I hate to say it, but we’ve been proven correct even faster than usual. We warned that the failure to treat nurses well would come back to bite the hospitals that went into Scrooge mode. As we posted on August 3:
In other words, if we have another crisis in hospitals, it’s due not just to Delta but also rule by MBAs:
We told you this would happen. The mass exodus of nursing staff came in waves, month after month. Now this sudden, debilitating, exponential growth of sick people needing care in our communities, & they have no one. YOU didn’t listen, YOU thought travel rates would “normalize.”
— Sarah, RN (@shesinscrubs) July 30, 2021
I was told I was “so intelligent for my age & such an asset,”
In the next breath I was told, I wasn’t worth one more dollar: “giving each person in this system a 1 dollar raise would cost, $2 million dollars, would you be happy with $1?”
I was stunned.
— Sarah, RN (@shesinscrubs) July 30, 2021
Today’s press has many stories about hospitals in Texas, Florida, and some other states being strained to the breaking point due to the latest Covid surge. Obviously, the big driver of this dire situation is the rapid rise in cases. Some also mention staffing levels and even say that their capacity constraint is not beds but manpower. That’s reflected in the super-high pay on offer for “traveling” nurses who go to hospitals that are willing to pay up for extra hands on deck.
Of course, most of these articles, particularly in corporate friendly venues like Bloomberg and Business Insider are going to depict burnout and fear of contracting Covid as the foundation of the nurse shortages. And those are certainly significant factors. However, not being willing to ante up to give nurses and other hospital support staff hazard pay (while eventually paying through the nose for traveling nurses) is an insulting statement about how much management values them. Why should they risk life, limb, and their mental health when the top brass makes clear it cares more about preserving and increasing its pay than spending up to take care of patients and employees?
It wasn’t hard to see that with Delta being super infectious and the US not heavily vaccinated enough to ground out contagion of wild type Covid, even before factoring in reduced efficacy of the Covid vaccines against Delta, that the US was set to suffer a nasty big spike and was likely to see overloaded hospitals again. We also warned that it is seen as unacceptable to the powers that be for heart attack, stroke, and car crash victims not to be able to get adequate care in emergency rooms. Associated Press reported that St. Petersburg is at that point:
In St. Petersburg, some patients wait inside ambulances for up to an hour before hospitals can admit them — a process that usually takes about 15 minutes, Pinellas County Administrator Barry Burton said.
While ambulances sit outside emergency rooms, they are essentially off the grid.
“They’re not available to take another call, which forces the fire department on scene at an accident or something to take that transport. That’s caused quite a backlog for the system.”…
At no other time during the pandemic have intensive care units seen a percentage of COVID patients as high as in the last two days. Last year around mid-July, the percentage edged to 45% with about 1,400 patients. Officials ramped up beds at hospitals and at their peak reported about 2,500 ICU patients at a time. At the height of last year’s summer surge, Florida had about 10,170 COVID-19 hospitalizations overall.
Notice the manpower concerns:
Nearly 70% of Florida hospitals are expecting critical staffing shortage in the next seven days, according to the Florida Hospital Association. The COVID-19 influx is also hitting as Florida hospitals are seeing “unusually high numbers of very ill non-COVID patients,” said the association’s president Mary Mayhew.
Associated Press also ran a stand-alone story on nurse shortages. Key sections:
The rapidly escalating surge in COVID-19 infections across the U.S. has caused a shortage of nurses and other front-line staff in virus hot spots…
Florida, Arkansas, Louisiana and Oregon all have more people hospitalized with COVID-19 than at any other point in the pandemic, and nursing staffs are badly strained.
One system is giving retention bonuses to keep from having nurses decamp to highly paid “traveling nurse” gigs:
Miami’s Jackson Memorial Health System, Florida’s largest medical provider, has been losing nurses to staffing agencies, other hospitals and pandemic burnout, Executive Vice President Julie Staub said. The hospital’s CEO says nurses are being lured away to jobs in other states at double and triple the salary.
Staub said system hospitals have started paying retention bonuses to nurses who agree to stay for a set period. To cover shortages, nurses who agree to work extra are getting the typical time-and-a-half for overtime plus $500 per additional 12-hour shift. Even with that, the hospital sometimes still has to turn to agencies to fill openings.
Twitter had already registered the nurse shortage. For instance:
COVID exploded in my ICUs this week. I was looking as far as Cincinnati to find an ecmo circuit for a young patient yesterday — while we have a few circuits available locally, there are no nurses available. Bed capacity is more than an empty bed, it’s a team to staff it, too.
— Jason B. Martin, MD (@jasonbmartin) August 7, 2021
By contrast, Business Insider ran a story on MD exhaustion. Its opening:
Ed Jimenez was walking down the hall of the University of Florida Health Shands Hospital recently when he ran into a nurse on staff.
The unrelenting pandemic has made it hard at times for Jimenez — CEO of the teaching hospital in Gainesville which counts more than 1,000 beds — to sustain morale among his workforce.
“Everybody I talked to was putting up a wonderful exterior: ‘We got this. We’re helping people,'” he recounted in an interview this week with Insider.
Still, he could see the anguish behind their eyes. The nurse reminded him of what has become one of the pandemic’s most sobering scenes.
