COVID-19 Update: New Variants, Same Staffing Challenges

Blog image New Variants Same staffing challenge
Cross Country Healthcare
January 22, 2021 01:09 AM (GMT-05:00)

Despite the silent and outspoken wishes of most Americans that on January 1, 2021, the world would wake up to a miraculous retreat of COVID-19, instead it has ushered in new strains that could add additional strain on an already-taxed healthcare workforce.

Officials have identified cases of a new, potentially far-more-contagious strain of the novel coronavirus in more than 30 countries, including the United States. The SARS-CoV-2 Viral Mutation – known as B.1.1.7 – first discovered in the United Kingdom has now been identified in more than 50 cases in the U.S. with officials fearing the new variant could worsen the country’s ongoing COVID pandemic.

With many experts’ anticipation that the new variant will ultimately become the dominant strain circulating in the U.S., as it has in the U.K., the impact of a more infectious virus could put even further unparalleled stress on the U.S. healthcare system.

How to Turn the Tables on the Pandemic.

In more than a year of circulation, the virus has mutated many times, but only two of the most recent variants – the UK version and another in South Africa – seem to make a substantial difference in its function. Meanwhile, the new variants come as the US sees a record-high number of COVID-19 hospitalizations and more than 350,000 deaths.

“We are urging our customers, providers, and our own staff to take the new COVID variant very seriously,” said Hank Drummond, Chief Clinical Officer, Cross Country Healthcare. “There is potential for a more contagious virus to topple an already precarious healthcare staffing situation. We must continue to focus on workforce solutions and planning in three critical areas to put this pandemic behind us.”

Testing and Tracing.

Health systems are pivotal partners in the continuous and expanding COVID testing and contact tracing. As more cases of the more contagious variant of the coronavirus are detected, there is mounting concern among scientists that the US hasn’t done enough to test and track infections which can leave healthcare facilities and consumers in the dark about the emerging rate and changes of potentially dangerous new strains.

The two major variants of the virus that have recently emerged raise questions about their contagiousness and the accuracy of testing. However, the good news is, neither is more dangerous than the virus that has circulated for the last year. The bad news is the new strains are about 50% more contagious than the virus that has been permeating the country in the past year which leads to a greater need for contact tracing.

Contract tracing efforts have been overwhelmed in many places by community spread of the virus, but with the appearance of the new variants, many believe these efforts should pivot to focus just on breaking the chains of transmission caused by the new variants. However, the country has already faced a severe shortage in contact tracing workers.

An NPR survey of state health departments in 2020 showed that the national coronavirus contact tracing workforce had tripled in a six-week time period, from 11,142 workers to 37,110. Yet, given the number of case counts, only seven states and the District of Columbia were staffed to the level that public health researchers said is needed to contain outbreaks.

To help shore up existing and future contact tracing staffing gaps, healthcare entities will need to engage external partners to help secure the additional staff needed to help contain the original and new strains of the coronavirus. For example, in the midst of the first pandemic wave, the State of Tennessee partnered with Cross Country Healthcare to staff COVID testing personnel in 89 rural locations to support contact tracing and COVID testing needs. Also, Pennsylvania secured a $23 million federally funded contract to recruit, hire, train, and support 1,000 paid contact tracing staff.

The staff required to meet adequate contact tracing also means additional staff is needed to satisfy the demands of getting tested in the first place. Healthcare organizations will need to revisit their staff planning and needs for a new year fraught with relentless and continuous changes in the pandemic landscape.

Fueling Vaccine Demand and Herd Immunity.

The recent news of the new virus variants has come as the administration of new vaccines has lagged in the US, further raising the worry that these strains will get a foothold before people can be protected against them. Yet, even if the COVID-19 vaccines are effective against the new variants, it may be many months before those vaccines are widely available in the country.

“Without aggressive efforts to educate and create demand for inoculations, as well as accelerating vaccine administration, our healthcare system may be further overrun with infected patients and hospitalizations,” said Drummond. This sentiment was echoed by one academic leader who projected that as new strains take hold in the US, they could cause an additional 10 million new infections by the end of February and as many as 150,000 more deaths.

