COVID-19 and the Health Workforce 7/20-8/3

(7/25/2022) COVID-19 Vaccination Perspectives and Illnesses Among Law Enforcement Officers, Firefighters, and Other First Responders In the US, January to September 2021
In a study conducted by the University of Miami-led team of investigators and published in JAMA Network Open, found that law enforcement officers, firefighters and other first responders are at increased risk of SARS-CoV-2 infection compared to health care personnel, but they have relatively low COVID-19 vaccine uptake. The study further noted that COVID-19 was the leading cause of line-of-duty deaths among US law enforcement officers in 2021. The researchers used data from the Arizona HEROES (Healthcare, Emergency Response, and Other Essential Workers Study) and RECOVER (Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel) groups, cohorts of first responders and other essential workers with a shared data collection protocol, to assess attitudes toward COVID-19 vaccination and illness among vaccinated and unvaccinated first responders. The findings suggest that state and local governments with large numbers of unvaccinated first responders may face major workforce disruptions due to COVID-19 illness. The study also suggested vaccine mandates, alternative work assignments to unvaccinated workers and the need to leverage trusted nongovernmental sources to address the issue of low trust in government.

(07/16/22) Burden of SARS-CoV-2 Infection in Healthcare Workers During Second Wave in England and Impact of Vaccines: Prospective Multicentre Cohort Study (SIREN) and Mathematical Model
In a study published by the British Medical Journal, rapid covid-19 vaccine rollout from December 2020 averted infection in a large proportion of NHS hospital workers in England during the second wave of the pandemic. Without the vaccine rollout, which prioritized frontline healthcare workers, an extra 10% of all patient facing hospital workers would have been infected – and staff absence due to covid-19 could have been 69% higher. Using a combination of statistical and mathematical modeling, they analyzed data from 18,284 clinical, support, and administrative staff with no evidence of previous infection who were recruited from 105 NHS hospital trusts in England as part of the SARS-CoV-2 Immunity and Reinfection Evaluation (SIREN) Study.

(07/28/2022) To Grow the Mental Health Workforce, Pay for Care Delivered by
Trainees
According to an article published in Health Affairs, in order to tackle the mental health workforce shortage which is causing the longstanding crisis of inadequate access to mental health care, the trainees need to be paid for the care delivered. The current shortage of psychiatrists in the US is 6,500, which HRSA predicted to grow up to 13000 by 2030, similar to the shortage of psychologists, which is predicted to be 14,000 by 2030. The article suggested a slew of reforms such as supporting educators who develop these professionals, bringing billing rules for psychotherapy (talk therapy) provided by trainees on par with the billing rules for trainees in other medical specialties, requiring all payers to reimburse bedside clinical teaching using a service modifier on the mental health code billed by a teaching practice and pursuing workforce policy through payment reform, as opposed to grants, which ensures the policies are sustainable and scalable. The article also calls upon the Congress to build the financial arena in which training programs can thrive, existing programs can expand and new programs can come up.

(07/27/22) Rob Peter to Pay Paul’: How Hospitals Are Grappling With Staffing Shortages
Amidst a surge in COVID-19 related hospitalizations, many hospitals are simultaneously preparing for potential surges caused by the BA.5 subvariant and mitigating critical staffing shortages. As of July 2022, hospitals in almost 40 states reported critical staff shortages leaving many hospitals scrambling for short-term solutions. Many are re-evaluating services, including testing all patients for COVID-19 and shifting staff to critical areas. The challenges of health workforce shortages also are extending to public healthcare. According to The Center for Disease Control, the results of a survey of public healthcare workers shows that 26.9% of respondents said they were thinking of leaving within the next year and 44.2% said they were thinking about leaving or retiring in the next five years.

