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Health Care Workers Confront Equipment Shortages, Infection Threat, Emotional Stress


Treating patients with COVID-19 is taking a toll on health care workers. Doctors, residents and nurses say there is not enough protective gear, that they're having to care for their colleagues who've fallen ill and that guidelines on how to care for the sick are constantly changing. Nearly a month into this declared pandemic, they say they don't know how much more they can handle without more support. NPR's Leila Fadel and reporter Will Stone join us now to discuss this.




SHAPIRO: Leila, let's start with you. You've been speaking with health care workers. What are you hearing from them?

FADEL: So most people I spoke to describe this mix of moral duty and absolute fear because they feel unprotected. There's also anger not just at their hospitals but, really, at the government. And some say they're already burning out. At one New York City hospital, an ER doctor told me she gets one N95 every five days. She says she watched a colleague's mask rip as she performed CPR on a patient, and 90% of their patients have COVID-19. She describes the emergency room as Chernobyl because there's no doubt that droplets from the patients are in the air all around them. And here in Los Angeles, I spoke to a nurse practitioner who says she's breaking down from the stress. Here's what she said about putting on that one N95 mask she gets per shift.

MARIE: And I put it on for the whole shift - don't eat or drink after - so I, like, lost three pounds in a week. The skin on the bridge of my nose is already opening up. Like, it's just so emotionally draining. I mean, the other day, I was almost having a breakdown. So I feel like if I - if this goes on for weeks and weeks and things only get worse, like, I just don't know how I'm going to be able to handle it.

FADEL: She asked me to use her middle name, Marie, because like so many health care workers, the hospitals have told them very explicitly not to speak publicly. And if they do, they risk their jobs.

SHAPIRO: Wow. And, Will, does that tape that we just heard from Marie square with what you've heard from the workers you've been speaking with?

STONE: Yes, I'm hearing the same kind of details. Many say hospitals are asking them to do all kinds of workarounds that would never have crossed their mind before the pandemic. I spoke to Sophia Rago who is an E.R. nurse based in St. Louis. She described a new policy at her hospital.

SOPHIA RAGO: Now you get one surgical mask and one N95 for three shifts in a row. You put it in a brown paper bag, and then you write your name on the bag. You give it to someone, and they're supposed to be disinfecting it between your shift. And do I trust that? No.

STONE: Rago says not only does this feel sketchy. But also, these protocols have been changing so often it's just hard to feel confident.

FADEL: And throughout this, the CDC guidelines have been changing and take into account the strain on supplies, but health care workers say they feel like these recommendations err on the side of less than they need. As a last resort, the CDC even recommended using a bandana or scarf in place of a mask. Many say the fact that the CDC suggested that - it makes them really distrustful of the very recommendations that hospital administrators are using to inform their policies.

SHAPIRO: Wow. So, Will, what happens when these health workers go home? How are they managing the stress?

STONE: Most tell me it inevitably spills over into your life emotionally and logistically. They have to isolate themselves from their family to be sure they don't accidentally get anyone sick. One critical care nurse from outside Seattle told me his wife started to show symptoms. They couldn't get her tested, though, so they immediately moved his two young children, including one who has an autoimmune condition, to his mother's home. He then started sleeping in his car, and now he's sick.

SHAPIRO: Well, that brings the question, what happens when these health care workers come down with COVID-19 themselves? Leila.

FADEL: Well, I spoke to Ramona Moll, a nurse who says she got sick at her hospital, UC Davis Medical Center in Sacramento, while treating an older patient with dementia who had COVID-19 symptoms. She says he tried to bite her, so when she tried to stop him, she thinks she got infected. It was mid-March at that time. She was required then to wear that simple surgical mask, goggles, gloves and a gown. And she says she blames her hospital for getting her sick.

RAMONA MOLL: The hospitals need to take responsibility for the fact that they did not take care of their nurses. They did not have the N95s available. I don't care what the CDC guidelines say. If your nurses feel uncomfortable in a certain area, you should give them what they need.

FADEL: She's on emergency administrative leave now while she isolates and recovers, but the hospital disputes her account; a spokesman saying in a statement that there were no COVID-19 patients at the hospital at the time she says she was infected.

SHAPIRO: Will, how are other hospitals handling this? Does anyone who contracts COVID-19 on the job get emergency leave?

STONE: Hospital policies vary. Some, like the hospital where the nurse Leila spoke to works, give emergency leave no matter where they got it. Others don't do that. I spoke to Edward, an ICU nurse who works at Swedish First Hill, a hospital in Seattle. We're only using his first name because he's afraid of retaliation for speaking publicly. He became sick with COVID-19 last month and says he had to use his sick time and vacation time.

EDWARD: I did not feel supported at all. In fact, I felt that their main concern was trying to explain away my positive results as community-acquired; really, trying to turn my positive results on something outside of the hospital.

STONE: In response, his hospital, Swedish, told me the safety of its caregivers is a top priority, especially during this pandemic. It might seem odd to argue over where Edward got infected, but it's important. At his hospital, if you get infected at work, you can get 100% pay through administrative leave. But if you get infected outside of work, you only get 80 hours of emergency time off. If you need more time, you get paid at 65% of your normal salary. First, though, you have to exhaust your sick and vacation time.

SHAPIRO: That is reporter Will Stone and NPR's Leila Fadel.

Thanks to both of you.

FADEL: Thank you.

STONE: Thank you. Transcript provided by NPR, Copyright NPR.

Will Stone
Leila Fadel is a national correspondent for NPR based in Los Angeles, covering issues of culture, diversity, and race.
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