Alameda healthcare workers tell the bosses: masks are disposable, workers and patients are not

By Katie Ferrari

The situation at Highland Hospital in East Oakland is dire. Highland, which serves tens of thousands as Oakland’s only public hospital, is only allowed to test ten patients per day for Covid-19, despite a dramatic increase in patients with respiratory issues. All other patients with Covid-19 symptoms whose vitals are stable are sent home to self-quarantine.

There is no testing available for workers, either. One nurse who was exposed to a Covid-19 patient was sent home, but told to come back to work the next day because she wasn’t showing symptoms. Because the hospital is so understaffed, she must come to work and risk infecting the staff and patients she interacts with. 

As the Covid-19 pandemic worsens, years of underfunding and mismanagement are endangering patients and workers at Highland and at Alameda County’s other public hospitals and clinics. But healthcare workers are fighting back to demand the resources they need to safely care for their patients.

Workers’ conditions are patients’ conditions 

Highland has broken sinks and empty hand sanitizer dispensers. Masks and gloves are not accessible at the hospital: nurses must submit requisition orders, and they are expected to reuse the disposable N95 masks that protect against coronavirus. 

Monica, an emergency room nurse who has started bringing her own masks to work, said that management is telling workers to keep their N95 masks because “if we lose it, we cannot get another one.” John Pearson, another nurse in Highland’s ER, emphasized that N95s are single-use masks: “This is like if someone told you to use one paper towel to clean the house.” 

Things are even worse for housekeeping, registration clerks, radiology techs, and other workers who interact with patients who may have Covid-19 in the emergency room: management is denying them basic life-saving personal protective equipment (PPE) like gloves and masks altogether. Bosses tell housekeeping to reuse cloth wipes while cleaning. 

What’s happening at Highland is a national issue. The U.S. has a severe shortage of PPE and the Trump administration has been slow to invoke the Defense Production Act to force private companies to manufacture critical protective gear. Proper PPE was essential to stemming the spread of Covid-19 in China, where healthcare workers were outfitted in multiple layers of PPE. In the midst of this shortage, the Center for Disease Control (CDC), which is supposed to protect workers and communities, has dramatically lowered its safety standards, telling healthcare workers to store disposable N95 masks in paper bags for reuse, or to just use a bandana. Highland management has followed the CDC’s lead, and is also denying PPE to the sexual assault response team. Sheleka Carter, who is now expected to care for trauma survivors without PPE, said workers are “being asked to do things that in a normal time would be unethical.” 

For example, the hospital only has three PAPRs, filtered masks that completely cover the head. These masks are essential to keep workers safe when intubating, or inserting a tube into a Covid-19 patient’s mouth and down their airway. Intubation is the first step in connecting an air-starved patient to a ventilator, and it places workers in very close proximity to the patient. Because Highland has only three PAPRs, just one critical Covid-19 patient can be intubated at a time — and three healthcare workers are expected to do a procedure that normally takes up to eight people. “This is an unsafe situation for everyone involved. Patients who are struggling to breathe thrash around frantically as doctors and nurses struggle to intubate them,” said Laura, an ER nurse. “Sometimes we’ve needed to have five people holding a patient down so that we can actually treat them, but now there are only three people doing intubation.” 

In a healthcare system centered on profits rather than patients, the compassion of care workers is being exploited, endangering an entire community. Pearson describes the choice Highland workers are forced to make: 

“Take care of patients in a way that’s unsafe, or the patients don’t get any care at all. That’s not a fair position to put us in. You’re exposing yourself to disease and you’re either taken out of the workforce, or you’re spreading infection to other people because you’re working while sick.” 

Healthcare workers are at greater risk of exposure to Covid-19 than the general population, and the lack of PPE exponentially increases workers’ risk of contracting and spreading the virus. Highland, like many other hospitals across the country, has likely become a vector of the virus instead of a place of healing. Kennedy, an ER nurse and mother of three, asked, “What’s going to happen when we all start dropping? Who is gonna take care of this community?” 

The failure of profit-centered healthcare 

Highland is a public safety-net hospital that serves the underprivileged, the homeless, and the undocumented, regardless of whether they have insurance. No one is turned away. Highland is severely underfunded because the people it serves are considered disposable. Now, in a pandemic, AHS is treating workers as though they are disposable too. Carter explains: 

“Poor people are the sacrificial lambs in all of this. We serve a community of people who don’t have money, who may not be insured. They get the leftovers and the scraps from everybody else, which is not right. In the midst of that, the employees that have decided to go to work every day in these safety-net hospitals have become sacrificial lambs along with the communities they serve.” 

Highland is one of eight public hospitals and clinics in the county that the Alameda Health System (AHS) administers. In 1998, just as the tech boom was starting to flood the Bay Area with wealth, the county moved AHS out of its funding jurisdiction. Instead of being funded and administered by the county, AHS is now run by an unelected board of trustees. It’s expected to be financially stable and self-sustaining, an impossible goal for a system that serves the poor and uninsured. AHS has been running a deficit for the past three years. It now owes Alameda County $130 million, according to Service Employees International Union (SEIU) Local 1021, the union representing AHS workers. Budget cuts have created understaffing and equipment crises that predate Covid-19. Instead of dramatically expanding staff to prepare for the virus, CEO Delvecchio Finley has laid off the hospital’s only Nurse Educator. Finley’s annual salary is over $800,000. 

Pearson pointed out that if the hospital were still a department of the county, the funding crisis could be quickly solved by a half-percent wealth tax on the county’s ultrarich: 

“It could easily fund, without any kind of inconvenience to all those extremely wealthy people, things like hand sanitizer, and enough nurses, respiratory therapists, and registration clerks to actually take care of all the patients.” 

Highland Hospital is a microcosm of the U.S. healthcare system, which was never set up to care for everyone, just those who can pay. Despite spending nearly twice as much per capita on healthcare than other developed countries, U.S. hospitals have never run a surplus. Instead, over 120 hospitals have closed in the past decade because they weren’t profitable enough. The extraordinary amounts of money that pour into the healthcare system line the pockets of health insurance CEOs and Big Pharma executives, while healthcare workers fashion gowns out of garbage bags and debate whether or not to spray their N95 masks with Lysol. 

“We’re going to have to rescue ourselves.” 

While management works remotely, sending emails instead of providing hands-on training and sourcing PPE, workers at Highland have taken matters in their own hands. They are beginning to organize to save their patients’ lives and their own. 

In addition to working full-time during a pandemic, workers started a GoFundMe which has raised over $42,000 and have sourced masks and PPE for themselves. On Thursday, March 26, Highland workers hosted a press conference in front of the ER. Each speaker fastidiously donned gloves and wiped down the bullhorn before talking about the nightmare unfolding in their hospital. Workers and community members chanted “Take it back!” as they demanded the county return to funding and administering AHS directly.  

Within two hours, workers had won a small but significant victory: CEO Finley sent out an email stating that two weeks of paid emergency sick leave would be available starting April 1. Pearson was quick to point out that this was already required by state law. Finley’s email made no mention of the severe understaffing and lack of PPE. 

Highland’s workers are continuing to fight for the protection and staffing levels if they and their patients are going to survive Covid-19, and the Alameda Labor Council has echoed their demand for the county to take AHS back. “No one is going to come down from the sky and rescue us. We’re going to have to rescue ourselves,” said Pearson. 

Until then, Monica urged the public to “Please stay home, practice social distancing, and shelter in place. We do not have the capacity to handle the influx of people coming in.”