AdventHealth oncology nurse Margaret Potter has shaved her head during Breast Cancer Awareness Month for the past twelve years to support her patients experiencing hair loss, a common side effect of chemotherapy. Potter says hair loss can be particularly emotional for women, and she doesn’t want them to feel ashamed.
“The day after I shaved my head for the first time, I went back, and one of my patients said, ‘Oh my gosh, I can shave my head now! Will you shave my head for me before you leave today?”
Potter works in the AdventHealth Cancer Center in Kansas City, Missouri. About 80-90 patients are treated in its infusion center daily. She says she sees firsthand how hair loss from chemotherapy has affected them.
“When my patients hear that they are going to lose their hair, it’s a variety of emotions. It’s a lot of tears and anxiety in the beginning,” says Potter.
She says the societal standards that place value on women’s hair have been a heavy burden for some of her patients and she’s been shaving her head 12 years to show them they’re not alone.
Daily Nurse honors Potter as the Nurse of the Week for the caring and compassion she shares with her patients during an incredibly emotional time by encouraging them to embrace their hair loss and help combat the stigma surrounding it.
“I look at my cancer patients when they lose their hair, and I see their strength, beauty, and courage, so I love to go out and champion that,” says Potter.
“When they see somebody that doesn’t have hair, it’s not always bad. A lot of the time, it is bad, but just go up and say, ‘Gosh, I don’t know your story. I hope you’re doing well.’ Just have that extra little bit of compassion because they are going through a lot.”
Potter says she plans to shave her head again next year at the Shave to Save fundraiser on April 26, 2024.
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
August is National Breastfeeding Month, and the U.S. Breastfeeding Committee has chosen “This is Our Why” as its theme this year. Much has been written about the physical benefits of breastfeeding for mother and child—better infection protection for babies and reduced cancer, high blood pressure, and diabetes risks for mom. I want to dive a bit deeper into the benefits for society. Positive outcomes begin at the individual level, but, as it turns out, breastfeeding benefits all of us.
Individuals
As a mother breastfeeds her baby, they experience close, skin-to-skin contact, promoting bonding and attachment. Mom usually talks to the baby, furthering that bond with the baby that close and looking up, the mother’s face is in the perfect range of the child’s visual ability at that age. The intimacy causes a surge of oxytocin, the love hormone, in both mother and child. Oxytocin promotes healing, reduces stress and sensitivity to pain, and lowers blood pressure for both participants. Another effect of the hormone is a feeling of confidence in the mother as she realizes she can care for her child perfectly. Feeling cared for and supported, the infant has an increased sense of security, leading to lower levels of depression, fewer behavioral issues, and better social functioning. Autistic spectrum disorders have been linked to low levels of oxytocin.
Society
It’s fairly easy to extrapolate some of those individual benefits to society. When babies have less protection from illnesses, they get sick more often and must visit a doctor. That can spread the illness and prevent at least one caregiver from working. Those visits and medications cost money; the caregiver may also deal with lost wages. Longer term, babies who aren’t breastfed are more likely to be obese, have other health issues, and score lower on I.Q. tests. These factors may reduce their ability to contribute to the workforce, earn good wages, and thrive in society. In turn, they may pay less taxes and rely more on government subsidies. In the U.S. alone, the mortality, morbidity, and health system costs of not breastfeeding total nearly $170 billion per year, in addition to the $2.2 billion spent on breast milk substitutes and 12,669 deaths. And this isn’t just a U.S. issue.
The World
The United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) recommend that infants are breastfed within an hour of birth, exclusively breastfed until they are six months old, and offered food and breast milk until they are at least two years old. But fewer than half the world’s infants are fed in a way that meets these guidelines. The consequences of that are staggering. According to the WHO’s The Cost of Not Breastfeeding Tool, the annual global results of not meeting breastfeeding recommendations include the following:
$507 billion in economic costs
$24 billion in health system costs
4.6 million cases of childhood obesity
195 million I.Q. points lost
424,249 deaths of children
93,863 deaths of mothers
Encouraging breastfeeding can also help mitigate pressure on the infant formula supply chain while recovering from the recent shortage. Knowing she can feed her baby herself will also reduce a new mom’s concern about formula shortages, whether the supply is safe, and affordability since breastfeeding saves a family $1,200 to $2,000 versus buying formula.
