Hospitals in the US are becoming dangerously overcrowded as soaring Covid-19 cases in the community are compounded by clinical staff catching the coronavirus.
This has put patients of all types at a greater risk, eroding much of the relief provided by Omicron variant’s displacement of the more virulent Delta.
“Overcrowding kills,” said Sameer Kadri, an intensive care physician at the National Institutes of Health Clinical Centre.
Dr Kadri was the lead researcher on a landmark study early in the pandemic that found Covid-19 patients’ risk of dying rose when hospital staff had abnormally high caseloads.
It found that one in four deaths could be blamed on such surges.
Even with Omicron, “at some point, overcrowding becomes a game of sheer numbers,” he said. “And if the numbers are really high, it’s not rocket science: Variant or no variant, overcrowding probably will continue to kill.”
Among dangerous conditions caused by the staffing crisis, nurses point to a rise in hospital-acquired infections, including Covid; pressure injuries, such as bedsores; falls among patients; and delays in removing devices such as catheters.
Many US medical centres are so crowded that if a patient at a small community hospital needs to transfer to another facility for lifesaving dialysis or advanced heart attack care, they may end up dying owing to the for lack of available beds, said Prof Doug White, a professor of critical care at the University of Pittsburgh School of Medicine. That’s what doctors call “dying in place” and it’s on the rise, he said.
Across the country, horrifying stories have been circulating within the medical community of patients found dead in their hospital room bathroom after they took off their oxygen supply to get out of bed. “The alarms went off and there was no one there to take care of them,” Mr White said. “Hospitals are maxed out and near the breaking point.”
Staff shortages affect all patients, not only those with Covid-19. “Everyone, whether you have a heart attack or renal failure or gall bladder disease, you and the Covid patients are competing for the same scarce resources,” he said.
Nearly one-fifth of hospitals report that they are critically understaffed, even as their patient loads break records. The labor shortages at some hospitals have grown so dire that military medical staff are on their way to help in six states.
Lifespan, a Rhode Island health system with more than 1,200 beds, is among the institutions fortunate enough to receive military help. Its chief executive, Dr Tim Babineau, said the staff shortage was “unprecedented”.
Its senior vice president, Lisa Abbott, was grateful the Biden administration had sent at least 17 members of the military to help but said the staffing shortfall was huge.
“It’s a dumpster fire,” she said. “It’s a pandemic wrapped in a labour crisis. Omicron is the accelerant on the dumpster fire.”
Lifespan’s flagship Rhode Island Hospital is able to treat only about 590 patients in a facility that has more than 700 beds. About 180 inpatients are Covid-positive, a greater number than at any other time during the pandemic.
The company employs 17,000 people, but more than 2,000 positions are unfilled. More than 600 staff are off sick with Covid.