Risking 'Essential' Workers’ Health to Protect the Bottom Line
When Mailinh Nguyen got the news that a patient she’d been caring for had tested positive for COVID-19, she was more than a little shook up. A certified nursing assistant at Fountain Valley Regional Hospital near Huntington Beach, Nguyen had just spent parts of two 12-hour shifts sitting with the patient, wearing no protection stronger than a standard surgical mask.
There was an explanation for that. Like most hospitals, Fountain Valley doesn’t test incoming patients for the coronavirus, meaning asymptomatic carriers of the disease may be admitted and then expose the very workers entrusted to care for them. In Nguyen’s case, it was only because the patient was trying to transfer to a nursing home that the COVID infection was discovered; it was the nursing home that required the test.
This is a scene that has played out many times in hospitals and health-care centers around the country in 2020, and it all draws back to a simple question: Why won’t these facilities, many of them owned by wildly profitable health corporations, spring for something as basic as a proactive testing process that would protect their own essential workers?
Until Newsom applies new protections, those workers remain in a bizarre class: deemed “essential,” yet not properly shielded from the spread of the virus itself.
“One, because it costs too much money, and two, because it reveals consequences that are adverse for the bottom line – staffing levels, employees being quarantined,” said Sal Rosselli. The president of the National Union of Healthcare Workers (NUHW), Rosselli has been engaged in an ongoing quest to make ground-level testing of hospital workers – and the patients who cross their paths – a requirement in California. (Disclosure: The union is a financial supporter of Capital & Main.)
Progress on the issue has been slow going. But it’s possible that a path to success may yet be paved by, of all things, the nursing home COVID crisis in California, which has prompted government-imposed changes – such as the test on Nguyen’s patient several weeks ago.
You have to back up a few steps to even process the thinking here. Over the past quarter century, the health care system in the U.S. moved aggressively away from the old clinic and family physician model to a heavily corporatized environment, one that prizes annual profit over patient care (or, in some cases, worker safety). The situation has been exacerbated recently by the mass closures of critical safety-net clinics across the country, as the virus kept regular patients away from such common and budget-saving practices as doctor and dental checkups.
The behemoths are the ones left standing. And, as Rosselli put it, “The ideology, the business model, hasn’t changed because of the pandemic. So health workers getting sick or dying – as one health care executive told me off the record, ‘It’s the cost of doing business.’”
Nguyen was fortunate; her own COVID-19 test came back negative. But she endured a different type of ordeal. When Nguyen informed management of her patient’s positive test, she said she was told to continue working while self-monitoring for symptoms. She put in two more shifts before finally going into quarantine and getting a virus test, which she said was not available to her at Fountain Valley. Instead, she went to an urgent care center, paid for the test herself and waited 10 days before being told she was in the clear.
“It was scary for me, because I live with my parents, and they’re both in their 70s,” Nguyen said. “I had to move out of the house for a few days because I didn’t want anything to happen to them. I stayed with a cousin, I stayed with friends, I stayed in the garage – basically, I was homeless until I got the test result.”
The lack of a proscribed testing process was found to be a major contributor to California’s nursing home COVID crisis earlier this year, and it prompted action from Gov. Gavin Newsom. Through the Department of Public Health, Newsom instructed all nursing homes and skilled nursing facilities to test all of their employees every month, including at least 25 percent of them each week.
The plan Rosselli is pushing on behalf of the NUHW is similar – in part, he says, because it appears to be working in the nursing home industry. It seeks the 25 percent weekly testing requirement for all health care workers, and it also calls for testing all “newly admitted, re-admitted and newly treated patients” for COVID-19 infection, as well as those who’ve displayed symptoms or had a known exposure. The union’s proposal would require that health care workers be tested when they have symptoms of the virus or “are exposed to a suspected or confirmed COVID-19 patient while not wearing appropriate PPE.”
That last stipulation would have benefited Nguyen, putting the onus on her corporate employer, Tenet Healthcare, to take action. But despite longstanding guidelines from the Centers for Disease Control and Prevention that healthcare workers exposed to the virus without adequate personal protective equipment (PPE) should be tested, “No hospital does that in California that I know of,” Rosselli said. “In fact, there are many that will not test you even if you have symptoms.”
Because Newsom was receptive to implementing significant changes in the nursing-care industry, the NUHW is optimistic that the governor will similarly move to apply those protections to health workers in hospitals, health care centers and correctional facilities. Until then, however, those workers remain in a bizarre class: deemed “essential,” yet not properly shielded from the spread of the virus itself.
“I’m still afraid something will happen to me again,” said Nguyen, who is back on the job at Fountain Valley. “It would be great if all hospitals – not just ours, but all of them – would test all patients when they arrive. That’s one way to take care of the people who are caring for the patients. The fact that it isn’t happening is really kind of ridiculous.”
Capital & Main