4th surge, hospital staff shortage, employee productivity

A group of hospital and business leaders spoke Thursday to share their concerns about an impending fourth COVID surge, hospital staffing shortages and a drop in employee productivity for businesses.

By sharing these concerns, experts hope unvaccinated Michiganders will realize the importance of protecting themselves and others from COVID-19.

Here are our takeaways from the briefing.

Fourth surge of COVID cases in Michigan

Geneva Tatum, MD, the associate division head of pulmonary and critical care medicine at Henry Ford Health System, said she has been through three COVID surges at Henry Ford Hospital, and she’s worried about a fourth.

“We are all deeply concerned that we are going to have a fourth surge,” Tatum said. “We have seen the devastating effects that this virus has taken on the human body, including those who were otherwise healthy when they came into the hospital and thought that they didn’t have to worry about being affected or infected by COVID, and thought that even if they did get infected that they’d have a relatively brief or low-symptom course. But even those patients, we’ve seen devastating consequences of COVID-19 disease, and all too often, too many patients who did not survive.”

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Tatum said she has spoken to many unvaccinated patients who are still convinced, 18 months into the pandemic, that they are healthy enough to beat the virus.

“Too many people, unfortunately, continue to rely on this information and disinformation that we’ve seen has drastic and deadly consequence,” Tatum said.

“It’s incredibly important to make sure we get more patients vaccinated, because if we don’t the threat of a fourth surge is very real.”

Hospital staffing shortages

After three surges of COVID, even the skilled intensive-care unit at Henry Ford Hospital is “very concerned” that there appears to be a fourth on the way.

“Staffing shortages that are happening all around the state have us strained, as well,” Tatum said. “We are losing our sense of hope that we would be able to end this pandemic faster when we started our vaccination roll-out many, many months ago.”

Medical ICUs have not returned back to their normal patterns and volumes of patients, Tatum said. She’s concerned that we haven’t yet made it through to the other side of the pandemic.

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“We want to make sure that we remain hopeful and not be discouraged by what we’re seeing with low vaccination rates,” Tatum said.

Early-career doctors and doctors in training have been greatly challenged by the COVID pandemic. Tatum said they’re seeing many patients their same age and struggling to make inroads and helping younger patients recognize that they are at risk.

“They recognize how patients’ beliefs impact treatment plans and how they follow recommendations, and it’s challenging for them to help them understand and help their patients, more importantly understand, what science is teaching them, and talk to them in a constructive way,” Tatum said.

The strain of a fourth surge could be a tipping point for all of Michigan’s health systems, according to Tatum.

Struggles for smaller hospitals

To represent smaller, rural hospitals in Michigan, Nicole Linder, MD, chief hospitalist at OSF St. Francis Hospital & Medical Group, shared her story.

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St. Francis is a 25-bed critical access hospital with a four-physician and one PA group and no ICU. Linder said the hospital has cared for an “inordinately large number” of COVID patients during the pandemic, considering their area.

“We’ve struggled, at times, with bed capacity, and our facility was able to get emergency authorization to increase the number of our beds available,” Linder said. “Those beds were expanded, but we did not have expanded staffing. For that increase in volume, the entire hospital staff kind of drew together and worked extra shifts and stayed late and did all we could to help out each other and our patients.”

During COVID surges, St. Francis had no beds available for sick patients — COVID and others.

“During and after this crisis, we did lose a significant number of nursing staff,” Linder said.

Those nurses tended to be the older, more experienced ones on the staff, she said, making it even more difficult to overcome. Some nurses opted for early retirement, and others moved to other areas of the profession.

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This is happening all over the United States, Linder said.

“I was really relieved and really hopeful when there was a highly effective vaccine developed much more rapidly that I could have dreamed,” Linder said. “I think there was a feeling that we were getting to the finish line and we just had to hold on until the vaccine was available and then everyone would be vaccinated and this whole thing would be over.

“Unfortunately, we now know that’s not the case, and we’re currently, at our hospital, experiencing a significant wave of COVID right now. We’re seeing many of the same systemic problems again, can’t get our patients transferred out to critical care services.”

Vaccinated vs. unvaccinated patients

This wave of COVID cases has been very different at St. Francis Hospital, in that it’s very clear that COVID hospitalizations are due to unvaccinated residents.

“The difference is that nearly all of the patients that we’re caring for made the choice to not be vaccinated,” Linder said. “We’ve seen very few vaccinated patients in the hospital — less than I can count on one hand. None of them have been very critically ill. None of them have died of the disease during our time with them.”

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She said the patients St. Francis is caring for and family members of those patients typically have a distrust of medicine in general. There’s also a “disbelief” when they’re very ill that they could really be so sick from COVID, she said.

But at the same time, those patients want and expect the highest level of medical care, Linder said.

“There seems to be this erroneous belief that all of these patients should be at a tertiary care center and that if we just gave the right cocktail of substances to them that we can cure this,” Linder said. “Unfortunately we all know that’s not the case.”

