Some hospital residents and fellows, many of whom have worked virtually non-stop during the COVID-19 response and who earn less than more-experienced staff, are becoming frustrated.

And a petition for hazard pay as well as life and disability insurance at NYU Langone underscores both the many fears of medical staff caring for patients at the epicenter of a pandemic, and the array of challenges facing strained hospitals in delivering such care.

The staff emphasizes that they are honored to care for the patients and undertake more clinical responsibilities, but the petition is a plea for more support. “As doctors, we are committed to serving our patients,” says the petition, a copy of which Newsday obtained Tuesday. “However, during this unprecedented time, we now find ourselves and our families at risk in ways we never imagined.”

The letter, addressed to NYU Langone leadership, stresses that the staff faces the risk of a “hospital-acquired infection” plus “increased hours and patient loads.”

Making the sensitive matter even more difficult is that management inadvertently sent staff an email chain in which NYU administrators were strategizing on a response. The email chain highlights deep divisions between hospital leaders and the petitioning staff.

The petition was visible online while petitioners tried to solicit signatures, and NYU leadership saw it and decided to respond, said Dr. Steven Abramson, vice dean for education, faculty and academic affairs at the NYU Grossman School of Medicine, which serves as NYU Langone Health's medical school.

Abramson and another administrator responded to items from the petition in an April 9 email: partially in the petitioners’ favor, as with the issue of individuals retaining program standing if they fall ill. But the administrators declined to commit to new forms of increased disability and life insurance and hazard pay.

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The pressure on staff has been a simmering issue among some of NYU’s hundreds of residents and fellows, known as “house staff,” placed across the system in Manhattan, Brooklyn and Long Island’s NYU Winthrop Hospital.

Their peers have faced similar difficulties. SEIU’s Committee of Interns and Residents, a union which advocates for these young doctors, has publicized safety issues during the pandemic like lack of protective masks.

Some other hospitals have promised monetary support for residents and fellows, a point noted by NYU staff complaints to administrators.

The administrative response included a rationale for why NYU was taking a different tack.

The chain of emails inadvertently sent included a letter one administrator wrote to some residents saying that NYU Langone projects an operating budget deficit of "one billion dollars" if the current environment extends through June. That's "without hazard pay to residents, nurses, doctors, advanced practice providers, respiratory therapists, transporters, housekeeping etc etc ,all who are in harms way."

The administrator also criticized the monetary request: "Now is the time to accept the hazards of caring for the sick and do what we are trained to do and fulfill our commitment to the health care needs o f (sic) our community rather than focusing on making a few extra dollars."

Another administrator who supervises the young doctors asked, "can we see who has their names on that petition? I would like to see if any of my fellows names are on it."

Abramson said this was not meant as a threat and the administrator wanted to know what the individuals were feeling. The email chain and other messages were shared with Newsday by a resident in the NYU Langone system.

The upshot is that NYU plans to announce a staff-relief fund paid for through philanthropic fundraising, Abramson said. It would be modeled after a fund NYU developed after superstorm Sandy, but details about who this would apply to in the NYU community and how much money would be awarded were not yet available.

All medical house staff who provided clinical care to COVID-19 patients would also be bumped up a notch on their salary levels: First-year residents at NYU start out making around $68,000, and each year the health care workers get more responsibilities and a pay bump of a few thousand dollars. This year, that bump was scheduled for July but will come early, retroactive to April 1, Abramson said.

It’s not the hazard pay some house staff are calling for. Abramson said that’s intentional. To get paid extra for fulfilling their role as a health care provider "is a transactional concept that goes against the fundamental principles of being a physician," he said.

Other New York hospitals were earlier to this issue.

NewYork-Presbyterian announced on April 2 a $1,250 bonus for staff who worked physically on site at a hospital campus or clinical office for at least one-week’s time in March through April. The bonus covers the likes of nurses and cleaners in COVID-19 wards, too, according to a spokesman.

The Mount Sinai Health System “is paying all residents, fellows (and nurses) a regular bonus in recognition of the difficult work related to the Coronavirus Pandemic,” writes Lucia Lee, senior director of media and public affairs.

Some hospitals are still working it out. Northwell Health is providing crisis pay to respiratory therapists and nurses working in a variety of units, according to spokesman Terry Lynam. But residents and fellows are left out. They would be eligible for a “heroes recognition compensation fund" that Northwell is in the process of finalizing, said Lynam.

There is agreement at least between NYU administrators and staff about the difficulty of the work being done.

Abramson believes the frustrations aired in the petition reflect a “cumulative sense of physical and emotional strain."

He noted that "these are people who for the last month have been working virtually without a break taking care of these very sick patients, watching people die."

Mark Chiusano is a member of Newsday's editorial board.