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Nurses Battling Coronavirus Beg for Protective Gear and Better Planning Nurses Battling Coronavirus Beg for Protective Gear and Better Planning
(about 16 hours later)
In the fight against the coronavirus, nurses play a critical role, but some on the front lines in the hardest-hit areas in the United States say they fear that their health is not being made a priority.In the fight against the coronavirus, nurses play a critical role, but some on the front lines in the hardest-hit areas in the United States say they fear that their health is not being made a priority.
Nurses in Washington State and California said they have had to beg for N95 masks, which are thicker than surgical masks and block out much smaller particles, and have faced ridicule from colleagues when expressing concerns about catching the highly contagious virus. Some have complained about being pulled out of quarantine early to treat patients because of staff shortages.Nurses in Washington State and California said they have had to beg for N95 masks, which are thicker than surgical masks and block out much smaller particles, and have faced ridicule from colleagues when expressing concerns about catching the highly contagious virus. Some have complained about being pulled out of quarantine early to treat patients because of staff shortages.
“If nurses aren’t safe, then really our community isn’t safe,” said Jenny Managhebi, a clinical nurse at the University of California, Davis, Medical Center, where 24 nurses were asked to self-quarantine after a patient tested positive for the virus. “If I’m not safe at the bedside, when I come home to my husband and my children, then they’re not safe.”“If nurses aren’t safe, then really our community isn’t safe,” said Jenny Managhebi, a clinical nurse at the University of California, Davis, Medical Center, where 24 nurses were asked to self-quarantine after a patient tested positive for the virus. “If I’m not safe at the bedside, when I come home to my husband and my children, then they’re not safe.”
Concerns from nurses in Washington State and California echo those of nurses nationwide. National Nurses United, a union that represents about 150,000 nurses across the country, announced on Thursday the sobering results of an online survey it recently conducted.Concerns from nurses in Washington State and California echo those of nurses nationwide. National Nurses United, a union that represents about 150,000 nurses across the country, announced on Thursday the sobering results of an online survey it recently conducted.
Of the 6,500 nurses who participated, 29 percent said their hospitals had a plan in place to isolate potential coronavirus patients, and 44 percent said they had received guidance from their employers about how to handle the virus.Of the 6,500 nurses who participated, 29 percent said their hospitals had a plan in place to isolate potential coronavirus patients, and 44 percent said they had received guidance from their employers about how to handle the virus.
Sixty-three percent had access to N95 face masks, and a quarter of the respondents had access to an even more protective mask recommended by the union, known as a PAPR, or a powered air purifying respirator.Sixty-three percent had access to N95 face masks, and a quarter of the respondents had access to an even more protective mask recommended by the union, known as a PAPR, or a powered air purifying respirator.
One California nurse, who is in a 14-day self-quarantine after caring for a coronavirus patient, complained that the Centers for Disease Control and Prevention was not testing her for the virus quickly enough. “This is not the ticket dispenser at the deli counter; it’s a public health emergency!” she wrote in a statement shared by National Nurses United.One California nurse, who is in a 14-day self-quarantine after caring for a coronavirus patient, complained that the Centers for Disease Control and Prevention was not testing her for the virus quickly enough. “This is not the ticket dispenser at the deli counter; it’s a public health emergency!” she wrote in a statement shared by National Nurses United.
At a news conference on Thursday afternoon, the union demanded, among other things, that the federal government ensure all health care workers receive the highest levels of protective equipment, that any vaccine that is developed be offered to the public for free, and that Congress immediately pass an emergency spending package in response to the virus.At a news conference on Thursday afternoon, the union demanded, among other things, that the federal government ensure all health care workers receive the highest levels of protective equipment, that any vaccine that is developed be offered to the public for free, and that Congress immediately pass an emergency spending package in response to the virus.
“The C.D.C. has been behind the ball at almost every step of the way,” said Jane Thomason, a union official who focuses on workplace health and safety.“The C.D.C. has been behind the ball at almost every step of the way,” said Jane Thomason, a union official who focuses on workplace health and safety.
Medical professionals have died in Wuhan, China, where the new coronavirus first surfaced late last year.Medical professionals have died in Wuhan, China, where the new coronavirus first surfaced late last year.
