In the United States, global epicenter of the coronavirus pandemic, hospital administrators claim personal protective equipment is scarce and ration it among front-line healthcare workers, although admins have been found wearing PPE unavailable to workers. "Essential” workers locally and nationwide are responding with protests, strikes and simply by telling their stories—here are a few that might hit nearer to home.









By Jonathan Salinas





As positive Covid-19 cases overtake emergency rooms around the country and around the globe, shortages in personal protective equipment (PPE) place healthcare workers at great risk. In the Rio Grande Valley, healthcare workers (HCWs) reuse PPE, like surgical masks, for entire shifts or even multiple shifts. Únete 956 spoke with three registered nurses from three hospitals in Hidalgo County. The hospitals where they work include Doctors Hospital at Renaissance (DHR), a South Texas Health System hospital and Rio Grande Regional Hospital . The nurses spoke anonymously for fear of retaliation.









News of PPE shortages in the Rio Grande Valley broke when a group of Texas Medical Association-affiliated doctors and business owners, belonging to the so-called Rio Grande Valley COVID-19 Physicians Task Force, launched an online petition , calling on local officials and industry to ameliorate PPE shortages, although no specific hospitals were mentioned. In light of pandemic-time shortages, reusing respirator masks reflects recent changes to the Center for Disease Control’s (CDC) federal guidelines. This policy change departs from what the Emergency Nurses Association (ENA) call an “ evidence-based practice ” of disposing respirators after every single use. The federal guidelines change also came weeks before President Trump finally authorized the Defense Production Act , mandating companies to produce ventilators and N95 respirators. N95s filter-out 95 percent of airborne particles and have proven effective against COVID-19, coronavirus droplets. N95s used to require custom fitting, although recent changes in guidelines permit non-fitted N95s, which nurses criticized and protested at the time and have mercilessly ridiculed on the internet ever since.









At the beginning of April, the DHR nurse received one surgical mask per shift. If nurses remove their masks, “hospital management makes us put them inside brown paper bags and then write our names on the bags.” Nationally, brown paper bag usage has been adopted by hospitals.





Since we began interviewing the nurse in early April, their mask ration, just this past week, drastically decreased from one mask a day to one mask every five shifts. DHR Health’s Twitter page recently boasted about surgical mask production at their hospital. DHR also published an advertisement/editorial in The Monitor on the same day, April 9.





This public relations (PR) offensive likely occurred as a result of Únete 956’s inquiries about the nurse's claims, which were made less than 24 hours before the Tweet; we reached out to DHR administration April 8. They asked about our story, we explained. The next day, we missed a call from a DHR representative, Marisa Castañeda, who we were later unable to reach, except for her voicemail, in which we left two messages. Still, Castañeda has not returned our calls. We did make contact with R-Myna Evans, a DHR Marketing Executive, who tried scheduling an interview with the author of the Monitor editorial or Castañeda, to no avail.









“Innovation at DHR Health thrives,” the April 9 Tweet read. “Our team has manufactured nearly 5,000 ( and counting) surgical masks in house to help supplement our PPE supply along with conservation efforts.”





Before this tweet, DHR Health’s Twitter page made no PPE references, as far back as April 1. Regardless of DHR’s makeshift PPE operation, or their employment of buzzwords and euphemisms like "Innovation," it’s obvious that rationing, or "conservation efforts” at DHR have become evermore dire.









Dr. Marissa Gomez-Martinez, of the DHR Health Edinburg CISD School Based Health Center , who published the editorial in The Monitor April 9, was the second element in this double-pronged PR maneuver to manage the PPE debacle. While Gomez-Martinez’s article was titled, "How do we protect the RGV community from COVID-19?," and while the article addresses public safety, the safety of healthcare workers, however, was left unaddressed. Perhaps Gomez-Martinez’s next piece can instead focus on, “How do we protect our employees, front-line healthcare workers, from COVID-19?”





PPE rationing, or "conservation efforts," is largely characterized by whether the person speaking is a front-line healthcare worker or a hospital administrator, or an administrator’s underling. DHR administration tried assuring HCWs that “only the front part of the mask” can become infected. “When we asked how the virus would not spread to the back of the mask,” the nurse said. “They can’t give us an explanation. They just tell us not to shake the bag.”





Protective facial shields at DHR, which are also to be disposed of after every single use, are being reused by applying sterilizing solution, with a wipe. At the moment, DHR does not appear to be manufacturing facial shields. Needless to say, HCWs do not believe they’re adequately protected treating positive case patients with insufficient respirators.





