About 24% of U.S. hospitals are reporting a "critical staffing shortage," according to data from the U.S. Department of Health and Human Services, as public health experts warn the COVID-19 surge fueled by the omicron variant threatens the nation's health care system.
"Given how much infection there is, our hospitals really are at the brink right now," Dr. Ashish Jha, dean of Brown University's School of Public Health, told CNN on Sunday.
Of the approximately 5,000 hospitals that reported this data to HHS on Saturday, nearly 1,200 -- about 1 in 4 -- said they are currently experiencing a critical staffing shortage, the largest share of the entire pandemic. More than 100 other hospitals said they anticipate a shortage within the next week.
The U.S. health care system is Jha's greatest concern, he said, noting the omicron surge could hamper its capacity to care for patients suffering from conditions other than COVID-19.
"The health care system is not just designed to take care of people with COVID … it's designed to take care of kids with appendicitis and people who have heart attacks and get into car accidents," he said.
"And all of that is going to be much, much more difficult because we have a large proportion of the population that is not vaccinated, plenty of high-risk people who are not boosted," he said. "That combination sets up a large pool of people who as they get infected will end up really straining the resources we have in the hospitals today."
These staff shortages are growing as frontline health care workers are either infected or forced to quarantine due to exposure to COVID-19 just as the demand for treatment skyrockets: More than 138,000 COVID-19 patients were in U.S. hospitals as of Saturday, according to the Department of Health and Human Services. That's not far from the all-time peak (about 142,200 in mid-January 2021) and an increase from around 45,000 in early November.
To safeguard hospital capacity, some facilities are forced to cut elective surgeries. In New York, for example, 40 hospitals -- mainly in the Mohawk Valley, Finger Lakes and central regions -- have been told to stop nonessential elective operations for at least two weeks because of low patient bed capacity, the state health department said Saturday.
The University of Kansas Health System is also close to implementing crisis standards of care, Chief Medical Officer Dr. Steven Stites said Saturday, telling CNN, "At some point ... we're too overwhelmed to do any of our normal daily work."
"At that point, we have to turn on a switch that says we got to triage to the people we can help the most," he said, "and that means we've have to let some people die who we might have been able to help but we weren't sure about -- they we're too far gone or had too much of an injury, or maybe we can't get to that trauma that just came in."
Stites said two waves were hitting Kansas simultaneously -- with delta accelerating post-Thanksgiving, to be met by omicron -- describing it as "almost a double pandemic." The vast majority of those being hospitalized are unvaccinated, Stites said.
About 62.5% of the total U.S. population is fully vaccinated according to the U.S. Centers for Disease Control and Prevention. About 36% of those have received a booster shot, the data shows.
Dr. Jonathan Reiner, professor of medicine and surgery at George Washington University, told CNN on Saturday the next several weeks will "look bad in many American cities."
"Forty hospitals in New York just canceled elective procedures. The D.C. Hospital Association, where I work, has asked the D.C. government for permission for hospitals to enact crisis standards of care," he said. "And that's coming to every city in the United States."
Los Angeles sees record weekly case numbers
Nationwide, 39 states are reporting a 50% or greater increase in cases during the past week compared to the previous week, according to a CNN analysis of data from Johns Hopkins University. As of Saturday, the seven-day average of new daily cases in the U.S. was 701,199, per JHU data.
Some localities are now seeing the most new cases they've seen the whole pandemic, including Los Angeles County.
On Saturday, the county reported more than 200,000 confirmed cases over the previous seven days -- the highest number of cases in one week since the start of the pandemic, according to a news release from the Los Angeles County Department of Public Health. Hospitalizations doubled over the week to 3,200 and there were 135 COVID-related deaths, the department said.
With infections rising, California Gov. Gavin Newsom on Saturday announced a proposed $2.7 billion COVID-19 Emergency Response Package designed to bolster testing and vaccination efforts, support frontline workers and battle misinformation, his office said in a news release. Newsom also signed an executive order Saturday "establishing consumer protections against price gouging on at-home test kits," according to his office.
