The Centers for Disease Control and Prevention had advised hospitals to isolate Kovid-19 patients to reduce staff exposure and to help preserve high-level personal protective equipment that is in short supply.
According to complaints from Occupational Safety and Health of California (CAL / Osha), Kovid patients continued to be scattered through Oakland Hospital. Areas of concern included the sixth-floor medical unit, where veteran nurse Jané Pieste-Ponder worked.
According to Mike Hill, a nurse in the hospital’s intensive care unit, Kovid patients on that floor were either not staying in their rooms because they were confused or obsessed with the rules. Hill, who is also the hospital’s principal representative for the California Nurses Association, said staff were not provided with highly protective N95 respirators.
“It was shortly before the nurses died on one of these floors,” Hill said.
On July 59, two nurses, including 59-year-old Pieste-Ponder, who died of complications from the virus, fell ill.
The California Nurses Association has filed a complaint to the state workplace safety regulator Kal / Osha. Similar concerns have been encountered throughout the US, according to interviews, review of government workplace safety complaints and health facility inspection reports.
Kovid patients have been combined with others for several reasons. Limited testing means that some patients carrying the virus were identified when they had already been exposed to others. In other cases, they had false-negative test results or had facilities outside federal guidelines that held no force of law.
As recently as July, a National Nurses United survey of over 21,000 nurses found that 32% work in facilities to which Kovid units are not dedicated. At that time, the coronovirus had reached all but 17 American counties, data collected by Johns Hopkins University show.
Federal work-safety officials have closed at least 30 complaints about the patient mix in hospitals nationwide without issuing a citation. They include a claim that the Michigan hospital housed patients who tested negative for the virus at the Kovid unit in May. According to a closed complaint by the Federal Occupational Safety and Health Administration, a hospital in New York also placed Kovid’s patients in the same unit with no infection.
Federal Health and Human Services officials called hospitals each day to inform if a patient who had arrived without Kovid-19 but developed a clear or confirmed case of Kovid-19 within 14 days. Hospitals recorded 48,000 reports from June 21 through June 28, although the number reflects some double or additional count of individual patients.
In Alta Bates, Oakland, hospital staff clarified Cal / Osha in official complaints that they wanted administrators to comply with the state’s unique law on aerosol-transmitted diseases.
Within five hours of detection – the rules call for patients with viruses such as Kovid-19 to be transferred to special units or to a special facility.
Initially, in March, according to Hill, the hospital built a 40-bed Kovid unit. But when a surge of patients failed to materialize, that unit was amalgamated into 12 beds.
Since then, a steady stream of virus patients were admitted, he said, to several tests positive only days later – and later they had been in the room regularly.
Between March 30 and July 30, Hill’s union and others filed eight complaints to Cal / Osha, alleging that the hospital failed to follow isolation rules for Kovid patients, putting some on the cancer floor had gone.
So far, regulators have done little. Governor Gavin Newsom ordered workplace safety officials to focus on “supporting compliance” rather than enforcement barring “most serious violations”.
According to Cal / Osha’s spokesperson, Frank Polzi, state officials “have delivered complaints to ensure proper virus prevention measures” by mail and phone, and two investigations are ongoing.
A third investigation related to transportation workers without N95 MPs confirmed or transferred to potential coronavirus patients at the Sutter Health facility near the hospital resulted in a fine of $ 6,750, Cal / Osha records show.
The link to the complaints also states that the hospital did not provide staff members who cared for patients with the virus, personal protective equipment (PPE) that were required by state law – an N95 respirator or something more protective. .
Instead, Hill said, employees on the floor with Kovid patients were provided with low-quality surgical masks, which was reflected in complaints filed with Cal / Osha.
Sutter’s health spokesman said the hospital took the allegations seriously, with Cal / Osha complaints being taken seriously and that its top priority was to keep patients and staff safe.
The statement also said that “cohabitation”, or the practice of grouping patients with the virus together, is a tool that “should be considered in a larger context, including patient acuity, hospital census and other environmental factors”.
CDC guidelines are not strict on the subject of keeping Kovid patients closed, noting that “facilities may consider designating entire units with dedicated facilities.” [staff]“To care for infected patients.
That approach succeeded at the University of Nebraska Medical Center in Omaha. A recent study reported “widespread” viral contamination around patients with Kovid-19, but noted that with “standard” infection-control techniques, staff caring for infected patients did not have the virus. met.
The hospital has set up a separate unit away from the air, minimizing the least developed protocol and limited access to the unit and trained staff to use the N95 respirator.
What worked in Nebraska, however, is far from the norm elsewhere.
In Southern California, leaders of the National Union of Healthcare Workers filed an official complaint with state hospital inspectors at Fountain Valley Regional Hospital about the risks posed by Kovid patients, which is part of the for-profit Tenet Health. There, the complaint states, patients were not routinely tested for Kovid-19 on admission.
A nursing assistant spent two consecutive 12-hour shifts on a general medical floor to care for a patient who needed monitoring. At the conclusion of the second shift, she was told that the patient had tested positive for Kovid.
According to a complaint by the California Department of Public Health, the worker wore only a surgical mask – not the N95 Respirator or any kind of eye protection. The complaint states that the nursing assistant was not offered a Kovid test.
The Department of Public Health said it could not comment on a pending inspection.
Barbara Lewis, director of the Southern California Hospital Division with the union, said Kovid patients were placed on the same floor as cancer patients and post-surgery patients in the hall to speed their recovery Were walking
A hospital spokesperson, Jessica Chen, said the changes were “quickly implemented” by the state’s health officials and directed some Kovid patients to be non-Kovid patients while surgeons. He said that they are kept in a room with closed doors. Kovid tests were given according to physician orders, and staff could access them at other places in the community.
Conversely, Lewis said, for high-profile examples of precautions that can be taken.
“Now we see what is happening with baseball and basketball – they are tested every day and a high level of caution is taken,” Lewis said. “Yet we have thousands and thousands of healthcare workers going to work in an extremely scary environment.”
KHN (Kaiser Health News) is a non-profit news service covering health issues. It is an editorial independent program of KFF (Kaiser Family Foundation) not affiliated with Kaiser Permanente