Education
Many expectant mothers have a vague idea that they should breastfeed, but few understand all the potential benefits for themselves, their babies, and society. As a nurse educator at Maryville University specializing in maternal-newborn nursing, lactation, and hospital prenatal instruction, I’m proud to see students go from classroom theory to a clinical environment where they see how it all comes together to impact real moms and babies in real life situations. I encourage students to provide that education to parents and set them up for family success. They can support, validate, and do small things to boost the mom’s confidence to care for her family. Students often report how rewarding it is to see a new mother gain confidence and feel better equipped to handle motherhood through something as simple and natural as breastfeeding.
One of the best ways to invest in the future is by protecting and promoting breastfeeding, being tireless patient advocates, and helping new and expectant mothers understand that breast milk is a baby’s optimal first food. It’s good for everyone—this is our why.
Missouri faces a shortage of primary care physicians, particularly in rural and underserved communities, making it challenging for residents in some parts of the state to access health care services.
Advanced Practice Registered Nurses (APRNs) can provide an alternative because they are trained to assess, diagnose, treat and prescribe for medical conditions in much the same way optometrists are trained to assess, diagnose, treat and prescribe for eye-related conditions.
But rules in Missouri restrict APRNs to practicing within 75 miles of their collaborating physician and require an initial one-month direct observation of practice between an APRN and an MD or DO and regular medical record reviews of the APRN from the MD or DO. What’s more, MDs and DOs cannot have collaborative practice with more than six full-time APRNs or physician’s assistants, and APRNs cannot conduct video visits or write for home health orders.
“I think it is very important to hear from nurses on the frontline,” said Pamela Talley, an MSN-DNP student in the College of Nursing who practices at CHIPs Health and Wellness Center on North Grand Ave. in the city of St. Louis. “We see the issues daily. We became nurses to take care of people, in response to seeing people suffer. Nurses have an ethical responsibility to advocate on behalf of those underserved populations. I believe it is a social justice issue and we must advocate for access to health care for all people.”
The students and faculty spent Tuesday morning talking to legislatures such as Sen. Steven Roberts and Sen. Brian Williams about access to health care, including for Talley’s clientele at CHIPS, a nurse-founded, free medical care clinic where most providers are volunteers in what is considered a medical-provider shortage area.
“I’ve been practicing as a pediatric nurse practitioner for over 30 years, mostly in the emergency department,” Kuensting said. “Children are a vulnerable population, often without health insurance, leaving the emergency department as their only source of health care. Organizations such as CHIPs and other nurse-led clinics in medical provider shortage areas can facilitate health maintenance and avoid episodic care visits for individuals and their healthcare needs, but the barriers APRNs face in Missouri make providing care extremely difficult.”
Talley had the opportunity to describe how restrictions impact her ability to care for patients in her community.
“It was great meeting with state legislators to discuss the need to reduce practice restrictions,” Talley said. “These restrictions are a barrier to vulnerable populations in both rural and urban areas. The current collaborative agreement creates restrictions to fundamental access to health care for people to manage their health and to live a quality life.”
She added: “If nurse practitioners could have greater independence and a less restrictive practice they would be able to provide much needed care in those areas where there are the greatest needs.”
There is precedent. Missouri temporarily lifted these restrictions for nearly two years during the COVID-19 pandemic with no adverse events, though that temporary lift expired on Dec. 31.
More and more states have also taken to permanently grants APRNs full-practice authority. On April 10, New York became the 25th state to take such action, and the Veterans Administration issue full practice authority to APRNs, regardless of the state they practice in, about two years ago.
