CLEVELAND — With the Omicron variant still causing a surge of COVID-19 cases in Ohio, one Northeast Ohio health system is urging its employees to stay the course.

The Cleveland Clinic is among those health systems having to make tough decisions, as hospital beds fill up and the pandemic takes a toll on caregivers.

In an email to the Clinic’s tens of thousands of employees, Cleveland Clinic CEO and President Tom Mihaljevic thanked everyone who served patients or offered support over the holidays. He wrote that he hoped the New Year brought them joy, but that they “all expected to be in a better place with the pandemic. That is sadly not the case.”

Dr. Kelly Hancock, chief caregiver officer at the Cleveland Clinic, oversees the 70,000 employees in the system. All employees are called caregivers, regardless of whether they’re involved in direct patient care.

“This has really become our most severe surge of COVID-19,” Hancock said, noting that more than 1,100 COVID patients are currently in the Clinic’s Ohio hospitals. She added that approximately 3,500 caregivers were out of work as of Monday, January 3.

“With this severe surge, we continue to be so proud of the dedication of all of our caregivers through all the ups and downs of this pandemic,” Hancock said. “We know that this has put a strain on the organization, a strain on our caregivers. We know that they're fatigued, but yet they come back every day and they do so with compassion and dedication for our patients.”

While there have been some breakthrough cases of vaccinated patients needing hospitalization, particularly those who are older or who have “significant underlying health conditions,” Hancock said the “firm majority” of those hospitalized are unvaccinated.

“That means a lot of the surge could have been prevented through widespread vaccination,” Hancock said.

As a result of the surge, the Clinic, like other health systems, has had to make tough decisions: postponing non-urgent surgeries, training caregivers to “redeploy” some of them into different roles. But the rising number of cases among caregivers, Hancock said, has “really impacted the way that we're able to deliver care.”

Now that the Centers for Disease Control and Prevention (CDC) offered new guidelines for shortened isolation and quarantine periods, Hancock said they’re making sure that “caregivers are capable of returning to work safely within that five-day period if they tell us that they're asymptomatic and they've been vaccinated.”

The Clinic has also set up self-swab caregiver testing at each of its regional hospitals, and it’s encouraging patients not to come to the emergency department solely for testing.

“The National Guard was brought in to stand up these testing sites, these walk-in testing sites, so it would be able to decompress our emergency departments so we could really care for patients who have diagnoses other than COVID,” Hancock said.

In addition to encouraging vaccination for those who have not yet gotten it, Hancock reiterated the importance of masking, social distancing, good hand hygiene, and other safety measures.

"We are the last touch"

For Gabbi Maenza (RN, BSN), who is a cardiovascular intensive care unit (CVICU) nurse and assistant nurse manager at the Clinic, the last 22 months have been unlike anything she’s dealt with in her six years in health care.

“It’s been tough,” Maenza said.

Maenza became an assistant nurse manager during the beginning of the pandemic, so she’s learned how to lead other nurses while taking care of patients. In the CVICU, she said many patients are “kind of on the last stretch.”

“We put them on ECMO, which is kind of like cardiopulmonary bypass. It's like the highest form of life support available to COVID patients, and we put them on there with the hope that we'll see a little bit of an improvement. Sometimes we do, sometimes we don’t,” Maenza said. “I think that's been the most difficult part is seeing the ones that don't make the improvement.”

Usually, the CVICU is home to patients that come from the operating room after open-heart surgery. Now, though, they’re getting a lot of overflow from the Medical ICU of COVID patients, who are mainly unvaccinated.

While staffing has been challenging, Maenza said, “We're going with the flow. We're trying our best here. We're adapting as much as we can. We're trying to make the best out of a pretty tough circumstance.”

Maenza admitted to being tired and said her colleagues are, too.

“We watch family members come in and see their loved ones, which is awesome that they're able to do that, but they're coming to see their loved ones, we’re gowning them up in PPE and we're watching them sometimes say goodbye,” Maenza said. “And if they can't make it in, we're calling them over FaceTime and saying goodbye for them or holding their hand.”

She added, “We are the last touch, the last voice they hear, and that's been really difficult for not only myself personally, but for all of my nurses, all of my clinical technicians, everyone that I've come across throughout this pandemic. I will say the hardest part is watching the patients and the family members.”

She urged people to take it seriously and said that while some variants may seem like the flu, others may not be as mild.

“You have to be willing to protect yourself, but also protect the people that can't be protected,” she said.

Maenza commended the nurses with whom she works, saying they’re strong and resilient and that she has “never met a stronger group of people.”

“They're working so hard to take care of people that can't take care of themselves, the ones that say that they're against the vaccine, but get COVID anyways. The ones that are adamantly open about ‘it’s not real’ or…we're doing our best to treat everyone like I would want someone to treat for my loved one.”

She added, “I want people to take it seriously, you know, mask up, stay six feet apart, get the vaccine, don't get the vaccine. It's obviously your choice. But one thing may prevent someone else's loved one from being the person that, we call it 'proned' in my unit.”

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