Dealing with Staffing Challenges During a Pandemic

With COVID-19 infecting hundreds of thousands of healthcare workers, requiring them to stay home for extended periods of time, the pandemic has wreaked havoc on the way medical practices and hospitals operate.

According to the CDC, more than 218,000 healthcare workers had tested positive for COVID-19 by mid-November. And last month, as the Midwest exploded with new cases, 900 staff members at the Mayo Clinic were infected in a two-week period alone.

“This has been and remains a challenge from an operational as well as a financial perspective,” said Myles L. Pensak, MD, chair of otolaryngology at the University of Cincinnati College of Medicine in Ohio and the Triological Society’s executive vice president. “The more we’re down in staff, the more we must cut back patient encounters. It’s an issue across the healthcare delivery food chain that negatively impacts everyone.”

Whether healthcare workers are infected on the front lines, in the grocery store, or by letting their guard down during leisure time due to pandemic fatigue, spiking cases are currently a big problem. And, just like in the general public, healthcare workers hold varying beliefs about safety protocols.

“Some healthcare workers follow the recommendations to the letter, and others do not,” said Anand K. Devaiah, MD, associate professor of otolaryngology, neurosurgery, and ophthalmology at the Boston University School of Medicine and Boston Medical Center. “There are healthcare professionals who are vocal on social media and other platforms advocating positions contrary to public health recommendations. This has been going on for months and adds to the public distress and discord. The recommendations are important for everyone to follow, realizing that as we learn they can change, and they’re there for a reason.”

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Last March and April, the otolaryngology department at NYU Langone Health in New York City saw the highest volume of sick staff members during the pandemic, according to J. Thomas Roland Jr., MD, Mendik Foundation chair in the department of otolaryngology–head and neck surgery and co-director of the NYU Cochlear Implant Center at NYU Langone Health. “Many of the infections could be attributed to social interactions and groups of physicians in close contact in touchdown computer spaces, before the mask wearing requirements were in place,” he said.

The departmental peak at NYU occurred prior to implementing basic safety protocols such as universal mask wearing and frequent hand sanitizing, as well as otolaryngology-specific safety measures, including specific protocols for scoping and examination. Other protocols put in place included HEPA filters in the office to purify the air every five to 10 minutes and filters placed on suction devices.

“Once we had protocols in place, very few staff members became sick as a result of a work exposure,” Dr. Roland said, “including staff working on the front lines treating acutely ill admitted patients known to be infected with SARS-CoV-2.” Despite absences, NYU was fortunate to have adequate staffing across departments; when additional staffing was needed to maintain care, employees were flexible to help cover across the institution.