“This course, and particularly this experience, is important for our APRN students to understand why being aware of the issues affecting our practice matter,” Kuensting said, “and more importantly, how to advocate for change.”
Photo at top includes U Missouri St Louis College of Nursing faculty members and students (from left): Laura Kuensting, Pam Talley, Marina Fischer, Marie Turner, Brooke Shahriary, Louise Miller, Kate Skrade, Carla Beckerle, Taylor Nealy, Ann Mwangi-Amann, Paige Bernau, Lucy Kokoi and Tammy Vandermolen at the Missouri Capitol last Tuesday to take part in the Association of Missouri Nurse Practitioners Advocacy Day. (Photo courtesy of Laura Kuensting)
In the rural northeastern corner of Missouri, Scotland County Hospital has been so low on staff that it sometimes had to turn away patients amid a surge in covid-19 cases.
The national covid staffing crunch means CEO Dr. Randy Tobler has hired more travel nurses to fill the gaps. And the prices are steep — what he called “crazy” rates of $200 an hour or more, which Tobler said his small rural hospital cannot afford. A little over 60% of his staff is fully vaccinated. Even as covid cases rise, though, a vaccine mandate is out of the question.
“If that becomes our differential advantage, we probably won’t have one until we’re forced to have one,” Tobler said. “Maybe that’s the thing that will keep nurses here.”
As of Thursday, about 39% of U.S. hospitals had announced vaccine mandates, said Colin Milligan, a spokesperson for the American Hospital Association. Across Missouri and the nation, hospitals are weighing more than patient and caregiver health in deciding whether to mandate covid vaccines for staffers.
The market for health care labor, strained by more than a year and a half of coping with the pandemic, continues to be pinched. While urban hospitals with deeper pockets for shoring up staff have implemented vaccine mandates, and may even use them as a selling point to recruit staffers and patients, their rural and regional counterparts are left with hard choices as cases surge again.
“Obviously, it’s going to be a real challenge for these small, rural hospitals to mandate a vaccine when they’re already facing such significant workforce shortages,” said Alan Morgan, head of the National Rural Health Association.
Without vaccine mandates, this could lead to a desperate cycle: Areas with fewer vaccinated residents likely have fewer vaccinated hospital workers, too, making them more likely to be hard hit by the delta variant sweeping America. In the short term, mandates might drive away some workers. But the surge could also squeeze the hospital workforce further as patients flood in and staffers take sick days.
Rural covid mortality rates were almost 70% higher on average than urban ones for the week ending Aug. 15, according to the Rural Policy Research Institute.
Despite the scientific knowledge that covid vaccinations sharply lower the risk of infection, hospitalization and death, the lack of a vaccine mandate can serve as a hospital recruiting tool. In Nebraska, the state veterans affairs’ agency prominently displays the lack of a vaccine requirement for nurses on its job site, The Associated Press reported.
It all comes back to workforce shortages, especially in more vaccine-hesitant communities, said Jacy Warrell, executive director of the Rural Health Association of Tennessee. She pointed out that some regional health care systems don’t qualify for staffing assistance from the National Guard as they have fewer than 200 beds. A potential vaccine mandate further endangers their staffing numbers, she said.
“They’re going to have to think twice about it,” Warrell said. “They’re going to have to weigh the risk and benefit there.”
The mandates are having ripple effects throughout the health care industry. The federal government has mandated that all nursing homes require covid vaccinations or risk losing Medicare and Medicaid reimbursements, and industry groups have warned that workers may jump to other health care settings. Meanwhile, Montana has banned vaccine mandates altogether, and the Montana Hospital Association has gotten one call from a health care worker interested in working in the state because of it, said spokesperson Katy Peterson.
