The following comments were made by Marty Harrison, a nurse in Philadelphia and member of PASNAP, at Socialist Alternative’s national virtual town hall on March 22. They graphically illustrate how the disaster of coronavirus has been exacerbated by capitalism and neoliberal policies. Another health care worker from New York City, Eljeer Hawkins, on the same call made the point that across the country 120 rural hospitals have been closed since 2005 while in New York City, no less than 20,000 hospital beds have been lost since 2000 due to budget cuts, a staggering 27% reduction in capacity.
The for-profit health care industry cannot provide safe quality care to all those who need it on a good day. And today is not a good day.
COVID-19 is a tipping point in this debate – the health care equivalent of the Greenland ice sheet falling into the sea. Socialists’ argument that capitalism cannot and will not provide any service no matter how necessary unless it is profitable has become the concrete experience of millions around the world. We need to be taking action to change that reality and save lives.
COVID-19, the novel coronavirus is, as its name indicates, new, a variation on a well understood theme. It was first recognized half a world away at the end of last year so that by the time it reached the U.S., we knew some critical basic facts about it. Namely, the virus caused respiratory infections which spread person to person through the air, in droplets and by contact with contaminated surfaces.
Health care workers are very familiar with the standard precautions for all of these transmission routes, the difference is COVID-19 isolation requires a combination of all three protocols.
Health care workers need gown, gloves, face shield/goggles and a respirator, a close fitting N95 mask or a PAPR, a battery powered air purifier.
Ventilators, in contrast, are machines that draw air in and out of a patient’s lungs. COVID-19 positive patients develop pneumonia requiring mechanical ventilation.
The need for an increased supply of both respirators and ventilators was easy to anticipate.
In January and February, as more and more information about the virus was in the media, Administration at my hospital – and I’ve heard variations of this story from nurses across the country – repeatedly assured us that they had a month’s supply of N95’s stashed away under lock and key. Once we started admitting symptomatic patients, that stock disappeared in three days.
There is no uncertainty in the science, if the microbe is airborne, we need at least the N95 level of protection. Without it, health care workers will inhale the airborne virus, if we become infected, we can spread it to others, including our patients and if we get sick, we cannot care for anyone else.
There is a lot of uncertainty about who is positive, because of the extreme limits on the availability of test kits. Health care workers want this level of protection when they’re giving care to patients with symptoms because there’s no going back. Once you’ve been exposed, you are exposed. The failure to test widely further exacerbates the demand for the N95’s at a time when supply is limited.
The Trump administration has done irreparable and unknowable harm by downplaying the dangers. Two weeks ago, in an act of truly criminal negligence, the Centers for Disease Control relaxed its standards related to the N95, allowing the substitution of a surgical mask IF the N95 was not available. The virus did not read the CDC memo and did not change its mode of transmission. We need N95’s to protect ourselves.
President Trump invoked the Defense Production Act which gives him the ability to tell corporations to manufacture N95’s, but he hasn’t acted on this authority.
His administration has found trillions of dollars for banks, cruise ship lines, and the stock market, but no money has been released for hospitals struggling to pay for added staff, equipment and supplies.
Health care workers are skilled and we know what we need to do our jobs well. A socialist solution for health care must include direct caregivers having democratic input and control over how care is delivered, our supply chains and how our inventory is warehoused for emergencies.
All of that Personal Protective Equipment is time consuming and exhausting to put on and take off and it must be done correctly to avoid cross contamination. We need more nurses to care for COVID patients at a time when staffing was already tight in part due to budget cuts resulting from the Trump administration’s attacks on Obamacare.
Those of you who don’t work in health care will find this difficult to believe, but a significant minority of health care workers are currently without work. In many regions of the country, hospitals and clinics are cancelling elective procedures–not just plastic surgery, but preventive care, diagnostic, therapeutic and palliative procedures which are necessary, but not urgent.
In my view, our employers must be providing any and all training we will need to back fill for our exhausted, quarantined, or sick coworkers. Direct caregivers over 60 years old or who are at higher risk for any reason must be offered paid leave or retrained to fill a need away from the bedside.
Socialist response to this crisis would include an assessment of the skills we have collectively and then a plan to use those skills most effectively in the service of patient care. It’s not rocket science, it may even sound simplistic, but it will not be possible as long as profit, not patient care, is driving decision making. And that’s what needs to change.