In El Paso and nationwide, hospital worker safety is an ongoing debate amid COVID-19
As COVID-19 cases have spiked in El Paso and other parts of the country, hospitals have borne the brunt of the crisis.
Throughout the pandemic, several groups of El Paso hospital workers have spoken out about worker safety concerns, including inadequate personal protective equipment and lack of access to COVID-19 tests for staff. El Paso members of the National Nurses Union and the Service Employees International Union have held multiple public protests demanding improved worker safety standards at local hospitals.
Although El Paso hospitals emphasize the efforts they have undertaken to promote and maintain the safety of their employees, some say they aren’t doing enough.
A technician who works at Las Palmas del Sol Healthcare wishes the hospital would do more to protect workers.
“We’ve literally doubled (in COVID-19 patients) in the last month. So floors are full. But I don’t get an N95 mask. I have my same N95 mask — I’ve had this one for two weeks now, and they’re only good for eight hours. The process they have is not good at all,” said the worker, who asked not to be identified for fear of repercussions.
Las Palmas del Sol Healthcare officials disputed the worker’s claim. “Employees caring for COVID-19 patients in our hospitals are provided with an N-95 mask for each shift they are working. If the mask becomes soiled or is compromised at any point during the employee’s shift, a new N-95 mask is provided for the duration of the shift that day,” the hospitals said in a statement.
COVID-19 hospitalizations in El Paso tripled, from 95 to 310, between June 23 and July 23.
In a statement, Las Palmas del Sol Healthcare said the hospitals have taken numerous steps to protect workers and patients during the COVID-19 pandemic.
“Since the onset of this pandemic, we’ve instituted several safety protocols to help protect our patients and staff. In March, we implemented universal masking throughout our hospitals, and we screen all patients, visitors and staff — including temperature checks — before they enter our facilities.” The statement also said, “We continue to follow the CDC’s and our local public health officials’ guidelines for preventing the spread of the coronavirus.”
Complaints over PPE, access to COVID-19 testing
Dr. Ogechika Alozie, chief medical officer of Del Sol Medical Center and an infectious disease specialist, said El Paso hospitals are prioritizing worker and patient safety.
“We have done all the things aligned with CDC guidance from the time that we realized COVID was going to be a concern, far before we ever had a case in El Paso. We all work collaboratively in the community, whether it’s Las Palmas del Sol, The Hospitals of Providence, University Medical Center; we all work together. The chief medical officers get on calls every other week, we’re all aligned with being safe.”
He said COVID-19 presents unique challenges for hospitals, and has necessitated that hospital leadership respond to changing standards and information from federal agencies.
“At any point in time, we as people can disagree about what a standard is, and the CDC has put out multiple standards and we’ve tried to adapt to that. I tell people all the time, it’s really easy in hindsight to pick at things,” Alozie said. “But in real time, we were doing the best we possibly could to protect our employees, understanding also that there are multiple trends of guidance coming from the CDC and the White House, and the (World Health Organization). But we always focus on ‘how do we keep our patients, how do we keep our staff as safe as possible?’ I think that’s really been the key.”
Elsa Caballero is the president of SEIU Texas, the union that represents many health care workers at HCA Healthcare, the corporation that owns Las Palmas del Sol Healthcare. In an interview with El Paso Matters, she emphasized that worker safety concerns are valid and should be taken seriously by hospital leadership.
“I have no reason not to believe the workers who are talking to us about the fears that they have. Especially when I go back to HCA and ask them what they’re doing and to provide us with information and they refuse to do so,” Caballero said. “There’s no reason for me not to believe the workers are clearly very scared about what’s happening in the hospital, and not having enough N95 masks or not having quality masks.”
Common complaints among staff members at multiple facilities throughout the city have focused on access to PPE and availability of staff testing for COVID-19.
A nurse who works with COVID-19 patients at The Hospitals of Providence said they have ongoing concerns about improper reuse of single-use personal protective equipment by hospital staff, like masks and gowns.
“We are reusing single use PPE, and of course there’s the increased risk of cross contaminating the lab, the medication room, the clean equipment room. There are a lot of safety issues, but the main problem is that they’re expecting us to reuse single use PPE,” said the nurse, who asked not to be named because of concerns of repercussions.
