Industry Voices—Hospitals and their communities cannot afford pandemic fatigue

With COVID-19 cases surging in more than three-quarters of states, and with the flu and winter holiday seasons rapidly approaching, we are growing increasingly alarmed about the potential for the pandemic to overwhelm emergency departments and intensive care units at essential hospitals—the hospitals that serve the uninsured, low-income and minority patients most impacted by the pandemic.

In hopes of preventing a dangerous surge, America’s Essential Hospitals, a national association of more than 300 hospitals with safety net missions, including Valleywise Health in Phoenix and Zuckerberg San Francisco General Hospital and Trauma Center in San Francisco, is reaching out to speak with one voice directly to the communities we serve.

We are asking residents to resist pandemic fatigue and continue to be vigilant with the preventive actions we know work: Wear a mask, wash your hands and watch your distance.

Unfortunately, that message has become routine and, for many, ignored. But it takes on new meaning when we hear it from front-line healthcare workers who too often find themselves holding a phone up to a dying patient for one last video call with family.

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These healthcare workers wear masks all day and, in videos from member hospitals around the country, are talking about how the simple act of wearing a mask can help prevent the suffering they see each day. Finding new ways to share and emphasize prevention messages is critical for essential hospitals. COVID-19 is straining resources and capacity of these hospitals and having a devastating and disproportionate impact on the underrepresented populations they serve.

We want to make sure people understand how individual decisions like wearing a mask can impact the entire community. Reckless behavior can make vulnerable people sick and overwhelm the healthcare systems that serve their communities.

America’s Essential Hospitals’ members are already seeing bed shortages in some states and daily case counts equaling or surpassing previous surges in the spring and summer. Many essential hospitals live with severe financial constraints in the best of times and are particularly at risk of being overwhelmed by new surges of COVID-19. Many of these mission-guided hospitals and healthcare systems do not have the reserves to purchase the equipment and hire the staff needed to confront another wave of COVID-19 patients.

While all healthcare systems have experienced financial strain, essential hospitals often lack the capital reserves many for-profit and other large systems rely on to weather difficult times. Adding to the strain, the low-income racial and ethnic minorities we serve are at higher risk because they are more likely to work in essential jobs that can’t be done from home, or their households rely on a single breadwinner who cannot afford to stop working.

In addition, many live in multigenerational households where isolation and social distancing are difficult. People we serve also suffer higher rates of chronic conditions, such as hypertension and diabetes, and are more likely to require hospitalization and intensive care due to COVID-19. They also may live in neighborhoods with different cultures and languages that make it harder to access health information.

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As people become weary of adhering to precautions to prevent the spread of the virus, we likely will see a decline in prevention and a corresponding increase in the number of COVID-19 patients hospitalized. We cannot afford to let this pandemic fatigue take over.

Our healthcare workers say it best. Krista Murphy, an RN in the intensive care unit at St. Luke’s Health System, an essential hospital in Boise, Idaho, said that after dealing with dying COVID-19 patients every day, it is troubling to hear that people don’t want to wear masks or even believe that COVID-19 is a real threat.

“It’s not a way you want to live, but right now this is where we are, and we all need to take a certain level of precaution. Wearing a mask is such an easy thing to do to protect your loved ones and your community.”

Susan Ehrlich, M.D., is CEO of Zuckerberg San Francisco General Hospital and Trauma Center and chair of America’s Essential Hospitals. Steve Purves is president and CEO of Valleywise Health, a public health system serving safety net patients, and chair-elect of America’s Essential Hospitals.