Healthcare workers on the front lines of meeting the challenge of diagnosis and treatment of COVID-19 are some of the most at risk for being exposed to the disease. At St. Joseph Hospital in Eureka, staff is doing its best to maintain precautions, even while concerned that they do not have the necessary supplies required by standards set by CalOSHA (California’s Division of Occupational Safety and Health Act) when dealing with an airborne disease. Many healthcare workers across California, including dozens in the Bay Area and from UC Davis Medical Center, have already been put on leave for mandatory self isolation due to inadvertent exposure to COVID-19.

While there are a limited number of tests available in Humboldt County at the current time, protocol concerns are being brought to the attention of St. Joseph Hospital CEO Roberta Luskin-Hawk in hopes of maintaining CalOSHA standards for interaction with an “Aerosol Transmissible Disease” (ATD) while performing essential job duties.

Tuesday, March 17, a letter from the regional chapter of California Nurses Association in conjunction with the National Union of Healthcare Workers was sent to St. Joseph’s CEO Roberta Luskin-Hawk demanding that immediate attention be given to meeting certain specific standards of protocol at the hospital, for safety of nurses and assisting staff members who are working in proximity to the highly infectious Novel Coronavirus.

In part, the letter signed by Ian Selden, Labor Representative, states, “Nurses at many Providence St. Joseph sites have been communicating with me constantly via email, phone and text since this crisis started. Although their concerns and recommendations vary greatly, the overwhelming sentiment is that their employer just does not care about them. This is unfortunate but I think it is within your power – and it is certainly your responsibility – to ensure their safety and security. As such, we call on you to immediately adopt the ATD standard.’”

The letter brings concerns regarding ‘Personal Protective Equipment’ (PPE) as well as ‘Powered Air Purifying Respirator’ (PAPR) standards of workplace safety and access to specific tools needed for healthcare workers exposed to airborne pathogens.

In the Intensive Care Unit (ICU), doctors, nurses and support staff are working around the most extreme cases, and require effective precautions in order to maintain the care of the most at-risk hospitalized patients. The Center for Disease Control and the World Health Organization both insist that maintaining safe procedures at medical screenings and during treatment, keeping hospital personnel protected, is critical to maintaining the level of care needed to address the Covid-19 outbreak.

James Ladika, a Registered Nurse in the ICU at St. Joseph Hospital, who also acts as a liaison between union members, hospital workers, and upper hospital management and administration officials, clarified that while supplies are limited, St. Joe’s nursing and support staff are doing their best to work with what supplies they have.

Ladika told us, “We aren’t reusing anything yet…As the leaders of National Nurses United have urged, I think we should continue to use the precautionary principle in our approach to this novel Virus. Employers have an obligation to limit as much as possible the spread of this pathogen, especially to [healthcare workers] whom put themselves in harms way for the good of us all. We should continue to use Airborne precautions until the spread of this virus is firmly understood and these decisions aren’t being driven by supply considerations.”

One of the most important components of Personal Protective Equipment (PPE) are proper face masks for hospital workers, especially those in direct proximity to suspected or confirmed Covid-19 cases. The demand letter is specific in listing appropriate protective masks as a needed resource. All masks are not created equal.

Ladika explained, “The N95 mask forms a seal around a user’s face. We have annual instruction that includes a process they use to ensure that the seal isn’t allowing air to slip in the sides. All air travels through a filter that traps 95% of tiny particles. A simple mask only blocks larger particles and simply reduces the overall exposure but can’t prevent tiny airborne particles from being breathed into the lungs. All it takes is one virus to cause disease.”

At least in the ICU, Ladika reports that they are currently using a full face mask resembling a spacesuit helmet. “We actually have been using a device called a CAPR which blocks 99% of tiny particles,” he told us.

The futuristic CAPR masks, which are usually in limited supply at most hospitals–because they are usually only needed while treating a disease like chickenpox, shingles, or tuberculosis–are being used at St Joe’s, but they are not abundant. According to the Cal-OSHA regulations, any presumptive or confirmed Covid-19 patients should also be placed in negative pressure rooms, and caregivers should wear N95s or CAPRs, not basic surgical masks or common ‘procedure masks,’ described by Ladika.

Healthcare workers anticipate a sharp increase in hospital visits correlating with the rise in suspected cases. Local community members who are feeling ill, specifically exhibiting symptoms of a fever with a cough and shortness of breath, are beginning to file into local hospitals requesting to be screened and ideally to be tested for the coronavirus, now being called Covid-19.

While union members are concerned for their workplace health and ability to remain available for shifts, they are not able to stay home during this time of need. It is being emphasized by union representatives that hospital staff are being as vigilant as possible while caring for their patients, even under less than ideal circumstances.

As of the time of publishing this report, we have not received a reply from St. Joesph Hospital regarding our request for comment on the letter sent from the union.

Of Further Interest:

St Joseph Hospital in Eureka has a bed capacity of 138 total, including 12 designated for ICU, of which it is unknown how many are occupied at this time. These dozen ICU beds are the only beds suitable for treating serious cases of suspected or confirmed Covid-19 cases, because only those beds are equipped with respirators. That ICU capacity may be expanding slightly in the near future, depending on availability of resources.

While there are about 160,000 ventilators in the nation, according to estimates by US Department of Health officials, there just aren’t enough to go around, according to the CDC. This is part of the reason that medical professionals are asking the public to “flatten the curve” in hopes of slowing the infectious spread.

Tuesday, March 17th, a press release from Humboldt County Public Health noted that 195 tests are available currently, with 20 per day at most being administered by hospital triage staff. The number of Covid-19 test kits available is expected to be bolstered when production of the test kits is stepped up at the manufacturing end sometime soon, according to the CDC. Until there are ample test kits circulated, regional hospitals are striking a delicate balance between testing to confirm suspected cases and testing for less obvious cases, such as potential community spread infections.

A Humboldt Health Alert updated numbers of testing, releasing this current information to the public:

March 17, 2020 – Public Health Lab Report

*Numbers below do not reflect testing by commercial laboratories.

People tested before the Public Health Laboratory came online March 7:

• 6 tested by the Centers for Disease Control and Prevention or California Department of Public Health

People whose tests were run by the Public Health Laboratory:

• 28

Results Summary to date:

• 34 total patients tested

o 1 positive, cleared

o 1 inconclusive, cleared

o 32 negative

Current test capacity:

• Public Health currently has a total capacity of approximately 195 tests and can process 20 samples a day with an approximate turnaround time of 48 hours.”

The most recent update regarding policy and statistics from the CDC is here.

¿Tienen preguntas acerca de COVID-19? Mande correo electrónico al Centro de lnformación Conjunta [email protected] o llame 707-441-5000.