Israel’s hospitals learned on Tuesday that they would receive funding to take on an additional 600 doctors and 1,500 nurses if the government’s forecasts are correct and the number of hospitalized coronavirus patients reaches 4,800 in the next month, with half of them being serious cases.
But many health care leaders warned that the extra staff won’t have a profound impact anytime soon because it will take time for them to be trained in treating COVID-19 patients in the midst of a crisis. Their contribution will only be felt only weeks, if not months, after they are hired.
Even if the new hires can get up to speed quickly, many doctors said the number of new staff that the government is offering isn’t enough to cope with the growing patient overload – and that is going to affect the quality of care.
Dr. Eytan Wirtheim, CEO of the Rabin Medical Center in Petah Tikva and chairman of the Union of Hospital Directors, told an Israel Medical Association conference on Thursday that the staff additions were critical and that “it’s important that we begin today to fill all these jobs and shifts.”
He said that in addition to the extra personnel, hospital chiefs had unsuccessfully sought an additional 300 beds for intensive care patients, 800 for internal medicine units and at least 300 for geriatric internal medicine wards.
IMA Chairman Prof. Zion Hagai said the extra medical personnel would not help seriously ill patients in the current COVID-19 wave. “If anyone thinks that we have increased our capacity for new patients, the fact is we have changed nothing – we’ve just added beds without the ability to treat patients,” he told the conference. “What are they thinking? That they can just push a button and out comes a trained physician who can begin to work? Experienced nurses also need to be trained before they can enter coronavirus wards.”
However, not all health care leaders discounted the impact of the extra staffing. Dr. Michael Halberthal, CEO of Haifa’s Rambam Medical Center, said that the numbers were in line with what the health care system had sought and that the extra doctors and nurses would be a big help in caring for patients.
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“I explained to Prime Minister Naftali Bennett the needs of the health care system today, with the hospital reaching the point of exhaustion and their ability to care for COVID-19 patients has become problematic, that 700-800 patients present a very serious challenge to the system,” Halberthal said.
“I told him that in addition, hospital staffs are in despair and that it’s going to be a problem telling them that they have to start up all over again for the fourth time, without any [respite on the] horizon,” he said, referring to the emerging coronavirus wave.
Halberthal said Bennett understood the problems and asked him to determine how many extra positions needed to be created. “We got everything we asked for,” he said, adding that the newly created positions would give the health care system a level of “resistance that it previously didn’t have.”
Nevertheless, Halberthal stressed that the staff increases would only help so much. “If, alas, we reach 4,800 hospitalized patients, the situation won’t be at all good – it will be terrible,” he said. “We’ll be engaged in a juggling act between coronavirus patients and all the rest. A situation like this is like a mass-casualty event – if a coronavirus patient arrives, we might have to decide we can’t save him or we won’t save him, as has happened in other countries.”
But Halberthal noted, “These added positions are helping us delay reaching that point. Without them, I believe we wouldn’t be able to cope with the situation in another two or three weeks, with 1,200 patients.”
While it is true that the new personnel won’t be able to treat COVID-19 patients immediately, they will relieve the pressure on those who are treating them. “They will join departments under less pressure while continuing to train. We can move experienced teams to coronavirus wards. It’s a pity this didn’t begin nine months ago, but it still remains important,” he said.
Even today, some coronavirus wards are reporting they are already overburdened. Dr. Jamil Mohsen, who heads the coronavirus ward at Hillel Yaffe Medical Center, described the situation in his unit as “as bad as it can be.”
“We are terribly overloaded and don’t have enough manpower. This is something that shouldn’t be happening in 2021,” he said, adding that his ward was built to treat 15 patients at a time but today has between 25 and 28 in serious condition.
“I have to deal with questions about where to even find a bed for a patient,” he said. “We need more staff and supplements for the teams so that we don’t get to the point where we can’t care for patients. So far, we’ve been able to meet our targets, even during the previous waves. I hope we don’t now reach a situation where we have no room for treating the sick.”
Mohsen said he hoped the additional staffing would prevent that and said he thought that the new doctors could be trained relatively quickly. “One of my challenges as department head is to take on staff who doesn’t necessarily have training in intensive care. I work hard to train them without compromising on the quality of care. We don’t put them on the front line immediately.
“In the first month, we teach them and they acquire the skills, and we continue teaching them afterward,” he said. “I don’t think there are doctors and nurses you can create at the push of a button, but I do think that there are people looking for a position and hadn’t found one until now.”