Inside omicron’s impact on Evanston health care workers: ‘You don’t get a rest day’

In early December, Dr. Ernest Wang, Chief of Emergency Medicine for NorthShore University HealthSystem, was visiting his daughter in France. She was studying abroad there, and Wang finally had a moment to get away from Evanston, with coronavirus cases and hospitalizations remaining low in the Chicago area. In his professional role, he had been leading the coronavirus response efforts for NorthShore’s network of hospitals in the northern suburbs around Evanston. 

But over in France, the COVID-19 situation was quickly becoming grimmer by the day. Scientists in South Africa had detected the omicron variant – a potentially much more contagious version of the virus – in late November. Within days of Wang and his family arriving in France, the public health authorities there had started ringing alarm bells about the number of new cases beginning to show up around the country. 

Watching the local pandemic news during his stay in Europe, Wang immediately knew what was coming when he showed up to his first shift back at NorthShore after returning from France. 

“I knew exactly what was going to happen,” Wang said. “I get home, it’s the middle of December, I do a couple shifts and it’s still not too high a COVID number, and then all of a sudden it’s like this switch turned on, and everybody coming in had COVID. Everybody either had symptoms related to COVID or just had COVID, and they were there for another reason.”

Of course, the omicron variant turned out to be just as infectious as advertised, and within weeks, Evanston started reporting hundreds of new COVID-19 cases each day. Over the last month, omicron has impacted practically every aspect of daily life around the city, from school to work to doctor’s appointments. Evanston Township High School had to shift classes online for the last week of the fall semester after more than 100 students tested positive for the virus in a one-week period. The city hit a record high of 273 daily new cases Jan. 13.

And even though Evanston is a highly vaccinated community, and omicron has proven to be slightly milder than earlier forms of COVID-19, the sheer number of new cases still inundated hospitals with patients sick from the virus. Last week, both Amita Health Saint Francis Hospital in Evanston and NorthShore Glenbrook Hospital, where all NorthShore COVID-19 patients typically stay, reported near-record highs of inpatient coronavirus cases. The surge has subsided somewhat recent days, but the latest wave continues to wreak havoc on the local health care system.

“I think most of us are more focused on the metrics, the indicators, the cases, and we forget the human aspects to our response to COVID, given that this is a situation that we have been responding to since February of 2020, and it continues,” said Ike Ogbo, Director of the Evanston Health and Human Services Department. “You hear about public health officials who have left their posts due to frustration, tensions and ever-changing protocols.”

At Saint Francis, a number of nurses and other employees have left the profession due to stress and burnout from the pandemic, said Dr. Harvey Friedman, a pulmonary and critical care physician at the hospital. To keep up with the high demand for care amid the omicron wave, Amita has started hiring contract nurses through third-party companies, Friedman said. 

Both Wang and Friedman also added that while the depth of COVID-19 knowledge built up during the last two years has helped alleviate some of the uncertainties of the pandemic, the latest surge of cases has exhausted workers.

“What we’ve done is we just limit our vacations right now, so we can each take maybe a day off per week for our mental health,” Friedman said. “So nobody’s really going on vacation, except maybe a long weekend or something like that.”

According to Friedman and Wang, Saint Francis and Glenbrook hospitals have expanded their available supply of ventilators and intensive care unit beds beyond what would be considered normal capacity to care for omicron patients, but the shortage of qualified nurses has created a bigger problem. At Glenbrook, there aren’t enough staffed beds for everyone who comes in needing one right now, so doctors and nurses have to prioritize the sickest patients, COVID-related or not, Wang said.

As he described the situation, local hospitals simultaneously have more sick patients and fewer staff than at any other time in the pandemic. Those conflicting problems have added a heavy burden on the dedicated and passionate health care workers who remain on the job.

“Imagine you’re on a treadmill, and your average comfortable pace is 6 miles per hour, and then the next day, you come in and the incline goes to 1%. And then the next day, you come in and it goes to 2, and then to 3 and then by the end of the month, you’re at 10, and the speed stays the same or increases,” Wang said. “That’s what it’s been like every single day for two years, and there’s no day to stop. You don’t get a rest day, you can’t lower the incline. The incline only goes down when omicron goes down.” 

Currently, infectious disease experts like Dr. Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Diseases, hope that the milder omicron variant of COVID-19 will help the virus become endemic, where people can live without the possibility of the disease overwhelming hospitals or the American health care infrastructure.

For the vast majority of fully vaccinated people, omicron does not present a major risk of hospitalization or death, experts have said. Friedman and Wang estimated that at least 90% of the COVID-19 patients they have seen in recent weeks are unvaccinated. 

Ogbo, the local public health leader, encouraged Evanston residents to have faith in protocols like universal mask-wearing and vaccine mandates to help tackle the omicron surge. If cases end up plummeting in the coming months, Ogbo said he hopes Evanston will be able to rescind those orders and return to a sense of normalcy in public life. 

But Wang’s main concern for the future remains the long-term consequences of the pandemic on nurses, doctors and other health care workers who have been on the front lines for almost two years now. When the dust settles after COVID-19 becomes more manageable and endemic, the medical field will have to address the sustained trauma experienced by workers, he said.

“The biggest contributor to the PTSD [post-traumatic stress disorder] is the sheer number of deaths that every health care worker has had to deal with over the past few years, especially ICU [intensive care] nurses and physicians,” Wang said. “The average citizen is just not exposed to this, just like soldiers returning from war. There will be a reckoning in health care around this after the pandemic is over, for sure.”

Ogbo said that providing more mental health resources for health care workers and the entire Evanston population is a top priority for his department in planning for the next five years. In the wake of a pandemic that has affected all residents in unique ways, the health care sector needs to rejuvenate its workforce, and local government needs to address an unprecedented need for mental health services, Wang and Ogbo emphasized in separate interviews.

“If you come to the emergency department at any one of our sites, we are committed to taking care of you, but we’re limited by our resources, like the number of beds,” Wang said. “But everyone who’s here really wants to be here and are the most dedicated people, so please be patient and kind.”