But in healthcare, staffing shortages are emblematic of much more. (And vaccine mandates are not the reason for shortages: in Rhode Island, for example, the two largest healthcare systems have retained more than 95% of staff after mandates were implemented, and other large systems retained even more.)

The reason is that nurses, technicians, doctors and other healthcare professionals have simply had enough. After 20 months of fighting this virus, handling overflowing patient loads, and dealing with angry and distrustful communities, they are leaving in waves. Although we are paying more for the scarce staff who remain, it still may not be enough to keep up safe staffing standards. Without healthcare workers, we have no care.

Right now, many hospitals are having to once again pause surgical cases and other elective procedures- not because of COVID-19, but because there is no longer adequate staff or beds. Even without a massive surge in patients with COVID-19, when we can’t transfer patients out of the hospital into a nursing home, the hospital beds stay full; when hospital bed are full, patients can’t be admitted from the emergency department; and when patients can’t be admitted, emergency departments’ waiting rooms and primary care offices fill up with untreated acute problems. Nurses and doctors are frustrated that they can’t provide timely care, and patients and families are angry at the waits. Everyone gets hurt, in the short term.

But these cancellations set off a chain reaction of debilitating systemic effects that will hurt for a long time to come.