COVID-19 and the Health Workforce 8/4-8/16

8/4-8/16 Updates

Vaccine Administration

New studies evaluate the effectiveness of COVID-19 vaccines among health care workers.

Vaccine Administration

(08/03/2022) Effectiveness of mRNA Booster Vaccine Among Health Care Workers in New York City During the Omicron Surge, December 2021–January 2022
This study analyzed the vaccine effectiveness (VE) of COVID-19 mRNA vaccines by comparing infection rates between those with 3 doses and 2 doses. The study included over 20,000 health care workers from Memorial Sloan Kettering Cancer Center, a large tertiary cancer center in New York City during a period where the Omicron variant was dominant. The results, published in ScienceDirect, found that those vaccinated with 3 doses had a VE of 32.5% versus those with 2 doses confirming that three doses of vaccine provides better immunity from COVID-19 infection than two doses. 

(08/02/2022) Association of Receiving a Fourth Dose of the BNT162b Vaccine With SARS-CoV-2 Infection Among Health Care Workers in Israel
A recent study of Israeli healthcare workers (HWC) found a decrease in breakthrough COVID-19 infections for those that received 4 BNT162b2 vaccine doses (6.9%) versus those that received (3) doses (19.8%). The study, published in the Journal of the American Medical Association’s Open Network, included 29,611 Israeli HCW across 11 general hospitals who had received 3 doses between August and September 2021 of which 18% (5,331) had received a fourth dose by January 2021. This study suggests additional vaccine boosters can be utilized as a tactic to help preserve healthcare operations during future COVID-19 waves.

Health Workforce Shortages

Long-term care workforce shortages could continue until 2026.

New Bureau of Labor Statistics (BLS) data shows thousands of new jobs in hospitals and health systems, yet workforce shortages continue.

The Health Resources and Services Administration (HRSA) was recently awarded over $45 million from the American Rescue Plan Act to develop the public health workforce in rural and tribal communities.

The Centers for Medicare and Medicaid Services (CMS) launched its “Nursing Home 5-Star Quality Rating System” which integrates staffing and turnover data.

Health Workforce Shortages

(08/10/2022) Grim Long-term Care Forecast: 4 More Years Until Workforce Recovers If Help Doesn’t Arrive
According to a report released Monday by the American Health Care Association and National Center for Assisted Living, despite reports of recent monthly gains in the number of long-term care employees, full recovery of the workforce could drag on until 2026 without substantive new assistance. The report also noted that the industry has lost more than 362,000 employees during the pandemic, with 223,700 of those from nursing homes. Among the suggestions made, some were- the need for federal officials to prioritize long-term care with solutions such as student loan forgiveness, CNA to LPN to RN scholarships, and grants to both long-term care operators and universities to provide incentives to create formal partnerships and payment for tuition, a pathway for temporary nurse aids to become certified nurse aids and need for policymakers and stakeholders to work together to address the root causes of the staffing challenges in nursing homes.

08/09/2022) Hospitals and Health Systems Add Almost 13,000 Jobs in July
Hospitals and health systems added 12,900 jobs in July, while US jobs overall increased by 528,000, according to data released today by the Bureau of Labor Statistics. Hospital employment remains over 40,000 below its March 2020 peak but has grown in 19 of the past 28 months for a slow-but-steady job recovery. Total health care jobs grew by 69,600 in July to a seasonally adjusted 16.4 million. While these numbers are promising, hospitals and health systems continue to face workforce pressures and inflationary costs that far exceed revenue growth as the nation recovers from the pandemic.

(08/09/2022) HHS Invests Nearly $60 Million to Address Workforce Shortages and
Increase Access to Health Care in Rural Communities
The Health Resources and Services Administration recently awarded $45.7 million from the American Rescue Plan Act to develop the public health workforce in rural and tribal communities. The grants will help train dental hygienists, medical and dental assistants, doulas and other community health workers; health information technology and telehealth technical support staff; community paramedical workers; and respiratory therapists and care coordinators for patients with long-term COVID-19 effects and chronic medical conditions. In addition to the ARPA grants, the agency awarded $9.7 million to help hospitals and others establish new medical residency programs in rural communities; $2.9 million to improve health outcomes in rural counties; and nearly $1 million to improve access to care for rural veterans.

