Doctors, nurses, infectious disease experts and hospital leaders have united in warning Americans against traveling or gathering in large groups for Thanksgiving, a US holiday traditionally marked by bringing extended family and friends around a dinner table.
Experts and frontline workers are fearful such events will cause an explosion of new Covid-19 cases, which could overburden hospitals struggling to recruit nurses amid an “exponential” rise in cases.
“Looking at the landscape right now and the number of people who are still set on having larger, multi-household, in-person Thanksgiving dinners, one can only assume that the current trend of new Covid cases will continue to increase,” said Dr Iahn Gonsenhauser, chief quality and patient safety officer at Ohio State University’s Wexner Medical Center.
If people move forward with such Thanksgiving plans, Gonsenhauser anticipates it would extend the public health crisis “to the point of requiring strict lockdowns just in time for the Christmas holiday”. Several experts said they had canceled plans and limited their own celebrations strictly to members of their own household.
“In the strongest possible terms, we urge you to celebrate responsibly,” the American Hospital Association, American Medical Association and American Nurses Association said in an open letter to the American public. The letter urged Americans to have “scaled-back” celebrations, and to wear masks, wash hands and social distance.
“We must protect the doctors, nurses and other caregivers who have tirelessly battled this virus for months,” the letter said. “You can do your part to ensure they can continue to care for you and your loved ones.”
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November 19, 2020
The letter echoed guidance from the US Centers for Disease Control and Prevention (CDC), which urged Americans not to travel over the holiday in its first public briefing since August. “We’re alarmed with the exponential increase in cases, hospitalizations, and deaths,” Dr Henry Walke, Covid-19 incident manager for the CDC said.
The period in the leads up to Thanksgiving has proved to be one of the most trying periods of the pandemic. More than 11.5 million Americans have been diagnosed with Covid-19, more than 250,000 have died, and more than 76,000 are hospitalized, according to the Johns Hopkins University coronavirus resource center and the Covid tracking project.
The warnings come as a minority of Americans still plan to gather large groups for the holiday according to surveys, amid a surge in cases that has gripped the upper midwest and spread out to much of the country.
A recent poll conducted by Wexner Medical Center found most Americans have adjusted holiday plans, but two in five still plan to attend gatherings of more than 10 people. One-third said they would not ask people to wear masks.
“Some people are still saying it’s fake news,” the nation’s top infectious disease expert Dr Anthony Fauci told Kaiser Health News. “That is a very difficult thing to get over: why people still insist that something that’s staring you right in the face is not real.”
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November 18, 2020
Gatherings of just 10 people can be extremely risky, especially risky in hotspots of the country. In Ward, North Dakota, where Minot is the largest city and which is now experiencing a surge, there is a 76% chance someone who is Covid-19 positive would attend a gathering of 10 people, according to a real-time risk assessment tool developed by researchers at the Georgia Institute of Technology.
“Back when Covid was on the decline during the summer months, and we felt we were headed in the right direction, we made plans to drive to Colorado,” said Gonsenhauser. “We canceled those plans. We will be connecting with others via our phone, our tablet, or our laptop.”
Gary Young, an expert in health policy at Northeastern University, said hospitals are already facing staffing shortages and extreme financial pressures from the pandemic, evidenced by hospital closures and layoffs at a time of unprecedented demand.
“There are still many hospitals, particularly in rural areas, that are going to be overwhelmed,” said Young. “The preparation is not as robust as areas that really experienced a surge in the spring.”
“Right now, we’re seeing really all-time highs in terms of demand in intensive care units all across the country,” said Parth Bhakta, founder and CEO of NurseFly, an online jobs platform for traveling nurses. “It’s significantly higher than what we saw in the early days of the pandemic, when we saw a huge amount of need in the New York area.”
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.@TheAtlantic obtained critical hospital staffing data from HHS, and as reported by @alexismadrigal, >35% of hospitals in 8 states are facing staffing shortages: More than 35 percent of hospitals in AR, MO, ND, NM, OK, SC, VA, and WI. https://t.co/2NjqyChLJE
November 18, 2020
Covid-19 appears to be causing a kind of vicious circle of staff shortages. Increasing Covid-19 cases causes hospitals to reduce profitable services, such as elective (but medically necessary) surgeries. That causes a “financial jolt” to hospitals, according to Young. At the same time, many regular nurses and doctors – once applauded daily – have faced burn out, political attacks and the validity of their experiences questioned.
Some traveling nurse jobs are now paying three times the average weekly pay a year ago, with traveling ICU nurse positions paying $6,000 per week or more, according to NurseFly. Although average pay is far lower, $2,246 per week, it is still up 28.3% on average pay in 2019.
Alongside increased pay and staffing shortages, at least seven nursing strikes have occurred nationally just through September, according to Beckers Hospital Review. Many included demands for better personal protective equipment, which runs short as cases surge.
“We’ve seen so many of these people that are somehow trying to link asking to wear a mask to stripping of freedom,” said Gonsenhauser. “But this is a civic duty – it’s a patriot responsibility we’re being asked to take up – and I don’t remember that was the last time that was removing one’s freedom.”
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