An already-taxed healthcare staffing market going into the COVID-19 mass vaccination efforts will likely create further workforce demand that healthcare enterprises will need to overcome. Healthcare administrators should now be asking themselves whether their facility has enough staff to support ongoing mass inoculation programs, and whether their staffing plan has the flexibility and scalability to adjust to the fluctuating phases of vaccine availability. In addition, a growing number of state and federal organizations are making maximum use of all healthcare professionals licensed to administer vaccines, including allied health professionals such as pharmacists.

Given that the US doesn’t have a tightly coordinated effort to track changes to the virus, these more contagious variants increase the stakes for getting people vaccinated as quickly as possible. Yet, as the race between the virus and the vaccine heats up, the country must ramp up efforts to create demand and educate consumers about the vaccine in order to achieve herd immunity. So far, only about 70% of the doses that have been distributed nationwide are still sitting on pharmacy shelves, according to federal data, because of challenges in getting shots into arms.

Healthcare organizations will need to prepare for the implications of more contagious strains that could make her immunity more difficult to achieve because the threshold for sufficient protection in a community depends on the speed with which a virus spreads. To learn more about how to mobilize healthcare staff to better educate, remove fear, create demand, and deliver the vaccine equitably, read “The Need for Unprecedented COVID-19 Mass Vaccination Delivery.”

Staffing the 2021 COVID Pandemic.

A more infectious virus means more cases, which leads to more hospitalizations and deaths. Meanwhile, US hospitalizations for COVID-19 remain high with 124,387 Americans with COVID-19 hospitalized for treatment, according to data from The Atlantic’s COVID Tracking Project.

Hospitals and intensive care units were already near capacity or exceeding occupancy levels at the end of 2020 and into 2021. Unfortunately, staffing in US hospitals, particularly among nurses, has reflected a patchwork of local shortages for many years earlier. Now, with a COVID-19 resurgence and new variants, the strain on hospitals to maintain appropriate staffing levels is exacerbated even further by ailing staff members and excessive burnout. In fact, 22% of US hospitals reported the week of November 16 that they anticipate a staffing shortage due to the pandemic – and that was prior to the emergence of new virus variants.

As hospitals and healthcare facilities continue to plan for and navigate the new pressures brought on by 2021, taking into account the record demand for travel, per diem and contract healthcare talent is imperative. “Already, orders at many of our client facilities have increased ten-fold in recent months as organizations continue to lose core staff to illness, fatigue, and burnout. So, engaging staffing partners early and often to scale up or down based upon rapidly changing needs will be critical to the successful navigation of what 2021 will bring,” says Drummond.

Many healthcare systems are utilizing part-time, travel, and per diem staff for additional shifts, reassigning nurses and other staff to bedside caregiving roles, and partnering with staffing firms to deliver additional resources. Others are finding creative ways to offload some of the extensive duties of front-line workers, such as adding phlebotomists in key departments to draw labs versus having nurses do so. Upskilling and cross-training team members who are not actively working due to the COVID-19 (i.e. elective surgery personnel) can be redirected to support patient care in the ICU setting. For example, certified registered nursing assistants can be trained to deliver support to nurses in the ICU and code/rapid response teams.

Adjust Short-and Long-Term Strategies.

As the year unfolds, the potential for even more virus variants is real so planning for increased recruiting complexity and difficulty is essential. Leveraging a valued and trusted workforce solutions partner can be invaluable this year and in future years. Look to them to provide deep labor market insight and guidance to help inform fluctuating and effective hiring decisions. Use all available recruiting avenues, from electronic means to tapping staffing partners to provide access to wider candidate pools – particularly the hidden “passive candidate” market. With growing needs for testing, tracing, vaccination programs, and patient care, adequate staffing will be challenging but more than necessary.

Long-term, healthcare organizations should consider adopting an enterprise-wide strategy. Consider more holistic approaches such as managed services, recruitment process outsourcing, and online talent marketplaces that can provide systemic rather than ad hoc talent acquisition. The best of these offer performance-based relationships that are highly congruent with hospitals’ current financial pressures.

Read more about how these partnerships have helped healthcare systems succeed during the COVID-19 pandemic.

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