It’s not just nurses at stake with vaccine mandates. Respiratory techs, nursing assistants, food service employees, billing staff and other health care workers are already in short supply. According to the latest KFF/The Washington Post Frontline Health Care Workers Survey, released in April, at least one-third of health care workers who assist with patient care and administrative tasks have considered leaving the workforce.
The combination of burnout and added stress of people leaving their jobs has worn down the health care workers the public often forgets about, said interventional radiology tech Joseph Brown, who works at Sutter Roseville Medical Center outside Sacramento, California.
This has a domino effect, Brown said: More of his co-workers are going on stress and medical leave as their numbers dwindle and while hospitals run out of beds. He said nurses’ aides already doing backbreaking work are suddenly forced to care for more patients.
“Explain to me how you get 15 people up to a toilet, do the vitals, change the beds, provide the care you’re supposed to provide for 15 people in an eight-hour shift and not injure yourself,” he said.
In Missouri, Tobler said his wife, Heliene, is training to be a volunteer certified medical assistant to help fill the gap in the hospital’s rural health clinic.
Tobler is waiting to see if the larger St. Louis hospitals lose staff in the coming weeks as their vaccine mandates go into effect, and what impact that could have throughout the state.
In the hard-hit southwestern corner of Missouri, CoxHealth president and CEO Steve Edwards said his health system headquartered in Springfield is upping its minimum wage to $15.25 an hour to compete for workers.
While the estimated $25 million price tag of such a salary boost will take away about half the hospital system’s bottom line, Edwards said, the investment is necessary to keep up with the competitive labor market and cushion the blow of the potential loss of staffers to the hospital’s upcoming Oct. 15 vaccine mandate.
“We’re asking people to take bedpans and work all night and do really difficult work and maybe put themselves in harm’s way,” he said. “It seems like a much harder job than some of these 9-to-5 jobs in an Amazon distribution center.”
Two of his employees died from covid. In July alone, Edwards said 500 staffers were out, predominantly due to the virus. The vaccine mandate could keep that from happening, Edwards said.
“You may have the finest neurosurgeon, but if you don’t have a registration person everything stops,” he said. “We’re all interdependent on each other.”
But California’s Brown, who is vaccinated, said he worries about his colleagues who may lose their jobs because they are unwilling to comply with vaccine mandates.
California has mandated that health care workers complete their covid vaccination shots by the end of September. The state is already seeing traveling nurses turn down assignments there because they do not want to be vaccinated, CalMatters reported.
Since the mandate applies statewide, workers cannot go work at another hospital without vaccine requirements nearby. Brown is frustrated that hospital administrators and lawmakers, who have “zero covid exposure,” are the ones making those decisions.
“Hospitals across the country posted signs that said ‘Health care heroes work here.’ Where is the reward for our heroes?” he asked. “Right now, the hospitals are telling us the reward for the heroes: ‘If you don’t get the vaccine, you’re fired.’”
Published courtesy of KHN (Kaiser Health News) a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
One November night in a Missouri prison, Charles Graham woke his cellmate of more than a dozen years, Frank Flanders, saying he couldn’t breathe. Flanders pressed the call button. No one answered, so he kicked the door until a guard came.
Flanders, who recalled the incident during a phone interview, said he helped Graham, 61, get into a wheelchair so staff members could take him for a medical exam. Both inmates were then moved into a covid-19 quarantine unit. In the ensuing days, Flanders noticed the veins in Graham’s legs bulging, so he put towels in a crockpot of water and placed hot compresses on his legs. When Graham’s oxygen levels dropped dangerously low two days later, prison staff members took him to the hospital.
“That ended up being the last time that I seen him,” said Flanders, 45.
Graham died of covid on Dec. 18, alarming Flanders and other inmates at the Western Missouri Correctional Center in Cameron, about 50 minutes northeast of Kansas City. His death reinforced inmates’ concerns about their own safety and the adequacy of medical care at the prison. Such concerns are a major reason Flanders and many other inmates said they are wary of getting vaccinated against covid-19. Their hesitancy puts them at greater risk of suffering the same fate as Graham.
