A lot has changed since the first COVID-19 cases appeared in Maryland last March, and few industries have had to adjust as rapidly and as often to accommodate new spikes in cases, new governmental guidance and new research as hospitals.
A report released Monday by the Maryland Hospital Association lays out just how much the virus has affected the operations of Maryland hospitals, which have spent large amounts of money, hired new workers and pivoted numerous services in response to the pandemic.
In April alone, hospitals in the state saw operating margins decline by $200 million; they also spent $70 million in capital in response to COVID-19.
Bob Atlas, president and CEO of the Maryland Hospital Association, says that among the largest costs were personal protective equipment, staffing and costs associated with testing and vaccinations.
“I think the costs of PPE were tremendous, just in terms of the quantities that had to be used and the costs, as shortages became so prominent … the consumption of isolation gowns and gloves and masks just has been tremendous,” he says.
Among PPE, spending on isolation gowns increased the most, with Maryland hospitals spending $75 million more on gowns than they had in 2019.
Hiring staff, including out-of-state nurses brought on to work in Maryland during an early period in the pandemic in which some states were hit harder than others, also proved pricey. From March to December 2020, 18 Maryland hospitals allocated $103 million to hiring additional staff, including nurses, respiratory therapists and intensivists; $4.6 million was spent on staffing in March alone.
While the vaccines themselves are provided by the federal government, there are operating costs associated with distribution that can pile up, such as the cost of buying the ultra-cold freezers necessary for storing the Pfizer and Moderna vaccines.
Hospitals have played a substantial role in vaccination efforts, delivering 450,000 vaccines to both hospital staff and patients by mid-February. In total, over 680,000 Marylanders had been vaccinated as of Feb. 15.
Hospitals also administered 1.2 million COVID-19 tests in the first six months of the pandemic, taking steps early on to make testing quicker and easier for patients.
Both the University of Pittsburgh Medical Center, which operates locations in western Maryland, and Johns Hopkins Medicine developed their own COVID-19 screening tests in March; Hopkins’ was used over 100,000 times by August. Frederick Health tested samples within its own laboratory, reducing wait times for results.
The pandemic has also caused a massive rise in telehealth services, with hospitals and health systems reporting a 82% increase in virtual primary care appointments, a 77% increase in virtual behavioral health appointments and a 70% increase in other virtual speciality care appointments.
Mental telehealth services have been vital as people nationwide struggled to cope with isolation and hospital staff struggled with the stress and trauma of the pandemic.
Atlas said he expects the telehealth boom to last past the end of the pandemic. “We have older people who have never connected (with their physicians virtually) who are now connected. We have younger people who prefer to communicate on electronic devices,” he says. “So now that that’s kind of enabled, they’re going to want to continue.”
Doctors are also now more familiar with the technologies associated with telehealth, allowing them to conduct these appointments more easily in the future.
As for whether the worst is behind us, Atlas believes, with some reservation, that it is.
“The reservation has to do with that we are not out of the woods by any means. The percentage of people vaccinated is only ten percent, and to get to herd immunity, it’s 70% to (over) 80%,” he said. In addition, new variants could potentially cause issues, as could people who begin to “let their guard down” in the coming months.
Although there are now a thousand fewer COVID-19 patients in hospitals than there were when hospitalizations peaked Jan. 11, the current number of cases — around 950 — is “an awful lot more than we had at the low point in the crisis when we were below 300,” Atlas said. “We are not out of the woods yet, but hopefully the decline will continue.”