When the novel coronavirus hit California, Jamille Cabacungan, a Filipino American registered nurse at the University of California, San Francisco Medical Center, rushed to sign up as a volunteer to treat infected patients.
She hesitated to answer, however, when asked recently about her training for that job.
The hospital is providing the necessary gear, she said, and more heightened training for some nurses. But not for all, and much of her training is coming from videos forwarded to her by the hospital, as opposed to hands-on learning-by-doing.
Her colleagues are depending on her — “we don’t want to put our pregnant coworkers or those who live with elderly people at risk,” she added — but the preparation is less intense than she expected, considering the risk involved.
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As California’s coronavirus strategy has moved from containment to mitigation, the health care workers on the first line of response to the epidemic are also finding themselves on the front line of potential infection.
The frontline caregivers are also begging for more protective gear, said Zenei Cortez, one of the presidents of the California Nurses Association/National Nurses United.
Health care workers are begging for personal protective equipment (PPE) to help them care for sick patients without contracting coronavirus. Cortez, a Fililpino American, told MSNBC that “it’s not too much to ask our administration to give us what we need to safely take care of our patients.”
PPE, which includes masks, gloves, headgear and clothing, is quickly being used. Reports from Washington state, which has the greatest number of deaths from the virus, nurses have resorted to using bandannas for a lack of face masks.
National Nurses United (NNU), the largest union of registered nurses in the United States, today called on an embattled nation to dramatically ramp up health care capacity in the face of the COVID-19 pandemic. “Imagine we were at war. We are—with a pandemic,” said Bonnie Castillo, RN.executive director of the Oakland-based NNU.
The Filipino American nurse noted the warning last week by a panel of leading immunologists, epidemiologists, and infectious disease researchers at the University of California San Francisco which predicted 40 to 70 percent of the US population will be infected over the next 12 to 18 months. “With a 1 percent mortality rate, the panel predicted up to 1.6 million people could die. That’s more than the total of all Americans who have died in all US wars,” said Castillo. “Yet our health care capacity is far short of what we need to respond to this national emergency.”
At present, Castillo noted, the amount of optimal personal protective equipment needed for nurses and other health care workers, is “drastically short of what is needed to stem the danger of becoming infected and exposing patients, family members, and other health care staff.” “Instead of rolling back standards, as the Centers for Disease Control and the American Hospital Association are proposing, we need to substantially increase the supply of the highest standard of protective equipment. That includes powered air purifying respirators, N95 respirators, and other proper protective clothing and gear,” Castillo said.
One immediate step, she noted, should be the coordinated release and distribution of all state and federal stockpiles of PPE for nurses and health care workers. “For too long, ‘just-in-time’ hospital management practices have prioritized profits over stocking enough supplies and staffing enough nurses to safely care for patients, and this has eroded the ability of our nation’s hospitals to properly prepare for emergencies like pandemics.
Cortez told Rachel Maddow on MSNBC that California Gov. Gavin Newsom says there are over 20,000 respirators being distributed but “Where are they?” asks Cortez. “We should also prioritize testing and paid quarantine for nurses and other healthcare workers who are exposed, to prevent the further spread of the virus and to meet the demand of a surge,” said Castillo. Various scenarios project up to 21 million people in the United States may need hospitalization, at a time when the country has only 925,000 hospital beds—less than half the per capita-rate of comparable countries. And if nurses and other health care workers are not protected, nurses emphasize, the hospital beds will not be staffed. The shortage extends to ventilators, negative pressure isolation rooms, and intensive care beds, critical for treating COVID-19 patients. To expand health care capacity, NNU recommends the following steps:
- Re-open all hospitals closed in the past five years (more than 120 since 2015), many of them in medically underserved communities. Bar the closure of any additional hospitals.
- Convert some current consumer production to medical equipment, as China has done, including ventilators and the highest standard level of personal protective equipment for health care workers. At the onset of World War II, the Roosevelt Administration directed auto factories to immediately shift from car production to making tanks, airplane engines and other war materials.
- Fund construction of new hospitals and other medical facilities, including community health centers, and mass production facilities for personal protective equipment and ventilators, which will also create employment opportunities at a time when many are losing jobs due to the virus-related economic crisis.
- Implement immediate free medical education and training in public colleges and high schools for new registered nurses and other health care workers, without lowering licensing or professional standards.
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