




































                                                                                                                             2021, Vol. 1 (S5) 15-17 
 https://doi.org/10.47488/dhrp.v1iS5.39 

 
  

 
http://dhrproceedings.org 15 © DHR Health Institute for Research and Development 

 
 

 

COMMENTARY 

Growing Shortage of Healthcare 

Workers Poses an Existential Threat 

to the Public Health System 

Strategies to Mitigate this Challenge 

in the Face of COVID-19 Pandemic 
Sohail Rao, MD, MA, DPhil1, 2 and Manish Singh, MD, FACS3 

 1 Executive Vice President, DHR Health, 5501 S. McColl Road, Edinburg, Texas 78539 and President 

& Chief Executive Officer, DHR Health Institute for Research & Development, 5323 S. McColl Road, 

Edinburg, Texas 78539.  

ORCID: https://orcid.org/0000-0001-5027-9992  
2 Correspondence should be addressed to: Sohail Rao, MD, MA, DPhil., DHR Health Institute for 

Research & Development, 5323 S. McColl Road, Edinburg, Texas 78539. Tel: (956) 362-2387. E-mail: 

s.rao@dhr-rgv.com  
3 Chief Executive Officer, DHR Health, 5501 S. McColl Road, Edinburg Tx 78539 and DHR Health 

Bariatric & Metabolic Institute, 5500 Raphael Drive, Edinburg, TX 79539 

ORCID: Manish Singh: https://orcid.org/0000-0003-4146-3282  

 

Received 12/27/2021 

Accepted for publication 12/29/2021 

Published 12/29/2021 

Keywords:  COVID-19; SARS-CoV-2; Omicron variant; CDC: Centers for Disease Control and Prevention; FDA: U.S. Food and Drug 

Administration; EVUSHELDTM 

The growing shortage of essential healthcare workers has 

been a chronic challenge worldwide. The COVID-19 

pandemic has exacerbated this challenge and has undermined 

the ability of many health systems to continue to offer 

optimal and timely clinical care to its patients. Many factors 

are responsible for this outcome not to mention the aging 

healthcare workforce, early retirements due to the COVID-19 

pandemic, mental and physical exhaustion, lack of strategic 

planning for workforce retention, and national and 

international mobility (1-3). Collectively, these factors have 

created an ambiguous future and a precarious disproportion 

between the demand and supply of essential healthcare 

workers. The burgeoning primary and breakthrough 

infections with Omicron variant of SARS-CoV-2 has placed 

yet additional burden on the healthcare system and its 

frontline workforce. 

Recognizing this advancing catastrophe, the Centers for 

Disease Control and Prevention (CDC) recently forwarded 

some guidelines to help assuage the same (4). At the core of 

these guidelines was the understanding that healthcare 

organization will: 

 Ensure any COVID-19 vaccine requirements for 

HCP are followed, and where none are applicable, 

encourage vaccination, including booster dose, as 

recommended by the CDC (5) 

 Understand their normal staffing needs and the 

minimum number of staff needed to provide a safe 

work environment and safe patient care under 

normal circumstances 

https://orcid.org/0000-0001-5027-9992
mailto:s.rao@dhr-rgv.com
https://orcid.org/0000-0003-4146-3282


DHRP, 2021, Vol. 1 (S5) 15-17  Shortage of Healthcare Workers: Strategies to Mitigate this Challenge 

  

 
http://dhrproceedings.org 16 © DHR Health Institute for Research and Development 

 

 Understand the local epidemiology of COVID-19-

related indicators (e.g., community transmission 

levels) 

 Communicate with local healthcare coalitions and 

federal, state, and local public health partners (e.g., 

public health emergency preparedness and response 

staff) to identify additional healthcare personnel 

(e.g., hiring additional healthcare personnel, 

recruiting retired healthcare personnel, using 

students or volunteers), when needed 

Under these revised CDC guidelines, healthcare workers who 

either have asymptomatic SARS-CoV-2 infection and/or 

higher-risk exposure (6) are allowed to return to onsite work 

as long as there is strict screening and surveillance protocol 

in place (Table 1). If fully implemented these measures are 

predicted to have some impact on mitigating the shortage of 

healthcare workers. However, it is undetermined at this stage 

if the healthcare workers, members of their families, co-

workers, patients, and caregivers would be willing to accept 

the inherent risk associated with this significant structural 

change in policy.  

