COVID-19 emergency declaration has ended, but Kentucky’s health care worker crisis hasn’t

After a brutal three years of fighting the spread of the coronavirus, is Kentucky’s health care workforce in good shape? Hospital administrators in Lexington say no, and data bear that out.

In late September, the Kentucky Hospital Association released the results of an annual survey. The association surveyed 96 acute care hospitals across the commonwealth, its highest participation rate in years.

Participants were asked about their personnel needs, and the results show 22% of nursing positions across the commonwealth were vacant. At the time, Kentucky needed more than 5,000 registered nurses.

Gaps in the health care workforce aren’t confined to just nurses, however, as the University of Kentucky’s Dr. Ashley Montgomery-Yates, chief medical officer at Good Samaritan Hospital, attested in a May 11 briefing.

“It’s also radiology techs and pharmacy techs … all of the people who are part of the team that make hospital care work,” Dr. Montgomery-Yates said. Those gaps extend outside of hospitals, too, she added. “It’s every piece of the health care puzzle.”

State data indicates more than 38,000 Kentuckians are employed in health care-related jobs, and there are about 250 businesses in that sector. Those figures do not include private health care, hospitals and physicians offices, according to the state Cabinet for Economic Development.

There are several theories as to why there’s been a mass exodus from the sector, but underlying them all is a feeling of being taken for granted by the general public, Dr. Montgomery-Yates said.

“I think that we as a society are going to need to step up and remind all of the people in health care that they are valuable,” she said.

That may mean paying health care professionals more, but according to Dr. Dan Goulson, chief medical officer with CHI Saint Joseph Health in Lexington, finding the money for that is another challenge.

“The supply (of workers) has gone down, and the demand has gone up or continues to be there, so financially you see essentially the bidding up of prices,” he said, referring to news reports of travel nurses earning highly lucrative salaries.

In early 2022, some were making as much as $150 an hour, according to one CNBC report.

“You have to start thinking about creative ways to solve your problems,” Dr. Goulson said. “The normal ways don’t work anymore.”

It isn’t just local hospitals or even those in Kentucky. In 2021, more than 333,000 health care workers left their jobs for a variety of pandemic-related reasons, such as burnout, long hours, heavy patient loads and personal health concerns, according one report.

The latest on COVID-19 in Kentucky

After more than 18,000 deaths from COVID-19 in Kentucky, the official coronavirus public health emergency ended May 11 — though the virus has not gone away.

The U.S. Centers for Disease Control and Prevention discontinued several metrics it provided on the weekly basis, including its COVID-19 community level map and transmission level map.

Now, the CDC is promoting hospital admissions as a primary indicator of exposure risk in a given community. At varying levels (be they low, medium or high) the agency makes different recommendations. It only recommends most people wear masks indoors, in public when local hospital admission is at a high level.

The COVID-19 dashboard from the Kentucky Cabinet for Health and Family Services indicates its last update was May 13.

The virus is still evolving and will continue to do so. The new XBB.1.16 strain, nicknamed the Arcturus subvariant, has doctors and public health agencies wary. Arcturus is highly contagious, can cause severe illness and has a competitive advantage over previous dominant strains of COVID-19.

Other issues also remain. Six percent of U.S. adults, or about 16 million people, still suffer from long COVID or other ongoing health problems after being infected with the virus, according to NPR.

Additionally, of those U.S. adults experiencing long COVID, about 4 million have symptoms that significantly affect their ability to carry out day-to-day tasks, including climbing a flight of stairs, focusing on a project or holding down a job, per the NPR report.

“We have to remember that the disease has not gone away,” Goulson said during the virtual news conference May 11.

Goulson was one of several Lexington physicians urging the public to keep up their vigilance to COVID-19 even as the national public emergency sunsets.

They recommended committing to effective public health strategies, like staying updated on available vaccines and masking when appropriate.

“If you’re sick, wear a mask,” Montgomery-Yates said. “You never know who in your life is immune-suppressed. You never know who you’re standing next to that you could make sick, and all you have to do is put on a mask.”

Other changes with end of emergency declaration

Individuals covered by state Medicaid programs can continue to receive COVID-19 tests without cost-sharing until Sept. 30, 2024. After that date, coverage may vary by state, per a fact sheet from the U.S. Department of Health and Human Services.

For people insured through Medicare, coverage for tests may change depending on what program they’re enrolled in.

Finally, the requirement for private insurers to cover COVID-19 tests at no cost to individuals ended with the expiration of the public health emergency. Insurance companies may still choose to cover them, however, so you should check with your insurer to see where things stand.

When it comes to COVID-19 vaccines, expect to pay a premium if you have not gotten your shot or go for a booster.

Both Pfizer and Moderna intend to raise the price three to four times higher. The exact price isn’t clear yet, but Pfizer recently told its investors it expects to set the price per dose at between $110 and $130, and Moderna has suggested a similar range, according to the Kaiser Family Foundation.

In a previous KFF report, the organization estimated between 5 million and 14 million people nationwide will lose their Medicaid health coverage as state programs around the country scale back their benefits.

With COVID emergency declaration over, 280K Kentuckians may lose Medicaid. What to know

Additionally, several of the metrics Kentuckians have come to rely upon to assess the pandemic in their communities have been phased out or discontinued altogether.

The federal health agency will no longer calculate a localized COVID-19 positivity rate, and while hospital data reporting will continue, it will move from daily to weekly updates.

Do you have a question about the coronavirus pandemic in Kentucky for our service journalism team? We’d like to hear from you. Fill out our Know Your Kentucky form or email ask@herald-leader.com.