For the first time in living memory, New York City streets are eerily empty. The entire state went on lockdown on Sunday under Governor Andrew Cuomo’s orders. Schools, restaurants, and cafes have been closed indefinitely and workers sent home or laid off. Those who can are working remotely, while balancing childcare and eldercare.
Meanwhile, thousands of healthcare workers continue to show up in what can arguably be called the most dangerous workplace: hospitals. According to data from the Superior Health Institute (ISS), as of March 17, healthcare workers infected with the coronavirus made up about 8% of the total cases in Italy. Nurses, doctors, paramedics, social workers, nursing assistants, and other healthcare workers across the country are grappling with tremendous changes. With their patients, their lives, and their families increasingly at risk, these workers now face sobering projections of 45 days before this crisis reaches its peak. To many, this feels like an eternity.
In New York City in particular, the highly contagious and often lethal COVID-19 virus presents a multitude of what, taken together, appear to be insurmountable risks and challenges to the already understaffed and overburdened hospital systems across the city.
Many hospital workers have demanded appropriate personal protective gear (“PPE”) to prevent exposure and infection. In addition, faced with the present-day reality of inadequate protective equipment and poor cohorting/isolation of coronavirus patients, healthcare workers have asked for expanded, expedited testing when they experience what could be coronavirus symptoms, or when they have been exposed to known COVID-19 patients.
Dee,* a patient care associate at a 1,500-bed hospital in East Harlem, described difficulties getting tested after caring for a patient who later tested positive for COVID-19. She found out only after the patient was discharged and reported her concerns to management. Dee was denied testing, had to seek out her own remedy and pay out-of-pocket: “According to the hospital policy, I couldn’t get tested because I’m not showing any symptoms. I felt like it was a waste of time reporting this information, but I had to say something. Even the RN spoke about this to her manager and director, but there was nothing that could be done. She asked if she could go home and they told her if she did, it would be without pay. She was devastated, worried and upset.”
Out-of-pocket expenses for “elective” testing – even for healthcare workers with known exposure to coronavirus – is overpriced and inaccessible. Jeff Bezos, Donald Trump, Jair Bolsonaro, Heads of States, and other “notables” have had no problem accessing these tests to allay their fears, seek early and aggressive care, and self-isolate with no concerns of affording food, rent, and healthcare. This is not the case for millions of Americans, including the frontline workers who are most at risk. As Dee says, “I was able to make an appointment with [a] virtual care doctor, which cost $126 out of pocket because my insurance doesn’t accept it. The reason why I did this was because my mother has a preexisting condition (COPD) and I want to make sure that I’m not contagious.”
When asked whether she felt the hospital and administration had undergone adequate preparation for the pandemic, Dee replied, “The hospital management doesn’t care about the well-being of their employees. This pandemic is making me think twice about staying in healthcare long-term.” Unfortunately, Dee’s experience is being replicated throughout the city – and the country.
At another hospital in Hell’s Kitchen, registered nurse Carol reports, “We have a clinic that does 2-hour testing outside, because I believe we are one of the testing centers in the city. They are still giving staff a hard time and flat-out refusing to test regardless of exposure. Employee health just started testing people, but only if symptomatic. I’m not symptomatic, but have had multiple unprotected exposure from staff and patients.”
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Testing should be available at no cost and easily accessed for all frontline healthcare workers who have been exposed to coronavirus, particularly when they are underprotected due to the national shortage of PPE. This is especially the case when studies show that 50-80% of people infected with coronavirus at any point may be asymptomatic. While it is too soon and the study sample too small to be certain, even a fraction of these numbers would be a cause for concern. Healthcare workers caring for immunocompromised, geriatric, or pregnant patients want to help their patients, not infect them because they are asymptomatic COVID-19 carriers.
Healthcare workers today have an essential role in dealing with the onslaught of the pandemic. Their safety, swift testing, quarantining, and treatment must be prioritized to prevent further shortage or even death of healthcare workers, and to stop the spread of the virus to at-risk populations and their families.
Elsewhere, we’ve described the “civic peace” prescribed by those who have systematically dismantled community hospitals, cut public healthcare spending, and managed the understaffing problem for years: “The crisis in hospitals did not fall from the sky. It is a result of decades of neoliberal policies by managers and politicians — the same people now calling on workers to sacrifice!”
The inhumane and cruel nature of capitalism and our government is being exposed in this pandemic, opening new possibilities. In a time of desperation, of demonstrable inadequacies and profit-making in healthcare, we must defend what we already have won, but we can also fight for more fundamental changes.
A few years ago, “Medicare for All” was too radical an idea for many. But today we see even bourgeois regimes like Spain are being forced to take measures like nationalizing private hospitals – because, frankly, there’s no other way.
We need to take control of our workplaces – starting with the hospitals, clinics, and factories that produce supplies and equipment to deal with the pandemic. While no one reform or policy will single-handedly absolve the contradictions of our society, one thing is clear: the solution and path to transformation will be wrought by our hands and collective power, not the bosses’. Through struggle and with the help of Marxist theory, we can understand our capacity to democratically rule ourselves and our society under a different ethos.
*The names of healthcare workers have been altered to protect their identity. Hospital administrations have been known to retaliate against their employees for speaking publicly about the lack of PPE and resources to properly care for their patients during the pandemic crisis.