New York City is the epicentre of the COVID-19 outbreak in the United States. At the time of this interview, there have been over 2,400 deaths in NYC alone. Hospitals are overwhelmed, and an already starved healthcare system at breaking point, just weeks into the surging crisis. Anger is palpable and nurses and doctors have been targeted for speaking out. Rebel News spoke to a NYC respiratory nurse who wishes to remain anonymous, but describes the COVID-19 reality at her hospital.
On my way into the hospital, the first thing I notice is the huge refrigerated truck that has pulled up out front. It is serving as a supplementary morgue. When I get into the building there is an eerie quiet even though it is extremely busy because no visitors are allowed. There are only patients and staff. When I get to my floor I find out which of my patients have died since my last shift, and which of my co-workers are out sick.
Last Saturday, the day started with a code. This is when someone has a cardiac or respiratory arrest, and health care workers perform CPR to try to revive the patient. Throughout the hospital there were over 20 that day. On a normal day there might be maybe two. We are understaffed. There are many more patients than usual and the patients who are admitted are very, very sick.
There isn’t enough personal protective equipment (PPE). In the past, all of the PPE we used – gowns, gloves, masks – were one time use only. They were for one encounter with one patient. And then we very carefully took it off so that we weren’t infected.
Now, all of that is out the window. We are lucky in that we have N95 masks, but we have one for the whole day. We have one face shield that we wash after every encounter, and that we take home and bring back again. For now, we nurses are changing our gowns but the patient care technicians are not, meaning they go a whole day with only one. Pretty soon, nurses will also be out of gowns, andrationing daily too. None of the PPE was designed for multiple use, so there is no real protocol for the safest way to use them repeatedly.
Many of my co-workers are out sick. Many have symptoms but are still on the job. One housekeeper on my floor is sick, along with her whole family, with COVID-19 but was directed by HR to come back to her job. So she is going in and out of every room, cleaning. She said she couldn’t afford to stay out, because she wouldn’t be paid to take time off since she was directed by HR to work.
Several of the dialysis nurses don’t have any sense of taste or smell, which is a common symptom of COVID-19. They aren’t able to get tested; so many people are struggling to get tested, and even when they do get a test, it can take up to 9 days for it to come back.
Instead of staying off work during this time, many feel forced to come in until they have a positive result. One sick dialysis nurse was told that the hospital is on war footing and that if he didn’t come in to dialyse his patients, no one would. These nurses dialyse the same patients every week and have relationships with them. So he is forced to choose between potentially exposing his patients to COVID-19 – which they may already be exposed to by coming to the hospital – or subjecting them to the risks and harm, and possibly death, that could be caused by missing their weekly dialysis.
These are the choices that nurses are making every day.
In many cases people are dying alone. Not only because no visitors are allowed, but because the need to conserve PPE means that nurses are not able to frequently check on patients. We wait and bundle the care together, such as medications and bringing in a meal. We only go in when we can justify the use of PPE. People who may previously have shared their last minutes with a nurse, if a family member wasn’t present, are denied that comfort now.
We need more testing. Even if you are a frontline worker who has symptoms, it is hard to get a test and we are told to go back to work. Healthcare workers need testing, and paid time off to safely self-quarantine.
Shortage of political will
Politicians don’t seem to have any urgency or awareness of the consequences of healthcare workers not having enough PPE. Many, many healthcare workers are already sick. This is going to cause a greater shortage of healthcare resources. Ventilators are extremely important, but when a patient is on a ventilator they are very vulnerable, and need close monitoring and care. The ventilator alone is not enough to save a patient, if a large percentage of the health care staff is out sick.
In the richest country in the world, nursing staff at hospitals are holding fundraisers and are making pleas to the community to try to get more protective gear. Other unions and community groups are doing their best to contribute. The high point of my day was when a medical resident came around with supplies, such as protective goggles, that were donated by a local Chinese-American community group – there was a cheer that went through the floor.
People are trying their best to help, but the only way to deal with the shortages, which are getting worse and worse, is for Trump to use the Defence Production Act. He must nationalise some of these companies, such as 3M and Honeywell, and produce the protective gear that is so desperately needed, and ramp up production to 24 hours a day.
Only then can we as nurses and healthcare workers realistically tackle COVID-19 and do our part in keeping patients alive, and the virus contained.
The U.S. healthcare system was in terrible shape even before this crisis because of its chaotic and cruel for-profit model. This pandemic has ripped the face off of a system which funnelled its resources into profitable services and systematically drained money from public health and basic care for poor and working people.
Not only is it a massively unequal and unjust system, but with no overall planning beyond producing short term profits for individual health care operators, the model does not make functional sense. Even now, as the hospitals reach their breaking point, the governor of New York Andrew Cuomo, is trying to push through billions of dollars in cuts to Medicaid.
This is a humanitarian crisis. We need universal single payer coverage now. We should nationalise PPE, testing and ventilator manufacturers, and bring hospital systems and pharmaceutical industries under public control to deal with critical drug shortages, coordinate overall resource allocation and prevent rampant pandemic profiteering.
In his daily press conferences President Trump alternates between implying that healthcare workers are stealing PPE and blaming them for the shortages and, on the other hand, calling us heroes. His actions – or lack thereof – expose how he believes that our lives, like our patients, are expendable.
Nurses at several NYC hospitals have held socially distanced speak-out protests in front of their hospitals this week. We need rapid action to save thousands of lives right now. We can’t go back to the broken status quo healthcare system that laid the basis for this unfolding tragedy.