Health experts fear staffing shortages at Austin-area ICUs as COVID-19 cases increase

Coronavirus Hospitalizations

The governor's office said 2,100 state-contracted healthcare personnel are 'in the process' of deploying

AUSTIN (KXAN) — So far, Central Texas hospitals have enough ventilators, medicine and even physical beds to handle an influx of coronavirus patients. When local health officials talk about nearing “full capacity” at area intensive care units, they are referring to concerns about having enough healthcare workers available to care for incoming patients.

Dr. Mark Escott, Austin-Travis County’s interim health authority, said their epidemiologists are worried area ICUs could fill up as soon as next Wednesday.

Pulmonologist and critical care physician Dr. Shailaja Hayden joined Escott and Travis County Judge Andy Brown on a Facebook Live Tuesday morning, calling the projection “chilling.”

Just weeks ago, Hayden pointed out Austin was accepting ICU patients from other cities, like El Paso. She noted this option may no longer be a feasible solution to assuage staffing concerns.

“Since all our surrounding metro regions are also in bad shape, there may be nowhere to transport anybody, and we may end up in a situation where we have to use less-experienced staff in makeshift rooms, and that’s a nightmare none of us want to come to,” she explained.

Dr. John Abikhaled, president of the Travis County Medical Society, said he shared these concerns.

He said there was one key difference between now and surges they saw over the summer, explaining hospitals in cities like Waco, San Antonio, Dallas and Houston were already seeing major spikes in admissions and ICU cases a few weeks ago. With Austin joining the list while most major cities are experiencing the spike, he said he’s concerned about what sort of surge resources will be available to Austin hospitals.

The Travis County Medical Society keeps a list of volunteer physicians in Central Texas, ready to jump in and help at area hospitals, but Abikhaled said they have not had to call on those volunteers yet. Right now, they are more concerned about having enough respiratory therapists and nurses.

Nurses needed

“It’s a pretty dire situation,” Zolnierek said. “While physicians order treatment and care, it’s the nurse that’s primarily delivering that care and coordinating that care.”

She said they have seen nurses come out of retirement to help fight the virus. More often than not, however, the approach involves moving nurses and staff from other departments within their hospital into critical care units.

“But that can only go so far,” Zolnierek warned. “There does come a point where you don’t have the staff resources to care for all the patients that need care.”

She noted when one nurse is moved, a hospital must “backfill that position.” She also cautioned against having too many medical professionals working in unfamiliar departments, outside their specialty.

Zolnierek also said the state — and some hospitals — are working with staffing agencies to incentivize nurses to come work where the need is especially great. That often involves working five to six long shifts for weeks at a time for a large pay increase.

KXAN reached out to Ascension Seton, Baylor Scott & White and St. David’s HealthCare systems in Central Texas to see if they were offering any incentives to nurses and other healthcare workers.

A spokesperson for the hospital systems said they currently have sufficient staffing and capacity to care for both patients with COVID-19, as well as those with other medical conditions. However, they recognized a spike in cases following “recent holiday gatherings.” They urged the public to follow safety measures now and ahead of the New Year’s holiday to prevent the spread of the virus.

With cases spiking in cities across the nation, Zolnierek said we are reaching a point where “there’s no place to pull from” to bolster staffing if they had to.

Zolnierek went on to say, “We are kind of beyond incentives. I think nurses who are able to work are working. I think it’s not about trying to get more, more out of us — more blood out of the turnip. The issue is we need to reduce the demand for nurses.”

She and Dr. Hayden sent a strong message to the community, begging Austinites to wear masks and stay socially distant from others.

Zolnierek also said the state coordinates volunteer nurses in their efforts to respond across Texas.

More help on the way

Renae Eze, Press Secretary for Gov. Greg Abbott, said the state was “working closely” with local officials in areas experiencing a rise in hospitalizations to provide resources such as medical personnel and supplies.

She said there are more than 9,500 state-contracted health care personnel currently deployed across Texas, with over 2,100 more in the process of deploying.

“The proven course of action is to enforce the existing protocols,” Eze explained. “That strategy was effective in slowing the spread over the summer and containing COVID-19, while allowing businesses to safely operate. The protocols work, but only if they are enforced.”

She pointed to these “mitigation protocols” in El Paso and Midland-Odessa. In Midland-Odessa in particular, she noted more than 18% of their hospital capacity occupied by COVID-19 patients at “its recent peak” on Nov. 23.

“Now, in just a few short weeks, they have reduced that capacity under the 15% threshold,” she said.

Eze then pointed to recent reports regarding bars and clubs in the Austin area being cited for violating COVID-19 guidelines, saying they have “shown a lack of enforcement in Austin.”

“Gov. Abbott continues to urge all Texans to follow the safe practices they mastered in the summer to slow the spread. We’ve slowed the spread before, and we will do it again as we begin to distribute vaccines and anti-body therapeutic medication to protect the lives and livelihoods of Texans,” Eze said.

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