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Melissa Harris-Perry: I'm Melissa Harris-Perry, and this is The Takeaway. COVID-19 infections due to the Omicron variant are slowing nationwide, but some states are still seeing high rates of hospitalizations, like Arizona. There, hospitalizations are up 26% over the past two weeks with a daily average of more than 3,400 people hospitalized. The Omicron wave has overwhelmed hospitals and overtaxed healthcare workers who are in their second year of pandemic response.

Frank LoVecchio: My name is Frank LoVecchio. I'm an emergency physician and public health doctor at University of Arizona and Arizona State University.

Melissa Harris-Perry: Dr. LoVecchio told us about his experience working in the ER in Phoenix, Arizona.

Frank LoVecchio: Right now, we're seeing volumes and people admitted to the hospital very similar to what we saw during the peaks last winter.

Melissa Harris-Perry: What does that mean on a day-to-day basis? It's not like emergency departments are ever calm, peaceful, restful spaces, but when you're in this surge, and certainly it's been two years but it's also been cyclical across those two years, what changes on a day-to-day basis for you and for other team members?

Frank LoVecchio: Right now, I think morale is the worst it's ever been. I think morale picked up once people started to get vaccinated, and we saw that we as healthcare providers were more likely than not not going to die from this. Now we see more and more people come in that are unvaccinated. We also see more people leave the field. We've had major exiters and maybe leave the emergency department, and you might go to another spot in the hospital, which has led to extreme staffing shortages. It's not uncommon for me to walk in any day and if we typically have 12 nurses to work the emergency department shift, we might have just 6. That's a common occurrence.

Before the pandemic, that would almost never happen. We might be too short and that would send off alarm bells of the severity of the situation. Now many times we run it half staffing, patients wait sometimes one day or so to get into a bed upstairs if they're admitted. We also see these people that leave the field, they many times would leave it for non-patient care fields. We can't compete, for example, with psychiatry with a nurse that could do intake for psychiatry many times from Zoom, and she would get paid more because, as you know, there's a shortage of psychiatrists and a shortage of mental health providers.

We also see this great rotation of nurses. I would work at the same place. I had been working at the same place for over 30 years. I know everyone by their first name, usually something about them except for now. The last year or so, every day is something new where there's new nurses. They come from other states. We see nurses from California who are working in Arizona, Arizona nurses working in California. Nobody stays put, and why is that? The attraction is money. If you're willing to work with COVID patients in the emergency department, I can guarantee you a signing bonus, free travel, free food, and whatever you make in one month, I'll give you that salary in one week.

Even the most dedicated nurses have been leaving our place and we see others come in. People can't stay put because we're attracting these traveling nurses, and it's very, very hard for me say as a nurse with 30 years' experience to work side by side with somebody who is a relatively new graduate who is making sometimes double what I'm making, and also getting to stay in a hotel room and get free meals. The same happens with clinicians like doctors and mid-level providers or physician assistants and nurse practitioners, but not as to a major degree as what's happening with nurses. A lot of our shortages are driven by nursing shortage.

Melissa Harris-Perry: Okay. One other layer I want you to talk with me about because I think that is such a helpful insight around what's happening with nurses, give me one more layer of understanding staffing and staffing shortages and morale and hospitals right now because I do think we tend to think of the professional roles like doctors, nurses, maybe physician's assistants. It's my understanding that there is also a shortage in emergency departments and in hospitals, in general, of all of those other support workers from custodial staff to the folks who we might think of as non-professional workers, but who make all of the professional work possible. Is that something that you're seeing in Arizona?

Frank LoVecchio: A doctor like myself would see a patient with COVID. I might go in, order a chest X-ray, I might order some lab work, I might order some other things to be done. What we're seeing then is the radiology tech, the person that takes the X-ray, we usually have three or four. Now we're down to two. The person that does your electrocardiogram, we usually have three or four to help with that. Now we're down to one, and almost every single one of those people that I like to say has closer contact with the patient. I have contact with the patient as a physician, but it's much briefer. These guys are in there. They're cleaning the patient, bathing the patient, putting IVs in them.

They have very, very close contact and almost every single one of them has gotten sick at some time during this pandemic. We always have somebody out. Also, somebody with that degree can work at another hospital for more money. It might be a hospital down the road. It's unfortunate, but there's a big competition keeping folks like that. People who we don't necessarily think about. There's an emergency room doctor who was working on shift. He probably has about 12 to 15 support staff, whether that be nurses, mid-level providers, techs, radiology techs, it takes a village. The doctor is just a very, very small part of it.

Melissa Harris-Perry: Talk to me a bit about the patients. Who are you seeing right now coming in? Are the demographics of the folks you are treating now similar to earlier in the pandemic or has it changed?

Frank LoVecchio: The demographics now are patients who are younger. What I mean by that is it was almost rare to find somebody admitted to the intensive care unit who is over 50 years old when the pandemic first started. Then vaccines hit and now it's the opposite. It's very, very common to have people under age 50 who are in the intensive care unit or admitted to the hospital.

We do local data and local surveillance, and right now when you look at patients who are admitted to the intensive care unit, the numbers for Arizona are the ratio is about 17:1 or 18:1. For every one patient I admit who has been vaccinated, I have about 17 or 18 who are unvaccinated. We see a lot of people who are unvaccinated. I agree the vaccines do not protect a hundred percent, but the main outcome measure or the main thing we looked at when we gave vaccines to people is to prevent you from being hospitalized.

Melissa Harris-Perry: For the last question, what is it you hunt people to know? What do you want our listeners to know and understand about the experiences of hospital workers right now during this part of the pandemic?

Frank LoVecchio: Once COVID made the jump from animals to humans, and we realized that we can pass it from human to human, it's 100% never going to go away. COVID will be in our lives forever. As human beings, COVID will be with us forever. The key is to control it. Have it at a low level, a predictable level, and just maybe have endemic outbreaks. More likely than not everyone is going to have to get vaccinated every year. The more people get vaccinated, the more we can stop these variants from happening.

Omicron is not the last variant that we're going to see. We got lucky with Omnicom because more likely than not it was less severe. What if Omicron was more severe? If it was more severe, we'd see a lot more deaths right now. COVID is here with us. COVID is here with us forever. More likely than not, everyone's going to have to get vaccinated once a year if not more in the beginning.

Melissa Harris-Perry: Dr. Frank LoVecchio who is apparently just framed my afternoon because I will be going out to get every cloth mask that I can find. Thank you for joining us here on The Takeaway.

Frank LoVecchio: Thank you so much. Thanks for having me.

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Melissa Harris-Perry: Give us a call at 877-869-8253, or record your message at 877-869-8253, or you could also send a voice memo to takeawaycallers@gmail.com.

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