with graduates from nursing programs because some of them also saw pandemic-induced curbs.
Howe said IU Health hospitals usually welcome some new graduates in December.
“We just haven’t had any,” she said. “They’re just not there.”
Tabor said the general labor shortage also is reducing hospital capacity. Beyond doctors and nurses, hospitals employ lots of people who provide critical services, including workers who prepare hospital rooms for the next patient or surgery.
Adams said giving health care workers some much-needed rest, including emotional rest, is becoming ever more difficult.
“Unfortunately it looks like there’s no end in sight,” he said.
More patients, longer stays
While COVID cases remain below their peak, Adams and Howe said hospitals are seeing more patients who have sustained traumatic injuries simply from spending more time outside their homes: More injuries from motor vehicle traffic, sports and everyday slips and falls.
In addition, the health care professionals said they are seeing more patients who had to or chose to delay care during prior COVID surges.
Tabor said in some cases, the delays have meant the patient’s condition has deteriorated, requiring more resources and longer stays, and again reducing hospital capacity.
And Adams said while many people wore masks a year ago, few people are doing so today, which increases the prevalence of other communicable diseases, such as the flu.
“This year already we’ve seen a ton of flu, mostly coming from the IU student population,” he said.
Tabor said given the staffing shortages, hospitals have few options outside of withdrawing employees from some areas to shift them toward emergency care. They’re making those adjustments knowing full well they are likely increasing their workload down the line.
“It’s going to be a challenge to manage through the next few months,” he said.
While the situation in Indiana isn’t as dire as in Europe — the German military is flying some COVID patients from at-capacity hospitals in the southern city of Munich to the northern city of Hamburg — Tabor said National Guard personnel have filled in some shifts in Indiana hospitals to allow people to catch their breath.
“We’re not, at this point, overwhelmed the same way that Europe is, but I am concerned where this next wave ... leads us,” he said.
Adams, Howe and Tabor all said the best thing people can do to reduce pressure on the health system is to get vaccinated. That means flu shots and initial, second and booster shots for COVID.
“That’s the best thing you can do to help that tired nurse, that frustrated doctor,” Tabor said.
Adams urged people to get their information about vaccines from reputable sources. He said the chances of developing COVID-19 and having a significant problem are much higher than having a significant problem from the vaccinations. Across the globe, nearly 8 billion shots of the vaccines have been given.
“We’ve never had a safer medication,” Adams said.
Howe asked that when people gather for the holidays, they avoid setting up a buffet line or, if they do, to have only one person plate the food. She said she wants people to connect because it’s important for their mental health, but people who are unvaccinated must remain careful, keep their distance and wear masks.
She also urged people to make sure they seek care outside of hospitals if possible to prevent overwhelming the system. People who have been dealing with a chronic problem can probably bypass the emergency room and set up an appointment with their primary care doctor. If people have mild symptoms and their primary care doctor is busy, they may seek help at an urgent care facility. Of course, she said, if people suffer emergencies — a serious injury, chest pain, a stroke — they should not hesitate to call 911 to get to the ER.
“When you have that emergency, we’ll be here for you,” she said.
Boris Ladwig is the city government reporter for The Herald-Times. Contact him at firstname.lastname@example.org.
This article originally appeared on The Herald-Times: Bloomington health care workers warn: Fight against COVID-19 not over