CSA News

Health care worker deaths surged during delta. How to keep them safer during omicron: Analysis

Jan 03, 2022
The omicron variant has now been detected in all 50 states. While more will be known about omicron in the near future, the toll the new variant is taking on an already taxed health care system is of concern now.

The omicron variant has now been detected in all 50 states. While more will be known about omicron in the near future, the toll the new variant is taking on an already taxed health care system is of concern now.

Take a look back at what the delta surge did to the health care workforce (defined by Centers for Disease Control and Prevention (CDC) as paid or unpaid workers who are exposed to patients or infectious materials) – many of them suffered burnout, had grueling workloads due to staffing shortages and non-COVID care was impacted.

The challenges are beginning to mount with staffing shortages because of omicron infections, and in some parts of the country hospitals are being strained.

Statistics from the CDC contain a pretty striking fact: seven of the 10 deadliest weeks for health workers during the pandemic occurred after July 2021. This was an inflection point in which we had rising cases of delta, more than 30% unvaccinated Americans, kids returning to school along with employers reopening offices in some parts of the country.

Deaths from COVID-19 at the beginning of the pandemic weren't surprising. It was a new disease, we were learning, and vaccines were not available. Personal protective equipment (PPE) was in short supply. Our knowledge of how to treat people was limited.

But then, as expected, holiday travel subsided and more importantly, vaccines became had more available and had even wider uptake with employee mandates. The number of deaths dropped.

Until late summer of this year, that is. Fewer than five health care workers died of COVID in early June of 2021. But during the first week of August 2021, the number shot up to 70 and a week later it was 85. In September, the number of health care workers dead from COVID spiked to 109.

Some experts say the rise in COVID-related health care worker deaths correlated with school reopening in the fall and the rise in the delta variant.

At over 18% of reported cases, health care workers continue to bear a significant brunt of COVID disease burden in the country. Continued exposure to infection including to higher risk unvaccinated people means increased risk to our critical healthcare workforce, said John Brownstein, Ph.D., an epidemiologist, chief innovation officer at Boston Children's Hospital and an ABC News contributor.

We don’t know the vaccination status of healthcare workers that have died but unequivocally the evidence suggests vaccines are highly protective against sever disease, hospitalizations and deaths.

Health care workers were at the front of the line for COVID vaccines. And sure enough, once they began to get vaccinated, their risk for death dropped precipitously.

But late summer correlated with six months after most health care workers would have gotten their initial shots. Last summer, Pfizer BioNTech, one manufacturer of COVID vaccines, reported that real-world evidence from Israel, one of the first countries to roll out a nationwide vaccination program, showed a decrease in efficacy about six months after people were fully vaccinated.

"Vaccination protection is waning," said Dr. Asha Shajahan, a family physician who practices in Grosse Pointe, Michigan. "The majority of people have had two vaccinations, but evidence supports the notion that protection from vaccines decreases over time."

Based on this information, we can take concrete steps to keep COVID-related deaths among health care workers low and improve working conditions during the pandemic. Here's how we can do that:

1. Don't go backward on vaccine mandates. Earlier this month, some of the largest hospital systems in the country dropped their vaccine mandates, citing the high cost of labor and uncertainty about whether the mandates will survive judicial review.

Hospitals, more so perhaps than any other employers, have an obligation to keep everyone inside their walls safe and healthy.

2. Booster shots should also be available to all—and mandated in all health care delivery settings. Both the FDA and CDC agree that all adults who have gotten vaccinations should get a booster, which reinforces immunity to the virus.

Data from LA County showed 20-fold increased protection with a booster compared to four-fold increase without, compared to unvaccinated, said Dr. Atul Nakhasi, a physician and policy advisor with the Los Angeles County Department of Health Services.

"Boosting and continuing the normal contact precautions continue to be the most effective way to curb the spread of omicron," said Dr. Sunny Jha, an anesthesiologist who has treated COVID patients in Los Angeles and member of the #ThisIsOurShot leadership team.

3. Health care systems must support the well-being of their workers. Long before the COVID pandemic first showed up, health care workers were known to be burned out and suffering. Doctors and other health care staff are often expected to be available 24/7, leading to an unhealthy work-life balance.

But since the pandemic began, clinician burnout has skyrocketed.

COVID continues to pose a threat to the health care system itself.

Dr. Shikha Jain, an oncologist with the University of Illinois Hospital & Health Sciences System, warned that a surge in COVID-19 cases and staffing shortages caused by health care workers who have left the medical field or are sick themselves is creating "a perfect storm."

"Our communities are still getting sick and pretty soon we won't have health care workers to take care of them," said Jain.

Health systems can alleviate burnout by giving health care workers mental health days to recoup after major surges in virus-related illnesses, Shajahan said.

She said that in Michigan, in the early days of the pandemic, "the National Guard was very helpful in relieving health care workers who were already so burned out."

Physicians are trained to look at numbers: heart rate, blood pressure, temperature. And that's why we have started looking at how many of our colleagues are dying from COVID. The spike we saw this fall was alarming. But it's also a reminder that, by taking specific measures and continuing to get unvaccinated Americans vaccinated, we can turn the tide and make work in health care safe for everyone.

A surge also means unnecessary loss of life among our frontline healthcare workers, added Brownstein.