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Health Disparities Will Devastate the Nation’s Capital During the Pandemic: A Physician’s Perspective

Less than a couple miles from the nation’s capital, where the seats of political power converge in one of the wealthiest cities in the world, egregious disparities in healthcare have left swathes of Washington D.C. undeserved or without access. A frontline physician implores us: We must act now.

Patricia Richards

March 25, 2020
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(AP Photo/Carolyn Kaster)

“Unprotected” and “disposable”: this is how nurses in Washington, D.C. hospitals are feeling as they brace themselves for the impending surge of COVID-19 cases in the region. As of March 24, D.C. has 183 confirmed cases of the disease, which doesn’t account for the countless cases that remain undetected due to a lack of ready access to testing. Exploitative policies that put nurses, patient care technicians, janitorial staff, and other hospital workers at risk make it abundantly clear that administrators are prioritizing profit over people’s health and safety.

Repeated reassurances from D.C. hospital administrators about their preparedness and concern for employee safety are little more than propaganda meant to obscure the truth. Healthcare workers are not being provided with sufficient personal protective equipment, increasing their risk of exposure to the virus. N-95 respirators – necessary for protection from the virus, especially during certain procedures – are in short supply and nurses have already reported being asked to reuse these single-use items. 

As if putting healthcare workers in harm’s way isn’t criminal enough, hospitals then require those who have been exposed to the illness to jump through hurdles to qualify for support. Despite suspected or known exposure, frontline workers are denied COVID-19 testing if asymptomatic. When staff raise the alarm on degraded safety protocols and lack of equipment which literally put their lives at risk, they are dismissed with both veiled and outright open threats of retaliation. More than the virus itself, it is these inhumane conditions that are leading to a sense of fear and hopelessness among healthcare workers as they gear up to fight this battle.

This blatant disregard for employee safety is not uncharacteristic for a corporate healthcare system which values the dollar over human life. What the coronavirus pandemic has unveiled is the long-existing rot at the root of this system. To understand the appalling response to this pandemic, it is important to understand the inequity that has always been inherent to the healthcare system. In D.C., this means understanding the injustices being carried out east of the Anacostia River, in the city’s poorest neighborhoods. 

In the past 20 years, six hospitals have been shut down in the nation’s capital. Providence Hospital closed down last year after 158 years of serving the community (its wards remain empty while healthcare workers fret about where to quarantine and treat the expected flux of COVID-19 patients). Now there are plans to close down United Medical Center in Southeast D.C., after D.C. Council systematically cut the hospital’s funding. Running this hospital to the ground was just the first step in the administration’s latest money-making scheme: the city’s mayor is now in negotiations with United Health Services (an organization that already misappropriated $100 million from George Washington University Hospital) to build a new hospital east of the river – one without a level 1 trauma center, a high-risk OB-Gyn division, or unionized workers.

The coronavirus pandemic is only the latest crisis that Southeast D.C.’s predominantly Black population is facing. Residents are denied (among many other basic human rights) access to a fully-functioning hospital, forcing at-risk mothers to travel across the city to deliver their babies, and causing young people with gunshot wounds to die on their way to a better hospital. These are just a few of the astounding healthcare disparities that are killing D.C.’s Black population.

We expect hospitals to be overwhelmed by COVID-19 cases in D.C., especially east of the river where there is only one poorly-funded hospital. Like other diseases, the outcomes of COVID-19, too, will be marked with disparities, resulting in poorer outcomes for residents of Southeast D.C. Most of the city’s ICUs are almost at capacity on any regular day, and the incompetent planning of the administration will ensure that there will be no room for healthcare workers to care for the several hundreds, maybe thousands that might require ventilators.

There is still time, however, to mitigate the damage and save lives. Funds need to be allocated for adequate protections for healthcare workers, including personal protective equipment (or PPE) and comprehensive, paid sick leave that does not come out of workers’ accrued PTO or normal sick hours. The city needs to fully fund the United Medical Center now and designate sections of Providence Hospital for treatment and quarantine. Testing needs to be made free and accessible to all D.C. residents and conducted at much higher rates. Such policies, in addition to fulfilling existing demands for decarceration and housing for those suffering homelessness, are the only chance we have to survive this pandemic and build a just society that can weather future storms.

Patricia Richards is a physician in Washington, D.C.

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Patricia Richards

Physician in Washington, D.C.

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