4 » A magazine for and about Oregon Community Hospitals. i f r t r it s it ls. Becky Hultberg President & CEO Oregon Association of Hospitals & Health Systems To find out more about your community hospitals, please visit us online at www.oahhs.org. The 1918 pandemic had three distinct waves. The first was in the spring of 1918, the second in the fall of 1918, and the third beginning in late 1918 and stretching into the spring of 1919. An estimated one-third of the world’s population contracted the 1918 flu, resulting in at least 50 million deaths worldwide. The 1918 flu was the world’s last experience with a significant global pandemic. Much has changed in the last 100 years including dramatic improvements in medical care and globalization. Global outbreaks follow a predictable course, yet our lack of recent experience with pandemics meant we weren’t prepared for something like COVID-19. Experts in 2020 warned us that this pandemic wasn’t going to be over in a year and that there would be a high death toll, but in those early days it was hard to wrap our heads around an event of this duration and magnitude. I remember participating in a call in March of 2020 when an epidemiologist predicted 500,000 deaths in the United States. 500,000! That couldn’t be right. As of early January, 825,000 people have died in the U.S. We all desperately wanted this to be over in 2020 so 2021 could return to normal. While we’ve had glimpses of normalcy this year, Oregon also had its worst COVID-19 surge in the late summer and early fall of 2021—almost 18 months into the pandemic. For hospitals, 2021 was perhaps a more disruptive year than 2020. The year started with Oregon hospitals taking the lead role (unexpectedly) in vaccinating Oregonians, a massive logistical effort across the state. With vaccine programs in high gear, returning to previous activities seemed a possibility in the early months of summer, when case counts fell and masks came off. The Delta variant changed those plans, racing through the unvaccinated population like wildfire, sending hospitalizations to their highest level of the pandemic and pushing the health care system towards collapse. Hospitals weathered the storm, with assistance from the state, but there was a cost. Workforce shortages, always a problem for hospitals, became a national crisis as burned-out staff left their jobs by the thousands. At the end of 2021, COVID-19 hospitalizations remained persistently high. Once again, necessary care was delayed in many communities (as it was in 2020) as hospitals coped with the surge of acutely ill patients, and those seeking care often arrived sicker and in need of more intensive services. Labor and supply costs have risen dramatically, while revenue has fallen. Many hospitals are emerging from the pandemic with significant financial challenges. Our health system withstood a tremendous strain, but we have seen that the system is fragile. As anchors in their communities, hospitals are the safety net, the only open door, available 24/7 when other institutions fail. But their presence is not guaranteed. What does this mean for 2022? COVID-19 will continue to be a factor in our lives and in the health care system. We all want to know how this will end, and if history is a guide, COVID will leave us not with a bang but with a whimper. As COVID-19 becomes endemic, we’ll continue to develop new coping tools, including the ability to live with the disease as a continuous presence. Normalcy won’t be a moment, but a process. Hospitals will struggle in the short term, both operationally and financially, as they recover and rebuild. They will need your support. As we go into 2022, we should feel hope. Hope that we will ease into normalcy. Hope that our hospitals and other institutions that have helped us weather this storm are still standing. Let’s all hope we can identify and capture lessons from the COVID-19 pandemic that will help us prepare for the future.
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