Inmates pointed to numerous covid deaths they considered preventable, staffing shortages and guards who don’t wear masks. While corrections officials defended their response to covid, Flanders said he’s apprehensive about how the department handles “most everything here recently,” which colors how he thinks about the vaccines.
Reluctance to get a covid vaccine is not unique to Missouri inmates. At a county jail in Massachusetts, nearly 60% of more than 400 people incarcerated said in January they would not agree to be vaccinated. At a federal prison in Connecticut, 212 of the 550 inmates offered the vaccines by early March declined the shots, including some who were medically vulnerable, The Associated Press reported.
The Missouri Department of Corrections said March 12 that more than 4,200 state inmates had received the vaccine out of 8,000 who were eligible because they were at least 65 years old or had certain medical conditions. Officials were still working to vaccinate 1,000 additional eligible inmates who had requested the shots. The department had not begun vaccinating the remaining 15,000 inmates or surveyed them to determine their interest in the vaccines. So far, about 18% of the total prison population has been vaccinated, which roughly tracks with the overall rate in Missouri even though inmates are at higher risk for covid than Missourians generally and should be easier to vaccinate given they are already in one place together.
Missouri placed the majority of inmates in its lowest vaccine priority group. It is one of 14 states to either do that or not specify when they will offer the vaccines to inmates, according to the COVID Prison Project, which tracks data on the virus in correctional facilities.
Another is Colorado, where Democratic Gov. Jared Polis moved inmates to the back of the vaccine line amid public pressure. The emergence of a more contagious variant of the virus at one prison, however, forced officials to adjust their plans and instead start vaccinating all inmates at that facility.
Lauren Brinkley-Rubinstein, prison project co-founder and professor of social medicine at the University of North Carolina, said that disregarding health officials’ recommendation to prioritize people living in tight quarters might make inmates less trustful of prison staff “when they come around and say, ‘Hey, it’s finally your turn. Let me inject you with this.’”
States cannot mandate that inmates take the vaccines. But Missouri officials have tried to encourage them by distributing safety information about it, including a videodebunking myths featuring a scientist from Washington University in St. Louis.
But persuasion is proving difficult at Western Missouri, given inmates’ longtime distrust of prison management. Flanders, Graham and others were transferred there from neighboring Crossroads Correctional Center following a 2018 riot that caused an estimated $1.3 million in damage and led to its closure. Inmates were angry that staff shortages had reduced time for recreation and other programming.
Officials acknowledge that staff shortages have persisted through the pandemic. “Corrections is not the most popular place to work right now,” Missouri corrections director Anne Precythe said at an early March NAACP town hall on covid and prisons.
Flanders, who is serving a life sentence for first-degree robbery, said the prison didn’t have enough nursing staffers to check on him during a bout with mild covid in November. He said other sick inmates also didn’t receive appropriate medical attention. Karen Pojmann, a corrections department spokesperson, said she could not comment on specific offenders’ medical issues.
Tim Cutt, executive director of the Missouri Corrections Officers Association, said he’s seen no evidence that Western Missouri even had a plan to contain covid. “They were quarantining for a while,” he said, “but it was a haphazard attempt.”
Also fueling skepticism of prison health care, inmates said, is the failure of many staff members to follow the corrections department’s mask mandate. Byron East, who is serving a life sentence for murder at South Central Correctional Center, two hours southwest of St. Louis, said in a phone interview that he has begged officers — many of whom live in conservative, rural areas where masks are less common — to wear face coverings.
“As an employee, your job is to protect, and we are not able to protect ourselves,” said East, 53. “You can catch something and then come in here and spread it to us.”
Amy Breihan, co-director of the Missouri office of the Roderick & Solange MacArthur Justice Center, a nonprofit civil rights law firm, said she didn’t see a single officer wearing a mask on Feb. 10 when she visited a correctional facility in Bonne Terre, Missouri.
