Week Newsletter 35

12/02-12/08 Updates

Surge Capacity Strategies

Record-breaking COVID-19 cases and hospitalizations lead to fears of the impact of cold weather and holiday gatherings in the weeks to come.

Health providers becoming sick or exposed to COVID-19 are straining hospital capacity and staffing capabilities.

Emergency field hospitals are opening across the US.

Surge Capacity Strategies

(12/05/20) US Sets New Daily Coronavirus Record With Nearly 228,000 Cases
Record-breaking case numbers for COVID-19 are becoming increasingly common, following Friday’s daily tally of nearly 228,000, more than 10,000 higher than the previous record tally set the day before. The Centers for Disease Control and Prevention is encouraging citizens not to travel for the upcoming holidays to avoid overwhelming hospital systems.

(12/05/20) ‘Extraordinary Acceleration’: Takeaways From the Pandemic Last Week
For the first time since April, daily death tolls from COVID-19 across the nation are reaching record levels. Hospitals are experiencing record breaking patient loads nearly everywhere in the United States, with increasing fear of a “Thanksgiving surge” on the horizon.

(12/04/20) Montana Nurse Describes How Coronavirus Pushes Rural Health Care to Its Limits
In this story from Here & Now, a nurse in Montana describes the impact of COVID-19 on rural health care providers, who are stretched thin treating unprecedented patient levels. With limited patient beds and staff available, sick workers are coming back to work as soon as they are able to continue patient treatment, even when not fully recovered.

(12/04/20) What Happened When the Only ER Doctor in a Rural Town Got COVID
This article highlights the impact of COVID-19 infection on rural hospitals, which often do not have resiliency to meet the demands of surges of cases and hospitalization. The example of the small town of Cheyenne Wells, Colorado, where the only emergency room physician at a small rural hospital became ill with COVID-19, requiring a physician to travel 10 hours from Texas to cover some of the shifts.

(12/03/20) ‘We’re All Tired Of This’: Health Care Workers In Seattle Prepare For Another Surge
This story from NPR discusses the new routines of health care workers treating patients with COVID-19, which are increasingly straining in preparation for continued cases and hospitalizations. Intensive care unit beds are filling up and providers are fearful of the difficulties to come.

(12/03/20) NYC Hospital Workers, Knowing How Bad It Can Get, Brace for COVID 2nd Wave
Members of the New York State Nurses Association are fearful of the strain and staffing shortages in hospitals across New York City, even as health leaders and city officials express they feel much better prepared to meet any surge that comes in the coming weeks and months.

(12/03/20) Quarantined Health Workers Compound Staffing Shortages at California Hospitals
As intensive care units in California are approaching maximum capacity, difficulty maintaining adequate staffing levels is becoming more apparent. While hospitals are confident they have the bedspace needed, they are less confident in their ability to meet workforce needs to treat patients in those beds.

(12/02/20) CDC Director: Winter Could Be ‘Most Difficult Time in the Public Health History of This Nation’
The head of the Centers for Disease Control and Prevention, Dr. Robert Redfield, has called for uniformity and harmony in messaging to prevent 200,000 deaths from COVID over the winter months. With over 90% of hospitals at risk of reaching maximum capacity, mitigation strategies are being encouraged as the best tool against further cases, hospitalizations, and deaths.

(12/02/20) US Hospital Use Surges; California Case Record: Virus Update
This update from Bloomberg provides some information on the hospitalization and new case trends for COVID-19. California is currently experiencing record-breaking increases in both cases and hospitalizations.

(12/02/20) As Hospitals Fill With COVID-19 Patients, Medical Reinforcements Are Hard to Find
This article from Kaiser Health News outlines the challenges being faced in hospitals across the United States as hospitalizations for COVID-19 continue into record territory. Due to the number of hospitalizations increasing across the country, there is limited availability to move staff across state lines, as may be utilized in previous emergencies to maintain hospital capacity.

