10 Secrets of Epidemiologists

A female doctor looks at a test tube

Unless you know an epidemiologist or are one yourself, those “disease detectives” might not have occupied a very large portion of your brain. Before 2020, that is. Now, with the coronavirus pandemic still at the top of mind—and at the top of so many headlines—there’s a good chance you’re at least aware that epidemiologists study diseases.

To be more specific, the Centers for Disease Control and Prevention (CDC) defines epidemiology as “the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.” So what exactly does this mean? Mental Floss spoke with a few epidemiologists to shed light on what they do, how they do it, and which germ-friendly foods they avoid at the buffet.

1. People often mistake epidemiologists for skin doctors.

Since the word epidemiologist sounds like it might have something to do with epidermis (the outer layer of skin), people often think epidemiology is some offshoot of dermatology. At least, until the coronavirus pandemic.

“Prior to that, no one knew what I did. Everyone was like ‘Oh you’re an epidemiologist—do you work with skin?’” Sarah Perramant, an epidemiologist at the Passaic County Department of Health Services in New Jersey, tells Mental Floss. “I would be rich if I had a dollar for every time I got asked if I work with dermatologists.”

2. Epidemiologists don’t discover a new disease every day.

Though some epidemiologists do look for unknown diseases—certain zoonotic epidemiologists, for example, surveil wildlife for animal pathogens that might jump to humans—most are dealing with diseases that we’re already familiar with. So what do they do every day? It varies … a lot.

Epidemiologists who work at academic or research institutions undertake research projects that help determine how a disease spreads, which behaviors put you at risk for it, and other unknowns about anything from common colds to cancer. But it’s not just about devising experiments and studying patient data.

“I like to tell my friends and family that my job is about four different jobs in one,” Dr. Lauren McCullough, an assistant professor in the department of epidemiology at Emory University’s Rollins School of Public Health, tells Mental Floss.

Writing, she says, is “the most important part.” It includes requesting grants, devising lectures and assignments, grading her students’ work, writing about her research, and more. She also sits on admissions committees, reviews other epidemiologists’ studies, and oversees the many people—project managers, data analysts, technicians, trainees, etc.—working on her own research projects.

Those who work in the public health sphere are often monitoring local outbreaks of diseases like the flu, Lyme disease, salmonellosis, measles, and more. If you test positive for a nationally notifiable disease (any of about 120 diseases that could cause a public health issue), the CDC or your state health department sends your electronic lab report to the epidemiologist in your area, who’s responsible for contacting you, finding out how you got sick, and telling local officials what steps to take in order to prevent it from causing an outbreak.

3. Epidemiologists have to make some uncomfortable phone calls.

Epidemiologists sometimes have to ask pretty personal questions about drug use and sexual activity when trying to figure out how someone got infected, and not everyone is happy to answer them. “I’ve gotten hung up on many a time,” Dr. Krys Johnson, an assistant professor in Temple University’s department of epidemiology and biostatistics, tells Mental Floss.

Some simply aren’t willing to accept that they might have been exposed to a disease without knowing it. After several employees at a certain company tested positive for COVID-19, for example, Perramant started calling the rest of the workers to tell them to go into quarantine; this way, she could prevent sick people who weren’t yet showing symptoms from spreading the disease without knowing it. But not everybody was open to her advice. “They would just swear up and down, ‘I haven’t been in touch with anybody who’s positive, please don’t call me again,’” Perramant says.

But there are plenty of cooperative people, too, especially victims of foodborne or diarrheal illnesses. “They really want to know where they got sick because they’re so miserable that they never, ever want to deal with that again,” Johnson explains. Parents of sick kids are also generally forthcoming, since they want to keep their kids healthy in the future. And then there are those who don’t have any problem spilling their secrets to a stranger.

“There was one woman who was very memorable,” Johnson says. “I called her about her Hepatitis C, and she was like, ‘Oh, honey, I did drugs back in the ’80s. That’s where I got my Hepatitis C. I pop positive every time!’”

