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- Nurses told Business Insider they expect COVID-19 cases and hospitalizations to spike after Christmas, much like they did after Thanksgiving.
- More than 47,000 Americans have died of COVID-19 since Thanksgiving. Smartphone data showed 13% of Americans traveled more than 31 miles from home to celebrate the holiday.
- Record COVID-19 hospitalizations in the US have caused nurses to become stressed and burned out.
- Vaccines were a “glimmer of hope,” but likely will not change the outcome of a post-Christmas COVID-19 surge, nurses told Business Insider.
- Visit Business Insider’s homepage for more stories.
Jason Harrison, an emergency room clinical nurse, said he remembers the day the winter COVID-19 surge hit his hospital in San Francisco – about 12 days after Thanksgiving.
The hospital set up a triage area outside in the ambulance bay in anticipation of an influx of COVID-19 patients. The first day he had no problems, Harrison said.
By the second day, Harrison could no longer find enough space for the COVID-19 patients coming in. In that one day, the nurse said, he saw more COVID-19 patients than in any one month all year.
“So I’m pretty worried about the surge after the Christmas and New Year’s holidays,” Harrison told Business Insider. “I’ve seen no indication that the population is going to modify or reduce its travel.”
The COVID-19 surge after Thanksgiving resulted in record hospitalizations. More than 47,000 Americans died of COVID-19 since Thanksgiving, after 13% of Americans traveled more than 31 miles from home to celebrate the holiday, according to an analysis of smartphone data. Some parts of California have almost no available intensive care unit beds left.
Ahead of Christmas, nurses across the country say they fear the winter surge will only get worse. Many nurses are already burned out, and some say they worry about resource shortages and staff leaving the profession for good.
Sarah Curran, a registered nurse who works in a cardio surgical ICU in Michigan, said after Thanksgiving, her hospital went from having, at most, 18 COVID-19 patients at a time to 86. The influx of patients means Curran's hospital has run low on masks and protective equipment, as well as sedatives used to keep patients on the ventilator comfortable.
Curran said she's been watching the people in her town host holiday parties on Facebook to see who she'll eventually see in the hospital.
"We're just kind of expecting the numbers to only get worse, unfortunately," Curran told Business Insider.
"A lot of doctors and nurses have told me, 'I'm going to quit.'"
Americans clapping for nurses coming home at night, commercials praising "healthcare heroes," and free food sent to hospitals characterized the initial COVID-19 outbreak in the spring as case counts slowly crept higher: It took 142 days this spring to go from zero to 2 million cases in the US, according to Johns Hopkins University.
Now, when COVID-19 cases are skyrocketing - the US recorded 1 million new cases in a week this month - the visible appreciation has disappeared, said Kristen Choi, a psychiatric nurse in Los Angeles.
Choi said healthcare workers have learned more about treating COVID-19 patients since the spring, meaning death rates are lower. Still, the long pandemic coupled with "demoralizing" pictures and videos of Americans not wearing masks and gathering has burned out healthcare staff, she said.
"I have talked to a lot of doctors and nurses who have told me 'I'm going to quit,'" Choi said. "I think that a lot of them are going into this holiday season burned out, and that's really scary [because] this pandemic still could get a lot worse."
AP Photo/Julie Bennett
A November survey by the country's largest nurse union found half of RNs have had difficulty sleeping since the pandemic, 80% feel more stressed, and 62% feel sad or depressed. Nurses in the ICU are leaving the job due to stress, resulting in hospitals facing staff shortages in at least 25 states.
A shortage of hospital nurses can lead to worse patient care. Linda Aikens, a longtime researcher who is now a professor at the University of Pennsylvania, just published a study in the American Journal of Infection Control that found assigning nurses to care for too many patients at once leads to higher mortality from sepsis. Research from Australia suggests higher nurses-to-patient ratios can save lives and lead to less readmission.
After the initial wave, many ICU nurses left their job or took travel contracts to make more money, said one intensive care nurse in Michigan. (Business Insider confirmed the nurse's identity prior to publication.)
The ICU nurse said she worries that increased COVID-19 surge will leave more staff feeling burnt out. Already, the nurse said she's often the only one during a shift who has more than a year's experience. Many recent nursing graduates filled the gaps in hospitals, but training a new nurse can take at least eight weeks, she said.
"I'm absolutely terrified for Christmas," the nurse told Business Insider. "We still have the Thanksgiving patients that are still so sick that we can't get them out of ICU. Where are we going to put the Christmas people?"
Vaccines offer a "glimmer of hope," but will not reduce the number of patients if Americans gather indoors without masks.
Choi, who volunteered for the Pfizer-BioNTech clinical trial, said the Food and Drug Administration's green light of vaccines offered a "glimmer of hope" to people in healthcare.
In the days following the FDA's decision to approve the vaccine for emergency authorized use, the US began distributing the first vaccine doses to high-risk healthcare workers, and many celebrated their vaccine appointments on social media. A video of Boston Medical Center staff dancing upon the arrival of vaccines was shared more than 1 million times on Twitter. Workers still need to wait three to four weeks before getting the second vaccine dose needed to reach full immunity.
But, Choi continued, "it kind of feels a little too late."
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Nurses told Business Insider they were relieved to get vaccines, but doubt the shots will prevent against a Christmas COVID-19 surge.
"It is just a bit too premature to say the vaccine is going to reduce the number of patients," Harrison, the San Francisco ER nurse, said. "It's definitely too early for that." He received his first vaccine dose on Friday and now must wait 20 to 21 days for his second shot.
Nurses said the best way to help healthcare workers and lessen COVID-19 transmission this Christmas is to keep a mask on, limit travel, and stay safe distances away from others.
But despite their efforts, nurses said the education around COVID-19 still falls short. Dennis Kosuth, an emergency room nurse in Chicago, said part of the problem with the upcoming Christmas surge is a lack of outreach to low-income communities informing them on how COVID-19 gets transmitted.
Kosuth said his hospital treats primarily Black and Latino essential workers, like delivery drivers or Amazon warehouse staff. Black, Latino, Asian, and Native Americans died disproportionately from COVID-19, per Centers for Disease Control and Prevention data, due in part because many cannot work from home. Kosuth saw one laid off patient into ICU after he lost health insurance and couldn't afford insulin for his diabetes.
Kosuth suggested getting public health officers to set up tents outside grocery stores or meet Americans where they are to inform them on why social distancing and wearing masks help the community.
"I think if this country was truly interested in educating people, they would have mobilized forces to do that," Kosuth said. "And I just haven't seen evidence of that."