Because there aren't enough staffers to safely care for the patients, hospitals are leaving beds empty, and a tight labor market has made finding replacements difficult.
Due to staff shortages, the Mass General Brigham hospital system in Boston kept 83 beds vacant on Friday. The University Hospitals system in Ohio recently closed up to 16% of its intensive-care beds, while Parkland Health & Hospital System in Dallas closed 30 of its 900 beds.
"It's definitely a brutal situation," Dr. Joseph Chang, chief medical officer at Parkland, said on a recent day when more than 500 of the company's 14,000 employees were absent.
According to doctors and healthcare officials, limiting capacity is a last resort for hospitals. The facilities do it to ensure the proper care and safety of current patients, even if it means leaving people in emergency rooms in limbo, making ambulances wait, and delaying treatment for cancer, heart disease, and other conditions.
Meanwhile, some hospitals are requesting that doctors discharge patients as soon as possible in order to free up beds, that remaining staffers work overtime, that any available temporary nurses be hired, and that volunteers and relief workers, including National Guard members, be enlisted.
"We live in a world of trade-offs," said Ron Walls, a physician and the chief operating officer of Mass General Brigham, which had 2,000 of its 82,000 employees test positive for Covid-19 in the 10 days ending Jan. 4.
Hospitals are resorting to desperate measures as other critical employers, ranging from airlines to police and fire departments, struggle with employee absences.
Between New Year's Eve and Jan. 6, the number of hospitals voluntarily reporting critical staffing shortages to the federal government increased by about 9% to 1,285 hospitals. Because those figures aren't specified in U.S. Health and Human Services Department data, it's impossible to know how many hospital employees are calling in sick and how many beds are lost nationwide.
Doctors and hospital officials interviewed by The Wall Street Journal said they recently reduced capacity by 3% to 10% due to staff shortages.
According to Janis Orlowski, the association's chief health care officer, members of the Association of American Medical Colleges, a trade group for medical schools and teaching hospitals, 5% to 7% of employees are out sick with Covid-19.
"Those are significant numbers when it comes to staffing a hospital," Dr. Orlowski said.
According to preliminary research, Omicron infections are typically milder than earlier cases. However, the variant appears to be more contagious, which means that more people are becoming infected and arriving in hospitals with severe disease.
According to HHS, the District of Columbia and 14 states, including New York and Illinois, reported a record number of hospitalized patients with confirmed or suspected Covid-19 this month.
According to Mary Beth Kingston, the system's chief nursing officer, the number of Covid-19 patients at Advocate Aurora Health's 26 hospitals in Illinois and Wisconsin recently reached a record, after doubling in the previous month. On December 29, the system set a new high of 1,224 users, which had since risen to 1,648 as of Saturday.
According to her, roughly 92 percent of those patients are unvaccinated, partially vaccinated, or due for booster shots.
Employees who called in sick have also exacerbated staffing shortages, she claims, after some nurses left to retire early or work for traveling-nurse agencies that offered higher pay.
As of Jan. 5, approximately 1% of Advocate Aurora's 75,000 employees, including nearly 430 clinical workers, were unable to work due to Covid-19.
To help fill the gaps, the system has hired some temporary nurses, and employees have taken on extra shifts, according to Dr. Kingston. Nonetheless, as of Friday, the system still had 50 beds closed at Advocate Trinity Hospital in Chicago and the nearby Advocate South Suburban Hospital.
Staffing shortages were alleviated somewhat, according to hospital officials, by late-December changes to the Centers for Disease Control and Prevention guidelines for Covid-19 isolation. The CDC reduced the recommended length of isolation to five days.
Employees who have been infected can now return to work earlier. Despite this, hospital systems continue to report hundreds or thousands of employees absent due to illness on any given day.
According to Robert Wyllie, the system's chief of medical operations, approximately 3,000 of the Cleveland Clinic's 52,000 employees in Ohio and Florida were home sick on average each day last week. So far, no beds have had to be closed, thanks in part to the deployment of 220 members from the Ohio National Guard to help fill in.
University Hospitals, based in Cleveland, reported that about 2% of its roughly 30,000 employees are home sick on a daily basis. To relieve strain, the system redeployed remaining staffers and moved some patients across hospitals, but it wasn't enough, according to Paul Hinchey, a physician and president of the system's community delivery network.
"Patients continue to arrive," he said.