Reasoning from unvaccinated patients

In hearing from patients who aren’t vaccinated, Linder said she’s been struck by those who said they don’t want to inject “some untested or foreign substance” into their body.

Linder said people don’t realize that if they’re hospitalized with a serious case of COVID, they’re going to be injected with foreign substances — many less proven than the COVID vaccine.

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“This is all to avoid a vaccine that has been proven to be safe and effective,” Linder said. “If you get the vaccine, you have a .001% chance of dying of a breakthrough infection. That’s a staggeringly small number.”

She believes people overestimate the effectiveness of the current treatments for COVID, especially in comparison to the vaccine.

“The best treatment that we have so far that I’m aware of is dexamethasone, and that only decreases your risk of death by 20-30% if you have a moderate to severe disease,” Linder said. “You can’t even give it in mild disease or it increases your risk of death.”

‘I am fatigued’

In closing, Linder shared a story about a patient who initially refused to get vaccinated, got infected with COVID and is going to lose her battle. She said that patient convinced several loved ones to get the vaccine, even though it was too late for her.

“I am fatigued and I am heartsick and I’m tired of watching people suffer needlessly and die of a disease that could have been prevented by a simple and safe and effective vaccine,” Linder said. “I don’t want to watch my patients’ families suffer with the grief of this, and also the guilt if they played some role in their family member’s decision not to be vaccinated.

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“The issues that we’re dealing with in caring for these hospitalized COVID patients that weren’t present during the earlier waves, I think, do create a new dimension of stress and sadness and fatigue for those of us on the front lines. You’re taking care of people who are dying that didn’t need to die.”

Productivity decrease for businesses

The president of C2AE, a company that provides architecture and engineering consulting services to government, education and manufacturing clients, spoke about the impact of COVID-19 on the business world.

“One of the major items for us, in impact, was on our employees,” Bill Kimble said.

In addition to being president of C2AE, Kimble is also charr of the SBAM Board of Directors. He said one of the most stressful parts of the pandemic for employees was not knowing whether their children would be in school.

“What we’ve seen over the last 18 months is that stress level go up and a productivity level go down,” Kimble said.

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That productivity decrease has been one of the greatest challenges for businesses throughout the pandemic, he said.

“In the architecture and engineering world, we rely heavily on collaboration between members,” Kimble said.

It’s important for people who work on projects together to be in the same space, so employees have been encouraged to get vaccinated, according to Kimble. He said it’s not required, and the company isn’t asking employees to disclose their vaccination status, but the importance of vaccinations is being stressed.

How effective are vaccines?

Tatum also provided some data about how effective vaccines are against COVID-19.

She said the vaccines are extraordinarily effective at preventing serious illness and hospitalizations.

“When these vaccines were studied, we know that they are 94-95% effective in preventing moderate and severe COVID-19 related disease,” Tatum said.

She said medical experts know that an “enormous number of hospitalizations” can be prevented through vaccinations.

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‘Personal’ decision

Rob Fowler, CEO of the Small Business Association of Michigan, said business leaders understand that residents have to make their own decisions about vaccination, but he urged unvaccinated Michiganders to consider the consequences of further COVID spread.

“We recognize and we respect that the decision to be vaccinated is a personal one,” Fowler said. “We know that people throughout our state — there are those who are still considering getting vaccinated, and I would just encourage those to consider the impact on small businesses in their community and throughout our state.”

He said he has watched COVID metrics rise in Michigan and in other parts of the country and world.

“We know that data matters, and it matters because it’s also what may trigger further government restrictions,” Fowler said.

Recently, the SMBA has been paying close attention to vaccination rates, he said.

“Vaccination is really one thing that people can do that will make a very positive difference for businesses in their community,” Fowler said.

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Henry Ford Hospital’s COVID numbers

Here are some of the COVID numbers specific to Henry Ford Hospital.

“As of 8 a.m. Thursday, of the 109 patients hospitalized with COVID, 22 of them are at Henry Ford Hospital,” Tatum said. “I think what’s important to recognize: While those numbers may seem low, they are still not insignificant.”

She said the number of COVID patients is affecting the hospital’s ability to treat other patients.

Of those hospitalized COVID patients, 77% are unvaccinated, she said. About 15% of them are in between doses.

Avoiding exposure during vaccination process

Tatum reminded Michiganders to avoid exposure to others and wear a mask before their vaccines have become fully effective.

“These numbers further illustrate the need not only for more people to be vaccinated, but it’s also important to be vigilant in reducing exposure until fully vaccinated,” Tatum said.

For people receiving the Pfizer or Moderna vaccines, this means staying vigilant between doses and for two weeks after the second dose.

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Flu season

Health experts are even more concerned about the rise in COVID cases because flu season is approaching in Michigan.

“Hospital capacity and resources may not be able to meet the demand due to the threat of these two confluent diseases happening at the same time,” Tatum said. “We don’t want that to happen. We all know that the stakes are too high for that, and we can end this pandemic once and for all through vaccination.”

She said the only way Michigan can get back to normal is if everyone gets vaccinated against COVID-19.

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