(12/01/20) Rhode Island Doctor Discusses Running Field Hospital Amid Fall COVID-19 Surge
With field hospitals opening in many places across the country to meet the needs of increasing cases and hospitalizations for COVID-19, Here & Now interviewed Dr. Paari Gopalakrishnan, who is running a field hospital in Cranston, Rhode Island, about what field hospitals are enabling in the pandemic.

Policies and Guidelines

Health care systems are staggering schedules to vaccinate their workforce while maintaining staffing requirements.

Hospitals continue to hire, long-term care facilities are experiencing job losses, and travel nurses are in extremely high demand.

Sexual and reproductive health care providers are adapting their practices to meet the needs of their patients in the pandemic environment.

Policies and Guidelines

(12/04/20) Health Systems Eye Staggered Schedule and End-of-week COVID-19 Shots to Mitigate Workforce Shortages
Health systems across the United States are preparing for receipt of the first batches of COVID-19 vaccines, requiring strategic scheduling and prioritization for employment inoculation. Workforce shortages are already a reality throughout the nation, with fear that side effects of COVID-19 vaccines could sideline more workers leading to these new strategies.

(12/04/20) 46,000 Healthcare Jobs Added in November; Hospitals See Job Gains
The latest jobs report from the United States Bureau of Labor Statistics indicates an increase in health care jobs in November, with hospitals seeing the largest increase. Nursing homes and residential care facilities experienced losses in jobs last month amidst the pandemic.

(12/03/20) Hospital demand for travel nurses intensifies as COVID-19 surges: 5 notes
This update from Becker’s Hospital Review highlights the current demand for traveling nurses in hospitals across the United States. Traveling nurses have been used to meet capacity demand in states such as Utah, Delaware, Illinois, and Hawaii.

(12/02/20) How OBGYNs Adapted Provision of Sexual and Reproductive Health Care During the COVID-19 Pandemic
In this issue brief from the Kaiser Family Foundation, the ways in which sexual and reproductive health care providers have adapted their practices in response to the COVID-19 pandemic. Integration of telehealth, declines in patient volume, and difficulties with finances and staff are all key findings.

Maintaining the Educational Pipeline

Medical schools across the US are reporting substantial rises in applications amidst the pandemic.


Physicians in academic medical centers share their experiences working through the Thanksgiving holiday.

Maintaining the Educational Pipeline

(12/07/20) ‘Fauci Effect’ Drives Medical School Interest as US Faces Physician Shortage
Medical schools across the United States are reporting substantial rises in applications, with the Association of American Medical Colleges reporting an 18% increase in 2020 compared to 2019. This article from NPR covers the change.

(12/04/20) Thanksgiving on the Front Lines: Doctors Working the Holiday Share Stories of Grief, Stress, and Hope
With cases and hospitalizations for COVID-19 rising across the United States, more health care providers are needed to treat patients during the holiday season. In this article from AAMCNews, physicians from academic medical centers share their experiences working through the Thanksgiving holiday in the COVID-19 pandemic.

Health Workforce Safety

A federal advisory committee has authorized the first available doses of a COVID-19 vaccine for health care workers and long-term care facility residents.

Difficulty acquiring personal protective equipment continues to burden smaller health care clinics and hospitals.

Many health care worker deaths are not being reported to state and federal authorities by the worker’s employer.

Health Workforce Safety

(12/01/20) Health Care Workers, Nursing Home Residents to Be Prioritized for COVID-19 Vaccine
This article from NPR covers the vote from a federal advisory committee at the Centers for Disease Control and Prevention that authorized the first doses of COVID-19 vaccination to go to health care workers and residents of long-term care facilities.

(12/01/20) The PPE Crisis Didn’t Go Away: Across the US, Grassroots Supply Networks Are Trying to Fill the Void
This article from STAT highlights the continued struggles smaller health clinics across the United States are experiencing to acquire personal protective equipment. Large hospitals and health care systems are better able to find supply lines, leaving smaller facilities at significant disadvantage.