4. Epidemiologists deal with a lot of rejection.

Public health epidemiologists have to learn to just shrug off all the rude tones and dial tones, and epidemiologists in academic settings need thick skin for different reasons.

“There’s just a lot of rejection,” McCullough says. “‘That idea isn’t good enough; this paper isn’t good enough; you’re not good enough.’ That is just a resounding thing. There’s a high bar for science; there’s a high bar for federal funding; and it takes a lot to cross that bar. So in the academic setting at these top-tier institutions, you really just have to have a thick skin.”

5. Just because epidemiologists’ guidelines change doesn’t mean they’re wrong.

Sometimes, McCullough explains, the story of a disease can change over the course of one study. When you look at the first 100 people in a 10,000-person study, you’ll see one story emerge. By the time you’ve seen 1000 people, that story looks different. And after you’ve seen the data from all 10,000 people, the original story might not be accurate at all.

Usually, epidemiologists can complete the whole study of a disease and draw conclusions without the world clamoring for half-baked answers. But with a brand-new, highly infectious disease like COVID-19, epidemiologists don’t have that luxury. As they’ve learned more about how the pathogens spread, how long they can survive on surfaces, and other factors, they’ve changed their recommendations for safety precautions. Everyone else in the world of epidemiology expected this to happen, but the general public did not.

“If we say something this week that contradicts what we said last week, it’s not that we were wrong,” Johnson says. “It’s that we learned something between those two time points.”

6. Being an epidemiologist would be easier if people kept better track of their behavior.

Often, people omit vital information about how they got exposed to an illness because they just don’t remember all the details. You could easily recall devouring a few slices of the decadent chocolate cake your mom baked for your birthday last Friday, but you might not be able to name every bite of food you ate on a random Thursday three weeks ago.

“People aren’t telling us the whole truth, but it’s not that they’re being intentionally obtuse,” Johnson explains. “With recall bias, unless there’s a reason for us to really remember, we’re not going to remember everything we actually ate.”

This has made it especially difficult to trace an aerosolized disease like COVID-19.

“All my friends going into the Fourth of July were like, ‘Should we have a get-together?’” Perramant says. “And I said, ‘You can have people over, but you better take an attendance list. You better have a little spreadsheet on Google Drive that has every person’s name and their phone number, so that when one person tests positive and gets sick this week, when I call you, you will be able to give me that information like that.’”

7. Epidemiologists have reason to be wary of buffets, cruise ships, mayonnaise, and cubed ham.

Infectious disease epidemiologists may have accepted that germs are a part of life, but they also know where those germs like to congregate.

“I don’t go to buffets, I have never been on a cruise ship and I don’t intend to, I’m super conscientious when I fly,” Johnson says. “And I’m really aware of whenever mayonnaise-based things are put out at family functions. If you’re ever at a potluck and people come down sick, the first thing people say [they ate] is potato salad or egg salad, because mayonnaise can spoil so quickly.”

“[Cubed ham] is one particular microbe’s very favorite thing to multiply on, so if you’re gonna have ham, make it a whole ham,” she says.

8. Teaching people is a really rewarding part of being an epidemiologist.

In addition to actually leading lectures in the classroom, academic epidemiologists also work extremely closely with their students on research projects; McCullough estimates that she’s in contact with hers at least once a day when they’re collaborating on a study.

“To work with someone so closely, and to watch them progress as a scientist and as a person, and then to have to let them go and send them out into the world, I find that very rewarding,” McCullough says of her trainees. “As a scientist in an academic institution, there’s not a whole lot of immediate gratification. Our papers get rejected, our grants don’t get funded, but the trainees are always a source of immediate gratification for me, so I hold them close to my heart.”

Epidemiologists in other spheres have teaching opportunities, too. When a community experiences a disease outbreak, public health epidemiologists like Perramant are responsible for helping the general public understand what they can do to prevent the spread.

“I like to teach kids about infectious disease and infection prevention for what’s relevant to them. We’ve had a couple of large outbreaks at summer camps, and last summer I put together a training for camp counselors,” Perramant says. “That’s always a part of my job that I really love.”

