Burnout and exhaustion 20 months into the coronavirus pandemic are powering the state’s hospital staffing shortage, not the requirement that all health care workers here be vaccinated.

“The shortage issue goes well beyond the mandate,” said Cara Welch, spokeswoman for the Colorado Hospital Association, “and … the mandate’s really just one very small piece with that.”

Burnout, Welch and representatives from several hospital systems and individual facilities said, is the primary factor. Thirty-eight percent of respondents in a small survey conducted by the Colorado Medical Society reported burnout to varying degrees. Nationally, nearly one in five health care workers have left the industry during the pandemic, according to a Morning Consult poll, and Welch said that number likely matches the trends in Colorado.

The Denver Gazette spoke with several major hospital systems, plus Denver Health, Pueblo’s Parkview Medical Center, San Luis Valley Health and Delta Health for this article. Collectively, the systems and individual facilities represent more than 40 hospitals statewide and employ tens of thousands of workers. None of them said the vaccine mandate, which became effective statewide in October, has played more than a minor role in their staffing levels.

Front-line health workers were among the first to receive vaccination priority a year ago, and hospitals have reported that uptake has been highest among those providers. 

Health worker shortages that predated the pandemic – particularly with nurses – are also exacerbating the situation, officials said, and the significant volume of patients filling Colorado hospitals is further straining capacity. 

“Between very high numbers of COVID-19 hospitalizations and record numbers of non-COVID patients, UCHealth has been caring for about 25% more patients,” said Dan Weaver, spokesman for the system. “That means we have about 25% more clinical shifts to fill. Our employees are extremely dedicated, and we appreciate that they continue to pick up additional shifts to care for patients, but responding to the ongoing surge over many weeks and picking up so many extra shifts is very challenging.” 

“The toll this takes on our workforce has been great,” said Banner’s Sara Quale. “We have seen a number of caregivers leave the bedside as a result of the COVID pandemic and burnout.”

The systems all reported minimal terminations for employees who were not fully vaccinated. Some systems – like UCHealth, Banner and Denver Health – all required vaccinations before the state instituted its own. At UCHealth, which employs 26,400 people, 119 were terminated. That number includes all staff – not just front-line providers. 

Centura had a 99.9% vaccination rate among its 21,000 employees in Colorado and Kansas. Twelve were out of compliance, a spokesperson said. Delta Health said it lost two people, San Luis Valley had “less than 3%” of employees out of compliance, Banner’s figure was below 2%, and HealthONE has terminated only one or two workers.

Statewide, 2.2% of the state’s roughly 280,000 health care workers – across all health industries and employee roles – were terminated or resigned because they didn’t comply with the mandate, a spokesperson for the state Department of Public Health and Environment said. 

For Denver Health, “it’s not people in direct patient care roles who have resisted vaccination,” said spokeswoman Rachel Hirsch. 

Welch said the mandate likely had larger impacts for smaller facilities in rural Colorado, where staffing is tighter even during normal times. 

“Certainly some rural hospitals have felt this pretty significantly,” she said, “but I think it’s important to note that’s also on top of people who have left for a variety of other reasons, and probably the leading factor being stress and burnout and exhaustion after two years of dealing with this pandemic.”

A year ago, when hospitals were facing the largest COVID-19 patient load of the pandemic, staffing was also the most pressing issue, more so than bed space or ventilators. But that shortage was driven by infections among staff, hospitals have said, requiring quarantines and thinning the ranks just as the pandemic was spiraling.

The mandates have helped address that amid this latest surge, officials said.

“Most importantly, COVID-19 vaccination has created a safer environment in our facilities for everyone, including our patients, visitors, staff and providers,” UCHealth’s Weaver said. “But it has also helped our staffing levels because so few employees are testing positive for COVID-19 and needing to be out of work on isolation as they recover.”