Latest COVID-19 surge not as bad as Omicron for healthcare staffing, but masks are back for some

A spike in sick leave following the winter holidays is nothing new, even in the era of COVID-19. The real question is how badly did it impact healthcare providers’ schedules and the reinstatement of mask policies? 

A Jan. 9, 2024, MGMA Stat poll found that nearly four in 10 (38%) medical group leaders said COVID-related sick leave was worse this winter than last winter, while most (52%) disagreed and another 10% were unsure. The poll had 434 applicable responses. 

This signals a slight uptick in staffing disruption compared to last winter, when a January 2023 MGMA Stat poll found that half of medical groups (50%) reported workers taking less sick/COVID-19 leave over the same period versus winter 2021. At that time, about one-third of medical groups reported sick leave was about the same as 2021, and only 17% reported an increase relative to the year before when the spread of the Omicron variant produced a perfect storm of worker shortages amid increased patient demand. 

Putting policy into practice 

The question of whether these practices require masks for providers, staff or patients largely hinges on existing policies. Practice leaders, facing reduced staff due to an uptick in COVID-19 illness over the holidays, reinstated mask requirements following Centers for Disease Control and Prevention (CDC) guidance — typically only in patient-facing areas and required for staff and symptomatic patients for potential COVID-19 or upper respiratory infections — did so in accordance with their existing organizational policies.  

Requiring masks as protection against respiratory viruses has ebbed across organizations in the past year. A March 2023 MGMA Stat poll found that just under half (49%) of medical groups still had a mask requirement in place at the time. One practice leader whose organization saw more workers out sick over the past few weeks questioned if they should have taken more steps: “The number of illnesses took us by surprise.” 

The disruption to practices comes as many healthcare organizations continue to struggle with maintaining enough workers in a competitive labor market. “We have been frequently short-staffed clinically due to a staff person or child having COVID,” one practice leader told MGMA, adding that it’s “just an additional layer of staffing issues we have had to work with this winter.” 

Some respondents told MGMA that maintaining separate entrances for symptomatic or likely exposed patients with stricter protocols in place has helped in recent months. Additionally, practice leaders from areas with particularly high immunization rates reported that the shots significantly limited the spread of viruses in the community. 

“Pirola” emerges 

Recent studies published in the journal Cell suggest the newly dominant COVID-19 variants known as “Pirola” — BA.2.86 and JN.1 — could result in more severe forms of disease. 

The first full week of January saw several areas and organizations reinstate indoor mask mandates for patient-facing areas in healthcare facilities, including New York City, where COVID-19 cases and hospitalizations spiked around the new year. Similarly, Mass General Brigham — Massachusetts’ largest health system — instituted a mask requirement on Jan. 2 for staff who interact with patients, based on an existing policy to reinstate masks when more than 2.85% of patients have symptoms of a respiratory virus. 

However, some mask rules were very short-lived. Within a day of the St. Louis, Mo., health department sending a mask policy update on Jan. 4, it was rescinded after that state’s governor intervened. 

The pervasiveness of coronavirus and other respiratory viruses this season comes after the CDC noted in its vaccination trends for the final week of 2023 that only 19.4% of adults were up to date with the current COVID-19 vaccine, while 17.7% of those 60 and older were up to date on RSV vaccination and less than half (44.9%) of adults had a current seasonal flu vaccine. 

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