© Provided by Business Insider Singapore Kaylen Smith demonstrates how to don the protective gear that must be worn when dealing with patients with an infectious disease as Massachusetts General Hospital in Boston prepares for a possible surge in coronavirus patients on February 27, 2020.

At least five US health workers have tested positive for the coronavirus, hundreds are in quarantine after exposure, and dozens are waiting on test results.

Healthcare workers are especially vulnerable to the coronavirus because they’re exposed to more viral particles.

Healthcare leaders say the US healthcare system is not ready for a widespread coronavirus outbreak.

Delays in testing, mask shortages, and staffing issues could all hinder the country’s response.

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As the coronavirus spreads in the US, healthcare workers are on the front lines.

At least five have contracted the virus, and hundreds of others have been exposed and sent home to self-quarantine over the last month.

“It’s high anxiety,” Sal Rosselli, president of the National Union of Healthcare Workers, told Business Insider. “There’s a lack of confidence that the industry is prepared to adequately provide a safe environment for patients that have the virus and for patients that don’t have the virus, and provide safe working conditions for the people caring for them.”

As coronavirus case numbers swell, asking health workers to stay home for two weeks after they’re exposed could leave hospitals short-staffed.

“Already, hospitals and nursing homes are often not staffed appropriately,” Rosselli said. “If a lot of health care workers contract the virus and have to stay home, obviously at the same time, more patients are being admitted to hospitals. It’s potentially a huge critical situation.”

On Saturday, the CDC updated its recommendations to encourage healthcare providers who have been exposed to the coronavirus but aren’t experiencing symptoms to continue coming in to work. They should check their temperature daily and wear face masks, the CDC said.

Healthcare workers have a high risk of getting coronavirus

The coronavirus has infected at least 111,000 people and killed 3,300. Nearly three-quarters of all cases have been in China. The US has over 600 cases; of these, 26 patients have died.

Healthcare workers are particularly vulnerable to infectious diseases like the coronavirus for a handful of reasons. First, medical staff members are exposed to more viral particles than the general public. Second, they face potential shortages of protective supplies and tests as the tide of patients rises. Third, a combination of stress and long hours could make their immune systems more vulnerable than normal.

In China, nearly 3,400 healthcare workers have contracted the virus. At least 13 have died.

© Tomohiro Ohsumi/Getty Images A passenger receives a temperature check before boarding a flight in Tokyo, Japan, on January 21, 2020.

The US could see 4.8 million coronavirus hospitalizations

Dr. James Lawler, a professor at the University of Nebraska Medical Center, offered estimates of how much the virus might spread in the US in a February webinar hosted by the American Hospital Association.

His projections suggest the US could see 96 million cases of coronavirus, 4.8 million hospitalizations, and 480,000 deaths. Hospitals should prepare for an impact on the system 10 times that of a severe flu season, the presentation said.

The CDC has lagged behind in testing and confirming suspected cases – as of Sunday, about 1,700 people had been tested. This also puts healthcare workers at risk of exposure, since limited testing raises the likelihood that patients go undiagnosed and spread the virus in medical settings. In Solano County, California, a patient with coronavirus went undiagnosed for four days each at two different hospitals last month because she didn’t meet the CDC’s coronavirus testing requirements.

Over 200 employees between the two hospitals were exposed and have had to self-quarantine for weeks. Three have tested positive for coronavirus.

© Reuters A general view of Centers for Disease Control and Prevention headquarters in Atlanta, Georgia.

“Healthcare providers may be being exposed, other patients may be being exposed, and until you can give confidence to people about those answers, we are in a crisis here,” Yale professor Howard Forman, a radiologist and expert in healthcare management, told Business Insider.

US hospitals are asking patients who suspect they might have the coronavirus to call ahead. That way, health workers can ensure they’re taken to an isolation room, and that all of the health workers involved wear personal protective gear.

But that’s not what always happens, Rosselli said.

© Smith Collection/Gado/Getty Images Warning sign with text reading

“There’s all kinds of workers that have direct contact with patients,” said Rosselli. “There’s a much larger number of housekeepers, dietary workers, technicians, radiologists, x-ray technicians, clerical workers.”

“It goes way beyond nurses and physicians,” he added.

Many healthcare workers at the Life Care Center were exposed

At the Life Care Center in Kirkland, Washington, 13 residents and one visitor have died. Officials said 70 staff members out of 180 had symptoms resembling coronavirus as of Saturday. In addition, 26 firefighters and three police officers who had contact with facility residents are also under quarantine. Kirkland Patch reported that 12 of those responders are experiencing flu-like symptoms.

Tim Killian, a spokesman for the center, said the state had provided enough test kits for all of the residents, but it was not clear whether there were also enough kits to test all staff members.

© David Ryder/Reuters Harborview Medical Center's home assessment team carry protective and testing supplies while preparing to visit the home of a person potentially exposed to the coronavirus in Seattle, on February 29.

In addition, 20 staff members at the Valley Medical Center in Renton, Washington, are being tested for coronavirus after exposure to a patient there. One has already tested positive and is in isolation. Eleven are awaiting results under quarantine.

Given the risk of staff shortages at hospitals like this, the CDC updated its recommendations for healthcare workers and facilities over the weekend, removing a requirement that asymptomatic workers who’d been exposed to a coronavirus patient stay home.

Asymptomatic transmission of the coronavirus has been recorded before, however. A study last month found that 20-year-old woman from Wuhan, China, transmitted the coronavirus to five family members without ever showing symptoms.

‘I did this assuming that if something happened to me, of course I too would be cared for’

After potential exposure to a coronavirus patient in a northern California Kaiser facility, an anonymous quarantined nurse released an open letter about her situation through the California Nurses Association.

“As a nurse, I’m very concerned that not enough is being done to stop the spread of the coronavirus. I know because I am currently sick and in quarantine after caring for a patient who tested positive,” she wrote. “I’m awaiting ‘permission’ from the federal government to allow for my testing, even after my physician and county health professional ordered it. I volunteered to be on the care team for this patient, who we knew was positive. I did this because I had all the recommended protective gear and training from my employer. I did this assuming that if something happened to me, of course I too would be cared for.”

Many health workers are concerned about getting paid during self-quarantine, Rosselli added. Some hospitals haven’t released guidelines yet around whether quarantines count as sick time, paid time off, or unpaid time.

“It’s not unusual for healthcare workers to live from week-to-week because they’re working class people generally, especially in nursing homes where the wages and benefits are inferior,” he added. “If employers don’t commit to paying folks if they have symptoms or if they contract the virus, we’re concerned that people will hide the symptoms because they live from week-to-week and can’t afford to take work off without pay.”

Lydia Ramsey and Jessica Snouwaert contributed reporting.

Have you been personally affected by the coronavirus epidemic? Are you a healthcare worker on the front lines of this disease? Have you or someone you know been tested or diagnosed? We want to hear your story. Please email science+coronavirus@businessinsider.com.