Notice Business Insider did not talk to any nurses or technicians: “Insider interviewed seven doctors, hospital leaders, and local government officials, to understand how they’re responding to the situation.” But the story did get one source to ‘fess up that ER care was being compromised:
At one South Florida hospital, some COVID patients have had to wait in the triage area for up to a day since no ICU beds were immediately available, said a doctor in the area who requested not to be identified as they were unauthorized to speak to the media.
And later on, it turned to nursing:
Meanwhile, hospitals are confronting a nationwide shortage of nurses.
Kevin Taylor, the emergency room director at Baptist Health’s two Bethesda Hospital locations in Boynton Beach, said that nurses on staff are making up for the lack of reinforcements by volunteering for extra shifts.
But that was it. The piece then turned to ambulances tied up waiting for admissions, oxygen shortages, and postponement of elective surgeries.
A local news station, in Tenessee, gives a more candid picture of the staffing stress. From WKRN:
Dr. [Todd] Rice [the director of Vanderbilt’s Medical Intensive Care Unit] says staff there faces two challenges. “It’s a double hit. You get hit with more cases, but you also get him from fewer people now to take care of those cases.”
It’s a problem people may not consider. “As the number of cases increases in our community, the number of our employees that are positive also increases,” he says.
That forces a team of specialized professionals to stay home. “We’ve had shortages of our nurses, and our nurse practitioners, and our respiratory therapists, because unfortunately, even if they’re vaccinated, and they’ve tested positive, they’re out of work for 10 days.”
But again, to hear from nurses, you need to go to Twitter (and I assume Facebook, to which I am allergic), where you learn that the heartrendering vignettes of nurses overwhelmed by suffering patients airbrushes out a key part of the picture: that the pay issues we flagged earlier are symptomatic of a lack of respect and concern:
of our sacrifices; including death for some of us from Covid-19 or other occupational hazards, we are treated as if we are invisible. No help is offered. No reinforcements are promised. Our coworkers are told to do more with less, each and every day. (3)
— LiveWellFeelWell (@LivWellFeelWell) August 5, 2021
The pace takes our breath. We watch as coworkers who have fallen are discarded like rusted out cars that have exceeded their usefulness. The broken cars line up in crumpled heaps in the junkyard in numbers that continue to multiply. We are told/forced to keep silent. (4)
— LiveWellFeelWell (@LivWellFeelWell) August 5, 2021
Mirable dictu, one media outlet is connecting the nursing shortage to pay levels:
The Birmingham Black Nurses Association and the Alabama State Nurses Association said the current shortage of nurses in our state has more to do with pay than COVID. https://t.co/VOFX2uN9Cr
— WBRC FOX6 News (@WBRCnews) August 10, 2021
A necessary but not sufficient condition to better treatment of nurses: the public at large recognized that they aren’t paid what they are worth:
Large majorities of Democrats and Republicans believe nurses and health-care aides are underpaid, while almost an identical number say doctors are overpaid, one study found. https://t.co/JOmcPUTF5c
— MarketWatch (@MarketWatch) August 11, 2021
Another looming battle is over vaccination of hospital employees is leading to more nurse departures. At the end of May, 1 in 4 patient-interacting hospital workers had not had any Covid injections; at the 50 largest, the ratio was 1 in 3. Press and media accounts indicate that vaccinated nurses resent working with unvaccinated colleagues, particularly since some hospitals assign only vaccinated staffers to Covid patients. However, some Evangelical sects oppose vaccine use, either out of mistaken beliefs that they rely on embryonic stems cells, or that mandating vaccination is the Mark of the Beast. Many youngish women are also concerned about reproductive effects; the mRNA vaccines can produce very heavy and early periods. The drug makers have not addressed this issue; they’ve instead talked about miscarriage risk, but have stayed mum on the weird menstruation and related fertility concerns. The failure to address this issue directly is not assuaging doubts.
The religious refusniks won’t be converted, and it’s an open question as to how many of the ones worried about reproductive risks will quit if forced to get a jab. Either way, a vaccination mandate will further thin the ranks of hospital nurses at the worst possible time.
So I hope readers will keep us posted with what they see in the local press and learn from medically-connected contacts about hospital and particularly nurse staffing and compensation. As you can infer from this post, what is happening on the nursing front lines is not well covered, despite its considerable importance in the struggle to contain Covid.
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Not only are nurses leaving the profession because of low wages, so are CNAs and Home Health Aides. Recently, I searched for a HHA for a loved one suffering from Long Covid and found that local agencies had no HHAs available and long client waiting lists. I wondered why this was and talked to a former HHA who told me local agencies pay HHAs only $8.25 per hr with no benefits. This is shocking. A person can make $12 per hr or more at local fast food restaurants! So HHAs are leaving their jobs to work in other professions. Who can blame them?
Until we start paying nurses, CNAs and HHAs what they are worth (they provide the primary care for our sick, aged and disabled!!!), our health care system will remain broken and our society as a whole will suffer greatly for it. Am I angry about this? You bet I am.
When my loved one was in the hospital, the nurses were fabulous. They were obviously very tired and stressed but we were impressed by their care and dedication. Several were “traveling nurses” from out-of-state.
One local agency has gone from employing 300 HHAs before the pandemic to less than 75 currently, even though there is a far greater need for HHAs from clients now. From what I understand, most HHAs left because they could find employment in other fields that paid better.
