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'People Really Don't Want To Listen To Me': Health Care Workers Reflect On One Year With COVID-19

henry county health center
Katarina Sostaric
IPR File
The Henry County Health Center in Mount Pleasant is one of the state's 82 critical access hospitals. It has just 25 beds. Smaller, rural hospitals like this were easily overwhelmed with COVID-19 patients during surges.

A year into the pandemic, COVID-19 has put an enormous strain on Iowa’s health care system, from the influxes of COVID patients to staffing shortages and budget crunches. Iowa hospitals and health care workers reflect on living with COVID-19 a year in.

Joel Wells said the worst moments at rural Wayne County Hospital came last fall, when COVID-19 hospitalizations were spiking statewide.

Wells, a family physician in the third decade of his career, said he had nine COVID-19 patients. That’s a lot for a 25-bed rural critical access hospital in south central Iowa.

"We had to make lots of decisions on the fly," he said, "and we had patients that really — when I say were critical, they were. We had quite a few deaths at that time."

But Wells said facing surges of sick patients was far from the only challenge his hospital has faced in the past year.

He said some patients have aggressively push backed against his public health recommendations. Something he said he and his colleagues never expected to experience during a pandemic.

"We, as a medical profession, don't have the trust that I thought we did. It just rocked my world. I just said, ‘Oh, man, people really don't want to listen to me,’" he said.

On top of all of that, Wells says about half of the Wayne County Hospital staff had to be furloughed last summer to deal with COVID-related budget shortfalls.

These challenges aren’t limited to small hospitals like Wayne County.

"There were multiple moments that when we were standing on the edge of the cliff, you never thought the cliff could be steeper," said Suresh Gunasekaran, the CEO of the University of Iowa Hospitals and Clinics, the state’s largest hospital.

He said there were times during last fall’s surge when his region was reporting no available ICU beds, and the entire health care system was completely stressed.

Like Wayne County, Gunasekaran said UIHC experienced economic strain that trickled down to every single hard-working staff member.

"We had folks that took pay cuts, and we had folks that gave back vacation and did these things that you know, very much were stressful, and very much were dollars out of their pockets," he said.

Gunasekaran said between the pay cuts and keeping up with COVID surges, his staff has never gotten a break in the past year.

"Now we're trying to rally, and so the physical and mental health of our staff is probably our biggest concern. There's only so much a workforce can take," he said.

A year of battling the coronavirus has left many hospitals and their workers across the state emotionally and financially drained.

Kirk Norris, the president and CEO of the Iowa Hospital Association, said the state’s hospitals have experienced a net loss of $400 million in the past 12 months so far.

"We've seen significant declines in surgeries. We've seen significant declines in ER visits," he said.

Initial estimates from the Iowa Hospital Association last year predicted that net loss to be more than $1 billion, but Norris said hospitals have received about $850 million in government aid from places the CARES Act and Payment Protection Program.

However, Norris said hospitals have more cash on hand at the moment because some are holding onto CARES Act funding as they're confused about how they can spend it.

He said this means it will be awhile before the full financial impact of the pandemic on the health care system will be seen.

“It's going to be 2022 or 2023 before people really understand what a true economic trajectory of this pandemic has been," he said.

Additionally, Norris said many hospitals are reporting their staff is exhausted -- and even experiencing PTSD-type symptoms.

"They've also experienced their staff being hired away for more money in larger population centers to respond to this because people can double their salaries in six months," he said.

But some hospitals seem to have fared better than others.

Joanne Roepke-Bode, the public relations manager for the Kossuth Regional Medical Center in Algona, another rural 25-bed hospital, said government support from the CARES Act helped the hospital avoid having to furlough staff.

Roepke-Bode said their biggest challenge in the last year was pacing and preparing for the virus. She says they were ready last spring for a surge in cases. But that didn’t happen until months later - in late fall.

"And then when cases came, I think people were already hitting COVID fatigue, you know, and they were just ready to move on," she said. "And that's when we kind of needed to really buckle down and say, 'oh, gosh, we need to stay home now.'"

In Wayne County, Joel Wells agreed pacing is a huge issue for many health care workers, who quickly forgot that a pandemic is a marathon, not a sprint, and didn’t stress that important message to the public.

"We had a tendency to paint hope. There was no hope," he said. "This was going to be a long siege. And I think a lot of us saw that and we just try not to talk about it."

Wells said he knows the pandemic is far from over, but with vaccines now available, he remains cautiously optimistic that a return to some normalcy is near.

Natalie Krebs is IPR's Health Reporter