March 6, 2023 – The effects of “Long Covid” – and its sometimes debilitating symptoms that may last for greater than a yr – have exacerbated an already severe shortage of healthcare professionals.
Hospitals have resorted to training programs, mobile nurses and emergency room staffing services. While the shortage of clinical staff continues, there’s also a shortage of support staff, with no sign of ending.
“Our clinical staff are the front line, but behind them there are multiple layers of people performing tasks that enable them to do their jobs,” says Joanne Conroy, MD, president of Dartmouth-Hitchcock Medical Center, a 400-bed hospital in New Hampshire. “Lab and radiology and support staff and IT and facilities and housekeeping… the list is endless.”
Studies suggest that Long Covid is contributing to the general labor shortage within the U.S. But because there isn’t any testing for the disease and symptoms and severity vary widely—and a few employees attribute their symptoms to something else—it's difficult to get a transparent picture of the impact on the healthcare system.
Recent research suggests that Long COVID hits the healthcare system particularly hard.
According to the U.S. Bureau of Labor Statistics, the system has lost 20% of its workforce over the course of the pandemic. Understaffing in hospitals has led to burnout and exhaustion amongst front-line medical staff.
Other research highlights the numerous impact on healthcare employees:
- In New York, nearly 20% of long-term COVID patients are still unemployed after a yr, with a very high number working within the healthcare sector. According to a new study on workers’ compensation claims.
- A brand new study in American Journal of Infection Control reports that intensive care nurses and nonclinical employees are particularly in danger. About 2% of nurses haven’t returned to work after contracting COVID-19, in accordance with a survey by the National Nursing Association, which represents unionized employees.
- In the UK, long-Covid symptoms are affecting the lives of 1.5 million people, in accordance with the Office of National Statistics, which monitors the impact of COVID, with almost 20% saying their ability to perform on a regular basis activities is “severely limited”, in accordance with February data.
While brain fog, fatigue and other symptoms of a protracted COVID pandemic sometimes last only a number of weeks or months, some people – whether at work or of their personal lives – develop chronic, long-lasting and disabling symptoms over time that may last for years.
Several recent research studies suggest that the impact of Long COVID on healthcare employees, who’re in closer contact with COVID patients than other professionals, is more severe than in other occupations and is more likely to proceed to have an effect in the longer term.
About 25% of those filing COVID-related compensation claims for lost work time are healthcare employees. according to a study by the National Council on Compensation Insurance. That was greater than another industry. At the identical time, the study – which included data from nine states – found that employees’ compensation claims for acute COVID cases declined from 11% in 2020 to 4% in 2021.
Last yr, Katie Bach wrote a study for the Brookings Institution on the impact of Long Covid on the labor market. In an email, she said she still thinks it’s an issue for health care employees and employees basically.
“It is clear that we have a stubborn group of long-COVID patients who are not getting better,” she says.
Hospitals must adapt
Dartmouth-Hitchcock Medical Center is the biggest health system — and certainly one of the biggest employers — in New Hampshire, with 400 beds and 6,000 employees at its flagship hospital and branch. Human resources officials are tracking COVID-19 infections amongst employees.
The hospital is treating fewer COVID cases. From a peak of about 500 per 30 days, they at the moment are seeing between 100 and 200 cases per 30 days. At the identical time, nevertheless, they’re seeing a rise within the variety of employees calling in sick or consulting the occupational health department with a variety of COVID-like symptoms, says Aimee M. Claiborne, director of human resources for the Dartmouth Health system.
It is evident that we’re coping with a stubborn group of long-COVID patients who will not be improving.
Katie Bach, Brookings Institution
“Some of it could be due to long COVID, some of it could be due to flu, RSV or other viruses,” she says. “We definitely pay attention to things like absenteeism and the reasons why people are checking in.”
They are also studying the issue of “presenteeism,” or employees coming to work once they will not be feeling well and will not be as productive, she says.
Those returning to work can tap into the corporate's existing disability programs for support — for instance, individuals with low energy or fatigue or one other disability can work shorter shifts or work at home. Dartmouth-Hitchcock can also be constructing more distant work into its system after trying that approach at the peak of the pandemic, Claiborne says.
Ultimately, some employees is not going to give you the chance to return to work. Those infected at work can also give you the chance to hunt compensation, but coverage varies from employer to employer and state to state.