Until we start paying nurses, CNAs and HHAs what they are worth
It’s almost as if you don’t care about the poor temporarily embarrassed multi millionaire hospital/nursing home administrators…They have mortgages, and private schools to pay for and their kids can’t be expected to take out student loans so there’s the college savings accounts, and those kids need at least a million to ease them into their working life (hopefully following in dad’s footsteps as a hospital administrator!!! [omg! gushing!]).
A nurse making 8.25 an hour doesn’t need any of that stuff. So. Selfish…..snark off…
Exactly. There are plenty of other options before we need to resort to radical tactics like raising pay. What about removing their platform by banning them from talking to media? Spreading news stories painting them as selfish? Undermining their unions? There are lots of possibilities.
And let’s not lose sight of the real villains here: the fast food companies. How dare they offer such profligate sums to workers? Our nurses were all perfectly happy on $8.25 an hour before they came along!
The complete corporate takeovers of all facets of healthcare has created unexpected consequences. A shortage of nurses is one. Not that long ago doctors ran their own practice. Being self employed meant they could decide how it was run. Once they became corporate employees they lost this independence. MBA’s were dictating how they do their job. For some this wasn’t a problem. Especially younger people entering the system. For many old timers , they either quit or are waiting for the time they can retire. Unfortunately we are creating a system where health care workers look at their employment as just a job. Where I live the corporate take over is complete. There is only 1 independent doctor that runs a walk in clinic. All of the rest are employees. At one time you could make a future appointment a year into the future. Now if it’s longer than a month you are told they will contact you to set up your appointment. It seems at every visit you get to meet a new group of providers. The staff is constantly changing. This tells me the patent will suffer because on constantly changing providers. It isn’t surprising that the US health care system is at the bottom in quality ratings. If you happen to be lucky and find a great provider your are the exception. The rest of us have to live with what we are given.
“The complete corporate takeovers of all facets of healthcare has created unexpected consequences.”
Excuse me, Jackiebass63, who didn’t expect that the corporate takeover of medicine would not result in wage freezes and cuts for those at the bottom and multi-million dollar bonuses for administrators and star surgeons at the top?
I saw the writing on the wall in the ’80s, and became a single-payer activist in the 90s after being widowed due to corporatized health care that killed my husband.
I do urge everyone who is concerned about this issue to join and support Physicians for a National Health Program NOW. You do not have to be a physician or medical professional to join: http://www.pnhp.org
PNHP has been in the trenches for decades. They should be overwhelmed with memberships and donations at this point — members of the NC commentariat who can afford to, please make it happen!
P.S. While it costs physicians $250 a year to join PNHP, a health professional (that would include nurses) or ally (that would be me) membership is only $50 a year. And here’s a more complete link:
https://pnhp.org/join-or-renew-your-membership-in-pnhp/
how can these coincidental “unexpected consequences” be so unexpected? I see how much intelligence is out there. I believe it is time to toss this meme aside and conclude it is intentional, with all the cognitive dissonance that entails.
At this time, private equity groups are seeking to buy primary care practices. Emergency room are also being sold to the money seekers. They expect it will yield big returns.
Don’t kid yourself. Private equity in health care is bad, but the entry of bottom feeders is a symptom of how bad the system has gotten, not the problem.
Most hospitals are tax exempt, not-for-profit “charities.” The difference between them and their for-profit comrades is that the 501(c)(3) hospitals slather a couple of layers of treacly “mission” sanctimony over their union-busting, price-gouging and patient abuse.
The trend of PE acquisitions of physician practices is a response the much bigger, earlier wave of hospitals buying up doc practices.
From 2009: https://www.nytimes.com/2017/01/19/upshot/who-will-care-for-the-caregivers.html
In the spring of 2020, before lockdowns & when large gatherings were still allowed, a state official told the Association of Hospice and Home Health Care that they knew there was a staffing shortage. If anyone said so publicly, they would be fined ten to twenty thousand dollars per instance. The lever arm is Medicaid contracts guaranteeing staffing ratios.
I’ve had secondary confirmation through a source on a psych unit. Both of these are one degree of separation reports.
The local hospital network has also preferentially started using outsourced nurses at twenty times the cost.
CT scan – each time I rap my tinfoil hat, it rings like a Conquistador helmet. A one-factor reason which resonates with current conditions is Disemployment. The move toward a gig economy, dumping employer responsibilities… Outsourcing the nurses also dumps liabilities on non-institutional cutouts.
When the main skilled nursing facility/rehab center abruptly shut its doors a couple months ago, the newspaper article made it seem as though insufficient profit was the reason. Weeks later, another article discussed the staffing issue. The home health business I have information about is rapidly decreasing its patient load and looks like a controlled descent into terrain, or at least selling off the business.
This would be bad enough/business as usual, but going into a pandemic the threat of fines was odd. An industry-wide refusal to raise wages. No discussion of facilitating training up new nurses, when we could have had a fresh crop of LPNs a year ago. That labor supply would presumably depressed wages, so the MBA Rule_1 “cut wages” is an incomplete explanation.
The Prince Philip Protocols refuse to take themselves off the board. Not that the overwhelming majority of officials are doing anything but turning their cranks, some may even be dedicated to their jobs. But at some level… Could we at least have a confirmed head of the FDA? In the middle of a pandemic? Please?
Several home health agencies in my area have closed in the past year. This in spite of increased need for home health care.
The reconciliation bill in Congress supposedly puts more money into home health care. Will that money go to increasing wages for Home Health Aides or will it go to the MBAs who own the agencies?
