United States of America - hospitals like war zones

A profound perspective on the situation affecting healthcare workers in the USA and positive union action is presented in the following report prepared by Maria Castaneda of the 1199SEIU United Healthcare Workers East for the PSI Health and Social Sector Task Force (HSSTF) meeting held on 11 May 2020

United States of America is the epicentre of the COVID-19 pandemic, with almost one third of all confirmed cases globally (1,298,287 persons) and more than a quarter of all COVID-19 associated deaths globally (283,153 persons). Healthcare workers have been battling to save lives. With the health system almost overwhelmed, worsened by lack of N95 respirators and other personal protective equipment (PPE), healthcare facilities have come to be “like war zones, chaotic, very stressful and frightening”.

PSI affiliates and other trade unions in the country have been doing their utmost best to help save lives and ensure the safety of healthcare workers. AFT, a PSI affiliate is taking action for citizens pressure to make the production of N95 respirators and other PPE a top priority, including with an online petition (support this – sign it here).

I live in New York City, the epicenter of the virus for the ongoing fight against the virus and for future healthcare crises.

My Union, 1199SEIU United Healthcare Workers East, represents frontline caregivers in five states, four of which are among those with most COVID cases, including New York. I live in New York City, the epicenter of the virus for the ongoing fight against the virus and for future healthcare crises.

Our members—not only in hospitals but in nursing homes and home healthcare-- include nurses, respiratory therapists, physician assistants, environmental services workers, dietary workers, transporters, nursing assistants, home health aides and clerical workers. They are the heroes in the fight against this global pandemic. Our communities salute and thank them for their dedication, courage and sacrifice during this crisis.

Our members describe their hospitals as being like war zones, chaotic, very stressful and frightening. From the first COVID patient to the surge of patients in our ER’s and ICU’s in just a few days, entire hospitals in NYC became COVID-designated facilities.

All floors became ICU-type units. But our frontline workers were not prepared for the crisis; they had not had adequate orientation or training to work safely in those units.

Even as they were fighting to save lives, our members were also fighting to have the appropriate Personal Protective Equipment (PPE) that they needed to protect themselves. It was a struggle to have the essential N95s, goggles, face shields, isolation gowns, hair nets, shoe covers and gloves. Members were told they could reuse the N95s or wash and clean their masks to use for up to one week. Hospitals were telling our members that they were planning to decontaminate the PPE and they could then be reused.

Our members continued to push for universal standards for infection control, which were being downgraded due to supply shortages. The workers were questioning their own mortality, and were afraid of bringing the virus into their homes and infecting their families. Some members were sleeping in their cars or garages, fearful of infecting their parents with compromised immune systems.

Thankfully, some hotels and Airbnb apartments offered free housing to healthcare workers and many have accepted the offers. At first, COVID testing was offered only to doctors and nurses, but eventually our Union was able to get testing for all members.

COVID19-positive patients were discharged from hospitals to recover in nursing homes that didn’t have the adequate staffing and PPEs. They consequently became “hot spots” with many deaths.

Childcare was an added burden because of the closing of all schools. Our Union again stepped up by paying for childcare support for members. Hospitals and nursing homes were experiencing severe short staffing because our workers were being infected with COVID19 and needed to be quarantined after being exposed or testing positive. Quarantined workers were being asked to report after 72 hours even if they still had respiratory symptoms. We continue to fight this unsafe return to work policy.

The PPE shortages also affected our nursing homes where seniors and most vulnerable populations reside. Many nursing homes have experienced COVID19 outbreaks. Initially, COVID19-positive patients were discharged from hospitals to recover in nursing homes that didn’t have the adequate staffing and PPEs. They consequently became “hot spots” with many deaths.

Our home health aides also serve the frail elderly and extremely vulnerable populations. These workers are essential, but are often left out of plans to receive even basic PPEs. In many cases, they don’t have regular face masks, let alone the N95 masks that are designed to help prevent the transmission of infections. These members are overwhelmingly immigrant women with an average age of 50 years old. Many have pre-existing health issues that make them vulnerable and at high risk of contracting COVID19.

1199SEIU demands that the Federal government release the PPE stockpile from the National Defense Department, and use the Defense Production Act to re-purpose existing manufacturing capacity to produce sufficient numbers of PPEs and test kits. We have called upon industries that have large supplies of N95 masks to donate them to healthcare workers. Supplies have increased, but healthcare workers continue to report daily struggles to get the PPEs they need.

With the introduction of the CARES legislation (which stands for Coronavirus Aid, Relief, and Economic Security), we need to make sure our healthcare and essential workers are the direct beneficiaries through the manufacture of PPEs, the allocation of hazard pay and other much needed resources, including paid sick leave, free testing and treatment, child care support, transportation and a fund to deal with long term trauma to healthcare workers.

Witnessing so many of their patients unable to survive the virus has been severely traumatic for many frontline caregivers. Through our Union’s health plans, we have been able to provide mental health counseling for our members.

The greatest numbers of COVID-19 casualties are to be found in our Black and Brown communities.

Of course the economy has collapsed in the face of the pandemic. Any economic recovery and transition to a post-coronavirus economy must address systemic racism and health disparities in our communities of color. These have always existed but the pandemic has dramatically demonstrated society’s inequalities.

The greatest numbers of COVID-19 casualties are to be found in our Black and Brown communities. A historic lack of economic resources has already made people in these communities particularly vulnerable to asthma and diabetes, which in turn has left them at greater risk of contracting the coronavirus. For example, The Bronx, New York City’s poorest borough, has one of the highest numbers of COVID-19 cases in the nation. It has the highest rates of asthma and hypertension; life expectancy is 10 years lower than residents just a few miles away in affluent parts of Manhattan and Brooklyn. The Bronx contains nine garbage transfer stations and three medical waste sites, and its highways serve as a route for diesel trucks day and night. In the transition to a post COVID-19 economy, these racial, economic, and environmental injustices must be addressed.

Asian workers are on the front line fighting COVID-19, as nurses, doctors, home health aides, certified nursing assistants, and every other job title. They are also essential workers taking care of our communities while we shelter safely in our homes. The hateful rhetoric and physical attacks against Asian people have no place in the fight against COVID-19. They must be condemned and combated by all the political, religious and cultural institutions that make up our communities.

Finally, there is no higher priority than voting out Trump and his Senate allies in November. Their delay in addressing the pandemic, their falsehoods and failure to confront the greatest public health catastrophe in a century reason enough (though there are others) to defeat them. Meantime, we will continue to work with our mayors and governors that believe in science and who use the expert recommendations of medical professionals to guide their policies and plans in reopening the economy and protecting our communities.

And we will continue to draw lessons from this crisis to better prepare ourselves.