With total COVID-19 hospitalizations in Texas surpassing 10,000 for the first time since September, Carrie Kroll, vice president of advocacy, quality, and public health at the Texas Hospital Association (THA), said Texas hospital staff are dealing with all of the exhaustion and anxiety you’d expect two years into the pandemic. Recent sharp and quick rises in cases, largely attributable to the highly contagious Omicron variant, have only made matters worse.
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“Our employees are used to this. They know what to expect. Certainly, this is not their first surge. Hospitals are really using their preparedness skills to rearrange almost every layer of care based on what services they can staff, who’s walked into the [emergency department (ED)] overnight, what patients they have in in-patient [care]… so, it’s just a very, very hectic place. And I feel for our members, just knowing how exhausted they are gearing up for this … next spike.”
Kroll said that although hospitals are now well aware of how to treat the virus and understand the toll that comes with it, staffing shortages continue to be their most formidable challenge.
“We’ve been at a deficit from the beginning of the pandemic … In the fall of 2019, we actually struggled with a very heavy flu season, so we were already taxed in terms of staff coming into the winter of 2020. And that has only been exacerbated throughout the pandemic … Everybody is aware that we’ve lost members of the health care workforce from exhaustion, fatigue … we’ve lost a segment of our employees based on the need nationwide, they’ve left certain jobs to go to other jobs for more pay. We have continually focused on how to recruit and keep staff … but we’ve never had enough of a quiet period during this pandemic to really get on top of anything.”
She added that the Omicron variant has made even routine care more complicated for hospital workers.
“Omicron has impacted so many more patients in an asymptomatic way. So you’ve got patients that are there because they’re acutely ill with COVID, but you have other patients that are there because they’ve had a heart attack or stroke or they have pneumonia, and they also have COVID. Our hospitals are having to wrap around additional services from an infectious disease perspective in a way they haven’t had to prior because they’re having to keep a whole lot more patients safe [and] provide the infectious disease layers around them so that they’re not spreading the disease internally.”
She said hospitals are also seeing a large number of patients walking into EDs for COVID-19 testing who might not otherwise be acutely ill, which has been adding additional strain that had not been seen in the previous two surges.
In addition to staffing shortages, Kroll said facilities across the state have also been running out of supplies used to treat COVID-19, such as monoclonal antibodies and testing kits. Gov. Greg Abbott formally requested federal support for additional testing locations, medical personnel, and monoclonal antibodies on Dec. 31.
“The inventory is just shot compared to what we were seeing previously. We had a lot of tools in the tool chest up to this point. We had vaccination, which is of course the number one tool … to potentially delay that acute level of illness that requires hospitalization, but we also had the monoclonal therapy, so that was another way that if you got COVID, you potentially could avoid hospitalization. And we had a significant amount of those infusion centers taking place regionally throughout the state … and they were doing as much as 1,000 doses a day with the expectation that it would decrease the burden on facilities.
But now … we are at a deficit when it comes to trying to use that to prevent hospitalization. So we just are at a place where without additional supplies, we are going to have a harder time keeping people from being hospitalized.”
Kroll emphasized that clear messaging to the general public and continual support for health care workers will both be key to curbing this surge.
“… [We need] any help that [legislators] can provide in terms of educating the public about the need for vaccination, the need for booster shots … we have about 4 million Texans who have been boosted, we have about 7.5 million who have yet to be [boosted] … We cannot provide additional beds to additional sick Texans if we don’t have the staff to care for them. We’re very thankful for the 4,000 bedside staff that they have approved, and we’re anxious to get those into our facilities.
… It absolutely impacts our frontline employees that they continually have to wake up and provide life-saving care in a very dramatic way because this pandemic continues. Be patient with the local health care providers and have some understanding as to how hard they’re working and try to provide them some support in all the ways you can in terms of [promoting] vaccination, being thankful, [and] having a pleasant temperament when you’re interacting with them.”