Working through a pandemic: Many health care workers face health risks, can’t take time off

Doctors, physicians, nurses, certified nurses’ aides (CNAs), medical technicians and medical assistants are just some of the people working on the front lines when it comes to helping sick patients and seniors.

A statewide coronavirus hotline is open 7 days a week from 8 a.m. to 5 p.m. at 1-888-535-6136. Information can be found on the DHHS website or the U.S. Centers for Disease Control (CDC) and Prevention website.

Bars, restaurants, movie theaters, gyms and schools are just a few public places that have been shut down in response to the COVID-19 outbreak in Michigan. However, hospitals, health care facilities and senior care facilities must stay open to provide care for those in need of care. 

When COVID-19, a disease caused by a new coronavirus, or any other disease is added into the mix, health workers face the risk of getting sick as they try to prevent the spread and help others. Symptoms of COVID-19 include fever, cough and shortness of breath, but the symptoms could take between two and 14 days to appear.

“The pandemic is unlike anything I have ever seen,” said Jessica Doutt, 27, a CNA who works at Lapeer County Medical Care Facility, also known as Suncrest.

Doutt said the threat of COVID-19 has changed the way she interacts with her coworkers and the residents at the facility she’s worked at for four years.

“In the nursing field, you look at [everything] as if it’s contaminated, that’s what you’re taught. If something touches the floor, it’s contaminated; if you touch your clothes, your hands are contaminated; skin to skin contact is also considered as contamination,” said Doutt.

She said that in a sense, nothing is ever clean enough and that she works in the cleanest environment.

“[COVID-19] is an invisible enemy, and I’m afraid an outside source could unknowingly give the virus to one of the patients,” said Doutt.

She added that CNAs are facing an additional challenge because they are taught to interact with residents through touch.

“Touch is so important, just holding someone’s hand makes such a difference and if I’m talking to someone I’m holding their hand or gently put my hand on their shoulder, there’s always some sort of touch that goes into almost every interaction with a resident because we’re showing we care,” said Doutt.

But Doutt doesn’t want to build a barrier between herself and the residents, so she is more vigilant about sanitizing and handwashing.

“I now also think twice when I pick up dishes from the table at work, and we don gloves to clean plates. Then I get the itch to wash my hands as quickly as possible,” said Doutt.

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COVID-19 caseload

Michigan has been seeing big upticks in the number of confirmed cases over the last week — although health officials warn that the actual number is probably much higher, as tests are scarce. 

According to the Michigan Department of Health and Human Services (DHHS), there are 1,328 confirmed positive cases of COVID-19 in Michigan at the time of this publication. Fifteen people have died.

Gov. Gretchen Whitmer spent the weekend being briefed by epidemiologists from the University of Michigan, Harvard University, Johns Hopkins University and the University of Pennsylvania. Based on that, Whitmer said at a Monday press conference that Michigan is on track to have 7 million people — 70% — contract COVID-19. One million people would need to be hospitalized, which would overwhelm the state’s medical system.

That’s why she signed the “Stay Home, Stay Safe” executive order to protect Michiganders from COVID-19. The order directs all non-essential businesses and operations to temporarily shut down and directs residents to stay home unless they’re a part of the critical infrastructure workforce, engaged in an outdoor activity or performing tasks necessary to the health and safety of themselves or their family. 

The order went into effect at 12:01 a.m. Tuesday and continues through 11:59 p.m. April 13.

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“Taking aggressive action to protect our communities is the most important thing we can do to mitigate further spread of COVID-19,” said DHHS Chief Deputy for Health and Chief Medical Executive Dr. Joneigh Khaldun. “If we do this now, we can make sure our hospitals and healthcare workers are prepared to take care of the sickest people. It is crucial that people do the right thing by staying home and staying safe.” 

According to the World Health Organization, there are more than 334,000 cases and 14,500 deaths tied to COVID-19 globally. There are more than 31,000 cases and 400 deaths reported in the United States. 

Since the outbreak, health workers around the globe have fallen ill and some have died. According to the University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP), about 1,700 health care workers, which makes up 8% of the total cases in Italy, are now infected with COVID-19, and some have died. The Washington Post reports that the federal government has gotten more than 60 reports of infections among health care workers. 