The rise in infections is also hitting Los Angeles' children hard.
At Children's Hospital Los Angeles, the positivity rate for children tested for COVID-19 has increased from 17.5% in December to 45% to date in January, according to CHLA Medical Director Dr. Michael Smit.
CHLA currently has 41 patients in-house who have tested positive for COVID-19, and roughly one-quarter of the children admitted to the facility with COVID-19 require admission to the pediatric ICU, with some requiring intubation, Smit told CNN on Saturday.
The rise in cases comes just as Los Angeles students are preparing to return to in-person classes Tuesday.
Los Angeles Unified School District, the second-largest school district in the country, is requiring all students and employees to show a negative COVID-19 test result before returning to the classroom.
The baseline test requirement was implemented at the beginning of the school year in August, and the district announced a week ago that both the baseline test, along with required weekly testing for all employees and students would continue through January, given the current omicron surge.
Shannon Haber, chief communications officer for LAUSD, told CNN on Saturday that similar protocols in the fall, along with vaccination requirements, universal masking and "Ghostbusters-level" sanitation practices, have made it possible for every one of its more than 1,000 schools to stay open for in-person learning this academic year.
Haber said that 100% of LAUSD employees are fully vaccinated and students 12 and older are required to be fully vaccinated by the beginning of the next school year, with 90% so far meeting that requirement.
Disputes over in-person learning
For the week ending Dec. 30, children accounted for 17.7% of new reported cases in the U.S., the American Academy of Pediatrics said, noting a record 325,00 new cases among children -- a 64% increase from the week prior.
In response to rising pediatric infections, disputes over whether in-person learning is ideal during the omicron surge and how students can safely attend school are playing out in various school districts this week.
The Chicago Public Schools (CPS) system has canceled classes since Wednesday due to a dispute between city officials and the teachers union over returning to the classroom.
The Chicago Teachers Union (CTU) had voted to teach remotely due to the COVID-19 surge, but the school district canceled classes, saying it wanted in-person learning.
The CTU presented a new proposal to Mayor Lori Lightfoot on Saturday that the union said would provide clarity on a return to the classroom, create increased safety and testing protocols and restart the education process for students.
CPS rejected the proposal, saying it looked forward "to continued negotiations to reach an agreement."
The school district did agree with CTU's request it provide KN95 masks for all staff and students for the remainder of the school year and said they will continue to provide weekly COVID-19 testing to all students and staff.
In Georgia, public school teachers who test positive for COVID-19 no longer have to isolate before returning to school, and contact tracing in schools is no longer required, according to a letter to school leaders released Thursday from Gov. Brian Kemp and public health commissioner Kathleen Toomey.
The Georgia Department of Public Health posted an updated administrative order Wednesday allowing teachers and school staff -- regardless of vaccination status -- to return to work after a COVID-19 exposure or a positive COVID-19 test if they remain asymptomatic and wear a mask while at work.
Lisa Morgan, president of the Georgia Association of Educators, told CNN on Saturday that she believed the changes were the "absolute wrong thing to do at the absolute worst time."
"We know that there are increasing cases in our children, there's increasing hospitalizations in our children and this action shows a lack of regard for the health and safety of educators, students and our families," Morgan said.
She said that educators wanted to be in classrooms with their students but that should be achieved by keeping people healthy.
The removal of the contact tracing requirement was frustrating, she said. "Now an educator will not know if there is a positive case in their classroom. Parents will not know if there is a positive case in their child's classrooms. So educators and parents will then be unable to make informed decisions to ensure their child's health and safety," Morgan said.
Teacher shortages in Boston led Superintendent Brenda Cassellius to step in to teach a fourth-grade class last week. She told CNN on Saturday the strain of the past two years had been difficult for adults and children.
"Particularly, it has been challenging for our high school children and our middle school students who have had significant isolation and disregulation due to mental health issues," she said. Going forward, Cassellius said, more testing capability was needed in her district.
"We need our teachers to be included in those tests because right now vaccinated students and teachers are not included in those tests. We do need some shifts in policy, particularly when we are in times of surge," she said.