Corrections Department Deputy Director Matt Sturm confirmed Breihan’s account at the NAACP town hall and said it has been addressed. He said the department expects staff members in all prisons to wear masks while inside when they can’t stay 6 feet apart from others.
“Right from the beginning, the Department of Corrections in Missouri has taken covid extremely serious,” Sturm said. The department deployed “everything we could get our hands on to help either prevent or contain covid,” including equipment for ventilation and disinfection.
Still, Missouri has reported at least 5,500 covid cases and 48 deaths among inmates at the state’s adult correctional institutions during the pandemic. The department doesn’t break down covid deaths by prison, but data from the advocacy group Missouri Prison Reform showed Western Missouri had 21 total deaths from covid or other causes last year, more than any other state prison even though its population isn’t the largest. Statistics on deaths in the previous year were not immediately available.
An automatic email reply from Eve Hutcherson, a former spokesperson for Corizon Health, which manages health care in Missouri prisons, directed a reporter to Steve Tomlin, senior vice president of business development, but he didn’t respond to questions. The company, one of the country’s largest for-profit correctional health care providers, faced more than 1,300 lawsuits over five years, according to a 2015 report from the financial research firm PrivCo. In Arizona, Corizon paid a $1.4 million fine for failing to comply with a 2014 settlement to improve inadequate health care for inmates.
Despite concerns about prison health care, however, some inmates have agreed to get the shot. East, who is Black, said he initially decided against it because he didn’t trust prison health and thought about the legacy of the Tuskegee experiments from 1932 to 1972, when researchers withheld treatment for Black men infected with syphilis. But he changed his mind after reading about how safe the vaccines are.
Flanders, meanwhile, is still weighing whether to get vaccinated as he mourns the death of his longtime cellmate Graham, a convicted murderer whom he considered a friend and father figure.
Flanders’ mother, Penny Kopp, said Graham helped Flanders manage his finances and kept him from gambling and getting involved with “inmates who are troublemakers.” Kopp, a former corrections officer in Indiana and Colorado, said she understands the challenges of working in a prison but wonders if enough was done to save her son’s cellmate.
Flanders said getting the shot would mean putting himself at the mercy of prison staffers, as Graham did — and that’s something he’s not ready to do.
Registered nurse Pascaline Muhindura has spent the past eight months treating COVID patients at Research Medical Center in Kansas City, Missouri.
But when she returns home to her small town of Spring Hill, Kansas, she’s often stunned by what she sees, like on a recent stop for carryout food.
“No one in the entire restaurant was wearing a mask,” Muhindura said. “And there’s no social distancing. I had to get out, because I almost had a panic attack. I was like, ‘What is going on with people? Why are we still doing this?’”
Many rural communities across the U.S. have resisted masks and calls for social distancing during the coronavirus pandemic, but now rural counties are experiencing record-high infection and death rates.
Critically ill rural patients are often sent to city hospitals for high-level treatment and, as their numbers grow, some urban hospitals are buckling under the added strain.
Kansas City has a mask mandate, but in many smaller communities nearby, masks aren’t required — or masking orders are routinely ignored. In the past few months, rural counties in both Kansas and Missouri have seen some of the highest rates of COVID-19 in the country.
At the same time, according to an analysis by KHN, about 3 in 4 counties in Kansas and Missouri don’t have a single intensive care unit bed, so when people from these places get critically ill, they’re sent to city hospitals.
A recent patient count at St. Luke’s Health System in Kansas City showed a quarter of COVID patients had come from outside the metro area.
Two-thirds of the patients coming from rural areas need intensive care and stay in the hospital for an average of two weeks, said Dr. Marc Larsen, who leads COVID-19 treatment at St. Luke’s.
“Not only are we seeing an uptick in those patients in our hospital from the rural community, they are sicker when we get them because [doctors in smaller communities] are able to handle the less sick patients,” said Larsen. “We get the sickest of the sick.”
