Frustrated health workers dread expected rise in COVID hospitalizations: ‘We’re exhausted’

A new Centers for Disease Control and Prevention report found 2020's death toll was worse than previously reported — finalized at nearly 3.4 million people. It also forewarned that 2021 is expected to surpass 2020's record number of deaths by at least 15,000. COVID-19 has become the country's third highest killer — only behind heart disease and cancer. Judy Woodruff takes a closer look.

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  • Judy Woodruff:

    New government data also indicates COVID-19 has contributed to the largest decline in life expectancy since World War II.

    A CDC report found life expectancy has dropped overall by nearly two years since 2019. 2020's death toll from all causes, including, but not limited to COVID, marked a 17 percent spike from the year before, totaling nearly 3.4 million people. And COVID has become the country's third highest killer, behind only heart disease and cancer.

    This comes as hospitals are reporting overwhelmed ICUs and staff pressed to their limits.

    For a closer look, we turn to Dr. Adnan Munkarah, executive vice president and chief clinical officer at the Henry Ford Health System based in Detroit, and Dr. Craig Spencer. He's an emergency medicine physician and director of global health in emergency medicine at Columbia University Medical Center in New York.

    And we thank both of you for joining us.

    Dr. Munkarah, to you first, Henry Ford Health Center in Detroit. How is your hospital doing right now compared to earlier in the pandemic?

  • Dr. Adnan Munkarah, Henry Ford Health System:

    Judy, in the past few weeks, we have seen a significant climb in the number of cases that we have had.

    Unfortunately, in Detroit, we are living now the fourth surge. And we started seeing the numbers climbing up in late July, early August. That climb was initially slow, but, in the past few weeks, we got up to numbers that exceeded what we have seen in the spring of 2021.

    So, our emergency department, our hospitals, including our intensive care units, have been functioning beyond capacity. We have patients waiting in the emergency department for hours to be able to get a bed in the ICU or to be transferred out of the emergency department.

    So we have been suffering significantly in our communities.

  • Judy Woodruff:

    How are you dealing with this, as you say, stretched beyond capacity?

    Are people simply waiting, or are you having to send patients elsewhere?

  • Dr. Adnan Munkarah:

    Unfortunately, there is no other place to send them, because hospitals across our region and across our state are full.

    And as I connect with our colleagues, our leaders across the region, there is no place to send them. So, what we are trying to do is maximize our capacity, opening certain areas that are not — that were not scheduled to be the areas for inpatient COVID.

    Today, I was doing rounds at one of our hospitals, and one of the areas that used to be a preoperative area, we had to expand beds in it to admit patients to it and to render care to these patients.

    We have had to postpone and cancel some surgeries last week in order for us to create capacity for patients in the emergency departments, as well as to create beds in the hospitals.

  • Judy Woodruff:

    And I want to ask you about that.

    What percentage of these patients have Omicron? Do you know? And what portion of them — proportion of them are unvaccinated?

  • Dr. Adnan Munkarah:

    So, first, I will start with the unvaccinated data, because this is data that we have.

    We have consistently been running 75 to 80 percent of our patients who are in the hospital are unvaccinated. And in the intensive care units, it's about 85 to 90 percent of patients are unvaccinated.

    With respect to Omicron, we are starting to test right now both in the state, as well as our institution. I don't have these numbers yet. But we know that the Omicron numbers are rising rapidly across the nation and in Michigan.

  • Judy Woodruff:

    And I want to — I want to turn to you, Dr. Spencer, in New York, because you have been writing about the stress that all this has meant for staff.

    So what does Omicron look like right now where you are in New York? And what about the stress it's putting on people who work in the health care sector?

  • Dr. Craig Spencer, Columbia University Medical Center:

    Well, as everyone knows, in the past really few days and few weeks, we have seen a dramatic uptick in the number of Omicron cases here in New York City.

    We were already dealing with hospitals and emergency departments that were really overfull, where staff were stretched, where space was already limited. This was true before the pandemic here in New York. That was worsened and exacerbated by the pandemic itself.

    And then, over the past few days, with more and more people getting sick, more people coming to the emergency room, thankfully, the overwhelming majority with coughs and colds and appear to be mild cases, it's still putting a lot of stress on our hospitals and our health care workers, many of whom themselves are testing positive and finding themselves sick in the past few days, meaning that that takes them out of service for seven to 10 days.

    Others are called to come in and cover their shifts, or maybe we don't have the same number of providers that we normally would to take care of the same number of patients.

  • Judy Woodruff:

    So, how are you managing, Dr. Spencer, given all this?

  • Dr. Craig Spencer:

    Well, health care workers across the country are going to continue to show up to work, until the day that they're not, right?

