Health care workers, public face stress, uncertainty in pandemic’s first year

Of all the changes brought about by COVID-19, among the most prominent has been the impact on hospital and medical staffs battling the pandemic as well as on the mental health of all, from first responder to the average person.

There is little that is the same, comparing life pre-pandemic to now in regards to working at the hospital, said Marian Martin, R.N. and Emergency Department manager at Bonner General Health.

Of its 25 beds, Bonner General has eight rooms set up for COVID-positive patients, with the rest dedicated for labor and delivery, postpartum and acute/critical care. The hospital has seen an increase in sick employees, resulting in staff shortages, and the increase in cases has pushed the Sandpoint hospital to near capacity.

“Overwhelming at times,” Martin described a typical shift. “Although the numbers of patients are similar or slightly less than usual, COVID patient care is much more labor-intensive due to the isolation precautions required.”

She is concerned not only about patient care but also about her co-workers — will she and her co-workers be able to stay healthy so there is enough staff when needed.

“Emotionally, it is wearing, there is no end in sight and how will we do it without enough staff,” Martin said. “There should be a work/life balance and for the staff in the Emergency Department that has been difficult because we are always asking them to work extra.
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Comparing life now to before the pandemic reached U.S. shores a year ago in Washington state, spreading to Idaho by mid-March, and looking toward the future, Martin had a simple message on how to get there: Take care of each other.

“Please wear a mask, just to help your fellow people,” she said. “It is as simple and polite as opening the door for someone. Just do it for the sake of your loved ones. If you don't wear a mask, social distance, and wash your hands frequently to help decrease the COVID cases, there may not be enough staff to care for all patients who are in need of care for all medical needs and illnesses.
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Kevin Knepper, CEO at Kaniksu Health Services, said one of the changes KHS has seen over the past year has been an increase in behavioral health patients as a higher rate of people experience or see increased rates of depression and anxiety.

Before the beginning of the COVID-19 pandemic, there was already a shortage of behavioral health specialists available in the area. At Kaniksu Health, there are currently 12 individuals working in the behavioral health program, he said.

“[That shortage has] been exacerbated. In our depression screenings, depression shows up much more,” he said, “There are more instances of depression being a co-morbidity.”

One silver lining for patients, Knepper said, is that there has been a decrease in no-show rates for people seeking help for mental health problems, because patients suffering from conditions like depression often find it easier to meet virtually than in-person.

“It’s actually led to what I would term better patient access,” he said. “The no-show rate is [usually] super high, because they’re suffering from depression and things that make it harder to show up in-person.”

Health care as a whole has also changed, he said, with moves toward more telemedicine and even more thorough safety protocols. Those telemedicine appointments tend to work well for adult patients, he said, but are more challenging for pediatric care.

Health care professionals have also been struggling with many of the same issues their patients have in addition to working to provide care, Knepper said.

“We’re just burnt out, tired, frayed,” he said. “And then you add how tedious the safety practices are, to make sure you get it right, to make sure you don’t accidentally create a high contact exposure.”

KHS is the largest primary care provider in the area, Knepper said. Because of that, they have been administering many of the COVID-19 tests. That also means that for the individuals running the testing clinics, there’s a high risk of viral spread if thorough safety precautions are not met exactly.

At the beginning of the pandemic, Gov. Brad Little shut down most operations in the state, the the KHS responded in kind, Knepper said.

Eventually, KHS reopened with new safety protocols: Front door screenings, temperature checks and mandatory masks, which proved the most controversial.

Even given those safety measures, one wrong move could mean risking exposure for front-line workers, he said.

“[The testing staff are] seeing anywhere from 40 to 100 positive patients a day,” he said. “It’s tedious.”

Now a year into the pandemic, the uncertainty surrounding COVID-19 has moved from questions about the virus itself to those concerning vaccine rollout, and acceptance.

“Much like the beginning, there was a lot of fog [concerning the virus],” he said. “I think that same fog is around the vaccine now.”

Timelines for vaccine rollouts have been unclear, he said, often changing day-to-day. There is also uncertainty about vaccine acceptance.

“We live in a community where vaccine acceptance may be low,” he said. “That’s something we’re trying to feel out, what levels of supply we have and what level of public acceptance.”

To do that, he said, the KHS health care providers are looking at previous years’ vaccination rates for the flu vaccine. In Idaho, flu vaccinations for adults 18 and older were at 41.4%, according to data from the Center for Disease Control.

Regardless of how popular vaccinations are, Knepper said, achieving herd immunity through vaccinations will be essential if the public wants to return to any semblance of normalcy anytime soon.

“It’s time to do what’s right for the community and not just what’s right for yourself,” he said. “If we don’t have wide acceptance of the vaccine, we’re going to live like this for another year.”