In the beginning of the coronavirus pandemic, it was unceasing demand for masks, face shields and other protective gear for health care workers that strained the system. Now, as the deadly virus spreads out of control across the entire country, the dominant concern is over a shortage of medical workers themselves.
Already, traveling nurse companies are seeing a record number of job openings — and skyrocketing pay rates — as hospitals scramble to staff up to meet the need brought on by soaring COVID-hospitalization rates. Medical systems, such as UCSF, that once dispatched their nurses and doctors to hotspots such as New York City are now refusing to part with their staff, mindful that they, too, may need all hands on deck. And the pleas from public health officials to stay home over the Thanksgiving holiday weekend are becoming increasingly urgent, with social distancing and masking being the primary way to prevent hospitals from filling up in the absence of a vaccine.
In the last several days, California has recorded more cases than ever — topping 20,000 new cases on Monday alone. Across the U.S., more than 178,000 new cases and 2,200 deaths were recorded Tuesday. More than 88,000 people are in the hospital with the coronavirus this Thanksgiving, including nearly 700 in the Bay Area — the most since August.
Across the state, with more than 1,550 people in the ICU, fewer than 2,000 ICU beds remain open and, according to the state hospital dashboard, some counties, have none or just a few available.
As of Wednesday night, Yolo County had 114 new cases for 4,476 people infected with 74 deaths and 12 people in hospital. It’s not known how many, if any, Yolo County people are under intensive care.
ICU patients, by nature, require intensive care, and in non-COVID conditions, that means just one or two patients per nurse. But meeting those staffing levels is becoming increasingly difficult.
“Right now, demand is three times what it normally is,” said Dan Weberg, head of clinical innovation at Trusted Health, a three-year-old startup that matches nurses to jobs in the Bay Area and across the country. “There might be enough physical hospital beds, but there’s just not enough staff.”
And while in past years and even earlier in the pandemic, all hospitals didn’t need nurses at the same time, that’s changed. Hospitals are drawing from the same finite pool of nurses and, in some cases, extending contracts — meaning other hospitals are left scrambling. In the Golden State, demand is especially high in Los Angeles right now.
But, Weberg said, “across the board, we’re seeing California prepping for the worst and getting ready.”
Renowned hospital systems, such as UC San Francisco, that sent doctors and nurses to New York and the Navajo Nation in April now are keeping staff close.
“We simply can’t risk it this time, when we could be slammed ourselves in 1-2 weeks,” tweeted Bob Wachter, chair of UCSF’s Department of Medicine.
Traditional traveling nurse agencies are also experiencing growing demand, with hospitals offering $6,000 or more a week to woo workers.
Trusted Health is seeing nurses who took time off return to the workforce, and those who had joined the faculty at nursing schools headed back into the trenches.
That’s happening at the state level, too — but not every effort to expand the pool has succeeded. While Gov. Gavin Newsom’s call for retired or out-of-work medical workers to join what he called the California Health Corps resulted in more than 90,000 volunteers, only a tiny fraction have actually been dispatched, with many stymied by expired medical licenses and other bureaucratic issues.
“There are approximately 900 California Health Corps cadre members available to support California’s response,” the California Department of Public Health told this news organization Wednesday in response to questions about the governor’s high profile call to arms this spring. Health corps members have worked more than 2,500 shifts supporting 109 facilities statewide.
The state has some of the strictest licensing requirements in the country, which affect even active medical workers. According to Trusted Health’s Weberg, it takes weeks for out-of-state nurses to become licensed in California, while the process takes just hours or days in other states such as New York.
All of it has meant months of strain for all medical workers, temporary and longtime staff alike.
“There are sometimes lulls where people can step back and say, ‘Oh great, this isn’t such a crazy day after all,’ and there isn’t that lull anymore,” said Deborah Burger, a Kaiser Santa Rosa nurse and co-president of the union National Nurses United. “There isn’t time to recharge your batteries, to get relief from the day-to-day stress of going into work and knowing that you’re exposing yourself to a deadly disease.”
The crush of work is compounded by the knowledge that there’s no end in sight to the pandemic, at least not yet. Burger’s husband recently showed her a flight tracker displaying planes crisscrossing the country in real time ahead of the Thanksgiving holiday.
“Nurses see what’s coming,” she said. “Christmas is going to be one big funeral, and it’s really disheartening.”