Dr. Rex Archer, head of Kansas City’s health department, warns that capacity at the city’s 33 hospitals is being put at risk by the influx of rural patients.
“We’ve had this huge swing that’s occurred because they’re not wearing masks, and yes, that’s putting pressure on our hospitals, which is unfair to our residents that might be denied an ICU bed,” Archer said.
A study newly released by the Centers for Disease Control and Prevention showed that Kansas counties that mandated masks in early July saw decreases in new COVID cases, while counties without mask mandates recorded increases.
Hospital leaders have continued to plead with Missouri Republican Gov. Mike Parson, and with Kansas’ conservative legislature, to implement stringent, statewide mask requirements but without success.
Parson won the Missouri gubernatorial election on Nov. 3 by nearly 17 percentage points. Two days later at a COVID briefing, he accused critics of “making the mask a political issue.” He said county leaders should decide whether to close businesses or mandate masks.
“We’re going to encourage them to take some sort of action,” Parson said Thursday. “The holidays are coming and I, as governor of the state of Missouri, am not going to mandate who goes in your front door.”
In an email, Dave Dillon, a spokesperson for the Missouri Hospital Association, agreed that rural patients might be contributing to hospital crowding in cities but argued that the strain on hospitals is a statewide problem.
The reasons for the rural COVID crisis involve far more than the refusal to mandate or wear masks, according to health care experts.
Both Kansas and Missouri have seen rural hospitals close year after year, and public health spending in both states, as in many largely rural states, is far below national averages.
Rural populations also tend to be older and to suffer from higher rates of chronic health conditions, including heart disease, obesity and diabetes. Those conditions can make them more susceptible to severe illness when they contract COVID-19.
Rural areas have been grappling with health problems for a long time, but the coronavirus has been a sort of tipping point, and those rural health issues are now spilling over into cities, explained Shannon Monnat, a rural health researcher at Syracuse University.
“It’s not just the rural health care infrastructure that becomes overwhelmed when there aren’t enough hospital beds, it’s also the surrounding neighborhoods, the suburbs, the urban hospital infrastructure starts to become overwhelmed as well,” Monnat said.
Unlike many parts of the U.S., where COVID trend lines have risen and fallen over the course of the year, Kansas, Missouri and several other Midwestern states never significantly bent their statewide curve.
Individual cities, such as Kansas City and St. Louis, have managed to slow cases, but the continual emergence of rural hot spots across Missouri has driven a slow and steady increase in overall new case numbers — and put an unrelenting strain on the states’ hospital systems.
The months of slow but continuous growth in cases created a high baseline of cases as autumn began, which then set the stage for the sudden escalation of numbers in the recent surge.
“It’s sort of the nature of epidemics that things often look like they’re relatively under control, and then very quickly ramp up to seem that they are out of hand,” said Justin Lessler, an epidemiologist at Johns Hopkins Bloomberg School of Public Health.
Now, a recent local case spike in the Kansas City metro area is adding to the statewide surge in Missouri, with an average of 190 COVID patients per day being admitted to the metro region’s hospitals. The number of people hospitalized throughout Missouri increased by more than 50% in the past two weeks.
Some Kansas City hospitals have had to divert patients for periods of time, and some are now delaying elective procedures, according to the University of Kansas Health system’s chief medical officer, Dr. Steven Stites.
But bed space isn’t the only hospital resource that’s running out. Half of the hospitals in the Kansas City area are now reporting “critical” staffing shortages. Pascaline Muhindura, the nurse who works in Kansas City, said that hospital workers are struggling with anxiety and depression.
“The hospitals are not fine, because people taking care of patients are on the brink,” Muhindura said. “We are tired.”
Published courtesy of Kaiser Health News. This story is from a reporting partnership that includes KCUR, NPR, and KHN.KHN (Kaiser Health News) is a nonprofit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.