9. Epidemiologists have a unique understanding of racial disparities.

At this point, it’s exceptionally clear that COVID-19 is disproportionately affecting people of color in the U.S. They’re more likely to be exposed to it, they have less access to testing, and the preexisting conditions that place them at a higher risk can be the result of systemic racism. When these trends started to become apparent, McCullough got flooded with phone calls asking why. Her answer? This isn’t new. As she’s seen in her work as a breast cancer researcher, Black women are more likely to die of that disease than their white counterparts, and similar health disparities exist across the board.

McCullough explains that the general public is finally realizing what epidemiologists already knew: That poor disease outcomes in minority, low-income, and rural populations aren’t because of anything those people are doing on an individual level. Instead, it’s a result of systemic issues that keep them from leading financially comfortable, healthy lifestyles with access to healthcare and other resources.

“It’s not just COVID—it’s almost every single chronic and infection ailment that’s out there,” McCullough explains. “So this is a real opportunity for people to step back and take an assessment of where we are in terms of our healthcare system, and what we’re doing so that everybody has equitable outcomes. Because people shouldn’t die just because they live in a rural area, or just because they’re poor, or just because they’re Black or Hispanic.”

10. They’ve had to deal with a lot of “armchair epidemiologists” lately.

Until this year, epidemiologists had to suffer through people mistaking them for dermatologists. Now, during the coronavirus pandemic, people finally know at least a little about their jobs. In fact, people are so confident in their newfound epidemiological knowledge that many are fancying themselves experts on the subject.

“At the beginning of 2020, there were like 500 epidemiologists, and now there are about 5 million. Everybody thinks they’re an epidemiologist,” McCullough says. “There’s a science to it, and it’s a science that requires training. We went to school for a really long time to be doctorally trained epidemiologists.”

It’s not just about advanced degrees, either. Beyond that, you need years of firsthand experience to grasp all the nuances of understanding methods, interpreting data, translating your findings into recommendations for the general public, and so much more. In short, you can’t just decide you’re an epidemiologist.

Perramant has her own analogy for the recent influx of self-proclaimed epidemiologists: “It’s like armchair psychology. Poolside epidemiology now is a thing.”

By: Ellen Gutoskey

Source: 10 Secrets of Epidemiologists

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How China Disciplines Its Tech Barons

Chinese internet giants have become compliant parts of the regime they promised to disrupt. For Tencent’s Pony Ma and other tycoons the future is fraught. In April 2022, a resurgence of Covid spread seemingly unchecked through the financial centre of Shanghai. The government imposed a strict lockdown, confining millions to their homes, triggering mass-testing on a scale unseen since the initial outbreak and outraging affluent urban residents who were increasingly sceptical about China’s Covid-zero policy.

In an attempt to control public opinion, the government told social media sites including WeChat – the super-app used by two-thirds of China’s population – to wipe and scrape posts deemed negative or critical of the policy. But the censorship backfired. There was an unprecedented public outcry, which became a virtual protest. A video documenting the dire fallout of lockdown began circulating online.

The six-minute clip known as Voices of April – a montage of audio recordings encompassing the cries of babies separated from parents during quarantine, residents demanding food and the pleas of a son seeking medical help for his critically ill father – resonated with the tens of millions in Shanghai and more across the country. The video was quickly marked as banned content and taken down from social media platforms in China. On the Twitter-equivalent Weibo, even the word “April” was temporarily restricted from search results.

Many deemed the video a neutral yet essential documentation of the human toll of Shanghai’s lockdown. A backlash ensued, as defiant users repeatedly shared the video in ways that could dodge web censors. Some posted the video upside down, others superimposed words or images or embedded other footage. WeChat censors tried to wipe posts sharing the video, but it was like a multi-headed hydra: no sooner did one get blocked, than another would pop up.

This seminal moment embodied the dynamics between the Chinese government and the country’s giant tech companies. On the frontline was Tencent, the entertainment and tech conglomerate that owns WeChat. For the better part of three decades, Beijing tolerated and even celebrated entrepreneurship. As the country leapfrogged into the digital age, China produced one company worth $1bn every 3.8 days in 2018, just a year after Tencent overtook Facebook to become the fifth largest company in the world.