Health care workers are among the groups most at risk of contracting the virus, as sick people report to emergency rooms and are treated before their condition is known. At least eight people who work in U.S. health care facilities have received a coronavirus diagnosis, including three employees of a hospital in Vacaville, Calif., and five people who worked at the Life Care long-term care facility in Kirkland, Wash.Health care workers are among the groups most at risk of contracting the virus, as sick people report to emergency rooms and are treated before their condition is known. At least eight people who work in U.S. health care facilities have received a coronavirus diagnosis, including three employees of a hospital in Vacaville, Calif., and five people who worked at the Life Care long-term care facility in Kirkland, Wash.
And health care workers who are exposed to it can also unwittingly transmit the virus.And health care workers who are exposed to it can also unwittingly transmit the virus.
At EvergreenHealth, a hospital in Kirkland where at least 11 deaths have occurred, nurses who were told to self-quarantine were later asked to return to work, according to the Washington State Nurses Association, raising fears that they could further spread the virus if they had contracted it.At EvergreenHealth, a hospital in Kirkland where at least 11 deaths have occurred, nurses who were told to self-quarantine were later asked to return to work, according to the Washington State Nurses Association, raising fears that they could further spread the virus if they had contracted it.
The association, which represents more than 16,000 registered nurses in the state, surveyed its members and reported that 40 percent of the Evergreen nurses who responded said they lacked access to adequate protective equipment. More than half said they did not feel prepared to provide care for a patient with a known or suspected case of the virus, which causes a disease known as Covid-19.The association, which represents more than 16,000 registered nurses in the state, surveyed its members and reported that 40 percent of the Evergreen nurses who responded said they lacked access to adequate protective equipment. More than half said they did not feel prepared to provide care for a patient with a known or suspected case of the virus, which causes a disease known as Covid-19.
The union said nurses at other hospitals around the state have also reported concerns about lack of equipment. “Some have expressed concern that they themselves or colleagues have been in close contact with Covid-19 patients and yet are being told to continue working,” the union said.The union said nurses at other hospitals around the state have also reported concerns about lack of equipment. “Some have expressed concern that they themselves or colleagues have been in close contact with Covid-19 patients and yet are being told to continue working,” the union said.
Mary Shepler, the chief nursing officer at EvergreenHealth, which includes the hospital in Kirkland, defended the facility’s preparedness and protocols. The hospital, she said, has adequate supplies, including single-use masks and face shields that are sterilized and reused.Mary Shepler, the chief nursing officer at EvergreenHealth, which includes the hospital in Kirkland, defended the facility’s preparedness and protocols. The hospital, she said, has adequate supplies, including single-use masks and face shields that are sterilized and reused.
The hospital, too, has conducted drills and training for such situations, Ms. Shepler said, adding that she understands the stress that people are under while dealing with a new virus.The hospital, too, has conducted drills and training for such situations, Ms. Shepler said, adding that she understands the stress that people are under while dealing with a new virus.
“It’s uncomfortable to all of us in this new zone,” she said.“It’s uncomfortable to all of us in this new zone,” she said.
Ms. Shepler said that after quarantining some workers who were exposed to coronavirus patients, the hospital determined that the extent of the quarantine was unrealistic because it left shortages in a needed work force. They brought nurses back who were asymptomatic — an approach deemed reasonable by the C.D.C., she said — and are testing them twice a shift. They are also required to wear masks while treating patients.Ms. Shepler said that after quarantining some workers who were exposed to coronavirus patients, the hospital determined that the extent of the quarantine was unrealistic because it left shortages in a needed work force. They brought nurses back who were asymptomatic — an approach deemed reasonable by the C.D.C., she said — and are testing them twice a shift. They are also required to wear masks while treating patients.
The California Nurses Association, a statewide union that has grown into the largest organization of nurses in the country, with representation of 155,000 nurses, is scheduled to hold a news conference on Thursday afternoon to demand access to “the highest level of protection” for nurses on the front lines. It also plans to demand training and clear plans for how to handle patients suspected of having the virus.The California Nurses Association, a statewide union that has grown into the largest organization of nurses in the country, with representation of 155,000 nurses, is scheduled to hold a news conference on Thursday afternoon to demand access to “the highest level of protection” for nurses on the front lines. It also plans to demand training and clear plans for how to handle patients suspected of having the virus.