(11/30/20) OSHA Let Employers Decide Whether to Report Health Care Worker Deaths. Many Didn’t.
Analysis of health care worker deaths in the Lost on the Frontline series from Kaiser Health News and The Guardian found that more than one-third of a 240-person sample of health care workers who died of COVID-19 did not have their deaths reported to a state or federal agency by their employers. Employers are required to report these worker deaths to the Occupational Safety and Health Administration, yet some employers claimed they could not prove COVID-19 infection occurred in the workplace and did not report the deaths.


The recent evolution of telehealth technology and services is being evaluated.

Federal agencies are continuing to expand the telehealth services available for reimbursement in response to widespread adoption and utilization.

Fears of infection from patients are leading some to avoid treatment, with telehealth as a potential alternative to maintain continuity of care.


(12/07/20) What Is Telemedicine, and How Has it Evolved During the Pandemic?
This opinion piece published in Forbes covers the background of telehealth services and how the COVID-19 pandemic has changed the way telehealth technology is used. Telemedicine has seen widespread adoption as an alternative to traditional in-person services.

(12/04/20) The Risks of Moving Health Care Delivery to the Internet
This opinion blog post published in Health Affairs compares the advantages and disadvantages to the movement of health care services to internet-based modalities. Since the COVID-19 pandemic began, there has been significant movement from traditional services to telehealth and other electronic, virtual-based services.

(12/04/20) HHS Expands COVID-19 Telehealth Capabilities in PREP Act Amendment
This article covers a new amendment to the Public Readiness and Emergency Preparedness (PREP) Act from the United States Department of Health and Human Services. This amendment aims to ease the regulatory burdens on health care providers seeking to provide telehealth services to patients across state lines.

(12/03/20) Survey: Make Telehealth a Regular Part of Care Management
A new survey from Luma Health finds that patients’ fear of COVID-19 infection may be keeping them away from in-person visits with their health care providers. Telehealth services are suggested as an alternative to help keep patient care on track.

(12/02/20) CMS Adds 60+ Services to Medicare’s Telehealth List in Final Rule: 7 Details
In this update from Becker’s Hospital Review, some new changes to the Centers for Medicare & Medicaid Services 2021 Physician Fee Schedule are listed, with impacts on telehealth services. More than 60 new services are added to the list of reimbursable services, potentially increasing access to patients.

(12/01/20) A Shifting View on Telemedicine
A palliative medicine and critical care doctor writes about the way in which patient and medical perception of telemedicine use has changed, both before and throughout the pandemic, in this piece published by The New York Times.

State Workforce Strategies

Hospitals in Wisconsin have joined the list of states asking staff to return to work during their quarantine period to address staffing shortages.

The governor of New York announced the state’s winter plan to address COVID-19 including boosting workforce capacity and enabling patient transfers to hospitals across regions.

Callifornia is seeking to test all staff members weekly for COVID-19 in acute care hospitals.

State Workforce Strategies

(12/02/20) Strained Wisconsin Hospitals Asking Staff to Return to Work During Quarantine
Hospitals in Wisconsin are resorting to requesting staff to return to work earlier in their quarantine process after potential exposure to COVID-19. The change to protocol comes as 40% of hospitals in Wisconsin are reporting critical staffing shortages and are reaching critical capacity.

(11/30/20) Governor Cuomo Announces Winter Plan to Combat COVID-19 Surge in New York State
New emergency hospital procedures have been announced from New York Governor Andrew Cuomo. These procedures are encouraging hospitals to prepare to boost workforce capacity through bringing in retired health care workers, as well as coordinating transfers for patients to other facilities statewide.

(11/30/20) California Urges Hospitals to Test All Workers for Virus
New guidance released by the California Department of Public Health urges all acute care hospitals to test all staff members for COVID-19 weekly, beginning the week of December 7. All health care workers deemed to be high risk must be tested, including doctors, nurses, students, volunteers, administrative workers, and food service workers in a hospital setting, regardless of their status as paid or unpaid.