The amount of money Chinese-focused venture and private equity funds raised grew nearly fourfold to $120bn. That bounty helped China transform from industrial backwater into one of the most dynamic and coveted markets on the planet. In addition to generating revenue, companies such as Tencent complied with government orders when it came to monitoring its citizens. For an authoritarian regime ruling over a population scattered across an area almost as large as the US, an app that dominates every facet of life proves enormously useful.

Some say WeChat should be called WeCheck, such is its capacity for mass surveillance. The early days of Chinese tech also saw the construction of the Great Firewall of China. One in five people on the planet using the internet access it through a filter that obscures Facebook, Twitter, Snap, Instagram, the New York Times and YouTube. In a sense, it’s a parallel universe, where nearly a billion people live and thrive – much to westerners’ surprise – on China’s equivalent of such mainstays. There’s Meituan for Deliveroo, Didi Chuxing for Uber, WeChat for WhatsApp and Facebook.

The services are often even better in terms of convenience and design. The Swiss army knife of a super-app, WeChat is the most deft at merging the functions of various western platforms, allowing people to chat, shop or order a takeaway. Domestically WeChat is known as Weixin, and the company has made a point of emphasising that it operates as two apps within and outside the mainland. China’s deficit of privacy controls means its companies and government have an edge when it comes to collecting the data that empowers the algorithms that screen, monitor, name-shame and, sometimes, imprison its citizens.

The dynamics between Chinese tech companies and the authorities are like no other. Before the pandemic I sat down once with an official and talked about the vicissitudes that startups and entrepreneurs endure. “No matter what kind of hotshot you are, we will always have a way of showing you who’s boss,” the person said, making an offhand remark about Tencent’s owner, Pony Ma. “Don’t think because you control a billion users and moved to Singapore or some overseas country that we can’t do anything about you.”

The official told me that when regulators felt Tencent needed to be taught a lesson, they would step up censorship efforts, block or shut down web services till the company got the message. The tactics were not always conspicuous. Given WeChat’s overseas ambitions at the time, they would sometimes disrupt its service for global users, delaying messages or transactions for just half a minute. “That small hold-up is more than enough to drive users crazy and make people ditch the app altogether,” the person said. “That’s how you show them some colour.”

The Wall no longer resides just within China. When Chinese people travel outside the country, the Wall follows them via their telecom providers. A person using a China Mobile sim card is barred from roaming on Google. Authoritarian nations in Africa, south-east Asia and Russia see the appeal of the model. They too want to create their own intranet. As the internet splits in two, aligning itself between the American and Chinese models, Tencent’s story offers a window into an alternative vision of what the global online sphere could become.

Tencent’s products are so convenient and intuitive; yet in the back of everyone’s minds is the knowledge that their every move, location and utterance is documented and potentially scrutinised. Nowhere is this contradiction more apparent than at Tencent’s headquarters, in the heart of southern Shenzhen’s hi-tech district.

Tencent’s office building took five years and more than half a billion dollars to construct. Ma handpicked NBBJ, the architect responsible for Amazon, Google and Samsung’s headquarters. But the billionaire wanted it to be more than a statement of financial largesse. With its twin gleaming towers of glass and steel, he turned the building into one of the world’s biggest laboratories for new internet services and connected devices. It features holographic tour guides, conference rooms that adjust temperatures based on attendance, and alerts for the best parking spots before commuters arrive.

What struck me was that within the halls of a building that serves as a towering paean to futurism and commerce, the Communist party’s influence is omnipresent. In its open-plan reading room, alongside books about the cosmos and the ancient Greek and Roman empires, Chinese President Xi Jinping’s book – tabulating his speeches and thoughts about how to govern – features on the most prominent shelves. QR codes in the gym bring up links to stories documenting battle victories during the Long March.

