Israeli Physicians Say Battle Against Coronavirus Now a ‘War of Attrition’

Hospital administrators describe growing pressure and burnout among medical workers in what one ward director calls ‘a nonstop war’

Ido Efrati
Ido Efrati
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Inside the coronavirus critical care unit at Sheba Medical Center, Tel Hashomer, July 2020.
Inside the coronavirus critical care unit at Sheba Medical Center, Tel Hashomer, July 2020.Credit: Emil Salman
Ido Efrati
Ido Efrati

Five months after the coronavirus erupted, with the country at the height of a second wave, hospital staffers are dealing with heavy workloads and growing burnout as they try to run two systems simultaneously – one for coronavirus patients and one for everyone else.

During the first wave, many non-coronavirus patients avoided hospitals. But that’s no longer the case.

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“During the first wave, it was a fierce battle against the coronavirus; today, it has already become a war of attrition,” said Prof. Ehud Grossman, director of the internal medicine department at Sheba Medical Center in Tel Hashomer and dean of Tel Aviv University’s medical school.

“Treating coronavirus patients is much more intense, but we also have to treat non-coronavirus patients, and there are a lot of them,” he added. “We were in terrible straits before the coronavirus and raised an outcry, but now the situation has gotten much worse.”

Grossman said people don’t understand that there is enormous burnout. “All the people who focus on the numbers and sit in all kinds of places making decisions don’t understand that there are combat units here engaged in a nonstop war – physical and emotional,” he said. “There are people who haven’t had a vacation in months and work every day under extremely difficult conditions.”

Two of Sheba’s seven internal medicine wards have become coronavirus wards. Three others are working at reduced capacity, mainly because some of the staff is in quarantine. The coronavirus wards have 11 patients on ventilators in critical condition and 29 in serious condition.

According to the Health Ministry, Jerusalem’s Hadassah University Hospital, Ein Karem is at 110 percent occupancy overall and 182 percent in the coronavirus wards. No other hospital’s situation is quite that bad, but the figures for Tel Aviv’s Ichilov Hospital are 106 and 110 percent, respectively.

Sheba is almost full overall and at 104 percent in the coronavirus wards. Shamir Medical Center (formerly Assaf Harofeh) is only at 66 percent occupancy, but its coronavirus wards are full.

“If you wander around and look at the number of beds or the corridors, it doesn’t look so terrible,” Grossman said. “But that’s misleading. The whole job has changed, and today, we’re only doing urgent tasks. That isn’t something you can do long-term.”

At Shamir, two of the seven internal medicine wards have become coronavirus wards. They house 49 patients, of whom 19 are seriously ill and six are on ventilators. All those patients require staff, so “the same number of non-coronavirus patients is now being handled by only five wards instead of seven,” said the hospital’s director, Dr. Osnat Levtzion-Korach.

During the first wave, she said, the hospital saw a significant drop in non-coronavirus patients. But that hasn’t been true during the current wave. “The pressure has increased greatly in recent weeks, though in the last two or three days, we’ve sensed a kind of stabilization.”

Moreover, many staffers are in quarantine, forcing the hospital to bring in personal from other wards. “The staff is devoted, but burned out and exhausted,” Levtzion-Korach said. “And it’s still summer. We’re all anxious about the winter, about the combination of the coronavirus and the flu.”

Hadassah Ein Karem’s four coronavirus wards house 96 patients, more than 20 of them on ventilators. To staff these wards, it’s adding surgeons, orthopedists and anesthesiologists. “This undermines our ability to treat our other patients,” said the hospital’s director, Prof. Zeev Rotstein.

Two weeks ago, the health and finance ministries signed a deal to provide hospitals and HMOs with funding for another 2,000 nurses, 400 doctors and 700 administrative workers. During a visit to Wolfson Medical Center in Holon on Monday, Health Minister Yuli Edelstein said the ministry would start telling each hospital and HMO how many new staffers it can hire this week.

Though health-care workers welcome the staffing increase, they say it still isn’t enough. And in any case, Grossman said, it won’t solve the immediate problem.

“Training a nurse or doctor to handle seriously ill patients takes a minimum of a year,” he said. “You can’t send raw recruits to fight Hamas’ commando unit.”

“They bought machines and built wards, but they didn’t do the most important thing,” he added. “They didn’t train staff.”

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