Staffing shortages fueled by the latest COVID-19 surge are forcing some health care employees and first responders in Marin to continue working despite being infected themselves.
“It’s definitely a last resort,” said Dr. Matt Willis, the Marin County public health officer. “You’re really trying to pick the lesser of two evils.”
The California Department of Public Health issued an advisory on Jan. 8 saying the fast-spreading omicron variant has caused “critical staffing shortages” in the health care field.
As a result, the department said, health care workers who have tested positive for COVID-19 and are asymptomatic may return to work immediately without isolation and without testing. The department said health care workers who have been exposed and are asymptomatic may also return to work immediately without quarantine and without testing.
Infected and exposed healthcare workers who return to work were instructed to wear N95 respirators. The order extends through Feb. 1.
Willis said that in addition to hospital workers and paramedics, the order applies to employees at long-term care centers, where most of the COVID-19 deaths in Marin have occurred. Willis said Marin hospitals and nursing homes have already followed the directive.
“The decision is made on a day-by-day basis,” Willis said regarding Marin’s three main hospitals.
Willis said some long-term care centers have staffed asymptomatic COVID-positive workers “on certain days where they otherwise wouldn’t be able to maintain minimum staffing levels.”
Willis said there are 56 Marin nursing homes where either patients or workers have recently tested positive.
“There have been no evacuations,” he said. “That is the biggest concern around our long-term care facilities. If they’re not able to staff to minimum levels, they might need to transfer residents to another facility.”
Willis said the “general rule” at both Marin hospitals and nursing homes is that asymptomatic COVID-positive workers are to be assigned to care for COVID-19 patients.
The state’s move was denounced by the California Nurses Association/National Nurses United.
“Gov. Newsom and our state’s public health leaders are putting the needs of health care corporations before the safety of patients and workers,” said Cathy Kennedy, the association president.
John Bagala, president of the Marin Professional Firefighters union, said, “It absolutely does not work for the fire service. We have communal living spaces. There is virtually no way for a COVID-positive firefighter to not directly expose other firefighters in the workplace.”
In Marin, firefighters are also responsible for providing paramedic service.
“I don’t know if anybody is letting the public know if they’re getting serviced by a firefighter who is COVID-positive,” Bagala said.
Bagala said 20% to 30% of his union’s members had recently either tested positive for COVID-19 or had direct exposure to someone with the virus. The union represents all 10 of Marin’s fire agencies and has 430 members.
Bagala noted that Marin firefighter/paramedics are transporting patients from convalescent homes and San Quentin State Prison, which recently instituted a lockdown because of another outbreak. As of Sunday, the prison reported 153 new cases among inmates in the last 14 days.
Willis said the county public health office recently managed to secure a supply of rapid antigen tests for Marin’s first responders so they can determine if they are COVID-positive. Willis said one reason the state decided to allow health care staffers to return to work without testing is a shortage of such tests.
Bagala, however, said firefighters are not happy about the increasing reliance on rapid tests instead of PCR tests, which take much longer but produce more reliable results.
“Many of our people have young children who are not yet vaccinated at home,” Bagala said. “They have loved ones who may be immunocompromised or have comorbidities.”
Willis said that Marin hospitals have not canceled elective procedures as they did during previous COVID-19 surges. But he said they are developing criteria for when they might take that step.
Kaiser doctors in Marin have sent messages to their patients urging them to delay non-urgent medical needs, such as a routine checkups or non-COVID vaccinations, until late February or March.
“The surge of new infections nationally is the steepest we have seen since the start of the pandemic,” Kaiser said in a company statement. “We are using all options available to maintain hospital and ambulatory care staffing so we can meet the needs of our patients. Some of these measures include employing traveling nurses, adjusting elective and non-urgent surgeries and procedures as needed, and offering our industry-leading telehealth capabilities in addition to in-person care.”
MarinHealth Medical Center has not asked infected employees to come to work, said Dr. Karin Shavelson, the hospital’s chief medical officer.
“We have not canceled surgeries and are not asking patients to delay care at this time,” she said.
Joanne Webster, chief executive of the San Rafael Chamber of Commerce, said some city businesses have cut their hours because of staffing shortages caused by employees becoming infected or exposed.
Webster said some local businesses cut their workforces late in the holiday season because of slower sales caused by the virus surge and are being cautious to prevent remaining employees from being sidelined.
Deputy Justin Swift, president of the Marin County Deputy Sheriff’s Association, voiced a stoic outlook regarding the latest chapter of the pandemic.
“It’s hard to get too excited when we’ve been dealing with this for a couple of years now,” Swift said. “I wish we could work from home, but our job can’t be from home. I understand that.”