An ambulance leaves Lakewood Regional Medical Center, Thursday, July 8, 2021. Photo by Brandon Richardson.

Six months out from the peak of the single greatest medical crisis in a generation, medical workers are still tired and burned out, local hospital leaders say. But despite the more aggressive and dangerous delta variant now the most dominant version of COVID-19 in the state, health care professionals remain cautiously optimistic that the worst is behind us.

“The health-care industry, our hospital, really stepped up to the challenge,” said John Bishop, CEO of Long Beach Memorial. “In so many ways, we’re a much stronger organization and industry than we were pre-pandemic.”

While the pandemic pushed staff to learn, adapt and collaborate, they paid a toll, Bishop said. Memorial recently conducted a survey of its staff, which found that employees are proud of the work they have done over the past 16 months but they are exhausted.

Even before the pandemic, burnout was rampant in the health industry. According to a paper published by the National Academy of Medicine in 2017, more than half of U.S. physicians and 43% of nurses were experiencing burnout. From 2011 to 2014, the prevalence of burnout increased 9% among physicians while other professions remained stable.

Since the onset of the pandemic in March 2020, one in four health care workers have considered leaving their job, according to a Morning Consult poll published in January, the height of the pandemic. About one in 10 health care workers resigned.

To combat burnout, Bishop said the hospital has made a host of resources available and asked staff to look out for one another should a coworker be showing signs of distress. The hospital’s spiritual care department for staff has been very active, Bishop said, adding that the hospital hosts weekly events. Employees are also being encouraged to take time off, Bishop said.

“There’s a sense of responsibility that caused people to probably take less vacation,” Bishop said. “They realize how important their work is and how much it matters. It was really inspiring to see.”

But despite the efforts by hospital leadership and the pride felt by staff, the pandemic was an extremely challenging time. The survey indicated there is a portion of staff considering transitioning into a different field and others are contemplating early retirement.

At Lakewood Regional Medical Center, COVID-19 brought on a higher number of early retirements and staff leaving the organization, according to CEO John Grah. Staffing has rebounded somewhat but the hospital continues to hire in clinical areas as patient volumes ramp back up, Grah said.

Emergency department patient volumes at Memorial are trending upward but remain about 20% below pre-pandemic levels as people continue to delay doctor visits, Bishop said. Overall hospital volumes are about 90% of pre-pandemic levels but the patients who do come in are having longer stays because their ailments have been exacerbated by putting off care. These issues are particularly prevalent in pediatrics, Bishop said.

“Parents are understandably very protective of their kids,” Bishop said. “But my fear is that someone would delay their care with an outcome that was otherwise avoidable just because they were scared to come into the hospital.”

Lakewood is having a similar experience, with patients coming in with higher acuity than they should due to delayed care. But volumes are going up and postponed procedures are getting back on track, Grah said.

After having extremely long emergency department and admission wait times throughout the pandemic, Grah said both have returned to pre-pandemic levels. At Memorial, wait times have actually decreased due to fewer patients coming in and the introduction of an expedited “super track” model that greatly improves patient triage and throughput, Bishop said.

Telemedicine remains more prevalent today than before the pandemic, Bishop said, but has declined compared to when the virus was surging most. For now, insurance companies are reimbursing hospitals for telemedicine the same as in-person visits thanks to expanded emergency access during the pandemic.

“We are watching how the regulations shake out over the coming months to understand what its best use in the hospital setting may be,” Grah said. “Clearly people are more comfortable today than we were pre-pandemic with telemedicine. I would expect in the long term we will continue to see a higher usage of telemedicine for outpatient services.”

If telemedicine insurance reimbursement does come back down in the coming months and years, Bishop said he expects it will still remain above pre-pandemic levels.

Another consequence of COVID-19 is a severe blood shortage, according to the American Red Cross. In late June, the organization issued a plea for LA County residents to donate blood for use over the Fourth of July weekend and beyond.

“Summer is traditionally a tight time for the blood supply and it has been aggravated this year by COVID and fewer opportunities to donate blood,” Grah said. “We have implemented the conservation strategies as requested by our blood supplier and to date have not had to postpone any elective surgery.”

The shortage is so critical, the Red Cross is incentivizing residents of all blood types—but especially type O and those giving platelets—to donate. Those who donate by July 31 will receive a $10 Amazon gift card and will be entered for a chance to win gas for a year. Memorial has offered paid time off to staff members who donate, Bishop said.

As a result of the blood shortage, some hospitals have been forced to slow the pace of elective surgeries until the supply stabilizes. Fortunately, Memorial and Lakewood have not had to take such drastic measures.

Despite the continued challenges brought on by the coronavirus, the outlook for the health system is looking up and looking forward, Bishop said. The connection between the community and medical facilities has been strengthened through the trials of the past 16 months, he said.

But both Bishop and Grah continue to advocate for more residents to get vaccinated, noting that it is critically important that society reach herd immunity. As of July 6, 56.7% of Long Beach residents have received at least one dose of a COVID-19 vaccine, according to city data.

“We highly encourage those who have not yet been vaccinated to do so,” Grah said. “But we are cautiously optimistic and believe the worst is behind us.”

Brandon Richardson is a reporter and photojournalist for the Long Beach Post and Long Beach Business Journal.