Even these demonstrations of loyalty are not enough. Common sense would suggest that the Communist party would be supportive of companies such as Tencent and encourage their expansion overseas. But Xi has chosen to make sure the aspirations of a rising class of immensely wealthy entrepreneurs are tamed before they turn political. It was only a matter of time before he went after these national champions.

A crackdown that started with the financial technology industry in 2020, has quickly expanded to engulf every sector from online education to gaming, and ride-hailing to food delivery. With footprints in all of these sectors via its investments in some 800 companies, Tencent has felt the pinch.

Despite Pony Ma’s reputation for being the most low-key and cautious of Chinese tech moguls, Tencent has not been spared. China halted its app rollouts for about a month in late 2021, has curtailed gaming time for those under 18, ordered an overhaul of its financial units, fined it for investment deal disclosure violations and suspended new game approvals this year.

The change in approach to the tech sector is underpinned by shifts in Xi’s priorities. It mirrors crackdowns in other sectors, including property. As China’s economy slows and Xi tries to increase the nation’s birthrate, the policies underscore the Communist party’s growing resolve to respond to mounting public dissatisfaction with hoarded wealth and narrowing avenues for advancement.

A phrase that has emerged in tandem with the crackdowns is “common prosperity”, which refers to China’s goal of becoming a modernised socialist society. The implications for China’s tech industry are far-reaching, and could shape the playbook for the next few decades.

There’s a Chinese saying “Li yu tiao long men” – “a carp leaping over the dragon’s gate”. Legend has it that if the carp manages to swim upstream and vault an arch atop a waterfall on the Yellow river, it transforms into an Oriental dragon, a snake-like creature symbolising imperial power. The story of China’s internet tycoons, like Pony Ma, for the past two decades is that of a generation of carp becoming dragons. The twist, though, is that these idealistic geeks, who ventured out to change the world, are now shackled and have become part of a system they wanted to change. Once self-made dragons have achieved the level of success they have in China, the more important question seems to be: when and how do they bow out unscathed?

Source: ‘We show hotshots who’s boss’: how China disciplines its tech barons | Internet | The Guardian

Related contents:

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06:01
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Manufacturing in China started to improve in May after the country lifted coronavirus lockdowns that shut down China’s richest and most populous city of Shanghai, as well as other industrial areas, according to an official survey released Tuesday.

The Purchasing Managers’ Index of the National Bureau of Statistics of China’s manufacturing industry jumped from 47.4% in April to 49.6% this month on a 100-point scale. Numbers below 50 reveal activity contracting.

New orders, exports and employment all improved during the month of May. More businesses in Shanghai are allowed to reopen this week after COVID-19 outbreaks were considered by the government as under control.Other industrial centers like Shenzhen and Changchun were also forced to shut down this spring due to the coronavirus, which disrupted the cities’ manufacturing and trade.

Tuesday’s data shows that “activity has started to rebound as containment measures were rolled back,” Capital Economics’ Sheana Yue said in a report, adding that the recovery “is likely to remain tepid amid weak external demand and labor market strains.”

More businesses in Shanghai, China’s most populous city, are being allowed to reopen this week after outbreaks were deemed to be under control. Other industrial centers including Shenzhen in the south and Changchun in the northeast also were temporarily shut down, disrupting manufacturing and trade.

Chinese President Xi Jinping is zeroing in on the ties that China’s state banks and other financial stalwarts have developed with big private-sector players, expanding his push to curb capitalist forces in the economy.

Source: China manufacturing begins to rebound as COVID-19 restrictions ease | Fox Business

In April, China’s industrial groups posted their biggest profit decline in two years, the latest sign of economic and corporate woes caused by a wave of coronavirus lockdowns. Industrial profits fell 8.5% in April from the same period a year earlier, the biggest drop since March 2020, when China was also engulfed in restrictions to deal with the initial outbreak of the virus.

The cutbacks are increasing pressure on the government, which is pushing to maintain its zero-Covid policy to eliminate infections through mass testing, lockdowns and quarantines. The strategy is a priority for President Xi Jinping this year as he seeks an unprecedented third term in office, but its rising economic costs pose a serious threat to the country’s 5.5% growth goal by 2022.