Across the country, Annette Gillaspie, a nurse at a small hospital in Oregon, says she — like many other health care employees — contracted COVID early within the pandemic, before vaccines were available and protective measures were in place.
She says she hasn't fully recovered three years later. She still suffers from a cough and POTS (postural orthostatic tachycardia syndrome), a standard post-COVID-19 automatic nervous system disorder that could cause dizziness and fatigue when a seated person stands up.
But she is back at work and the hospital has accommodated her, for instance by moving the parking zone closer to the constructing.
She remembers being exposed to the virus – she forgot to placed on protective goggles. A couple of days later, she was in bed with COVID. She says she never fully recovered. Gillaspie says she sees many other people at work who appear to have symptoms of long COVID.
“Some of them know it's COVID-related,” she says. “They're doing the same thing I'm doing — fighting through it.”
They do it because they love their work, she says.
Shortages across the country
Millions of individuals live in a situation that the federal government describes as “Areas with shortages of health professionals” without enough dentists, general practitioners and psychologists. In hospitals, vacancies for nurses and respiratory therapists increased by 30% between 2019 and 2020, in accordance with a American Hospital Association (AHA) survey.
According to the AHA, hospitals might want to hire as much as 124,000 physicians and no less than 200,000 nurses annually to fulfill growing demand and replace retiring nurses.
When the pandemic hit, hospitals needed to employ expensive traveling nurses to address shortages brought on by one wave of COVID outbreaks after one other. But when the AHA finds that there is a shortage of health care workers existed before the pandemic.
The federal government, conditionsAnd Health systems have programs in place to deal with the shortage. Some hospitals are training their very own staff, while others could also be trying to expand the “scope of care” for existing providers, equivalent to physician assistants. Still others try to support existing staff who could also be affected by burnout and exhaustion – and now Long COVID.
The numbers on long COVID are – just like the disease itself – difficult to measure and continually changing. According to the Household Pulse Survey, between 10% and 11% of those that have had COVID suffer from long COVID. an ongoing data project of the Census Bureau.
A health care provider from the UK recently wrote that she and others initially simply continued working because they believed they might overcome the symptoms.
“As a doctor, the system in which I worked and the martyr complex instilled by medical culture enabled this view. In medicine, being sick, being human and caring for ourselves are still too often seen as a kind of failure or weakness,” she wrote anonymously within the journal BMJ.
Jeffrey Siegelman, MD, a physician at Emory University Medical Center in Atlanta, also wrote a journal article about his experience with Long COVID in 2020 in JAMAICA. More than two years later, he continues to be affected by Long COVID.
He was unable to work for five months, then began his practice part-time and was exempt from night work – “a big challenge”, he says, for an emergency doctor.
In general, he feels that the hospital has “bent over backwards” to assist him return to work. He is now within the strategy of returning to work full-time with some concessions.
“I've been really lucky in this job,” says Siegelman. “This is not what most patients with long Covid have to deal with.”
He ran a support group for hospital employees who had long Covid – including clerks, technicians, nurses and doctors. Many people tried to beat their symptoms to do their jobs, he says. Some people whose disability insurance was exhausted were laid off.
He admits that as a physician he had higher disability insurance than others. However, since there isn’t any diagnostic test to substantiate Long Covid, he shouldn’t be free from self-doubt and stigma.
Siegelman was certainly one of the doctors who questioned the physiological basis of ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), a condition just like long COVID that usually occurs in individuals who have lingering symptoms of infection. He not does that.
Researchers are starting to link ME/CFS and other long-term problems to COVID and other infections, and research is underway to raised understand what are referred to as post-infectious diseases.
Hospitals are coping with a lot, Siegelman says, that he understands why some are hesitant to acknowledge that folks are working at reduced capability.
“It's important that hospital managers talk to their staff about this and give people the opportunity to admit that it's taking longer than expected to recover from an illness,” he says.
In medicine, he says, you're expected to indicate up for work unless you're on a stretcher yourself. Today, persons are rather more willing to call in sick in the event that they have a fever – a superb development, he says.
And as he prepares to return to work, the symptoms persist.
“I still can't taste anything,” he says. “It's a constant reminder that something serious is happening here.”
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