What is a Prince Phillip Protocol?
“In the event that I am reincarnated, I would like to return as a deadly virus, to contribute something to solving overpopulation.” – Prince Philip (attributed)
American Society depends on a high level of trust in order to function, when you destroy that trust as is happening now there are consequences.
I was out and about yesterday for an oil change and to get my tires rotated and noticed quite a few
“Now Hiring” signs, including a huge banner on the local Safeway store.
It’s not just healthcare workers leaving…
Starting wages for retail workers here in Sonoma County varies from $15 to $18 per hour with regular gas at the cheapo station running $4.49 per gallon, cash price.
Here in the North American Deep South (NADS) we are seeing “Now Hiring” signs everywhere as well. The wages being offered at the fast food outlets, (which emporia advertise their wage rates,) are in the $8.00 to $9.00 USD per hour range. Those supposedly offering higher wages are not advertising those rates. It’s the old trick of, ‘you have to apply to find out.’ No matter what, the local management now has your information and can tell the Home Office that they are “aggressively” recruiting for workers.
Gasoline prices are hovering at the $2.57 USD per gallon price at the cheapie stations.
A very good source for gasoline prices is ‘Gas Buddy.’ The website hosts an interactive map that shows real time prices. Near the bottom of the scroll click on ‘Gas Price Map.’
See: https://www.gasbuddy.com/
Is there an ‘honest’ cost of living measurement tool? (I cannot find one, but then, I live under a rock.)
Stay safe!
Here in the ticking heart of the CVBB another evang mega-church has been under construction since Covid came calling and is nearing completion. It looks like no other building i’ve seen, way out there.
Why is that houses of worship often have such flamboyant architecture and yet on the inside the most conservative flock imaginable?
I chalk it up to basic Calvinist Theology, or, the rich are rich because G– wants it so. Thus, outward signs of prosperity are also signs of ‘grace.’ On a more basic note, that big shiny church complex is a proclamation of the worth of the congregation. Those associated with the ‘symbol’ of G–‘s grace manifest on earth share in the reflected glory.
It’s a phenomenon that goes back to the “temple” complex at Gobleke Tepe in Turkey, (dated to approximately 10,000 BC,) and probably earlier.
Gobleki Tepe: https://www.theartnewspaper.com/news/is-this-the-world-s-first-architecture#:~:text=At%20around%2012%2C000%20years%20old,before%20writing%20or%20the%20wheel.
Couldn’t be the ‘no taxes’ gift by Pres Johnson still reaping benefits 50 years later?
Good point. Taxes are, in a monetary sovereign, a tool for social engineering.
Something useful on the subject from L. Randall Wray: http://www.levyinstitute.org/pubs/Wray_Understanding_Modern.pdf
As the good Reverand Lovejoy says; “There’s money in religion.”
Zappa agrees, “Heavenly Bank Account”: https://www.youtube.com/watch?v=3-9zrUvTqFw
Hi, ambrit. Hope you and yours are safe and well.
A sub shop that I visit that supports first responders had a sign out advertising crew positions for $9 and for shift managers, $12. Then a new sign appeared offering $11 for crew and $14 for shift managers.
I have no idea if they were successful at those rates, but the sign is still there, as are many, many others all over town.
Employers need to get a clue. More pay means more spendable money for the workers which means more income for the employers, basic economics. Short term profit uber alles has destroyed business’ owners common sense.
Greetings from the hillfolk Mr. Zelnicker. Please be vigilant and stay safe.
I do wonder how much of what we see “on the street” is the result of truly small, (Mom and Pop) stores or franchise outlets. ‘Round here, the local national chain fast food outlets are mainly owned by local or regional “investors.” The stores are often run by the national chain as part of a ‘turnkey’ deal. Those outlets that are run by local magnates seem to be seriously infested by neo-liberal values. Are the local ‘investors’ fully ‘bought into’ the national short termerism philosophy? I do not know enough of such persons to really know. (The one local magnate I did speak with on occasion has moved on down to the Coast.)
There seems to be a physical separation between the “working classes” and the “owning classes” going on. The proliferation of gated communities, usually situated in the exurbs, is formalizing this trend. The truly wealthy in this region are mainly now esconsed in exurban/rural locales, often on large acerage. Our local football millionaire has several hundred acres west of town with the gated drive, a half mile driveway, and a reasonably working farm setup. I’d almost characterize it as a feudal manor.
My danger sign for the local economy, rent to own, title pawn, and payday loan shop closings is still flashing red. Several more of the smaller outlets have closed over the last few months. Nothing says “Hard Times” better than “Out of Business” signs in the windows of the pawn shops and small loan storefronts. (One local pawn shop closed down six months ago.)
Be safe!
Addendum: I drove past a local Popeye’s Fried Chicken outlet this afternoon and saw a big banner above the door: “Now Hiring. Crew Members $10.00, Shift Managers $13.00.” This is one of the aforementioned locally owned and run fast food chain outlets. So, wages are budging a bit here.
My sister up in Kansas City yesterday mentioned the “shockingly bad driving” going on there now. Thinking on it, I have seen something similar happening around here. It’s looking a bit like bumper cars.
Stay safe.
Expected to give their all in the equivalent of a frontline trench, but at least they wont be shot for leaving it.