“I’ve accepted the likelihood I’ll get COVID-19” the nurse said. “It’s not a matter of if, but when. And when I do, I’m certain it will be because of my PPE.” According to the nurse, DHR—a " physician-owned " hospital and topic of explosive exposés published here , here , here , and (if I may say so) here—said in advance that they will not assume liability should HCWs contract COVID-19, arguing HCWs could've contracted it outside of work.









As a physician-owned hospital, whose doctors are themselves shareholders, DHR physicians may "self-referral" surgical patients, which is profitable in two ways for DHR physicians. (DHR used to be notorious for self-referring medicare patients who they fraudulently overcharged by over-testing, sending the bill to the federal government, until the Affordable Care Act put an end to this now-illegal racketeering scheme.) Because Governor Abbott banned electi ve surgeries state-wide as part of his disaster declaration, it's reasonable to assume DHR is taking a financial hit. So, why not just keep wages as low as possible, cut back on safety costs and then call it "conservation efforts" in the press?









A South Texas Health System nurse in McAllen receives one mask and one paper bag per day. She brings extra masks, in case her hospital runs out, although she says her hospital receives PPE donations. While the hospital possesses enough PPE to confront a COVID-19 outbreak, the nurse said, South Texas H.S. still rations. We reached out to South Texas H.S. for comment April 13. Later that day, we received a phone call from Sandra Alaniz , South Texas H.S.'s Marketing Director. “Look, I’m just here to collect information, alright? I’m not here to give you a story. So how about you just tell me everything you know and I won't tell you a thing? How about that?,” Alaniz asked over the phone.





I laughed and then asked about South Texas H.S.’ PPE guidelines and workers rights. Alaniz admitted she was not "authorized by corporate” to answer that question. She suddenly became terse, unlike before. Although Alaniz tried intimidating us from seeking information, she fails in effect, as the hostility deployed by her in response to a simple question, and—like DHR—South Texas H.S.'s preference in keeping their PPE guidelines out of public view, reveals more than what Alaniz and her "corporate" bosses thugishly try to conceal.









A Rio Grande Regional Hospital nurse said, “We get one paper bag, one gown, and one mask for droplets or airborne for the day. But I know nurses at other hospitals who’ve used masks brought from or even made at home.” Rio Grande R.H. confirmed these PPE rationing measures. They were the only hospital to respond to our inquiries and answer PPE-related questions on the spot, without ever having to ask for our questions in advance, unlike DHR and South Texas H.S.





In recent developments, a Knapp Medical Center healthcare worker published an open letter April 9 describing "irresponsible and unethical" decisions taken by hospital administration, throughout the pandemic. Knapp Medical Center is located in Weslaco, Texas. The letter, which was shared more than 170 times as of April 13, was published by RGV Truth and Justice (RGVTJ), a hard-hitting, investigative journalism Facebook page. In it, the worker warns hospital administrators' guidelines risk further community spread.





This three-page indictment of Knapp's administrative guidelines describes the manifold ways hospital administration fall short of compliance with even downgraded CDC guidelines. As of yet, the hospital has not publicly responded to the letter’s claims, although RGVTJ reported April 10 that an implicated hospital administrator, allegedly seen donning PPE unavailable to some front-line HCWs , unsuccessfully and hysterically pressured workers to publicly refute the claims.





RGV Truth and Justice Facebook post. 10 April 2020





These reports come as deaths among medical workers treating COVID-19 around the globe rise , although no RGV medical worker has passed away treating COVID-19, yet. Hidalgo County Judge Richard Cortez infamously stated March 31 that a ‘tsunami ,’ regarding COVID-19 cases, was coming to the Valley. In whatever kind of 'tsunami' we’re in, one of its many 'waves' is sure to be composed of RGV front-line workers. The current begins to stir, as one McAllen H-E-B confirmed an employee tested positive April 9. From 146 positive cases April 10, Hidalgo County rose to 190 April 13 .





The nurses criticized federal and state governments lacking preparedness, as officials possessed ample warning of the virus’ spread. “We’ve known about this since December. The federal government had so much time to prepare, but they did nothing. President Trump even called this a hoax, at one point. He disbanded the government’s pandemic response unit in 2018. Shame on them,” one nurse lamented. “Where was the Surgeon General?,” they went on. “Where was the CDC? These are the people who were supposed to protect us!”





In early February, U.S. members of Congress utilized classified coronavirus information, provided to them by U.S. Intelligence officials at classified coronavirus briefings to engage in insider-trading . Meanwhile on the U.S. - Mexico border, government officials discuss lucrative border wall contracts funded by billions of U.S. Congressional dollars, 3 billion of which was allocated by Congress, including this contract in Laredo , set to announce in May , while another $10 billion or so was diverted from military contracts, counter-narcotic funds, and U.S. Treasury accounts into Homeland Security and Military accounts. Ongoing border wall construction, which threatens community spread of coronavirus, continues .