    We have seen a lot of nurses have left the profession. We have seen a lot of doctors, we have — a lot of physician assistants, respiratory techs, others who have really weathered this pandemic and didn't expect to be doing this two years in who eventually just kind of gave up or were burned out.

    And as I wrote in The Atlantic yesterday, there's no fuse, no new fuse that you can use to fix a broken circuit. It just — we don't have the strength. We're exhausted. We're tired. And there's just not enough of us to provide the care that's currently needed or will be needed, even if a small number of Omicron cases comes into our hospitals and into our ICUs.

  • Judy Woodruff:

    And, Dr. Munkarah, back to you in Detroit.

    You mentioned that staff are being strained. What are you seeing there?

  • Dr. Adnan Munkarah:

    What we are seeing, first that people are tired, and also, to some extent, frustrated, because they feel many of these hospitalizations can be prevented if more people get vaccinated.

    And this is the most frustrating part for people. And I — as I'm talking to our staff, and I made rounds today, unfortunately, we are seeing sick patients who are in their 30s, 40s, and 50s needing to be on ventilators, and we are losing some of them. '

    And the majority of these aren't vaccinated. And there is nothing harder for a care provider, for a health care provider to see somebody lose their life for something that we could have prevented with a vaccine, with a treatment that is easily available to all of us.

    So, we are working with our staff.

  • Judy Woodruff:

    And that's a message we have been hearing every day from the White House.

    Today, at the White House COVID briefing, Dr. Spencer, one of the pieces of news we heard, the good news about a pill to treat COVID, although it will take time to get it manufactured in sufficient numbers, but not so good news about the monoclonal antibodies that are used to treat people once they are sick.

    How is that bit of information going to affect your ability to work with people?

  • Dr. Craig Spencer:

    It's a great question.

    And here in New York City, there is a lot of kind of angst and a lot of people are quite worried. But, again, this is not March 2020. At that time, we were inundated. The hospitals really cleared out for everything but COVID patients. We didn't have a lot to offer patients at that time, other than our great supportive care.

    But we didn't have treatments, we didn't have vaccines, other things that we have now. We do have — we have had a lot of clinical trials that tell us how to improve the survival dramatically of severe COVID patients.

    We have vaccines, as Dr. Munkarah pointed out, have kept the overwhelming majority of people out of our hospitals, thankfully, even if there's a lot of them. And the monoclonal antibody news is indeed bad news, because we know that the monoclonals that may work are already in short supply and haven't really been distributed.

    But the news today that the FDA is authorizing the Paxlovid, the medication from Pfizer, should be helpful. It's going to be a limited supply at first, but it had a dramatic impact on keeping people out of the hospital. And that's been one of the things that we have been missing to date, not a treatment in the hospital, not a vaccine, but something for people who get sick to keep them out of our E.R.s, out of our ICUs.

    The challenge is going to be scaling it up, making sure people are able to get a diagnosis, get a test, and get those medications from the pharmacy in the five days, the first five days of that illness, where it's been shown to be very effective.

  • Judy Woodruff:

    And, Dr. Munkarah, on that question of the pill and the monoclonal antibody treatment, how much of a difference do you think all this can make?

    And, frankly, when I hear you say staff being frustrated working with people who've not been vaccinated, are you — how hard are you having to work to keep staff at it?

  • Dr. Adnan Munkarah:

    Our — we are really grateful to great staff who have been committed to provide the best care that they can for our patients.

    But it is — after being there for 18 months at the present time and after doing it time after time after time, I can tell you everybody is fatigued. And we are working with them very closely to thank them for what they are doing.

    And, still, it is so uplifting to see the smiles on their face when we are rounding and we are talking to them and seeing them lend their care to the patients. I agree that the news about the monoclonal antibody is distressing for us, because we have been giving about 700 to 800 doses a week to make sure that we keep our patients and our community out of the hospital, so that they don't need the care that they — into being in the intensive care unit or being in a hospital bed and occupying that.

    We are very hopeful that the pill will — kind of provide some relief. And we are really hoping that the — that the monoclonal antibodies that are effective become more available to us, so that we continue to provide these in the outpatient setting.

    We need to keep our patients out of the hospital, because it's not only impacting our staff. It is also impacting non-COVID patients from getting the care that they need to get to, patients who have severe cardiac disease, who have advanced cancer, who have a bad stroke.

    We don't want them to be sitting out there and avoiding coming to the hospital because they are scared.

  • Judy Woodruff:

    Well, Dr. Adnan Munkarah, Dr. Craig Spencer, it's so clear that you both very much have your hands full. And we appreciate your taking time to talk with us today. We wish you the very best in the days to come.

    Thank you very much.

  • Dr. Craig Spencer:

    Thank you, Judy.

  • Dr. Adnan Munkarah:

    Thank you, Judy.

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