I really don’t know what the world is coming to for an MBA. I mean you abuse your workers, underpay them, chew them out in public, order them not to wear masks at the beginning of a pandemic, go out of your way to make working conditions as hard as possible for them, fire them at whim, order them to work overtime as if they had no family responsibilities, never do anything nice for them, try to cheat them to improve your corporation’s bottom-line to make you look good, treat them as disposable assets and so what do they do? They quit on you, that’s what.
Are they even allowed to do that?
I’m sure Congress will think up a way to prevent that type of abuse of MBA’s by their ungrateful workers!
Most of these employers don’t understand that productivity correlates to how workers are treated. I know personally in my over 40 years of working, that how you are treated determines how much extra not required effort you are willing to exert. With a good boss it is easy to go the extra mile. The opposite is true for a bad boss.
I am sure the MBA’s are thinking of ways to lobby Congress for more immigrant and H1B labor as we speak
They’re also looking for other labor groups that can be easily exploited.
> and so what do they do? They quit on you, that’s what.
> Are they even allowed to do that?
Finland has (a) a national health system and (b) strong unions. About 15 years ago, the nurses’ contract was up for renewal. The Government said ‘Oh, you nurses! We love you! And we DO appreciate how hard you work, in such an important profession! But, we’re so very sorry, there isn’t any money available to give you a raise this time. We just don’t have it. It’s not there. There’s simply nothing we can do.” The nurses’ union said ‘Well, if that’s what you think — but we do have the right to strike, you know.’ The Government immediately rammed through the Parliament some kind of ‘Emergency Conditions No-Striking Allowed’ legislation. The nurses’ union said ‘All right, if that’s the way you want to play it — and within a matter of days tens of thousands of nurses signed a pledge to quit unless a serious pay proposal was forthcoming. Mirabile dictu! The Government found the money!
We had the same reaction recently in Poland when the elected officials (at the US equivalent of Congress critters and Senators) decided they needed to double their salary. It did not go over well with nurses, teacher, doctors, etc. Not sure what the current status is. Probably shelved for a more convenient moment.
I know this is probably unthinkable right now, but later when things hopefully settle (Delta wave should peak in the next week or so; maybe by October we won’t have so many stories about crowded ICUs) can these folks go on a strike?
I have no idea how many nurses are unionized. Maybe it is very few, if not this could be their best shot.
IMO bean counters pay attention when you step on their air hoses.
Honest questions:
1) Why do you think the Delta Wave will peak soon?
2) Why do you think the current wave will peak with Delta?
3) You don’t think there will be an Autumn/Winter wave?
Assumptions like these have gone into justifying the sort of disastrous staffing decisions under discussion here, but the assumptions themselves were, as is now self-evident, unjustified. They were also never justified by any legitimate evidence.
I think a lot of Covid propaganda has amounted to illusion-of-control booster shots for the target groups, and I think it’s extremely pernicious – in particular I think one of its main functions is to deter people from banding together in sufficient strength to stomp that air hose.
Well, if we’re lucky, we’ll see the Delta wave in the US suddenly reverse direction like it did in the UK (https://www.worldometers.info/coronavirus/country/uk/). UK rates were rising sharply and then suddenly changed direction downward on July 18th. I don’t know what caused it, but the change was very abrupt. And fortunately their death rate was much lower than it had been during their previous wave, likely due to a high vaccination rate that kept the severity of most people’s illnesses down.
As for a wave in the autumn and/or winter? Yeah, I wouldn’t bet against that. Right now we’re seeing a crisis in southern states because people there are spending most of their time indoors in the air-conditioning, hiding from the heat. This means more people breathing recirculated air that contains more virus-laden aerosol particles.
And once the weather changes, it’ll be people in northern states who are spending most of their time indoors where the furnace or heat pump is on, hiding from the cold. And even worse, the lower humidity of their air will remove moisture from aerosol particles, decreasing their mass and increasing their loft time.
My guess is that we’re nowhere near finished with this, even if the Delta wave does reverse in the near future.
only to be replaced by a new much stronger one
Lambda
I’ve read that the UK vaccinated differently; they put much more time between the two shots and that seems to make a big (beneficial) difference. So we may not have their good fortune.
Cases are back up. The decline appears to be a data artifact, due to people deleting NHS reporting apps after blanket false notices were sent.
And the UK is not the US. Second Covid shots much later than ours due to the second shot being 10-12 weeks after the first. So they will see the impact of waning immunity later than we do.
Cases are up, initially at unnerving rebound rates in my vicinity (College town, low vaccination rate because of age profile) and in the surroundings (rural, coastal top staycation area, barely touched by previous waves because of innate cultural social distance and geographic remoteness from major urban areas and transport hubs).
However, daily percentage growth rates are falling to single digits and if the trend continues will reverse. The rebound looks like the effect of Freedom Day linking up a few uninfected populations to the main epidemic. They flare up and die out.
That said, school term in September and autumn weather will raise indoor mixing rates and provide another spike. When will the false summits end…?
On the vaccination profile, most primary and booster vaccinations are administered 8-12 weeks apart to maximise the boost (hepatitis A, tetanus etc). My bet is that the improvement from the UK’s delayed booster will persist many times longer than the mere delay itself. I hope I am right.
And then there is debilitating Long Covid. It is affecting vaccinated people who have breakthrough cases as well as unvaccinated people. It’s not going away any time soon.
