Masks with rotted elastic straps, long delays on test results and shortages of critical staff. These are just a few of the challenges detailed by hospitals in a report released Monday by the Department of Health and Humans Services’ Office of Inspector General (OIG).
The report surveyed 323 hospitals across the U.S., most of which were currently treating Covid-19 patients. It reported “severe shortages of testing supplies” and long waits for test results, which exacerbated problems with staffing and access to protective equipment.
Hospitals said they struggled to keep up with the demand for testing because they lacked test kits or certain components, such as nasal swabs and reagents. Those that outsourced their tests often faced to a commercial or public lab often faced delays as they too are overwhelmed with tests.
According to the report, hospitals frequently reported waiting more than seven days for results.
“According to one hospital, 24 hours would typically be considered a long turnaround time for virus testing,” the OIG noted in the report.
The delays in test results and available tests have big implications downstream. It means patients have to wait in beds dedicated for Covid-19 patients while they await their results. Even if they were feeling better, some patients couldn’t be discharged.
“Many hospitals reported that post-acute-care facilities were requiring negative COVID-19 tests before accepting patients discharged from hospitals, meaning that some patients who no longer required acute care were taking up valuable bed space while waiting to be discharged,” the report stated.
Another shocking anecdote: One facility refused to take a patient unless the hospital sent them a week’s work of masks for the patient and their care staff. The patient hadn’t tested positive.
Staffing, supply shortages
Hospitals also reported shortages of staff and protective equipment, exacerbated by the lack of testing. Not knowing whether or not patients might have Covid-19, medical workers have to use more protective equipment. In some cases, they might have to self-isolate, not knowing whether they’ve been exposed to the virus.
Several hospitals said they would struggle to maintain their operations if even a few staff were exposed to the virus. One rural hospital said if a patient tested positive for Covid-19, it would have to quarantine 16 staff members, effectively halting its operations.
At another hospital, one staff member who tested positive had been exposed to others on staff, but the hospital did not have enough test kits for them.
The lack of available testing means healthcare workers also burn through more masks. One hospital reported that its staff needed 307 masks per day to care for 23 patients with suspected cases of Covid-19.
“The testing turnaround presents a challenge, especially for our ‘rule-out’ patients…we have to use a lot of PPE on those rule-outs,” another hospital administrator said in the report. “And especially when it’s a negative, we basically used all that PPE for nothing.”
Federal and state governments have been sending hospitals equipment to replenish their supply, but it hasn’t been enough, and in the worst cases, is defective. Backlogs and inflated prices have also made masks difficult to purchase.
One health system reported receiving 1,000 masks from the federal and state governments, but it had expected a larger supply. Worsening the problem, 500 of the masks were for children—unusable by its staff. Another hospital reported receiving a shipment of 2,300 N95 masks from a state’s strategic reserve, but they were not usable because the elastic bands had dry rotted.
“Hospitals reported that heavier use of PPE than normal was contributing to the shortage and that the lack of a robust supply chain was delaying or preventing them from restocking PPE needed to protect staff,” the report stated. “Hospitals also expressed uncertainty about availability of PPE from Federal and State sources and noted sharp increases in prices for PPE from some vendors.”
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