School of Medicine, University of Connecticut, Farmington, CT, USA.
Yale School of Public Health, New Haven, CT, USA.
Infect Control Hosp Epidemiol. 2024 Jul;45(7):804-807. doi: 10.1017/ice.2024.62. Epub 2024 Jun 5.
Throughout the COVID-19 pandemic, many areas in the United States experienced healthcare personnel (HCP) shortages tied to a variety of factors. Infection prevention programs, in particular, faced increasing workload demands with little opportunity to delegate tasks to others without specific infectious diseases or infection control expertise. Shortages of clinicians providing inpatient care to critically ill patients during the early phase of the pandemic were multifactorial, largely attributed to increasing demands on hospitals to provide care to patients hospitalized with COVID-19 and furloughs. HCP shortages and challenges during later surges, including the Omicron variant-associated surges, were largely attributed to HCP infections and associated work restrictions during isolation periods and the need to care for family members, particularly children, with COVID-19. Additionally, the detrimental physical and mental health impact of COVID-19 on HCP has led to attrition, which further exacerbates shortages. Demands increased in post-acute and long-term care (PALTC) settings, which already faced critical staffing challenges difficulty with recruitment, and high rates of turnover. Although individual healthcare organizations and state and federal governments have taken actions to mitigate recurring shortages, additional work and innovation are needed to develop longer-term solutions to improve healthcare workforce resiliency. The critical role of those with specialized training in infection prevention, including healthcare epidemiologists, was well-demonstrated in pandemic preparedness and response. The COVID-19 pandemic underscored the need to support growth in these fields. This commentary outlines the need to develop the US healthcare workforce in preparation for future pandemics.
在整个 COVID-19 大流行期间,美国许多地区都经历了与各种因素有关的医疗保健人员 (HCP) 短缺。特别是感染预防计划,由于工作量不断增加,而没有特定的传染病或感染控制专业知识,几乎没有机会将任务委托给其他人。在大流行的早期阶段,为重症患者提供住院治疗的临床医生短缺是多方面的,主要归因于医院为 COVID-19 住院患者提供护理的需求不断增加,以及休假。HCP 短缺和后期激增期间的挑战,包括与奥密克戎变异相关的激增,主要归因于 HCP 感染以及隔离期间和照顾 COVID-19 家庭成员(尤其是儿童)的相关工作限制。此外,COVID-19 对 HCP 的身心健康产生的不利影响导致人员流失,这进一步加剧了短缺。在急性后期和长期护理 (PALTC) 环境中的需求增加,这些环境已经面临关键人员配备挑战,包括招聘困难和高离职率。尽管个别医疗保健组织以及州和联邦政府已采取行动缓解反复出现的短缺问题,但需要开展更多工作和创新,以制定长期解决方案,提高医疗保健劳动力的弹性。那些具有感染预防专业培训的人,包括医疗保健流行病学家,在大流行准备和应对中发挥了至关重要的作用。COVID-19 大流行凸显了支持这些领域发展的必要性。本评论概述了为未来的大流行做好准备,需要发展美国医疗保健劳动力。