Mandatory overtime —recently described by an American Federation of State, County and Municipal Employees union leader as “ a gun being pointed to your head ”—was “banned” in Texas, in 2009, with the minor exception to the Governor’s ability to declare a state of emergency, which he did in March and then extended it April 12. During a recent flood, in the flood-prone RGV, DHR administrators threatened to lobby Governor Abbott in invoking a disaster declaration in order to utilize mandatory overtime against HCWs. The nurse described this threat in similar tones as the union leader.









To cope with the stresses of being a front-line HCW during this pandemic, thousands of nurses are taking to Instagram and Tik Tok, showcasing excellent meme and video-making ability. In this world, baby Yoda memes (which originally symbolized adorableness in pop culture, often co-opted by many industries) now present the coronavirus as a sinister force, quietly incubating inside your PPE. The memes encapsulate what HCWs experience on the daily. One nurse attributed the rise of nurse memes to 'denial,' relying on dark humor for a quick laugh. “It's like we're in denial and I guess we’re creating memes to try and make light of the situation,” the nurse said. As an activist, one might also nominate these subversive memes as legitimate protest art in the age of pandemics and quarantines.









Hospital administration and management's imposing unsanitary working conditions upon HCWs has developed class-consciousness. HCWs, and their memes, realize hospital ownership (the capitalist class) and upper management (the middle/upper-middle class) work hand-in-glove to exploit them. One nurse said HCWs resent the fact that those who dictate PPE policy changes are not themselves on the front-lines. Although hospital administrators and managers may hold healthcare licenses, and may even be nurses or doctors, “they work behind a desk. They’re not out there, like us.” Other nurses believe rationing is a necessary sacrifice. As you saw, a meme for them also exists. HCWs in any case have been conscripted into a war for which they never volunteered. “It feels like nurses are being sacrificed,” one nurse said. “But I didn’t sign up to be a martyr.” Although their job requires ensuring patients they'll always stand by their side, HCWs, especially mothers, like two nurses we spoke with, second-guess that commitment.









Hospital workers’ rights vary. According to the nurses, neither Doctors Hospital at Renaissance nor South Texas Health System offer hazard pay or paid time off, should HCWs contract COVID-19, despite the likelihood PPE would be to blame if HCWs tested positive. DHR's marketing team did not respond when asked about their workers' rights. And although South Texas H.S. spokeswoman Alaniz said she was not allowed to speak with the media about PPE guidelines and workers' rights, she said she could forward the questions to "corporate," if we sent her an email. We did this morning and have not heard back. Unsurprisingly, Rio Grande R.H. was the only hospital confident enough to promptly answer this question the moment we reached out because its employees, unlike DHR and South Texas H.S., receive pandemic protections, including hazard pay and paid-time-off, according to Rio Grande R.H. public relations officer, Adriana Morales, who offered any information we needed.









Bold protests and strikes by “essential” workers across the country, which were already brewing, have now erupted. Nurses in Arizona, California, Florida, and, yes, Texas, organized a one-day strike in October to protest workloads and insufficient patient safety. 13,000 Seattle HCWs launched a three-day strike in January to demand fair wages, among other things. Nurses held a national day of action March 11 to protest the downgraded CDC guidelines. HCWs and medical union members in California organized protests March 21 against closing Seton Medical Center . Nurses from Jacobi Hospital, in the Bronx, demonstrated March 30 for PPE . Harlem Hospital HCWs demonstrated April 6 .









No strikes or protests by RGV healthcare workers have emerged, yet, although one nurse mentioned a past attempt by HCWs to organize, which DHR hospital administration repressed, threatening legal action against potential strikers, nonetheless suggesting, and indeed proving that the seeds of labor-organizing in the RGV, and around the world, are en cosecha, in harvest.





Meanwhile, as other essential service industry workers like Amazon workers and delivery workers organize and mobilize, our local Sprouts Farmers Market Workers , and their allies, launched a petition April 5 , demanding “COVID 19 PPE for Workers and Customers Now!,” earning more than 7,255 signatures , as of April 14. KRGV reported April 8 that some demands, like PPE and sick days, had been met, while others, like establishing a safety committee among workers from each store department, hangs in the balance. Protests and strikes will surely spark more protests and strikes.









Private owners of industry, throughout modern history, have "sacrificed" workers until workers stood up for their rights, which continues today. Healthcare workers in the Rio Grande Valley, during this pandemic, have begun to stand up for their rights in extraordinarily dangerous conditions. However, front-line healthcare workers, while fearing for their and their family's health, also fear losing their jobs for speaking-out. Únete 956 will continue being a platform for the RGV working-class in their ongoing struggle for safety and better wages.





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