(08/08/2022) CMS Enhances Nursing Home Rating System With Staffing and Turnover Data
The Centers for Medicare and Medicaid Services recently launched its enhanced “Nursing Home Five-Star Quality Rating System” which integrates data nursing homes report on their weekend staffing rates for nurses and information on annual turnover among nurses and administrators. CMS research shows that higher nurse turnover is associated with lower quality of care. Nurses who have worked at a facility longer are more likely to know residents well enough to recognize small health changes and act before they become larger issues. Similarly, administrators with longer tenures help create stable leadership which can lead to more consistent policies and protocols that are tailored to better serve residents. In January, CMS began posting weekend staffing and turnover rates on Medicare’s Care Compare website. The agency is now incorporating that information into the consumer-friendly Nursing Home 5-Star Quality Rating System. Through this enhancement, CMS will hold facilities to a higher standard and incentivize more robust staffing by strengthening personnel’s impact on overall star ratings.

Health Workforce Resilience

A new study evaluates if demographics and COVID-19 symptoms predicted COVID-19 deaths among healthcare workers in the US.

A recent report explores the experiences of US social workers as essential workers during the COVID-19 pandemic.

A new report examines the exclusion of nurses in debates around public health policy and their lack of representation in media coverage, health care leadership, government, and academic publications, especially during the COVID-19 pandemic.

A Lancet article discusses how violence towards health care staff has worsened and/or become more frequent due to the COVID-19 pandemic and explores new strategies in response to the problem.

Health Workforce Resilience

(08/08/2022) COVID-19 Symptoms and Deaths Among Healthcare Workers, United States
This study analyzed over 6 million laboratory-confirmed COVID-19 cases reported to the Center for Disease Control during January 1, 2020–October 12, 2021 and found 7.02% of cases were in healthcare workers (HCW). The fatality rate of HWC was 0.33% versus 24.64% for non-HCW. The findings, published in Emerging Infectious Diseases, found higher deaths for HCW over the age of 50, male, black, or Asian. In the general US population, there were 3 distinct peaks in deaths; the study found that deaths among HCW also peaked during the first stage but remained low after April 2020.

(08/06/2022) “We Are on the Frontlines Too”: A Qualitative Content Analysis of US Social Workers’ Experiences During the COVID-19 Pandemic
The paper explores the experiences of US social workers as essential workers during the COVID-19 pandemic. A large cross-sectional survey of US-based social workers from June to August of 2020 found the desire for formal and informal recognition of social work as essential/frontline work, the evolving roles of social workers in responses to increased demands, and physical safety and resulting emotional distress were the top themes for respondents. The findings suggest that recognizing and supporting the role of social workers as frontline workers is crucial to the response and recovery from COVID-19.

(08/03/2021) The COVID-19 Pandemic and the Push to Promote and Include Nurses in Public Health Policy
In a recent paper published in the American Journal of Public Health, Jennifer Morone, a nurse and research fellow with the National Clinician Scholars Program at Yale School of Medicine, and colleagues explore the historical, and frustrating, phenomenon of exclusion of nurses from the conversation in debates around public health policy and their lack representation in media coverage, health care leadership, government, and academic publications. The paper called COVID-19 as “an exemplar of nursing’s invisibility” and gave recommendations and practical tools to tackle this underrepresentation and increase nursing visibility and influence in public health policy at the individual, community, systems, and national levels such as – embedding structural competencies, health policy curricula and value of media presence and visibility within nursing education; establishing interdisciplinary collaboration opportunities between schools of medicine, pharmacy, social work, and public health; leveraging of nurses’ existing leadership, communication, and advocacy skills by community health organizations and health systems; expanding pathways for nurses to conduct policy-relevant and action-oriented research and increasing the number of doctorally prepared nurses engaged in the health policy process.

(07/30/2022) Violence Against Health Workers Rises During COVID-19
A new joint study by the International Council of Nurses, the International Committee of the Red Cross, the International Hospital Federation, and the World Medical Association and published in The Lancet has found that the violence against the country’s healthcare workers is endemic regardless of the country’s security situation. Out of the 120 responses received to the 31-question poll from May to July, 2021, the report found that of those organizations who had received reports of violence, 58% respondents perceived an increase. International Council of Nurses Chief Executive Officer Howard Catton said concrete action was needed to end the impunity for those who are violent. The survey shows the importance of improving relations between health personnel and patients and family members, with most participants suggesting training in communication skills as an effective measure for de-escalating potentially violent situations. Despite the persistent presence of violence, practical solutions do exist. The report highlighted successful strategies from Bulgaria, Columbia, Italy, Portugal, and Taiwan which could be implemented globally.