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Michigan health workers across the state are at risk, too. 

There are 20 to 30 employees at Heartland Health Care Center in Livonia were possibly exposed to COVID-19, according to the Service Employees International Union (SEIU) Healthcare Michigan. The news came after it was revealed that a patient there had tested positive for the disease. Currently, it’s not known if any other nursing home residents were exposed.

The Bay County Health Department announced that a physician at Covenant HealthCare in Saginaw was tested for COVID-19 two weeks ago, and the results came back positive. 

After that, the county Health Department, Covenant HealthCare and other area county health departments worked together to inform patients and staff who had contact with the physician so they could take immediate action to minimize their exposure to others.

Bay County Executive Jim Barcia, a former congressman, said he has directed the health department to utilize all its available resources to work diligently with local health care providers, townships and cities, and community organizations to protect residents. 

“We all need to do our part to fight the virus, including frequent handwashing, maintaining social distances of six feet, avoiding large crowds and most importantly, staying home when you are sick,” said Barcia.

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In an additional move to protect health care workers, Whitmer declared Friday that all non-essential medical and dental procedures be postponed until after the COVID-19 outbreak.

“Health care professionals are working around the clock to help protect and treat Michiganders, and by temporarily postponing non-essential procedures, this will free up staff and critical resources that will be needed to address the ongoing public health emergency that we are facing,” said Khaldun. 

Safety equipment shortage

Health workers are expected to follow procedures to protect themselves and their patients from catching COVID-19 or any other disease during their stay in those facilities.

“The highest priority for hospitals is to keep their patients and health care workers safe so they can provide the appropriate care to their patients without fear of transmission of the disease,” said John Karasinski with the Michigan Hospital Association (MHA), which represents 164 member hospitals across the state. 

The problem is, many health care facilities don’t have enough protective equipment. 

A startling recent report from NBC News showed nurses and health care workers are reporting shortages of personal protective equipment (PPE) across the country. They’re also being forced to ration or reuse supplies, including surgical and N95 masks, for fear of running out. Many also said they were facing shortages of basic sanitary supplies, including hand sanitizer and disinfectant wipes.

“If not addressed immediately, COVID-19 has the potential to overrun our health care systems,” said Andrea Acevedo, President of SEIU Healthcare Michigan. “Our health care workers will be pushed to the brink; therefore we need to take steps now to ensure they are protected.” 

The Michigan Nurses Association (MNA), a labor union representing more than 10,000 registered nurses across the state, says nurses have also reported a lack of, or improper rationing of, PPE such as N95 masks.

Many people in Michigan and across the country have taken to sewing masks at home and donating them to hospitals in need.

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Nurses also told the MNA there’s been a failure to set up proper protocols for screening and treating suspected or confirmed COVID-19 patients, including health care staff and others entering health care workplaces.

They said there’s been a failure to guarantee that nurses in vulnerable populations – those 60 or older, with underlying medical conditions, immunodeficiencies or confirmed pregnancies – won’t have to take care of COVID-19 patients.

The shortage of critical supplies like hand sanitizer, masks, gowns and ventilators is something that Whitmer has been trying to solve. Whitmer said she had her team reach out to World Health Organization (WHO) officials about obtaining more tests, as President Trump told governors that they should seek out solutions on their own supplies.

Whitmer also called up the Michigan Army National Guard to assist DHHS with assembling and loading critical personal protective gear, such as gloves, gowns and face shields. Once packaged, DHHS will deliver the supplies to various local public health departments.

In addition, Whitmer announced that Michigan’s licensed distilleries are permitted to produce ethanol-based hand sanitizers to help with demand. The Big Three automakers have shut down plants due to the spread of COVID-19, but Fiat Chrysler Automobiles announced it will be producing and donating masks for first responders and health care workers. And General Motors suppliers are switching gears to make parts for ventilators in short supply at hospitals. 

