Hospitals address worker shortage as COVID, flu and RSV cases swamp their beds

Published on: November 23, 2022 1:58 PM EST|Updated on: November 23, 2022 3:29 PM EST

A healthcare worker prepares a dose of the COVID-19 bivalent booster at the start of a vaccination campaign for people 80 years and older, in Santiago, Chile, Wednesday, Oct. 26, 2022.

LifeBridge Health has raised its minimum wage for the second time in two years in an effort to recruit and retain workers in hospitals and clinics that continue to be strained by the coronavirus pandemic — and now face a large number of cases of other respiratory viruses, including flu and RSV.

The infections have prompted repeated calls from hospital and state health officials for the public to get flu shots and COVID-19 boosters and take extra precautions to prevent unnecessary trips to the emergency room. The requests take on new urgency as people travel and gather during the holidays.

The pay hikes at LifeBridge, and just about every hospital in the state, show that officials don’t expect the crush of cases and general workload to abate anytime soon.

Wages have increased by about 25% at Maryland hospitals since the start of the pandemic in early 2020, according to the Maryland Hospital Association.

“This is on top of the vast majority of hospitals who are already at or above $15 per hour minimum wage,” said Nicole Stallings, executive vice president and chief external affairs officer for the association. “Despite these actions, our hospitals continue to face significant shortages.”

LifeBridge, which includes Sinai, Northwest and Grace hospitals in and around Baltimore, raised the minimum wage to $16 an hour, citing workers’ “valuable contributions” and the “high-demand market.”

Hospitals and health systems employ about 110,000 people in Maryland.

The increase in minimum wages, announced in the past year by several hospital systems, including Johns Hopkins Medicine and the University of Maryland Medical System, reflect the need to attract and keep support staff who do jobs like clean rooms and deliver meals.

But there are shortages among higher-paid medical workers too, particularly nurses. The association has reported that one in four nursing positions is vacant in hospitals. Some nurses have left the profession, become sick themselves, or joined temp agencies that in some instances pay significantly more — another burden for the hospitals that use them.

The number of COVID-19 patients has dropped from the pandemic high above 3,300 in January, but hundreds remain hospitalized with the virus. There currently are 418 people hospitalized with COVID-19, according to state health data. Eight are children.

A just-launched RSV dashboard from the Maryland Department of Health shows the respiratory syncytial virus has been a particular problem this year, largely for children. The virus, common in cold-weather months, normally hits children hard, and officials have said that they began seeing cases during the summer.

There is now an unusually high number of hospitalizations, which has caused hospital systems to move patients around the state and even out of the state for care. It has also caused long wait times in the emergency departments.

There are currently 129 people hospitalized with the RSV, down from 256 just weeks ago. That brings some relief to the hospitals, though the level remains far higher than it’s been in the past few years, likely due to pandemic precautions. There were 44 hospitalized this time last season and 59 the season before.

Despite the drop in RSV cases, infectious disease experts at Sinai say we have “not turned a corner” with the virus. Cases nationally remain high and people should take the warning ahead of holiday travel. People should take extra steps, like frequent hand washing and staying home if they are sick.

“At Sinai Hospital, while we have seen some decrease in cases on our general pediatric inpatient unit, our pediatric intensive care unit, PICU, remains full,” said Sharon Boston, a LifeBridge spokeswoman. “RSV remains a serious concern and there are still too many cases. With the upcoming holidays, please be sure not to kiss or hold babies if you are sick, as babies are more likely to have a more severe infection.”

Older children also are becoming sick because they have not yet had the virus. Boston said the experts advise parents to know where the nearest hospital with a PICU is located when traveling.

Sinai and state officials also are encouraging people to get flu shots and COVID-19 boosters, or what they call a “flooster,” since the inoculations can be done at the same time. The state recently reported that officials had dispensed 1 million bivalent boosters, those with protections against the original and the omicron COVID-19 variants, which would mean one in six Marylanders had gotten the shot that new federal research shows is modestly better at protecting people from symptomatic infections.

But it’s RSV that has gotten the recent attention because of the strain on pediatric units across the state.

State officials say RSV symptoms show up within four to six days after infection: runny nose, decrease in appetite, coughing, sneezing, fever and wheezing. Flu normally includes aches, fever and fatigue. There is an antiviral medication to lessen the severity of flu and antibiotics for secondary bacterial infections, though hospitals have reported these have been in short supply.

Officials say to seek medication attention for children who have trouble breathing, are not drinking enough fluids or have worsening symptoms from any of the viruses.

Flu cases also are “very high” according to a voluntary reporting system in Maryland. There were 224 people hospitalized with influenza in the week ending Nov. 12. Two adults have died so far this season.

“Maryland has seen an early surge of severe respiratory illness, especially in very young and school-age children,” said Dr. Jinlene Chan, MDH Deputy Secretary for Public Health Services. “Many children recover at home within a week or two, but others can get seriously ill and require hospitalization.”

Many pharmacies and primary care doctors, as well as local health departments, are offering the flu and COVID-19 vaccines. There is no RSV vaccine available yet. Some clinics can be found at marylandvax.org.