Being a resident physician in internal medicine, I work as part of a multidisciplinary team of doctors, nurses and other health professionals. For us, caring for patients with covid-19 on the hospital floors and in the intensive care units has become our new norm. And as our direct contact with infected patients has exponentially increased over the past few weeks, the water cooler chatter has heated up. We wonder aloud what we’re going to do when we run out of personal protective equipment (PPE), where we’re going to quarantine ourselves when we get sick, and how best to keep our loved ones safe.
As Thomas Kirsch, an emergency physician in Washington, put it in a recent Atlantic article: “How much risk do health-care workers have to take? Or, more bluntly: How many of us will die before we start to walk away from our jobs?”
Hazard pay is loosely defined by the Labor Department as “additional pay for performing hazardous duty or work involving physical hardship.” With or without proper PPE, health-care workers are putting their physical health on the line every day during this pandemic when they leave their shelters and families to treat those with covid-19.
If you have any doubt, the proof is in a viral tweet that reveals the emblematic bruises — lines of capillaries shattered under the pressure of an N95 mask — now marking the faces of Italy’s strained health-care workers. And they are the lucky ones, for at least they’re still alive.
Pandemics do not spare those who care for the sick. In 2003, nearly half (44 percent) of SARS infections in Toronto were health-care workers. Our jobs, by their very nature, put us at great risk for exposure to novel infectious diseases. We are in proximity to known infected people and spend a disproportionately large amount of time with these infected people compared with the general public, both known risk factors for contracting covid-19, according to the Centers for Disease Control and Prevention.
The federal government, meanwhile, has exacerbated these inherent hazards of our work by failing to secure and distribute PPE to essential health-care personnel. For instance, while the Strategic National Stockpile of N95 respirators was already known to be woefully inadequate at a total of 17 million masks, many of these masks were recently found to be past their expiration date.
Perhaps revelations such as these are what prompted the CDC to ultimately encourage health-care institutions to use expired masks anyway, despite acknowledging that they “might not perform to the requirements for which they were certified.”
Still, many of America’s health-care professionals are at the front lines of this pandemic with far less effective PPE than an expired respirator. Some are wearing the once-ubiquitous surgical mask, which doesn’t filter out airborne particles like N95 respirators do.
But many health-care institutions are already running short on these, too. Where some practitioners were previously requiring a dozen or more disposable face masks per shift, we are now being relegated to one per week. Others of us, left with no better option, may be soon forced to resort to the CDC’s latest contingency “plan” — using homemade masks, bandannas and scarfs as PPE.
By armoring our front lines with mere swaths of cloth, shown in the medical literature to be nearly 97 percent ineffective, we are armoring our only hope with little more than a false sense of security. If we cannot properly equip them, should we not at least properly pay them?
Doctors started calling for hazard pay for front-line clinicians in mid-March. One district of the National Union of Hospital and Health Care Employees has filed a complaint against a New Mexico hospital for refusing to enter negotiations for hazard pay for its employees. And in the same amount of time, a Change.org petition for hazard pay for nurses, doctors, and other health-care professionals has racked up nearly 400,000 signatures.
Politicians, too, are catching on to the idea of hazard pay for those on the front lines. On March 30, President Trump said in a “Fox & Friends” interview that his administration was “looking at” providing health-care workers with hazard pay through a future relief package. Treasury Secretary Steven Mnuchin agreed, saying in a subsequent Fox Business Network interview that it was “definitely something we’ll put in the next bill.”
Political rhetoric notwithstanding, let me be clear: This is not just about money. Far more than money, I want people to wash their hands and to stay home, and when they come into the hospital, I want access to appropriate PPE to treat them with.
But for the phlebotomists who have to expose themselves to draw the blood tests I order, for the respiratory therapists who have to change the ventilator settings I request, for the nurses who have to dispense the medications I prescribe, and for my fellow residents who will have to cover my shifts when I inevitably get sick, I want hazard pay — for them and for their families.
This is about showing support for our health-care workers during a pandemic in the same way we support our troops during a war. The American people are good people, which we’ve already seen in our hobbyists sewing homemade masks, philanthropists donating to research efforts, and corporations switching gears (quite literally) to produce ventilators and PPE.
Commensurately, let us not delay in honoring our nation’s health-care workers — my colleagues and friends — as they risk their lives battling for our collective health on the front lines of the covid-19 pandemic.
Nathan Wood is a primary care internal medicine resident at Yale New Haven Hospital in New Haven, Conn.