More Michigan healthcare workers on the frontlines of the coronavirus outbreak are getting sick.
Some are testing positive for the virus themselves – at Sparrow Health System in Lansing, at least seven caregivers have tested positive, even though that area hasn’t been nearly as hard hit as metro Detroit.
Other doctors and nurses have been exposed, but are being asked to return to work before their quarantine is over, raising questions about hospitals’ back-up plans and staffing capacity.
But what happens if we get to the point where there’s a serious shortage of critical care providers, is still an open question.
“They’re exposing other colleagues”
A nurse at a hospital in southeast Michigan got some news that, at this point, is a fairly predictable part of the day: A patient of hers tested positive for COVID-19.
That patient had been coughing a lot, lots of droplets in the air, and the staff around them weren’t wearing the right protection. So the hospital told those staffers to go home for two weeks.
But then, a few days later, they were asked to come back if they didn’t have a fever, even though some of them were showing other symptoms.
“So there were a number of staff who came back to the bedside who did not feel well, who had symptoms of malaise and coughing and sore throats and other things associated with this COVID who were brought back to the bedside, to care for patients,” the nurse says. (We’re not naming her or her employer to protect her job.)
Health care workers across metro Detroit tell us the lack of supplies, testing, slow results, and constantly changing protocols about who should be quarantined, are major issues. And that makes it easier for the virus to spread.
Because there aren’t enough masks, those on the front lines are inevitably getting exposed. And because there aren’t enough tests to identify everyone who’s sick, more people end up getting exposed.
“So for my own health and family, I'm concerned,” the nurse says. “I'm also concerned that people who have a more definitive exposure than I did are back at work and they're coughing and they're exposing other colleagues and they're coughing in the patient's room.”
Trying to fill in the gaps
Hospitals can’t just send home everyone who may have been exposed to the virus.
“So if you're exposed, there's a whole algorithm that's set in place,” a doctor at another southeast Michigan hospital says, walking us through an email outlining the system they’ve been given to figure out which exposed staffers should go home, which ones should just monitor their symptoms, and so on. "And it depends on your risk profile. If you have medium or high risk exposure to a COVID-positive patient, that puts you along one branch of the algorithm. If you have low risk exposure, that puts you through another branch of the algorithm…”
It’s a long email.
But ultimately, there is a finite supply of medical workers who have certain skill sets, he says.
“What happens when you start knocking them down? And I think what the hospital’s trying to do, from what I’ve read, is identify people who may not necessarily be accustomed to that role, to help fill in the gaps.”
Each hospital is looking at different options here. First, they’d likely pull in staff from other departments, to fill in in the emergency room or the intensive care unit.
“Each hospital closely monitors current staffing and draws from a resource pool made up of clinical staff from other areas, such as surgical suite or outpatient offices, who are available now that many elective procedures and appointments have been postponed,” says Laura Blodgett, a spokesperson for Saint Joseph Mercy Health System.
“As members of Trinity Health, a national organization with hospitals across 22 states, we are also able to solicit staff from our sister hospitals in other states that are not as affected as we are in Michigan right now, who may be interested in being deployed here," Blodgett said. "Additionally, we are working with our in-house staffing solution, FirstChoice, to recruit nursing teams that are willing to travel. We are reaching out to staff who left or retired in good standing and are willing and able to return to the workforce.”
Other Michigan hospitals are also reaching out to staffing agencies and retired healthcare workers. In other states, they’re essentially graduating medical students early.
“But if this becomes overwhelming, like New York, I'm not quite sure what the protocol is going to be from there,” the southeast Michigan doctor says. “Because as you know, right now, New York is just a mess.”
This doctor, and others, say it feels like they’re in a war. But it’s a war they’re being asked to fight without the protections they need. And that doesn’t just leave them feeling exposed. It leaves them feeling expendable.
"I feel like when we look retrospectively, we're going to feel really ashamed at how we treat our providers,” the nurse from the first southeast Michigan hospital says. “And we'll look back at the number of dead providers and just wonder how we could have let that happen.”
Editor's note: additional reporting for this piece comes from Will Callan, Jennifer Guerra, and Sarah Hulett.