“The thing I am most worried about is the psychological and the emotional preparedness or readiness (of staff),” Gilpin said. “A lot of our staff are still fried. We’ve all been working extra hard even since COVID slowed down in Michigan.
“We all know it is inevitable there is going to be another surge and nobody’s really taken a lot of time off to break from this mentally. So if we were to get hit again with another big wave, I think the amount of burnout you’d see among staff would be significantly greater than what we saw back March in April.”
The health care workplace has long been known for its long hours, demanding pace and emotional intensity. Hospitals have tried to put in safeguards to address burnout and post-traumatic stress disorder caused by long-term stress reaction, but shortages of workers brought on by COVID-19 created almost impossible circumstances.
Jeff Desmond, M.D., Michigan Medicine’s chief medical officer, said the academic health system learned many lessons from the initial COVID-19 surge.
“If we see increasing cases, and we are not seeing a big bump in hospitalizations now, we have our supply chains ready to respond,” Desmond said.
Michigan Medicine, which includes the University of Michigan Health System’s three Ann Arbor hospitals, accepted more than 300 COVID-19 transfers from metro Detroit hospitals in addition to its own patients.
“Every hospital was challenged with PPE, but we never ran out. We have a more detailed and rigorous way of supplying (PPE) than we did in the past,” said Desmond. “Our hospital early on required masks for all. We have continued that policy for PPE for the pandemic.”
The three health systems also have much greater ability to test patients and employees for COVID-19 testing ability for staff and patients.
“We have in-house (virus diagnostic) testing and also serology (antibody) tests now,” Desmond said. “We test all patients who come into hospital whether symptomatic or not.”
Riney also said Henry Ford has more experience setting up COVID-19 intensive care units and shifting staff around from ambulatory to inpatient to maximize patient support.
“We have very specific triggers as to what priority we would use to expand ICU capabilities if demand exceeded supply (on) a hospital by hospital basis,” said Riney, adding: “Our clinical teams have continued to learn and evolve the best way to take care of and treat COVID patients.”
But hospital officials say if COVID-19 hospitalizations start to spike again, they must take action to manage that influx along with thousands of patients they now have in their hospitals for elective surgeries and procedures that were postponed.
As Michigan set aside executive orders to stay-at-home and nonessential medical procedures in mid-June, hospitals began to ramp up services that are now between 60 percent to 80 percent of pre-COVID volume.
“We are in midst of that planning” to manage a more mixed patient population, Desmond said. “We can be a little more nuanced for services with cases and do more testing. We cohort those (COVID-19) patients and manage those and elective cases. We will see what decisions need to be made and adjust more nimbly as things progress.”
Gilpin said Beaumont has since closed its COVID-19 ICU units, but could “flip a switch” and activate them again if the volume of coronavirus patients increase.
“We are managing things on a site by site basis, looking at capacity and judging if they have the bandwidth to performing elective surgeries or not,” Gilpin said.
Riney said he hopes citizens wear masks and take common-sense precautions to avoid spreading COVID-19.
“We’ve run models that relate to (another COVID-19 wave) and what elective surgeries we would start to curtail,” he said. “We just hope to avoid the wholesale shutdown of elective surgeries or other care because as we’ve all learned that prolonged deferment of care too long and ended up with more complicated situations.”