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PPE? Check. Vaccines? Check. Enough Nurses? Check and see.

Hush Naidoo
Nurses aren't so much leaving medicine as they are leaving emergency care medicine. That makes some in the field nervous as the holidays and two competing strains of coronavirus meet.

The South Carolina Hospital Association says the state's facilities are prepared for a potential Omicron-led surge, as far as equipment and capacity are concerned. The toll the pandemic is taking on nurses ... that's more troubling.

The last time South Carolina saw COVID-19 cases rise to the 1,000-per-day level was at the end of July. That uptick followed several weeks of decreasing, even double-digit-per-day cases amid a surge in vaccinations – all of which made it seem as if COVID was on the wane.

But that uptick starting in July introduced us to the Delta variant, which ushered in a huge wave of cases and deaths that spiked during the week of Sept. 18 and took until early November to drop below 100 deaths per week.

That surge put tremendous strain on the state’s already-strained hospitals; and the South Carolina Hospital Association (SCHA) is taking seriously what a potential surge in Omicron variant cases might mean for exhausted emergency room staff.

“Workforce is a major concern,” says Schipp Ames, spokesman for the SCHA. “There’s a lot of burnout. Nursing is part of what’s being called ‘the Great Resignation.’”

The moniker, also called the Big Quit, refers to a lingering trend of workers in several industries leaving their jobs this past year as an offshoot of the endless pandemic. It has much to do with the tangle of supply chain snags, livability, and worker safety issues, in general. For nurses and other ER medics, Ames says, more lucrative opportunities away from the on-again/off-again chaos of COVID spikes and souring sentiment by some in the public are luring away healthcare workers from in-patient and emergency care wards.

Reports about the numbers of nurses needed in the whole country are not encouraging either. One report from RegisteredNursing.org predicts South Carolina to be more than 10,000 nurses short of where it will need to be by the end of this decade. That puts South Carolina fourth among states with the greatest raw number of nurses needed, and the three ahead of it are California, Texas, and New Jersey – three of the most populous states in the union.

Nursing programs at the University of South Carolina are expanding, and new programs like the Galen College of Nursing, which will start accepting students in Myrtle Beach in January, are trying to address the problem, but until more scrubs get filled, the strain that the pandemic is putting on weary, overworked, and emotionally drained nurses will gnaw away at what emergency and in-patient caregivers in the state’s hospitals have.

“We’ve found PPE,” Ames says. “We have testing. We’ve developed multiple vaccines in a short time frame. The one thing we’ve been chasing these last two years is workforce.”

The upside to what Ames just said is that South Carolina’s hospitals are, equipment-wise and capacity-wise, in a good position. He says hospitals around the state showed during the summer/fall surge that they can adapt and expand when needed, including repurposing public buildings and shuffling their own existing spaces to accommodate more patients. So, he says, hospitals here are in good shape to accommodate another spike – which could already be in the making.

According to the state Department of Health and Environmental Control, or DHEC, cases of COVID in South Carolina have mainly stayed between 500 and 1,100 per day so far this month. Weekly deaths have stayed around 60 – about 40 fewer per-week than in November.

Like case numbers, total COVID hospitalizations spiked in mid-September, to more than 2,500 on Sept. 17. They dropped below 350 just before Thanksgiving, but were back to 547 as of Wednesday. Covid-related emergency visits had dropped from a quarter of all hospital visits in September to about 13 percent in mid-November; they make up 16.6 percent of emergency hospital visits this week.

Most of the COVID that is here is still Delta, but the Omicron variant is now officially in the state, and that’s causing hospitals to steel themselves for a potential next round. DHEC announced the state’s first three identified Omicron cases on Wednesday; public health agencies around the world, from the European Union to the Centers for Disease Control and Prevention say Omicron could become the predominant strain of the coronavirus within weeks.

“Hospitals have been told that we should expect a wave,” Ames says. “We’re holding our breath.”

If there’s another hopeful aspect for Ames in all this, it’s that we’re not in the same position we were in when 2020 was drawing to a close. Heading into 2022, half of South Carolina’s vaccine-eligible population is inoculated, booster shots are happening, and there are potential oral medications and expanded alternative treatments for those who do not want to get the vaccine.

DHEC, as does every other public health agency, urges vaccination and booster shots as we stare down a holiday season of close, indoor gatherings with crowds right in the midst of a fast-spreading, extremely contagious variant. But Ames says it is wise to admit that vaccines are not for everyone.

“There’s no denying that there’s a lot of skepticism over the vaccines,” he says. “We need more alternative treatments for the vaccine-hesitant.”

A word about the holidays

According to DHEC:

DHEC expects testing demand to increase during the days leading up to the Christmas holiday, and this may increase turnaround times for COVID-19 test results. We strongly encourage residents who need to get tested to do so on or before Sunday, December 19, to ensure they receive their results before Christmas Eve. Please double check DHEC's website or call ahead to a testing or vaccine site to check their hours and availability around the Christmas and New Year’s holidays, as times for testing and vaccine clinics may vary.

Christmas Week (Thursday, Dec. 23 – Tuesday, Dec. 28)  

  • DHEC will not be releasing data Friday, Dec. 24 – Tuesday, Dec. 28 in observance of the Christmas holiday. On Wednesday, Dec. 29, DHEC will be reporting out data from Wednesday, Dec. 22 – Monday, Dec. 27.  
  • Many testing and vaccine sites around the state will be closed in observance of the holiday, including all DHEC health departments. In addition to being closed Christmas Day and Christmas Eve, many sites will be closed the days before and after the holiday. Please check the DHEC testing locations webpage or call testing and vaccine providers to check their schedule. 
  • DHEC call centers will be closed, meaning residents cannot call in to receive testing results, ask COVID-related questions, etc. 

  New Year's Day (State Holiday falls on Monday, Jan. 3, 2022)  

DHEC will not be releasing data on Jan. 3 in observance of New Year’s Day.  Data will be released on Tuesday, Jan. 4 and include 4 days’ worth of data from Thursday, Dec. 30 – Sunday, Jan. 2. 

  • Many testing and vaccine sites around the state will be closed in observance of the holiday, including all DHEC health departments. Please check the DHEC testing locations webpage or call testing and vaccine providers to check their schedule. 
  • DHEC call centers will be closed, meaning residents cannot call in to receive testing results, ask COVID-related questions, etc.
Scott Morgan is the Upstate multimedia reporter for South Carolina Public Radio, based in Rock Hill. He cut his teeth as a newspaper reporter and editor in New Jersey before finding a home in public radio in Texas. Scott joined South Carolina Public Radio in March of 2019. His work has appeared in numerous national and regional publications as well as on NPR and MSNBC. He's won numerous state, regional, and national awards for his work including a national Edward R. Murrow.