Hi Raymond, here are my honest answers, which are really just guesses and not meant to undermine the nursing community, who need more than ever to band together and get our support to crush the MBA-driven management of public health.
1) hope more than anything … but if I had to give a logical reason, following the UK pattern would be the best one. I absolutely could be wrong here and nobody has much of a track record of predicting things with COVID.
2) I don’t know exactly what you mean here, but maybe it is that the Delta wave could turn into the Delta-Lambda wave and amplify even more. That would be truly frightening. Can’t rule it out either.
3) I suspect there will be a winter wave. Not sure how big it will be … on another site someone wrote that we may be lucky that Delta hit during the summer, respiratory viruses tend to hit harder in the winter time and by the fall we should have more natural immunity. But that doesn’t mean some new mutation won’t emerge …
I’ve done pretty well! It’s not much to brag about though, I haven’t done much more than read papers that were cited here or on twitter, and pay attention to any knowledgeable sources I could find who didn’t seem to have an axe to grind.
That’s the reason I was curious about the bases for your expectations. From the beginning of the pandemic the majority of the people I’ve discussed the subject with have had severly unrealistic expectations about what was likely to be coming next.
I’m starting to think that it’s actually a false sense of uncertainty that drives this.
I think it’s unlikely that our current wave will end with Delta as the dominant variant. Actually it’s not entirely clear to what extent ‘Delta’ is even a useful category anymore. But in any case, as the sun follows the moon something will succeed Delta, probably something we’ve bred ourselves, almost certainly something worse, which will be superseded by something yet more horrible and so on. I wish this were hyperbole.
I bet none of the prominent health care leaders and COVID Twitter stars will say anything about the nurses strike at St Vincent in Worcester. Ashish Jha is scolding Delta airlines for not mandating vaccinations, but not his ceo friend who could change his corporations hostile stance to their nurses. And this is in Jha’s backyard. He lives 30 minutes away.
https://twitter.com/Bob_Wachter/status/1425174302307995653?s=19
Yeah this post made me think of St V’s. Management is so dumb, thinking it’s just a replay of the disastrous ballot question from a few years ago without considering the immense change in context re labor, covid, conflict.
I have been getting requests to work a Mass strike, Worchester then?
As far as covid units go, they don’t care who works there vaxx or unvaxx, cause many people flat out refuse to work those floors.
Constant mention of Florida, biggest problem with FL, the pay is real bad, the RN to PT ratio compared to other states is also real bad, that was before CV. Most of the hospitals are HCA in FL, cheap in every aspect.
People are leaving cause travel pay is better than it has been in years.
The hedge funds bought up medical practices and hospitals. What else could have happened when those morons started to squeeze every penny out of their conquests like they have with everything they’ve reduced. That is: everything Wall St has ever touched has turned to dross. They’re a threat to the survival of the human race.
https://www.nbcdfw.com/news/coronavirus/parkland-hospital-nurses-deal-with-short-staffing-and-fatigue-due-to-covid/2714301/
‘It’s No Longer a PPE Crisis, It’s a Caregiver Crisis:’ Parkland Nurses Deal with Short Staffing and Fatigue
https://www.texastribune.org/2021/08/05/texas-hospitals-nurses-covid/
Texas hospitals hit by staffing crisis as burnout depletes workforce and COVID-19 surges
https://www.columbiamissourian.com/news/state_news/nursing-shortages-across-mo-counties-confirmed-by-recent-study/article_91351608-e3f4-11eb-8f7c-c7e696ffd3eb.html
Nursing shortages across Mo. counties confirmed by recent study
The historical solution to the exploitation is exploration is Unions.
But forming a bargaining unit in the us is riddled with deliberate, employer driven, barriers. Where are the supporters of Labor? Republicans, funded by the wealthy, or Democrats funded by the wealthy?
Neolibralism has succeeded, Unions are Mears shadows of themselves.
The historical solution to the exploitation is exploration is Unions.
But forming a bargaining unit in the us is riddled with deliberate, employer driven, barriers. Where are the supporters of Labor? Republicans, funded by the wealthy, or Democrats funded by the wealthy?
Neolibralism has succeeded, Unions are Mears shadows of themselves.
Private sector unions lost their fight the moment Nixon reached out to China. The outsourcing to arbitrage labor and environmental law, etc.. all provided financial incentives to offshore and there were no offsetting tariffs..
The only unions that really have power in the US are the public sector unions which only have the power that they do as their income streams are insured via de-facto capture of the taxation and judiciary authorities via the R/D political machines.
My Sister-in-Law is a nurse. During early COVID, the ERs here were virtually empty, so the local not-for-profit hospitals LAID OFF nurses. When things opened up, and patients started coming back, they never hired back the nurses. They over-worked the ones they had. My SIL left, took a job as a nurse at a prison because it is LESS STRESSFUL and BETTER PAY. Many of her co-workers quit and came back to their same jobs as traveling nurses. Another note from my SIL – the conditions were such that she felt her license was at risk because she was so overloaded with patients.
“Large majorities of Democrats and Republicans believe nurses and health-care aides are underpaid, while almost an identical number say doctors are overpaid, one study found. ” – I love how we seem to have successfully blamed doctors (whose wages are also falling in the MBA-driven care) for the low wages of nurses and health care aides.