Some reuse of single-use personal protective equipment is compliant with CDC guidelines.
Monique Poessiger, a spokesperson for the Hospitals of Providence, said the hospitals follow “strict policies and protocols” for safety and health. “Employee health follows processes and procedures for testing and return to work as recommended by the El Paso Department of Public Health and CDC,” she said in a statement.
Standards and protocol for PPE, staff COVID testing, and response protocol to exposure vary from facility to facility, and have changed over time as the outbreak has spread throughout the community.
Ryan Mielke, spokesperson for University Medical Center, detailed the way UMC responds when there is a potential exposure incident, as of July 22.
“When an associate has a work exposure to COVID-19 related to contact with a positive patient or co-worker, the exposure is immediately evaluated by our occupational health and iInfection control departments. The evaluation takes into consideration factors such as whether or not the appropriate PPE was being worn at the time of the encounter, the length of the encounter, and social distancing. If the encounter is determined to be low risk, the associate is provided with a 14-day self-monitoring tool and occupational health conducts regular checks on the associate. If the encounter is deemed to be medium or high risk, the associate is placed off of work for isolation with the self-monitoring tool. For symptomatic associates, occupational health will place them off of work and schedule them for a telehealth visit with one of our clinic providers who can request a test, with results returned between 24-48 hours.”
No UMC hospital workers were interviewed for this story, nor has UMC been the site of public demonstrations related to hospital worker safety concerns.
Increase in health-care worker OSHA complaints
Some El Paso hospital workers have filed complaints with the Occupational Safety and Health Administration as part of ongoing efforts to demand heightened safety standards.
El Paso Matters obtained copies of two OSHA complaints, filed against Del Sol Medical Center and Las Palmas Medical Center. The complaints, both filed in May 2020, state that “Employees who deal with COVID-19 patients are not provided proper PPE such as face shields and N95 respirators.”
A representative from the El Paso OSHA office provided data that demonstrates a dramatic increase in OSHA complaints among medical facilities in El Paso. She said that the El Paso OSHA office has received 32 complaints between March 1 and June 30 from workers in the “health care and social assistance” category. During the same period in 2019, the El Paso office received one complaint from a worker in this category.
The El Paso OSHA office hasn’t issued any violation notices to medical facilities tied to COVID-19 hazards, the representative said.
Nationally, OSHA complaints have skyrocketed in response to the pandemic, with nearly 7000 federal complaints and over 17,000 state complaints as of July 20. Some national media have argued that OSHA has been “toothless” in its response to COVID-19 worker safety concerns, and a former senior OSHA official recently stated that OSHA has decided “not to enforce the law” in regards to the COVID-19 pandemic, saying that OSHA has “completely failed.”
The nurse at The Hospitals of Providence agreed with this assessment of OSHA, and said “OSHA and the CDC are useless right now, as far as I’m concerned.”
Both OSHA and the CDC have issued guidelines that weaken safety standards within the context of COVID-19, and a June Kaiser Health News investigation found that 35 health care workers died at medical facilities that OSHA had already received complaints about. As of June 21, none of those complaints had led to a citation.
Health-care workers say they struggle to access COVID-19 tests
Some workers have reported difficulty accessing COVID-19 tests at medical facilities, and expressed concerns about their own health. An environmental services worker at Las Palmas del Sol Healthcare who asked not to be identified because of concerns over repercussions, said they were refused a COVID test by a coworker after reporting COVID symptoms, including headache, nausea, and dizziness.
“(The person administering tests) said I look very good, it doesn’t seem like you have it. She said it’s better that I don’t give it to you because I’ll have to take you out of work.”
Las Palmas del Sol Healthcare officials disputed this worker’s account. “Like all hospitals in El Paso, we are following guidelines from the Centers for Disease Control and Prevention (CDC) for additional testing and return to work policies. Employees do not work when they are symptomatic and awaiting their COVID-19 test results. Those who test positive for COVID-19 are unable to return to work for at least 10 days from the onset of symptoms and at least 3 days following resolution of fever and improvement in respiratory symptoms,” the company said in a statement.
