COVID-19 surge sidelines health workers when they’re needed most

COVID-19 hospitalizations in the U.S. reached new highs this week, testing the nation’s health-care workforce as the virus sidelines medical workers.

More than 118,000 people—roughly equivalent to the population of Lansing, Michigan—have been in hospitals with COVID on average over the past seven days. That’s a record, according to data from the COVID Tracking Project.

While record COVID admissions strain emergency rooms and intensive care units, the crisis squeezes smaller clinics, too. Uncontrolled infections mean more patients coming in, even as staff exposed to the virus must stay home.

Four of the six nurses who work at Klamath Health Partnership, a not-for-profit clinic in Klamath Falls, Oregon, were out last week after exposure to COVID. About 16 of the clinic’s patients were hospitalized, double the typical number, so the clinic’s doctors spent twice as much time making rounds at the hospital.

Because so many people are out, the clinic’s chief operations officer, Amanda Blodgett, has been wearing scrubs and swabbing patients coming in for coronavirus tests. She estimates that roughly 20% of the 135-member staff were sick or quarantining the week before Christmas, everyone from clinicians to front-desk workers to call-center employees.

“I haven’t been doing very many COO things,” Blodgett said. “I do that stuff at home at night.”

Blodgett has an MBA and isn’t a medical provider. She went through the same training the clinic gives to medical assistants so she could backstop front-line workers when cases started to mount. “Swabbing a patient is incredibly stressful,” she said. She canceled plans to take time off during the holidays and expects to be filling in until it’s safe for quarantined staff to return.

Klamath Health Partnership is a federally qualified health center, designated by the government to care for people in underserved areas. It typically sees 12,000 patients a year in a county of about 68,000. Many are migrant or seasonal farmworkers.

The county has recorded more than 1,700 cases, a tally that’s roughly doubled since the last week of November.

The expanding epidemic has strained all aspects of the clinic’s operations. Klamath Health Partnership contracted with an assisted-living facility to conduct weekly tests of residents and staff as required by the state. With case rates up, they now have to test twice a week. “That takes staff out of my clinic,” said Blodgett, who’s collected the swabs herself.

To relieve the local hospital this fall, Klamath Health Partnership also turned part of its space into a “transition” clinic. Patients from the emergency room who weren’t sick enough to be admitted to the hospital could be taken there to get oxygen and IV drugs.

“Our goal was to help them turn rooms faster,” Blodgett said.

She closed it in December because she didn’t have enough workers to keep it open.

While the U.S. has been dealing with widespread COVID cases since March, the crisis has escalated in the past month. The U.S. has almost 19 million cumulative cases to date. December alone has accounted for more than 5 million, according to COVID Tracking Project data.

That means roughly three out of every 10 cases has been recorded this month. In California, which added more than 900,000 cases so far in December, the proportion is higher: 43% of all the state’s COVID cases so far have been recorded this month.

Nationally, the tally of new positive cases declined in recent days, though it’s not clear how much is due to the Christmas holiday slowing testing and data reporting. The U.S. reported an average daily increase of almost 180,000 cases over the last week, compared with 213,000 a week ago.

Even if cases decline, hospital admissions and deaths lag new diagnoses, and will likely keep climbing for weeks. Holiday travel and gatherings this week could ignite new chains of transmission, driving cases, hospital admissions and deaths higher next month.

In Klamath, some of Blodgett’s staff is expected back this week, but she’s worried about what might happen after Christmas and New Year’s.

The clinic asked state officials for help finding staff, she said, and was told to contact other clinics and hospitals.

“My organization is the backup plan to our hospital,” she said. “Sometimes the folks in the metropolitan areas forget that in rural Oregon, in rural America, we don’t have backup plans.”

More than 333,000 U.S. residents have died of the pandemic, according to Johns Hopkins University.

COVID cases increased 7.1% over the past seven days, according to the COVID Tracking Project. The West is bearing the heaviest burden, with the Tracking Project reporting 41% of the nation’s cases over the past seven days.