My daughter is a pre-kindergarten teacher for moderately to severely disabled kids. They let all the classroom aides go last fall when they went to remote learning. Last Spring when they went back into the classroom many of these aides were nowhere to be found. My guess is they all found other, likely better paying, jobs. She had one aide instead of two and often was alone in the classroom which is not supposed to happen. Hopefully, things will be better come September.
As of today, I cannot accompany my 96 y.o. father-in-law into the hospital for his appointments, since I am not vaccinated and don’t plan to be. I am having trouble figuring out what will happen when I get to the door of the clinic with him. It is my understanding that hospitals are obliged, under the ADA, to provide assistance to the disabled so that they can get medical care. Will they have a duty to provide a wheelchair pusher to get him from the front door to his appointment, and someone to stand with him while he is treated and help him hear what is said?
They don’t have the staff for that. They don’t have the staff for much of anything, right now, even here in rich Silicon Valley. They have relied forever on family members for this free labor. It seems that if they have to cover even a small amount of their obligations themselves, they will go broke fast.
The “pandemic of the unvaccinated” has largely been a “pandemic of neglect of health care systems.”
This overwhelming display of short-term thinking for profit is the type of brain dead normal some people are raving to go back to.
That is why the masks scare the most deluded. It’s a reminder that there is something terribly wrong and none of the institutions, that are supposed to be trusted, can do anything but think about short-term profit.
I just found out this morning my nephew’s lovely wife, an RN with a two years experience, is going *on the road*. The hospital is treating ’em badly. My nephew quit his dead-end job. The planning has begun. No kids, a dog. They’re savers, not spenders.
Destroying an entire generation of crucial health care providers hardly seems like a winning strategy for society, but it sure wins the next quarter! I guess “I’ll be gone, you’ll be gone” applies to health care, too.
Here in southern Oregon the main hospital group is having a large outbreak on top of no rehab beds in nursing homes that is also caused by a shortage of staff. Only 64% of the hospital workers are vaccinated in a county with an even lower vax rate in the general population. The pandemic is exposing the multiple fault-lines of our so-called health care system.
There is something deeply amusing about watching college educated people with 15 credits of econ acting as if the moral world has collapsed because they can’t find qualified workers to work for the pay they are offering.
Please re-read chapter one of Samuelson on the supply and demand curve and either raise the pay or do the job yourself.
And PS, if you’re a recent college grad, date a nurse, EMT or doctor; you woun’t regret it. There is something about watching scared, dying people try to survive that is the best reality check this side of combat. Phoneys don’t last long.
It’s not just hospitals that are in need of qualified employees.
Schools in the LA unified school district can’t fine qualified staff either. See: https://www.latimes.com/california/story/2021-08-11/la-back-to-school-covid-recovery-hit-by-teacher-shortage
PS. NC has always been one of the clearest “chrystal ball” on the Interweb.
Under-staffing (bad ratios) was ALREADY a problem before the current situation (at least at the hospital my SO works at as a CNA) …..
Much of the hysteria towards enacting measures for the sake of ‘hospital capacity’ has seemed to neglect the staffing issue (clearly a $$$ issue for penny-pinching admin)
‘Giving each nurse a dollar raise would cost two million dollars’ – That indicates a Hospital Holding Company is involved in this calculation. These HHCs have spread throughout the country, buying up hospitals, clinics and urgent care offices, and add an additional layer of managerial rent seeking griftitude. Sad.
I have not kept up on the reporting, but I thought I had recently read that these companies were reporting record or near record profits, and were also receiving funding from the various bills passed for CV relief.
Much as I respect physicians dedicated to their profession, I often hold nurses in still higher regard. I have no source, but I recall from somewhere that the probability of patient recoveries after hospitalization often depend more on the quality of the nursing they receive than the quality of their physicians.
When I was in college, I worked on weekends as the graveyard switchboard operator/informal ‘guard’ — I looked more threatening than I was in fact. Many of the nurses and hospital personnel came by to tell me stories on their breaks as we neared 4 am — the dead-of-the-night. I heard other stories when I made my rounds visiting nursing stations as the the dead-of-the-night approached. Almost all of the stories included some telling episodes of the way nurses were pushed back from their mission to protect and help patients. I heard stories of surgeons adjusting the lamps in surgery without changing their gloves. I heard stories of near misses in catching mal-prescribed medicines — mal-prescribed in dosage or failure to account for interactions with the other medications a patient was taking. I heard horrible stories of organs, like the bleeding uterus of a 24-year old Spanish speaking women removed to stop the bleeding without true consent, after the surgeon ‘slipped’ and dug too deep using his curet. She was never told after the surgery why she could never bear a child.
The mal-valuation of nurses came home to me when I talked with the Nurse who rented out the room where I stayed briefly after one of my many moves. She told me the nursing service she worked for was paid $21 per hour for her service and she was paid $8.50 [or thereabouts — I am old and my memory takes shortcuts] — to provide her services. This story is from the early 1990s. Of course state licensing laws worked to heavily favor the nursing services over the nurses who worked for them. I doubt things have improved since that time.
I am little surprised that nurses, teachers, and other helping professions are leaving, when even physicians hesitate — except those carrying heavy student debts — to carry on in the omni-present wringers turned by Big Money. The Market is a purveyor of Death.
My cousin’s daughter in Indiana is a nurse. She is not evangelical and I don’t think she wants to have more kids. But she has no interest in being vaccinated and would quit if there were a mandate there.