Official data last week showed a drop in overall activity in April at a time when Shanghai, China’s financial center, was closed and residents were chained to their homes. Retail sales, an important indicator of consumption, fell 11%, while industrial production also fell. Unemployment hit 6.1 percent, the highest level in two years. The lockdowns are estimated to have affected dozens of cities and hundreds of millions of people. Restrictions are also being put in place in Beijing, which reports dozens of cases daily.

The latest outbreak in China was centered mainly in Shanghai, where about 63,000 infections have been reported and where many residents are still staying at home. Officials stressed the need for a rapid citywide response to the highly contagious Omicron variant. Zhu Hong, senior statistician at the National Bureau of Statistics, said the outbreak “had a big impact on the production and operation of industrial enterprises” in April, adding that profits fell by 22% for manufacturing companies in particular.

The authorities, which had already eased monetary policy in response to last year’s real estate liquidity crunch, have taken other steps to support the economy. Last week, China’s mortgage lending rate was cut for the second time this year. Analysts at Goldman Sachs pointed to the impact of “high raw material costs” on industrial profits, in addition to supply chain disruptions caused by Covid lockdowns at manufacturing centers.

“We expect further policy easing on the fiscal front to stimulate demand, given the downward pressure on growth and the uncertainty of the pace of recovery from the Covid disruption,” they said.

An Omicron Surges Spark Chain Reactions That Strain US Hospitals Everywhere

Registered nurse Nvard Termendzhyan, center, sets up a table for Linda Calderon, right, as her twin sister Natalie Balli, far left, rests in her bed in a Covid-19 unit at Providence Holy Cross Medical Center in Los Angeles, California, on December 13. The sisters were admitted to the hospital on the same day, a few days after their Thanksgiving gathering.Jae C. Hong/AP 

America’s hospitals and their workforces have reached and exceeded their breaking points in the last two years — and another surge of Covid-19 is already underway.

Earlier this month, with a new wave of Covid-19 cases looking likely after the omicron variant was identified, Rhode Island emergency doctors wrote their state leaders to warn that any new surge of patients would “lead to collapse of the state health care system.” In Kansas, patients in rural hospitals have been stuck in the ER for days while they wait for a transfer to a larger hospital with the capacity and resources to care for them.

With the fast-spreading omicron variant now upon us, some of the rhetoric around the pandemic has changed. Government officials, starting with President Joe Biden, are pointedly differentiating between the risks for vaccinated and unvaccinated people. This could create the perception that some places face more of a risk than others: Perhaps omicron will threaten rural communities (where vaccination rates are lowest) and their health systems, but perhaps more vaccinated cities and their hospitals will be better off.

Such thinking would be misguided. As convoluted and sometimes siloed as the US health system may seem at times, it is still a system. Patients transfer between facilities based on capacity or clinical need. If rural hospitals are shipping seriously ill patients to their urban neighbors, which already tend to run close to capacity even in normal times, a rural Covid-19 crisis could quickly become a crisis for everybody.

One hospital being overwhelmed isn’t a one-hospital problem, it’s an every-hospital problem. Even if your community is not awash with Covid-19 or if most people are vaccinated, a major outbreak in your broader region, plus all the other patients hospitals are treating in normal times, could easily fill your hospital, too. That makes it harder for the health system to treat you if you come to the ER with heart attack symptoms or appendicitis or any acute medical emergency.

Already, because of existing staffing shortages, rural hospitals are finding it difficult to find room for their patients at larger hospital systems. With omicron spreading rapidly, increasing the number of patients seeking care while sidelining health workers who have to quarantine, systemic overload may not be far off.

“When you have a Covid patient who needs ICU care, those hospitals are turning away patients,” Carrie Saia, CEO of Holton Community Hospital, located in a town of 3,000 people about 90 minutes east of the Kansas City metropolitan area, told me earlier this month. “We’re sending our patients farther away. Not because they’re full, they’re just out of staff.”

At earlier points in the crisis, large hospitals would limit transfers from smaller facilities in order to preserve their capacity to treat the most seriously ill patients. As a new wave driven by the omicron variant takes off, that could happen again.

