As Hospitals Fill With COVID-19 Patients, Medical Reinforcements Are Hard To Find

https://www.npr.org/sections/health-shots/2020/11/30/938425863/as-hospitals-fill-with-covid-19-patients-medical-reinforcements-are-hard-to-find

November 30, 20205:02 AM ET

Blake Farmer
Carrie Feibel

 

 Hospitals in much of the country are trying to cope with unprecedented numbers of COVID-19 patients. As of Sunday, 93,238 were hospitalized, an alarming record that far exceeds the two previous peaks in April and July, of just under 60,000 inpatients.

But beds and space aren't the main concern. It's the work force. Hospitals are worried that staffing levels won't be able to keep up with demand as doctors, nurses and specialists such as respiratory therapists become exhausted or, worse, become infected or sick themselves.

The typical workaround for staffing shortages — hiring clinicians from out of town — isn't the solution anymore, even though it helped ease the strain early in the pandemic, when the first surge of cases was concentrated in a handful of "hot spot" cities such as New York, Detroit, Seattle and New Orleans.

 
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Tennessee has now built its own field hospitals to handle patient overflows — one is inside the old Commercial Appeal newspaper offices in Memphis, and another occupies two unused floors in Nashville General Hospital. But if they were needed right now, the state would have trouble finding the doctors and nurses to run them because hospitals are already struggling to staff the beds they have.

"Hospital capacity is almost exclusively about staffing," says Dr. Lisa Piercey, who heads the Tennessee Department of Health. "Physical space, physical beds, not the issue."

When it comes to staffing, the coronavirus creates a compounding challenge.

As patient caseloads reach new highs, record numbers of hospital employees are themselves out sick with COVID-19 or temporarily forced to stop working because they have to quarantine after a possible exposure.

"But here's the kicker," says Dr. Alex Jahangir, who chairs Nashville's coronavirus task force. "They're not getting infected in the hospitals. In fact, hospitals for the most part are fairly safe. They're getting infected in the community."

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Even the region's largest hospitals are filling up. This week, Vanderbilt University Medical Center made space in its children's hospital for non-COVID-19 patients. Its adult hospital has more than 700 beds. And like many other hospitals, it's had the challenge of staffing two intensive care units — one exclusively for COVID-19 patients and another for everyone else.

And they're coming from as far away as Arkansas and southwest Virginia.

"The vast majority of our patients now in the intensive care unit are not coming in through our emergency department," says Dr. Matthew Semler, a pulmonary specialist at VUMC who works with COVID-19 patients.

"They're being sent hours to be at our hospital because all of the hospitals between here and where they present to the emergency department are on diversion."

Semler says his hospital would typically bring in nurses from out of town to help. But there is nowhere to pull them from right now.

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But Johnson says the sacrifices shouldn't just come from the country's health care workers. Everyone bears a responsibility, he says, to try to keep themselves and others from getting sick in the first place.