Some nurses may not want to be vaccinated because of the side effects of the vaccine. I talked with an RN at a local cosmetic clinic two months ago not long after she’d had her second shot. She was really, really unhappy about the pain she had been in and for how long it lasted. She was also extremely unhappy that she had been pressured by her employer into having it done. I am sure that she has told other nurses about her experience. She is most definitely not Evangelical (she’s a lapsed Catholic) and she had mentioned to me in the past that she and her husband don’t plan to have kids, so that wasn’t it for her either.
Is there any case in history where heavy handed government intervention didnt lead to shortages and price increases?
Why don’t you do some research and tell us? As is, your question doesn’t seem to lead to discussion.
A hint: If you are from the US of A, try the New Deal. Try T Roosevelt and trust busting.
If you are from Europe, you may want to look at land reform, when estates were broken up, in several countries. Spain is a pretty good example.
Forgive me, but I fail to see how this comment is related to the article?
I would assume that overwork, underpayment, and open displays of management’s contempt for nurses would be the same in all states.
So if the current wave of hospital pressure is worse in some states than in others, the question arises as to why that is.
It seems unpopular just lately to look at the role which Republican Governators and other leaders at the State level play in obstructing simple efforts such as mask mandates to slow the spreading around of coronavid. But it either does play a role or it does not play a role, regardless of whether it is currently fashionable or unfashionable to say that it either does or does not. Reality will remain real, whatever people choose to say that reality is.
If Abbott and DeSantis have played a role in propelling coronavid to new highs in their respective states, and if the nurses in those respective states see that role as being obvious and apparent, some of those nurses may well decide at some near-future point to move to states where the governors did not take an activist role in spreading disease the way Abbott and DeSantis have chosen to do. And especially if other states end up with less of a re-surge problem in hindsight, more nurses will move from Texas and Florida into not-Texas and not-Florida.
Anything to that informal hypothesis? Time will tell.
Doubt that. You seem to forget the long term care bs by the dems governors when all this first started. It isn’t dem or blue, it is cheap MBAs that hire on more MBAs. They do studies to figure how to increase satisfaction scores, rather than hire staff to do the work and thus increase satisfaction.
Right, like new York that has/had a governor that covered up covid deaths or that had nonsensical indoor/outdoor mask and dining rules.
Incompetence is bipartisan.
Well . . . if nurses in Florida and Texas see it the way I say it, they will begin a quiet exodus of nurses from Florida and Texas over the next few years.
As I said, time will tell if my little hypothesis is proven correct or not by events. if no such exodus happens, y’all can laugh last at me all you want.
We’ll know in a few years, one way or the other.
There is another story hidden in this post that concerns me greatly. When Mary Mayhew talks about “unusually high numbers of very ill non-COVID patients”, she may be describing the first wave of post-COVID cases that reflect COVID morbidity. A radiologist I know has been telling me horror stories for some time about patients with mild or asymptomatic disease showing extensive evidence of tissue scarring. She described how difficult it was to interpret mammograms from COVID patients due to scarring of breast tissue. Unfortunately this is anecdotal and I have yet to see published studies describing this in more detail. Nevertheless, the published descriptions of uncontrolled blood clotting that accompanies severe cases offers a plausible explanation for this scarring as a known consequence of infection.
This is important intel even if anecdotal. Sent it on to our Covid brain trust. Thanks.
‘She described how difficult it was to interpret mammograms from COVID patients due to scarring of breast tissue.’
Logical when you think about it but then the penny dropped. How are they supposed to tell the difference between covid-damaged lungs and lung cancer going forward?
I’m not a radiologist, so I can’t comment on the interpretation of lung scans, but what concerns me more broadly is that micro-clotting as a possible feature of this illness, could result in a wave of post-COVID health issues that overwhelm our already enfeebled health system. More patients needing dialysis (scarring of the kidneys), more diabetes (scarring of the pancreas), more brain damage (“brain fog?”), etc., etc.. If just 5% of the people who get COVID have extensive tissue scarring, that is more enough to cause a public health crisis. And the people most likely to be impacted by this are the over-worked, grossly underpaid “essential workers”.
Here is a little tiktok video by someone who says his wife had to be discharged from the hospital without treatment of problems she went into the hospital for having to do with moving through the Stage Four Breast Cancer management process. She was discharged without the treatment for which she had been admitted because room had to be created for the expected in-surge of covid patients.
So this wife’s husband asks a very real and pertinent question of all the people who chose not to get vaccinated when they could have chosen TO get vaccinated with equal ease. I suspect he is not talking about the poor, the unreached, the barely employed who will be persecuted for taking any time off relative to vaccination or vaccination issues. I suspect he is talking strictly to the Trumpanon Foxanon vaccine boycotters.
Here is the video.
https://www.reddit.com/r/LeopardsAteMyFace/comments/p2n2v5/dont_trust_medical_professionals_because_of_the/
And here’s a little gem.
https://www.reddit.com/r/WhitePeopleTwitter/comments/p2kvza/welli_didnt_mean_that_kind_of_co2/
Ok, let me say this more more time, unlike what the news is telling you vaccinated people are here in the hospital. Don’t believe me, look at Israel. I watched the CEO at one of the places where I work flat out lie on the news and say that those admitted were unvaxxed.
I hate to be a cynic, but I wonder if these staffing articles are a way to get more foreign nurses. These places love those foreign contract workers, they pay them peanuts, work them ragged.