COVID-19’s Uptick Impact on Acute Care, Staff and Patients

Saying COVID-19 has altered our lives would be quite the understatement. In addition to the nearly 1.5 million casualties, many others have lost their jobs, businesses, and their mental well-being. Organizations across all industries are struggling to stay afloat, including ones in healthcare. Facilities, staff, and patients have all been impacted as a result of COVID-19.

Impact on Organizations

When The World Health Organization (WHO) declared COVID-19 as a pandemic on March 11, hospitals shut down all elective procedures to focus their attention on treating the virus. This ultimately harmed their income and even led to the permanent closure of several emergency hospitals. Office-based practices had reductions of 60% in visit volumes in the first months of the crisis and hospitals will lose an estimated $323.1 billion in 2020¹.

In order to fight the virus, healthcare staff worked a significant amount of overtime, which resulted in even more revenue loss. They were also providing extra care for their families, which included child-care services, transportation, and extra tests². A recent Commonwealth Fund survey showed that 40% of respondents or their spouse/partner who lost a job or were furloughed had insurance through the job that was terminated¹. Hospitals were also treating individuals who were uninsured, in a heroic effect to support those who have lost their jobs.

Another major issue during the height of the pandemic was the shortage of PPE and other medical equipment needed to treat the virus. Some hospitals are now manufacturing their own, which will not only prepare them for a second wave or future pandemic but will make up for some of the lost revenue³.

Impact on Staff

Already a prevalent issue in healthcare, reports of physician burnout have escalated because of the pandemic. For a long time, doctors and nurses felt stressed out and overworked, but a least they had a family to come home to. Now after their shifts, many healthcare workers isolate themselves from their families in order to protect them from the virus. This means sleeping in separate rooms from their spouses, skipping family dinners, and spending less time with their children. This has caused a surge in mental illnesses such as loneliness and depression among clinicians.

Burnout not only affects the clinicians but the patients too, as it is associated with loss of empathy, impaired job performance, and increases in medical mistakes. In order to bring patients back to health, the caregiver must first be healthy themselves.

More compensation is not the answer for solving burnout, either. A recent report showed that 50% of doctors would sacrifice at least $20,000 of their salary to reduce their work hours and have a more flexible schedule⁴. Even after the pandemic is over–unless we see a change in working conditions –physician burnout will continue to plague the healthcare industry.

Impact on Patients

The US has been one of the most affected countries in terms of COVID-19 deaths. The United States has 4% of the world’s population but, as of July 16, approximately 24% of its Covid-19 deaths¹. Aside from the starling numbers, the pandemic has affected patients’ care routines. According to an Accenture survey, 70% of patients have deferred or cancelled treatment since March due to fear of being infected, lack of transportation, and other various COVID-related reasons⁵. Women are not getting mammograms; children are not getting immunizations; mental health patients are not seeing their therapists; patients with diabetes or hypertension are not having their chronic conditions properly managed; and so on. Skipping appointments and treatments can have negative long term affects for individuals, like the progression or worsening of a condition or injury. When diagnoses are detected early, the chances of recovery are much higher. Late discovery may lead to intensive treatment that could have been avoided.

To avoid delayed treatment, many patients have turned to digital health services, such as virtual visits and remote monitoring. Prior to the pandemic, 2-7% of doctors were ready to offer video-consultations, but now it is closer to 60%⁶. Nearly half of all patients in the Accenture survey said they are now getting treatment at home instead of going to their healthcare provider’s office. The satisfaction rate is high due to faster response times, more personal communication, and the convenience of being able to manage and monitor their care from home⁵.

How to handle a second wave

One of the main reasons, COVID-19 hit acute care hospitals so hard is because they were not prepared for it. Now, they have some experience under their belt. As state regulations have loosened towards the end of the summer, COVID-19 cases began to rise again. Acute care hospitals need to come up with a plan and get a head start on how they will handle the second wave. Contact tracing shows where the geographical hotspots for COVID-19 are. If hospitals begin to see a rise in their area, they can begin to prepare themselves.

Healthcare organizations should begin to stock-up on supplies, including tests, medical equipment, PPE, food, and toiletries. By sending home low-risk and asymptomatic patients, hospitals can make room for the critically ill. Patients with less severe condition can be monitored at home through wearable devices and virtual visits. Influenza is a virus that generally peaks in the winter season, causing a surge in hospitalizations. Getting our flu shots is another way to clear bed space and put less burden on our healthcare staff. Unfortunately, elective procedures may have to be postponed again until infection rate decreases, or a vaccine is available.

COVID-19 has affected organizations, staff and patients all over the world and unfortunately, there is not much we can do besides practicing social distancing and following our government’s health and safety regulations. We are all in this together and we must make the best out of these difficult and unprecedented times.

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REFERENCES:

1) Blumenthal, David, et al. “Covid-19 – Implications for the Health Care System.” New England Journal of Medicine, 22 Oct. 2020, https://www.nejm.org/doi/full/10.1056/nejmsb2021088.

2) “Hospitals and Health Systems Face Unprecedented Financial Pressures Due to COVID-19: AHA.” American Hospital Association, https://www.aha.org/guidesreports/2020-05-05-hospitals-and-health-systems-face-unprecedented-financial-pressures-due

3) Landi, Heather. “The COVID-19 Pandemic Will Have a Long-Term Impact on Healthcare. Here Are 4 Changes to Expect.” FierceHealthcare, 18 May 2020, https://www.fiercehealthcare.com/tech/4-ways-healthcare-will-change-from-impact-covid-19-experts-say

4) Hartzband, Pamela, and Jerome Groopman. “Physician Burnout, Interrupted.” New England Journal of Medicine, 25 June 2020, https://www.nejm.org/doi/full/10.1056/NEJMp2003149.

5) “How COVID-19 Has Permanently Changed Patient Behavior.” Accenture, 10 July 2020, https://www.accenture.com/us-en/insights/life-sciences/coronavirus-patient-behavior-research

6) Koh, Dean. “COVID-19 Has Pushed Digital Health Forward, but Challenges Still Persist.” Healthcare IT News, 8 Sept. 2020, https://www.healthcareitnews.com/news/emea/covid-19-has-pushed-digital-health-forward-challenges-still-persist