As Karen Joynt Maddox, a practicing cardiologist and associate professor of medicine at Washington University in St. Louis, told me in August: “During Covid surges, we were told to limit transfers only to patients who had needs that could not be met at their current hospital (i.e. decline transfers because the family requested it, but equal services available at both places) because that was the only way we could make sure that we did have the ability to accept patients that only we (or another major referral center) could handle.”

The feedback loop works in reverse as well. Recently, the HCA hospital in Conroe, Texas, about 40 miles north of Houston, was dealing with such a staffing shortage in its emergency department that the facility temporarily asked ambulances to bypass it because the ED couldn’t handle any more patients, according to a spokesperson. Suddenly, hospitals in the heart of Houston were seeing an unexpected surge of patients who needed emergency care, causing long wait times at their facilities.

America’s hospitals are all in this together. So what can we do quickly to relieve the burden for all of our hospitals and prevent unnecessary deaths?

How we can all help hospitals handle a surge in omicron patients

Last week, the Biden White House detailed a new plan for helping hospitals handle the coming surge of Covid-19 patients. They are deploying emergency medical personnel to six states: Michigan, Indiana, Wisconsin, Arizona, New Hampshire, and Vermont. They are also planning to deploy another 1,000 military doctors and nurses in January and February, as well as ordering FEMA to work with states to add hospital beds. The White House also said it had 100,000 ventilators in the federal stockpile that could be deployed as needed.

Those policies could certainly help to alleviate the pressure on hospitals in places facing particularly acute crises. But the truth is, they can only do so much. US hospitals cannot suddenly grow the staff and physical capacity to handle another enormous surge of Covid-19 patients.

Infected medical workers add to the strain on hospitals. Hospitals have seen a spike in nurses and doctors testing positive; by late December, the El Centro Regional Medical Center, about two hours east of San Diego near the US-Mexico border, was seeing 5 to 10 percent of its staff either infected or being tested for exposure at any given time, according to CEO Adolphe Edward. Other hospitals have told me they are also seeing a growing number of workers test positive, which requires them to stop working and isolate.

The Centers for Disease Control and Prevention recently revised its isolation protocols for health care workers who test positive for Covid-19, shortening the standard isolation period from 10 days to 7 (if accompanied by a negative test). But that still takes doctors and nurses out of commission for several days if they contract the virus. (On Monday, the CDC released new guidelines for the general public stating that those who test positive can stop isolating after five days if they do not have symptoms.)

“You can send all the ventilators you want,” Roberta Schwartz, executive vice president at Houston Methodist Hospital, told me. “I have no one to staff them.”

Nearly 99 percent of rural hospitals said in a survey released in November they were experiencing a staffing shortage; 96 percent of them said they were having the most difficulty finding nurses. According to a September study commissioned by the American Hospital Association, the average cost of labor expenses for each discharged patient has grown by 14 percent in 2021 — even as the number of full-time employees has dropped by 4 percent.

“The only things I can think of could not be accomplished in two weeks,” Peter Viccellio, associate chief medical officer at Stony Brook University Hospital in New York, said. “We have a severe staffing shortage everywhere, and it’s not going to go away. It existed before Covid, and Covid just exacerbated it.”

Some policy changes — smoothing schedules that better distribute surgeries (and therefore patient volume) throughout the day or week, earlier discharges or more weekend discharges — could help. “But this won’t happen without a mandate,” Viccellio said.

“We won’t prevent future catastrophes because of a very simple reason. It requires that we think of the future and plan for it,” he added. “You can see how that’s working out. We can’t frigging plan for one month from now.”

More money from the federal government could also allow hospitals to beef up their staffing, said Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, which represents critical access facilities. But all of these policies targeted directly to hospitals may only help at the margins. The American health system’s capacity is what it is — the time to act was long ago. Instead, the US health care system is behind many of its wealthy peers in the number of practicing medical staff in its hospitals.

