Thousands of medical staff in isolation: Will coronavirus care suffer?

“We cannot continue working the same way."

Coronavirus quarantine ward at Sheba Hospital in Ramat Gan (photo credit: AVSHALOM SASSONI/MAARIV)
Coronavirus quarantine ward at Sheba Hospital in Ramat Gan
Increasing numbers of medical professionals in isolation endanger the healthcare system’s ability to give proper medical treatment to Israeli patients, according to Arnon Afek, deputy director-general of Sheba Medical Center, Tel Hashomer.
On Saturday night, the Health Ministry released the latest report on the number of medical professionals in quarantine due to coronavirus: 3,030, including 814 doctors and 893 nurses. Some 42 medical professionals have been diagnosed with the virus, and the number continues to rise.
“We cannot continue working the same way,” Afek said. “We overcame some of the challenges in the interim by recruiting staff from other departments, people volunteering and working together, but we cannot go on like this.”
He said that Sheba and several other Israeli hospitals have implemented a series of protocol changes in hopes of bringing down the number of medical staff in isolation and of working more efficiently during the coronavirus crisis.
Among those changes is that whereas medical teams used to meet in person in the morning to discuss patients and their progress, today they are meeting via teleconference or other digital means. 
At Sheba and many of the country’s other top hospitals, medical staff has been divided into teams of physicians and nurses. They work 12 hours on and then 24 hours off and never come in contact with members of the other teams. 
“It is forbidden for them to meet each other so there can be no contact,” Afek explained. “The idea is that if one group is isolated because someone gets sick, there will be two groups left that can each work 12 hours on and 12 off until the third group can return to work.”
Afek said all medical personnel are now encouraged to wear protective gear all the time, such as medical-grade masks, and that the hospital has separated its emergency-room care into different wings – some inside the main facility and some outside. If someone is suspected of having coronavirus or has respiratory disease, he or she is brought to the external wing until a test confirms that the person does not have it. 
Doctors and nurses across the country have complained of lack of masks and other protective gear, explaining that without these items, they are exposing themselves and their patients to coronavirus. Over the weekend, several doctors in separate TV interviews called on individuals who might be hoarding masks to donate them to the hospitals where they are sorely needed. 
Prof. Dan Ben-David, president and founder of the Shoresh Institution for Socioeconomic Research and a faculty member at Tel Aviv University’s Department of Public Policy, described the situation as “eerily reminiscent of the Yom Kippur War” when the storehouses were lacking military equipment and protective gear for Israel’s front line soldiers.
“Healthcare staff is equivalent to our soldiers in the Yom Kippur War,” he said. “We do not have what we need to protect these healthcare workers. They are not fighting a foreign enemy, but a foreign virus – and they are getting sick in big numbers because we have not been able to provide it.”
Based on the 945 patients diagnosed with coronavirus reported by the Health Ministry on Sunday morning, medical staff accounts for 4% of sick people. 
But Afek said that the hospitals are not yet at a deficit of protective gear, rather a deficit is projected if action is not taken swiftly. He said the Health Ministry is working to procure the necessary gear, and that a factory in Sderot will begin increasing production of two kinds of hospital-grade masks next month, which should fill the void. 
“In the future, this shortage will be overcome,” he said.
Afek also confirmed that all staffing and related changes are being done in consultation with the Israel Medical Association, and most hospitals in Israel are making similar shifts. 
Ben-David said that the loss of medical staff could be hurting care more than people realize. 
He said that the number of nurses in Israel is one of the lowest compared to all OECD countries, as is the number of nursing school graduates, “so we have no degree of freedom. There are so few nursing staff to begin with that losing nurses is a big deal in terms of the care of the patients.”
Ben-David said he suspects that the lack of nurses has a negative effect on the intensiveness of care that can be given to patients and also the cleanliness, which can lead to an increase in infectious disease.