Highland Hospital fires nurse who wore garbage bag as PPE

By Katie Ferrari

SEIU 1021, the union that represents Highland Hospital workers, is asking the public to email the Alameda County Board of Supervisors to demand that Alameda Health System, which administers Highland Hospital, reinstate the fired nurse immediately and hold AHS accountable for its anti-worker actions. You can take action here.

On Monday, April 13, Highland Hospital fired a nurse for wearing a garbage bag as a gown. Saber Alaoui, a nurse in the Telemetry unit, had fashioned the gown out of a garbage bag to protect himself, his patients, and his wife — who has cancer — on March 28.

“I can’t do this. If my wife gets sick, it will kill her.” 

At the start of his 12-hour shift on the evening of March, Alaoui said, he and his coworkers learned that their unit had fewer than 20 gowns to get them through the next week. Each time a worker enters the room of a patient with an infectious disease like Covid-19 or Clostridium difficile, they need to put on a fresh gown. Over the course of a 12-hour shift, it can take a dozen to several dozen gowns per patient to protect all the workers that need to go in and out of the room to take care of the patient and to keep the room stocked and clean. Because of the shortage, Alaoui says, the supervisor told workers they could only use the gowns for Covid patients. She suggested Alaoui and his coworkers use patient gowns to work with all the non-Covid patients, even though the cloth gowns wouldn’t protect them from bodily fluids or other hazardous substances.

Alaoui’s wife is immunocompromised: she was diagnosed with breast cancer in January and started chemotherapy in February. Alaoui was already living in terror of spreading Covid to his wife and child. When he came home from work, he would remove all his clothes in the garage before showering, and would often sleep by himself in the family’s guest room for multiple days afterward. Now he was being asked to go into the room of a patient with an antibiotic-resistant infection without proper personal protective equipment (PPE). 

Alaoui thought to himself, “I can’t do this. If my wife gets sick, it will kill her.” So he did what many nurses across the country and at his own hospital have been doing. He got a roll of garbage bags from a housekeeper, cut out holes for his arms, and wore it as a gown. Then he went into his patient’s room and cared for them. 

When his supervisor saw him wearing the garbage bag gown, she commended his creativity, he said. Alaoui took a photo of himself to show his wife and shared it with a coworker. 

Covid-19 spreads through lack of testing and protective gear

Healthcare workers like Alaoui at Highland have been fighting for adequate PPE for months. Traveling from one patient’s room to another without proper PPE increases the chances of healthcare workers and non-Covid patients contracting the virus. The situation is especially dangerous because Covid-positive patients are not isolated in their own unit at Highland. Alaoui’s Telemetry unit includes cancer patients undergoing chemotherapy, patients with antibiotic resistant infections like MRSA and C. diff, and Covid patients on hydroxychloroquine, the controversial experimental treatment that can cause cardiac arrest or death.

The national lack of tests puts workers and patients in a dangerous Catch-22. There are patients with Covid symptoms in Alaoui’s unit who have not been tested, but because of the PPE shortage, management is limiting PPE use to patients who have tested positive for the disease. This means workers are prohibited from wearing adequate PPE around patients who are probably infected but cannot be tested, and the dangerous working conditions spread the virus further through the hospital.

Alaoui suspects this situation contributes to the catastrophic spread of the disease into local nursing homes: “We have staff that work in the hospital and they have other jobs in nursing homes.” He is adamant that “to stop the spread, we need PPE for every patient we interact with because we don’t know who has Covid.”

At Highland, Alaoui says workers have to ask management for every item of PPE, including sanitizing wipes. He says managers sometimes give nurses one N95 or surgical mask and tell them to use it for the whole week. These masks are meant to be used once and changed between patients. “If I wear the same mask as I go from one room to the other, then I’m spreading the disease around,” Alaoui explains. 

Alaoui has seen lab technicians begging supervisors for masks. Security guards, housekeepers, and intake specialists all come into direct contact with potential Covid patients in the emergency room, but often are not issued masks. Meanwhile, he’s seen members of management — who have limited contact with Covid patients — wear masks in their offices. 

When asked for comment on the PPE shortage, Terry Lightfoot, Director of Public Affairs at Alameda Health System, said “We currently have sufficient PPE to perform our operations. We are conserving PPE to prepare for a potential surge. Anyone needing PPE to perform the work should have access to it.” When asked about security guards, housekeepers, and intake specialists without masks, Lightfoot said that “people who need masks are getting them depending on their role and where they work in the hospital.”

Workers will keep wearing trash bags to protect themselves, Alaoui says, “because housekeeping doesn’t have gowns to go into Covid patients’ rooms.”

Healthcare workers’ fight for PPE dismissed as “political theater” 

Alaoui’s garbage-bag selfie made its way onto social media and sparked an article in the San Francisco Chronicle on April 2. Suddenly, the bosses no longer found Alaoui’s creativity commendable. Now it was an embarrassment to Highland Hospital, which was already plagued with mismanagement scandals and healthcare workers raising money to buy their own PPE. After the Chronicle article ran, Alaoui says managers told him, “You’re not supposed to do this. You should have come to us, we would have given you the PPE, we have plenty.”