(07/25/22) Survey Flags Public Health Worker Exodus Due in Part to COVID-19 Impact
According to findings from a 2021 survey published on July 22, 2022, in Morbidity and Mortality Weekly Report (MMWR), over 40% of the US public health workforce plans to leave their jobs within the next 5 years, and 51% said more staff were needed to respond to COVID-19. The survey was conducted by researchers from the de Beaumont Foundation and the University of Minnesota, who collected responses to the online 2021 Public Health Workforce Interests and Needs Survey (PH WINS) of state and local governmental public health agency workers participating in the Big Health Cities Coalition and a national sample of local health departments from September 2021 to January 2022. In response to being asked what was needed to respond to COVID-19, in addition to funding, 51% cited more staff, followed by more support from the community (30%) and elected leaders (26%).

(07/25/22) Hospitals Struggle With Staff Shortages As Federal COVID Funds Run Out
Hospitals in the US are dealing with severe staffing shortages which are making it difficult to prepare for a potential COVID-19 surge in the fall and the new BA.5 subvariant. As of July 22, nearly 40 states have reported critical staffing shortages and patients hospitalized with COVID-19 has risen over 40% in the last month.. This comes as federal funding for COVID-19 is starting to run out, leaving hospitals with less flexibility to hire new staff. Hospital staffing shortages will continue to be a long-term issue. America’s resistance to preventive measures like social distancing and masking will also lead to more hospitalizations and stress the health care system even more than it currently is.

(7/26/2022)Centering Health Equity in Telemedicine
A special report published in the Annals of Family Medicine by researchers from San Francisco and New York, outlines actionable steps to address the growing racial/ethnic, linguistic and socioeconomic disparities in telehealth models of care during the COVID-19 pandemic, by outlining the pillars of a health equity framework from the Institute for Healthcare improvement and overlaying a concrete example of telemedicine equity. The paper advocates for making health and racial/ethnic equity in telemedicine a strategic priority, building structures and processes to support telemedicine equity, deploying telemedicine strategies to address determinants of health, eliminating institutional racism in telemedicine provision and partnering with patients and community organizations to implement telemedicine.

(07/27/22) Doctors with Disabilities Push for Change as Long COVID Affects Their Workforce
The Center for Disease Control found that nearly 1 in 5 American adults experience symptoms consistent with Long Covid. A study in 2020 found that health care workers (HCW) were 7 times as likely to experience severe COVID-19 than those in non-frontline jobs. The symptoms of Long COVID are poised to become part of the long list of wellness issues causing workers to leave healthcare. A new group, DocsWithDisabilities, is focusing on changing the culture, practices, and policy of healthcare to be more accessible to disabled HCW. By implementing disability inclusion healthcare organizations will increase the pipeline and help with retention of HCW.

(7/24/22) The Unsung Heroes of Public Health
CBS News reports explores the public healthcare system and some of the challenges that the COVID-19 pandemic has presented including the collision of politics and public health and the toll the pandemic is taking on healthcare workers. The report ends on a positive note indicating the pandemic may have increased interest in making a difference with Harvard school of public health reporting a 50% year over year increase in applications.

(07/20/22) CMS Still Determining What COVID Waivers to Keep, Drop After PHE Ends
The Centers for Medicare & Medicaid Services (CMS) is making decisions about which COVID-19 regulatory waivers will remain permanent or will be terminated at the end of the public health emergency. The Department of Health and Human Services on Friday increased the public health emergency for 90 more days through Oct. 6 2022, which gives health workers more time for planning and preparation. CMS is committed to 4 areas to help support states and providers once the PHE ending happens. These include: maintaining health insurance coverage; providing coverage and reimbursement for testing, vaccines, and treatments; issuing new provider regulations and guidance to ensure patients and health workforce safety; and keeping the healthcare system accessible through federal state waivers.

(07/20/22) Racial Health Disparities Appear in Cancer Care Access During COVID-19
A new research study from JAMA Network Open, finds racial health disparities for cancer care access for black and Latin patients during COVID-19. Researchers found that Black and Latinix cancer care patients were 3 times more likely to experience delays in clinical visits, lab tests, imaging, and change of location of care, compared to White participants. Black adults were 6 times more likely and Latinix adults 3 times more likely to have cancer treatment delays for more than 4 weeks compared to adult White cancer care patients. Each month cancer treatment is delayed, can increase death by 10%. A survey from this research study found that Black and Latinix respondents had less trust in physicians and more trust in community and faith-based organizations.