US coronavirus hotspots desperately seek trained medical staff
In New York, hospital beds are being set up in Central Park, inside a vast conference centre, and on a military vessel moored off Manhattan. Across the US, carmakers are producing ventilators, distilleries are making hand sanitiser and tailors are sewing face masks.
But another shortage is proving harder to address: the dearth of medical workers to treat coronavirus patients. An emergency alert — usually used to warn of hazardous weather or track missing children — appeared on every New Yorker’s phone on Friday night, asking healthcare workers to volunteer to help.
Demand for doctors and nurses with experience in emergency departments and intensive care units has soared in recent weeks as the pandemic has spread. “There is not enough of anything,” said William Jaquis, president of the American College of Emergency Physicians.
As an acute shortage of medical staff begins to take its toll in New York, the epicentre of the outbreak in the US, mayor Bill de Blasio on Friday proposed a draft of healthcare workers.
Speaking on MSNBC, he called for a “national effort to enlist doctors, nurses, hospital workers of all kinds and get them where they are needed most”.
He added: “I don’t see, honestly, how we’re going to have the professionals we need to get through this crisis.”
The Pentagon said on Friday that it was “well prepared” to help with logistics if there was a mass volunteering of doctors from around the country to help with the fight against the pandemic. If called upon, such a command and control role could involve flying volunteer medics from their home airports to coronavirus hotspots, starting with New York.
The US has fewer physicians per capita than hard-hit countries such as Italy and Spain, with 2.6 per thousand people compared with 4 and 3.9, respectively, although it has more nurses, according to the Kaiser Family Foundation, a healthcare policy think-tank.
To address the problem, hospitals in the hardest-hit states are scrambling to recruit clinicians from those with fewer Covid-19 cases, and retraining staff who work in other fields of medicine. About 80,000 retirees have volunteered to return to work in New York, on top of more than 1,000 military medics.
Requests for critical-care nurses have risen 250 per cent in a month and vacancies for respiratory therapists have soared 400 per cent, according to Vizient, a staffing provider. There has also been a surge in demand for cleaners and nursing assistants.
How many more staff may be needed will depend on how much of the country coronavirus devastates — and how many healthcare workers become infected and have to stay at home.
Steven Corwin, chief executive of New York Presbyterian, the city’s largest healthcare system, said staffing was the “nub of the problem right now”.
He said there were 600 coronavirus patients in intensive care at New York Presbyterian, where everyone from radiologists to surgeons were being diverted to treat them. The problems were compounded by 400 of his clinicians being exposed or infected with the virus and having to stay at home.
“We’ve tried to hire extra people. We’ve had a little amount of success, not a huge amount of success,” Mr Corwin said. He is relying on clinicians learning extra skills as they work. “There’s just not enough time to put people in a classroom for two or three weeks.”
The White House, which has been criticised as slow to procure supplies, has not put in place a plan to channel staff to the worst-affected states. The federal government has waived licensing requirements, allowing doctors to practice in other states, but only some have taken steps to accept other states’ licences.
Ashish Jha, director of the Harvard Global Health Institute, described the situation as “haphazard”.
“What would be ideal would be an office out of the White House, coordinating medical staff and working with states to relax rules about licensure,” he said.
The decision to support the hardest-hit areas has been left to individual clinicians. Amit Phull, a clinician and vice-president of Doximity, a social network for doctors, said he was torn between flying to New York to help and preparing for what is to come at his own hospital in Chicago.
“These are personal decisions to think about where and when my involvement would be most impactful,” he said. “There’s a pull in myself to stay at my institution and help when the problem gets there.”
Andrew Cuomo, New York governor, has appealed to medical workers in other states: “We need help. We will pay you. And more importantly, we will return the favour.”
Staffing agencies are seeking to entice workers to New York with higher pay, hotel rooms and benefits from free meals to paying family members for childcare.
But the surge in “hazard pay” may challenge some hospitals, which are financially stretched because more profitable elective procedures have been cancelled. The $2.2tn federal coronavirus relief bill allotted $100bn for hospitals, but it is unclear how it will be distributed or when it will arrive.
Nursefly, a marketplace for temporary healthcare work, said more than 1,200 nurses signed up to work in New York last week, up more than 1,000 per cent from the same period in February. Pay for a temporary registered nurse was up 73 per cent in March, compared with January.
Michael Fazio, chief executive of Prime Staffing, a nursing agency, said he had 4,500 openings in emergency rooms and intensive care in New York. Nurses were flying in from across the country, some taking vacation time to do so, he said.
Another worry is that shortages of personal protective equipment could exacerbate staffing problems by exposing more medical workers to the virus. Clinicians have died in the US, as have medical staff in other countries. Nurses in New York have protested outside hospitals about the rationing of masks.
It is also not just well-paid doctors and nurses who are at risk.
Rob Baril, president of Service Employees International Union’s district 1199 in Connecticut, said that lower-paid workers in long-term care facilities were also putting their health on the line by working without proper protection.
“People are not going to risk their lives for $13, $14, $15, $16 an hour,” he warned.
Additional reporting by Katrina Manson in Washington