“Employers shall plan for a surge of patients with possible or confirmed Covid-19, including plans to isolate, cohort, and to provide safe staffing,” the union said in a statement. “Any nurse/health care worker who is exposed to Covid-19 will be placed on precautionary leave for at least 14 days and will maintain pay and other benefits during the full length of that leave.”“Employers shall plan for a surge of patients with possible or confirmed Covid-19, including plans to isolate, cohort, and to provide safe staffing,” the union said in a statement. “Any nurse/health care worker who is exposed to Covid-19 will be placed on precautionary leave for at least 14 days and will maintain pay and other benefits during the full length of that leave.”
Some nurses at other hospitals have reported being asked to take their personal paid leave to cover periods of mandatory quarantine. California has one of the strictest nurse-to-patient ratios in the country, with one nurse for every two sick patients in intensive care units. Some nurses said they were concerned that hospitals would struggle to meet that quotient if too many were forced into quarantine.Some nurses at other hospitals have reported being asked to take their personal paid leave to cover periods of mandatory quarantine. California has one of the strictest nurse-to-patient ratios in the country, with one nurse for every two sick patients in intensive care units. Some nurses said they were concerned that hospitals would struggle to meet that quotient if too many were forced into quarantine.
Training for how to use protective gear, nurses said, is almost as important as the gear itself, because taking it off incorrectly can result in spreading dangerous fluids from a sick patient.Training for how to use protective gear, nurses said, is almost as important as the gear itself, because taking it off incorrectly can result in spreading dangerous fluids from a sick patient.
“It used to be that you’d get a full day training,” said Gerard Brogan, the director of nursing practice at the California Nurses Association. “Now, they will send a nurse and doctor to the internet to learn how to don and doff a hazmat suit.”“It used to be that you’d get a full day training,” said Gerard Brogan, the director of nursing practice at the California Nurses Association. “Now, they will send a nurse and doctor to the internet to learn how to don and doff a hazmat suit.”
Updated June 12, 2020 Updated June 16, 2020
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
A nurse at a hospital run by Tenet Healthcare in Orange County who spoke on the condition of anonymity, fearing reprisals, said staff members have not been told what to do if a possible coronavirus patient walks into the emergency room. The nurse said some doctors have ridiculed staff members who have raised concerns.A nurse at a hospital run by Tenet Healthcare in Orange County who spoke on the condition of anonymity, fearing reprisals, said staff members have not been told what to do if a possible coronavirus patient walks into the emergency room. The nurse said some doctors have ridiculed staff members who have raised concerns.
“It’s been pretty disturbing what is happening,” said the nurse, who is among the most experienced nurses at the hospital. “Some doctors have been walking through the hospital for weeks with respirator masks. Others have been brushing it off like, ‘If you think this is a big deal, you are a conspiracy theorist and you are weak.’”“It’s been pretty disturbing what is happening,” said the nurse, who is among the most experienced nurses at the hospital. “Some doctors have been walking through the hospital for weeks with respirator masks. Others have been brushing it off like, ‘If you think this is a big deal, you are a conspiracy theorist and you are weak.’”
A spokeswoman for the hospital network said the hospitals were prepared to care for coronavirus patients and were working to protect the health and safety of staff members.A spokeswoman for the hospital network said the hospitals were prepared to care for coronavirus patients and were working to protect the health and safety of staff members.
Ms. Managhebi, the clinical nurse in California, said nurses have asked that N95 masks be made available on the supply carts in their units, rather than having to ask a manager or an assistant manager for one, as is the current practice.Ms. Managhebi, the clinical nurse in California, said nurses have asked that N95 masks be made available on the supply carts in their units, rather than having to ask a manager or an assistant manager for one, as is the current practice.
She also said nurses wanted the UC Davis hospital to adopt a detailed set of protocols about how they should handle suspected coronavirus cases, similar to a plan for Ebola that stipulated everything from the elevator that would be used to transport a patient to the specific staff members who would treat the patient.She also said nurses wanted the UC Davis hospital to adopt a detailed set of protocols about how they should handle suspected coronavirus cases, similar to a plan for Ebola that stipulated everything from the elevator that would be used to transport a patient to the specific staff members who would treat the patient.
But, Ms. Managhebi said, “They responded to our request and said it wasn’t necessary at this time.”But, Ms. Managhebi said, “They responded to our request and said it wasn’t necessary at this time.”
Dana Goldstein and Mitch Smith contributed reporting.Dana Goldstein and Mitch Smith contributed reporting.