Whitmer on Monday again stressed that states have largely been left to their own devices to deal with COVID-19, and the supplies that the federal government has allotted to Michigan hospitals have been barely enough to cover one day’s shift at a single hospital.

“So while I can’t do overnight what the federal government should have done over the course of months in planning, my team and I are working 24/7 to secure the things we need,” Whitmer said. 

And yet, in spite of these shortages, doctors, nurses and health care workers press on. 

“Our focus, as always, is taking care of patients, and nurses are determined to keep doing our jobs during this crisis,” said MNA President Jamie Brown.

Doutt said her facility has new protocols in place to protect both employees and residents. 

As soon as she gets to work, she gets in line at a checkpoint in front of the facility with other coworkers to get their temperatures taken. If their temperatures are within normal range, they are allowed to go on to the next checkpoint, which ensures that the workers have been screened. Then the workers are able to clock in for their shift.

“The line moves very quickly. I doubt I have sat there waiting to get my temp taken for more than a minute. It seems to be working really well,” said Doutt.

The facility has also changed the way it prepares food for staff and residents, as well. Doutt said kitchen staff are not preparing a salad bar or preparing hot food; instead they are serving cold lunches. Doutt said she and her coworkers have been told that they are not supposed to congregate in the café, but they can take their break in an unoccupied conference room or their vehicles to observe social distancing guidelines.

Working while sick

Hospital and care facility workers are still expected to report to work and provide care throughout the COVID-19 outbreak and an influx of patients is expected during the coming weeks. 

What if you can’t stay home while you’re sick?

That’s a reality for some health care workers, including Stacey Johnson, 29, who is a registered nurse at Stonegate Health Campus, a senior care center located in Lapeer.

Johnson has worked at the facility for about seven years and provides care for 27 residents there, who, due to their age, may face more health risks if they contract COVID-19.

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Johnson said she is taking precautions against COVID-19 by washing her hands and practicing social distancing. However, Johnson said she has gone into work while sick due to staffing issues.

“If we are experiencing symptoms that aren’t COVID-19 related, we’ve been told we need to be at work, because we’re short-staffed,” said Johnson.

Johnson said that she and her coworkers accrue paid time off (PTO) for hours worked, but they aren’t offered any type of compensation while they’re quarantined beyond using leftover PTO time to cover their unworked shifts.

She adds that staffing issues at the facility she works at are taking a toll when it comes to her health.

“It’s hard to stay healthy when only getting three hours of sleep between shifts,” said Johnson.

Johnson said there was a recent instance where she worked a 15-hour shift with no break or chance to eat while she was on the clock. She adds workers at the facility aren’t represented by a union and the facility just went through a management shift.

And she isn’t alone. 

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The MNA said there’s a concern that nurses who become exposed or infected to COVID-19 at work could suffer lost wages or use their own vacation time.

SEIU Healthcare Michigan, which represents 11,000 workers in home care, nursing homes, and hospitals across the state, last week sent memos to all facilities it represents, demanding employers take several measures to protect union employees, including:

• Paid administrative leave for all workers that have been exposed to COVID-19.
• All testing and treatment for COVID-19 paid by employers.
• No repercussions be taken for employees notifying their employer if they believe they may have come into contact with COVID-19.
• Personal Protective Equipment will be provided by the employer at an employee’s request.

“These measures are the first step to ensure that all our workers are protected,” said Acevedo.

Protecting patients from COVID-19

Last week, Whitmer signed Executive Order 2020-11 on Monday, which prohibits all events and meetings drawing more than 50 people in shared indoor spaces in response to COVID-19, which has since been overridden by the stay at home order now in effect.

Regardless, health care facilities, residential care facilities, congregate care facilities, and juvenile justice facilities are excluded and still operating. In-person visits at Michigan’s prisons, juvenile correctional facilities and care facilities also have been discontinued. 

“We are taking every measure we can to mitigate the spread of coronavirus and protect Michigan families,” said Whitmer. “This is a hard time for families, and we will continue to put their health and safety first when making these decisions.”

Doutt said the hardest part of the new precautions is discouraging visitors for everyone’s safety.

“I say this is the worst part,” she said, “because no one likes seeing families being separated.”