Alozie, the Del Sol medical director, emphasizes the importance of over-communicating when it comes to ensuring that workers feel safe and understand hospital safety guidelines.
“If somebody came in and told me they didn’t stay safe, we’d have a conversation. What’s their risk, patient type, what unit are you on. And I would explain to them the guidance and the policy. They may not agree with me. There are patients and persons across the country and the world that don’t always agree with their position or the experts. It doesn’t necessarily mean either of us are wrong. They have their feelings, I have the guidance and critical expertise to make that decision,” Alozie said.
The nurse from The Hospitals of Providence said that hospital workers are often referred to community testing sites if the worker would like to receive a COVID-19 test.
“The hospital does not test us. I know a couple of nurses that have actually been tested, and it’s not being done by the hospital. It’s only being done by MedPost or the city’s testing site,” the nurse said.
Excessive wait times and other problems have been reported at the city’s first-come, first-served and appointment-based drive-through testing sites. For essential workers like hospital staff who have long hours, spending their day off waiting in line to receive a COVID-19 test can be a burdensome task.
Hospitals of Providence spokesperson Poessiger didn’t respond to a question of whether employees are sent to community testing sites rather than being tested at their workplace. “All employees complete a COVID-19-related screening every day when they come to work and, along with physicians and vendors, have their temperature checked every time they enter or reenter our hospital. Employees should not report to work if they are symptomatic, have tested positive for COVID-19 or if they are being tested for COVID-19.”
The toll of COVID-19 on health-care workers
As of July 21, the CDC reports over 100,000 positive cases of COVID-19 among healthcare personnel in the United States. Of that, 549 deaths are reported, although the CDC website indicates that they only have information for the death status of 66.7 percent of the health-care personnel confirmed to have COVID-19.
The El Paso Department of Public Health reports that 321 health-care workers have tested positive for COVID-19 at health-care facilities as of July 17. Two El Paso health-care workers have died of COVID-19 infections. Health-care facilities include more than general purpose hospitals. The El Paso Psychiatric Center had a large COVID-19 outbreak in the spring and its numbers are included in the city’s “clusters report” for health-care facilities.
The health department doesn’t provide case numbers at specific facilities, a practice that was upheld in a divided City Council vote on Tuesday.
El Paso Matters requested information from Las Palmas del Sol Healthcare, Providence Memorial Hospital, and University Medical Center regarding the rate of COVID-19 positive cases among hospital staff. University Medical Center is the only facility that directly responded to this request and provided this information.
“While less than 2 percent of our employees have had positive test results since the beginning of the pandemic, we have no evidence that these associates were infected at the hospital but could have similarly been exposed due to community spread,” UMC’s Mielke said in a statement. “It is worth noting that we have aggressive and comprehensive testing protocols and screening, throughout our campus. We ensure all of our employees have all of the necessary PPE they need to do their job of protecting their patients, themselves and others.”
Mielke said UMC has about 3,000 employees, so 2 percent would represent about 60 people.
Alozie at Del Sol Medical Center emphasizes the importance of both historical and national context for the health care response to the pandemic. He said the public is seeing the science in real time, things that normally happen outside of public scrutiny.
“This is not a local conversation, this is a national conversation. Part of that national conversation is driven primarily by fear. At some point in time, all of us in health care have been afraid. We’re afraid for our own health, the health of our families, we’re afraid for the health of our friends. This is a global pandemic, a lifetime event,” Alozie said.
“I think it’s also important to realize that we have to be reasonable. There have been times when various parties have been concerned, potentially angry, upset about a direction that multiple health-care systems across the country have gone in. What we’ve forgotten is that human discourse is the key to setting any conversations. I over-communicate. I have hospital-wide calls, deliberate calls to nursing to radiology, to environmental services, to ask questions. I want people to realize that they can ask the question at any point in time. I think the frustrating thing is when those conversations don’t happen, or when people make a determined effort not to engage in the conversation.”
Cover photo: An El Paso nurse protested the lack of personal protective equipment on May 8. (Corrie Boudreaux/El Paso Matters)