MNA Memo on CDC Finding Nurses Hospitalized with COVID at Alarming Rate

TO:                 The Massachusetts General Court           

FROM:          The Massachusetts Nurses Association

RE: CDC Finds Nurses Hospitalized with COVID at Alarming Rate

A new study[1] from the Center for Disease Control (CDC) confirms what nurses in Massachusetts have known for months- nurses and nursing assistants are at a significant risk of contracting COVID-19. In this study examining coronavirus hospitalizations in the healthcare industry, nurses and nursing assistants accounted for the vast majority of healthcare workers hospitalized.

KEY FINDINGS

• 36% of healthcare workers hospitalized with COVID-19 were nurses or nursing assistants
• 28% of all hospitalized healthcare workers were admitted to an Intensive Care Unit (ICU)
• Median age at hospitalization was 49 years

COVID-19–Associated Hospitalizations Among Health Care Personnel — COVID-NET, 13 States, March 1–May 31, 2020

While the findings in this report are not surprising, they should be sobering. We are putting our frontline healthcare workers at significant risk when there are things that could be done to mitigate these risks and support those who do become ill.   

PPE

The CDC report cited the increased risk faced by frontline nurses due to their “frequent and close patient contact leading to extended cumulative exposure time”. In many hospitals across the country- and right here in Massachusetts- this frequent exposure has been exacerbated by a lack of proper personal protective equipment (PPE). Nurses in Massachusetts have been sounding the alarm on the lack of proper PPE since the earliest days of the pandemic. This latest report is one in a series exposing the increased risk to frontline healthcare workers. Following a lowering of infectious disease standards from the CDC, frontline nurses were told to only use N95 masks for certain procedures and then to reuse single-use N95 masks across multiple shifts and multiple days. This was coupled with a shortage of visors, face shields, goggles, gloves and gowns and a lowering of safety standards driven by supply not science. Eight months into this pandemic, there is still a lack of transparency on the amount of PPE healthcare facilities have available. This cannot and should not continue. As cases surge across the state, we must ensure that nurses and all frontline healthcare workers have access to the proper PPE that meets pre-pandemic CDC standards.

There is currently language pending before the Health Care Conference Committee to address the lack of transparency around PPE in the Commonwealth.

• SECTION 41 of H. 4916 Notwithstanding any general or special law to the contrary, the department of public health shall publish daily on its website the data it receives from health care facilities pursuant to the federal COVID-19 guidance for hospitals. The report shall include data in the aggregate and broken down by health care facility.

This language would require the public reporting of information currently reported to the Department of Public Health (DPH) including personal protective equipment supplies on hand at healthcare facilities. This information is currently required per federal COVID-19 guidance. This transparency will help to identify gaps and shortages when it comes to PPE and the specific items each facility needs. Addressing the PPE shortage requires transparency and data which will allow healthcare facilities, frontline healthcare workers and the Commonwealth to take the steps necessary to protect workers and patients.

• SECTION 33C of H. 4916 On or before October 1, 2020, due to the 2019 novel coronavirus, also known as COVID-19, the house of representatives  commonwealth resilience and recovery special committee shall hold a hearing to determine  the available supplies for personal protective equipment, which meet the standards of the federal Center for Disease Control that were in effect on January 6, 2020, held by (i) acute care hospitals licensed under section 51 of chapter 111; (ii) any facility as defined under section 1 of chapter 6D; and (iii) any other entities identified by the special committee. The special committee shall also determine anticipated demand for personal protective equipment.

This language would convene a hearing to determine the current personal protective equipment (PPE) supplies on hand at healthcare facilities to meet pre-crisis standards. The lack of PPE for frontline healthcare workers has been an ongoing issue throughout the COVID-19 crisis. Nearly five months into the pandemic in the Commonwealth, our healthcare workers are still working without the proper PPE. The lack of clarity and transparency about what supplies hospitals and state facilities have on hand coupled with the Center for Disease Control (CDC) lowering infectious disease control standards and safety precautions has compounded the problem. To be able to address the PPE issues, we first need to know where we stand and how far we are from meeting the science-based standards that were in place pre-crisis.       

Testing and Notification  

The CDC report confirms that frontline nurses are getting sick- in many cases sick enough to require hospitalization. Another strategy for mitigating the spread within healthcare facilities is to increase testing and standardize notifications for potential COVID exposure. Hospitals are still not consistently testing workers exposed to positive or suspected COVID patients nor informing them of potential exposure so that the workers may seek out his or her own test. In many cases, frontline healthcare workers still cannot access testing on-site at their place of work. Testing of the healthcare workforce must be a priority and that the testing, as well as notifications related to testing, should utilize standardized criteria.

Occupational Presumption

This report also underscores the need for comprehensive occupational presumption legislation for frontline healthcare workers. At least 14 other states have taken action, either via legislation or Executive Order, to provide frontline workers with some type of occupational presumption related to COVID-19. Regrettably, Massachusetts is not one of these states, however there is still legislation pending in both the House and Senate to address this oversight.

• An Act Relative to Emergency Hazard Health Duty (H4611)  which establishes a presumption that any public safety officials who contract, have symptoms of or who otherwise become affected with the coronavirus (COVID-19) that results in hospitalization, quarantine, or self-quarantined measures, contracted their medical condition or incapacity to work in the line of duty and individuals would not be required to use sick time or any other paid time off (PTO).                                                                                                   
•  Status: The bill was reported favorably out of the Joint Committee on Public Safety and Homeland Security and is currently before the House Committee on Way and Means.
• An Act Relative to a COVID-19 Presumption for Public Employees (HD5050) which would presume any public employee in the Commonwealth required to work outside their home during the COVID-19 state of emergency, and who contracts, has symptoms, or is otherwise affected by COVID-19 came into contact with COVID through work or work-related activities and further entitles surviving spouses and children of employees who die as a result of work-related COVID-19 to a pension calculated based on the maximum possible salary for the position.                                                                                                                                                                  
•  Status: The bill is currently before the Joint Committee on Public Health.

This report is just the latest in a series underscoring the risks to frontline healthcare workers. It is now time to act upon this information. We are asking for you to take action to protect and support frontline healthcare workers.

Thank you.

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