When the Alameda County Board of Supervisors held a joint meeting with the Alameda Health System (AHS) Board of Trustees on April 7, AHS CEO Delvecchio Finley, whose salary is nearly $800,000, suggested the photo of Saber in a garbage bag gown was staged. Trustee Joe Devries, who as assistant to Oakland’s city administrator has proposed ticketing unhoused people, rolled his eyes and called the photo “political theater.”

“We are disposable,” Alaoui says. “If you get sick, you just go home. No pay, nothing. Nurses are being thrown to the wolves. If a nurse gets infected, you know for a fact that hundreds of community members are going to get infected. The store, the supermarket, everywhere.”

Highland’s management has taken its cues from the CEO and trustees, not the frontline workers fighting the virus. “Our management doesn’t care that the security guards and housekeepers have families to go to,” Alaoui said. “When you don’t have to take care of patients, you don’t feel how we feel. You don’t feel our pain.” 

A life turned upside down

Alaoui’s pain has been acute. “I couldn’t begin to describe how our lives have turned upside down. The magnitude of the cancer was not enough, the next thing you know, we have Covid.” 

His voice grows ragged as he explains, “it’s very stressful. Sometimes, I swear, I wake up in the middle of the night and just want to cry. I want to help my patients, but I don’t want to bring Covid to my family, I don’t want to bring it to my wife.” When he’s off work, he self-isolates for days in the family’s guest room, unable to play with his son. If the stress and loneliness gets to him or his family before the 14-day virus-incubation window passes, he comes out to see them.  “What are you going to do?” he asks. “I’m damned if I do, damned if I don’t. My wife, she needs that hug to know she’s not going through her cancer by herself.”

On April 13, Alaoui was fired. His termination letter cited charting and medication offenses that SEIU-1021 steward John Pearson says are common occurrences for nurses working at the busy, understaffed, and underfunded county hospital. Pearson says Highland was able to fire Alaoui on these grounds because he was still in his probationary period, which would have ended on May 4. In his nine months at the hospital, Alaoui says he had never received a verbal or written warning. In their termination letter, management claimed to have given Alaoui a reprimand on March 29 — but email records provided by Alaoui show that on March 30, they offered him a promotion to a better-paid supervisor position. 

Alaoui says that when he asked his manager if the firing was an act of retaliation, she refused to answer. Lightfoot, AHS’s director of Public Affairs, told Majority that Alaoui’s termination was “absolutely not” retaliation.

Alaoui was fired despite the Occupational Safety and Health Administration’s explicit protections for Covid-19 whistleblowers. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has suspended its hospital inspections during the pandemic, and in an email, the California Department of Public Health said it was limiting on-site inspections to “immediate jeopardy” complaints. Healthcare workers are some of the only people left who can bring dangerous hospital practices to light. 

Now, in the midst of a pandemic, with his wife battling cancer, Alaoui is unemployed and his health insurance will run out at the end of the month. “I put my life on the line for the public,” he says. “I just want my job back. I can’t go without health insurance for my wife. We were living paycheck to paycheck because I’m the only provider. And California is not cheap. So I was just trying to make it, and now I don’t know if I’m going to make my car payment or my rent.”

Covid is an act of nature. This disaster is an act of capitalism.

It didn’t have to be this way. Alaoui’s personal crisis and our country’s social crisis could have been avoided. Covid is an act of nature, but the disaster unfurling around us is an act of capitalism. 

Like a nightmare Rube Goldberg machine, step after step of the capitalist system’s “response” to Covid has failed Alaoui and the country. The United States’ economic system has made the country extremely susceptible to a horrific pandemic like this one. For decades, austerity has shredded the social safety net. Healthcare has been increasingly privatized and underfunded. Hospital after hospital has closed. Politicians in both the Democratic and Republican Parties have fiercely resisted Medicare for All, which we desperately need as millions of people are thrown off their employer-provided health insurance.

When some members of Congress were briefed on the disease in January, they sold their stocks and raked in profits instead of securing PPE stockpiles. Stimulus packages have bailed out corporations and sent measly $1,200 checks to working-class people — but only to citizens. Millions who have lost jobs or had their pay cut will be unable to pay rent. Immigrants and inmates remain trapped in crowded, unsanitary ICE detention centers and prisons where the virus spreads rapidly. Las Vegas hotels sit empty while the city turns parking lots into dangerous “homeless shelters.” 

As essential workers and people of color continue to die disproportionately from Covid, national conversations center on reopening the economy instead of nationalizing production of the PPE and ventilators so critical to protecting workers in healthcare and other essential services. “We sent a man to the moon, manufacturing PPE must be easy. Other countries are doing it left and right,” Alaoui says. “Look at China and Italy: they have hazmat suits, because they know how precious the nurses are. But here, we are disposable. It’s all about the bottom dollar.”