So the quickest and surest action to prevent hospitals from being overwhelmed is actually to prevent people from needing to go to the hospital with Covid-19 in the first place, hospital leaders said. Get vaccinated — with three doses. Wear masks indoors in public places. Test before you see people who don’t live in your house.

Following the pandemic playbook can make a difference for hospitals bracing for another grim winter in this pandemic.

“The more we can help keep the public protected, the more we can keep our workers here,” Schwartz said, “and lessen the burden of this.”

Dylan Scott

I grew up in Ohio, lived in Las Vegas for a year and moved to Washington in 2011. I cover health care and other domestic policy. You’ll probably see me tweeting about Cleveland sports or the last movie I watched.

Source: An omicron Covid-19 surge anywhere can strain US hospitals everywhere

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CDC Recommends Cutting Covid Isolation Time To 5 Days For Some Healthcare Workers

With hospitals in some areas struggling with staffing shortfalls amid a nationwide surge of Covid-19 cases, the U.S. Centers for Disease Control revised its guidelines Thursday to recommend that healthcare workers who contract Covid-19 but display mild-to-moderate symptoms and are not moderately or severely immunocompromised can return to work five days after symptoms first appear, down from 10 days previously.

Key Facts

Healthcare workers who contract the virus should also wait until at least 24 hours after their last fever without the use of fever-reducing medications and must wait until symptoms like coughing and shortness of breath have improved, according to the guidelines.

Some hospitals have voluntarily adopted a seven-day isolation period for infected staff, the New York Times reported.

The Centers for Disease Control and Prevention (CDC) advises someone who tests positive to go into isolation for 10 days. Critics say that the policy does not take into account how the pandemic has developed over the last two years.

Omicron is now the dominant strain in the U.S. Although more transmissible than prior variants and amid a spike in breakthrough infections among the fully vaccinated, the strain so far appears to be causing milder symptoms.

The CDC also recommended that hospitals cancel all non-essential procedures and visits if necessary to mitigate staffing shortages. Other new CDC guidelines also revised rules for workers who have higher-risk exposure to Covid-19, such as having their eyes, nose or mouth exposed to material possibly containing the virus, but who are not confirmed to have been infected.

In general, asymptomatic workers who have been exposed to the virus in this way do not require any restriction from work if they have received all recommended vaccine doses, including boosters, the CDC said.

Fauci told CNN reducing the 10-day isolation recommendation would help those without symptoms return to work or school, although added “no decisions” had been made yet.

Key Background

As the spread of the highly transmissible omicron variant raises infection rates across the U.S., hospitals have struggled with worker burnout and understaffing. In Massachusetts, New York and Ohio, the National Guard has been deployed to reinforce overburdened hospital staff, Spectrum News reported. “When it comes to the workforce, it’s fair to say we’re facing a national emergency,” American Hospital Association President Rick Pollack told NPR.

Tangent

Airlines for America, a trade association representing most of the nation’s largest airlines, asked the CDC on Thursday to shorten its quarantine recommendation to five days for fully vaccinated people who have a breakthrough Covid-19 case. A4A CEO Nicholas Calio cited potential worker shortages and operation disruptions amid the omicron coronavirus surge if the quarantine time isn’t reduced.

However, flight attendant union chief Sara Nelson pushed back against the airlines’ call on Thursday, saying it would pose health risks. “Although breakthrough infections are mild, the 10-day isolation is extremely disruptive to people’s lives,” he told Newsweek. “It’s unnecessary if a person is contagious for a significantly shorter period of time,” Adalja noted.

Omicron is the most dominant COVID strain in the U.S., comprising of 73 per cent of new infections last week. But even if proven to have milder systems, there are fears the health care system could be overwhelmed if infections put medical workers out of action.

I cover breaking news for Forbes. Previously, I was editor for The Cordova Times newspaper in Cordova, Alaska. In 2018, I obtained a Master of Journalism

I am a Hawaii-based reporter covering breaking news for Forbes. I graduated from the University of Hawaii with a bachelor’s degree in Journalism and

Source: CDC Recommends Cutting Covid Isolation Time To 5 Days For Some Healthcare Workers

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