 Table 1: CDC Guidelines for Work Restrictions for Frontline Healthcare 

Workers with SARS-CoV-2 Infections and Exposures*   

 

*https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-

shortages.html 

It is abundantly clear that the need to protect the healthcare 

workers and the environment in which they practice is 

quintessential to mitigate this crisis. It is also imperative that 

to continue to retain public trust in our healthcare system, we 

adopt policies that are widely accepted and easily 

implemented. It is also perturbing that we have arbitrarily 

and conveniently segregated healthcare workers into those at 

high risk of exposure and otherwise. The reality on the 

ground is that ALL healthcare workers are at an equally high 

risk of exposure and therefore must be treated accordingly. 

However, it is understandable that to gain maximum benefit, 

we may need to prioritize the implementation and 

distribution of limited resources.  

Fortunately, we have the tools to accomplish these outcomes 

without placing undue risk on both the patients and the 

providers. Our recommendations are outlined in Figure 1 and 

briefly iterated herein. In most institutions, the healthcare 

workforce is vaccinated with at least the two-dose primary 

vaccination. This followed the mandatory ruling by the 

Centers for Medicare and Medicaid Services requiring that 

all Medicare and Medicaid-certified providers and suppliers 

must be vaccinated, and they must meet this requirement to 

continue to participate in the Medicare and Medicaid 

programs (7). For symptomatic and/or asymptomatic 

COVID-19 positive healthcare workers, we recommend that 

we follow the recently published CDC guidelines (Table 1). 

On the contrary, every attempt should be made to protect 

those healthcare workers who are COVID-19 negative and 

prevent breakthrough SARS-CoV-2 infections in this cohort. 

In an attempt to accomplish this outcome, we are 

recommending that the immunity against SARS-CoV-2 in 

frontline healthcare workers who are actively engaged in 

patient care must be passively enhanced by treating them 

with the recently authorized monoclonal antibody – 

EVUSHELD
TM

 (8). Given the observed long-acting benefit 

of treatment with this monoclonal antibody, it is postulated 

that its use would minimize the risk of getting infected with 

SARS-CoV-2 (9). Additionally, with waning immunity, we 

are advocating that ALL healthcare workers must be 

considered for a 4th dose (or 2nd booster dose) of mRNA 

vaccine at least 90-days after their last booster dose. While 

still awaiting approval from the Ministry of Health, the 

Israel’s Pandemic Response Team has already recommended 

this later protocol providing 4th dose of mRNA COVID-19 

vaccine to all healthcare workers; at-risk people; and those 

who are >60 years of age (10). 

Figure 1: Proposed Interventions to Mitigate the Prevailing Shortage of 

Healthcare Workers 

 

This is a watershed moment in the history of healthcare 

industry, and it demands that we think innovatively in an 

attempt to moderate this nascent crisis. The focus of this 

manuscript was to underscore the impact of COVID-19 

pandemic on healthcare industry and to propose innovative 

solutions to mitigate the shortage of healthcare workers.  

https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html


                                                                                                                              
DHRP, 2021, Vol. 1 (S5) 15-17  Shortage of Healthcare Workers: Strategies to Mitigate this Challenge 
 

 
  

 
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Nevertheless, we must continue to address other intractable 

challenges that are more impactful in developing a long-term 

sustainable strategy to overcome the burgeoning shortage of 

frontline healthcare workers.   

Diclosures 

SR declares no conflicts of interest.  

MS declares no conflicts of interest. 

References 

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2. Turale S, Meechamnan C, Kunaviktikul W. Challenging 
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10.1111/inr.12598. PMID: 32578249; PMCID: 
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5. Interim Clinical Considerations for Use of COVID-19 
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6. Interim Guidance for Managing Healthcare Personnel 
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7. Medicare and Medicaid Programs; Omnibus COVID-19 
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8. Coronavirus (COVID-19) Update: FDA Authorizes New 
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Prevention of COVID-19 in Certain Individuals. U.S. 
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https://www.fda.gov/news-events/press-
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