Omicron’s holiday surge causes a perfect storm for medical practices

The holiday season didn’t bring much relief for medical practices across the country; rather, they were visited by the ghosts of the COVID-19 pandemic’s past.

A Dec. 28, 2021, MGMA Stat poll asked medical practice leaders how their organizations have been affected by the arrival of COVID-19’s winter surge. From 323 responses, the following themes emerged, which echoed past spikes in COVID-19 cases:

Staff shortages exacerbated by healthcare workers quarantining/isolating due to confirmed COVID-19 cases or exposure

The surge in Omicron-variant COVID-19 cases created new staffing headaches for many poll respondents, many of whom already faced shortages from difficult labor markets for medical assistants (MAs), front office workers, nurses and more.

Increased employee callouts for exposure to coronavirus and confirmed COVID-19 cases forced some medical groups to close or reduce hours at some clinics just as demand for COVID-19 tests and care spiked. Other practice leaders told MGMA that they’ve shifted staff away from ancillary services to support other areas of the organization to avoid longer wait times. Many practice leaders said they anticipate boosting their telehealth offerings soon to move more ambulatory office visits to virtual care, thereby expanding their access as more patients stay home due to illness or caring for family who are sick.

This perfect storm of staffing shortages and increasing demand was described as a “disaster” by one respondent, and the pressure is intensifying feelings of burnout in the industry. As one poll respondent told MGMA, “staff and providers are stressed to the max — so am I!”

A demand for COVID-19 testing “skyrocketed” in cities, but not so much in rural areas

Throngs of patients turned to medical practices just ahead of the holidays for COVID-19 testing. However, several practices reported not having adequate amounts of testing kits, nor adequate staff to keep wait times down for testing clinics.

In many parts of the country, drive-through testing clinics produced snaking lines of vehicles in facility parking lots and nearby roads, with patients sometimes waiting hours for their test — and then days thereafter for results. Even retail pharmacies reported “unprecedented demand for testing services.”

The major exception to this surge in demand seemed to be rural parts of the country, where several practice leaders said they did not experience an influx of patients seeking COVID-19 testing or vaccinations.

Reaching rural populations remains a major hurdle for public health leaders. A recent report by The New York Times looked at three rural counties with low vaccination rates — LaGrange County, Ind., Cameron Parish, La., and Winston County, Ala. — which pointed to the impact of conspiracy theories about vaccines and misinformation as major factors that keep patients hesitant to be vaccinated.

Elective surgeries have been put on hold in the worst COVID-19 hot spots

Overall COVID-19 cases and hospitalizations have risen to levels high enough in some parts of the country to prompt some organizations to pause elective surgeries, which has also been reported by Healthcare Dive. A Kaufman Hall report found operating room time was on the rise in previous months before the rise of the Omicron variant, which has led to higher ICU utilization by COVID-19 patients and stymied recovery that was underway following the summer surge initiated by the spread of the Delta variant.   

More staff members have shifted to remote work

The increase in remote workers for medical practices has prompted many MGMA-member practice leaders to update office phone services to allow personal phone use by employees, often with voiceover IP (VoIP)/“softphone” apps that help mask individual phone numbers to look as though the office’s main number is being used, or installing software onto their PCs to call and message from a desktop. As one MGMA member noted in a recent MGMA Member Community discussion, “this solution has made remote and hybrid work much more conducive to keeping up with the call volume.”

What led us to this point?

A surge in holiday travel this month prompted a similar spike in demand for COVID-19 tests ahead of family get-togethers and vacations — and many parts of the country were ill-prepared.

As reported by the Associated Press, home tests for COVID-19 were scarce and left many travelers “waiting hours in chilly temperatures at testing facilities across the country” — with a promised effort from the White House to distribute hundreds of millions of free COVID-19 tests coming too late for many Americans.

The increased holiday travel occurred just as the United States topped 50 million COVID-19 cases and 800,000 deaths since the start of the pandemic, according to the Centers for Disease Control and Prevention (CDC).

This winter surge of COVID-19 as the new year approaches was concerning enough for the CDC to release emergency guidance for healthcare facilities to deal with a rise in cases from the Omicron variant, specifically:

• Allowing healthcare workers with COVID-19 who are asymptomatic to return to work after seven days with a negative test — or sooner if there are staffing shortages
• Eliminating quarantine times following exposure to the virus if a worker has received all recommended COVID-19 vaccine doses and has no confirmed infection.

Confusion over the CDC guidance update was intensified a few days later, when the CDC again updated its guidance of isolation restrictions for asymptomatic patients from 10 days to five. The CDC’s announcement was met with opposition from National Nurses United, which warned that the shortened isolation periods could put patients and staff in danger.

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ADDITIONAL RESOURCES

• MGMA COVID-19 Recovery Center — The latest updates, tools and resources to help your practice navigate the pandemic.
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• MGMA Stat: Measuring the Impact of the COVID-19 Pandemic — Find all our COVID-19 data stories going back to the start of the pandemic.
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