Health care workers’ lives are not expendable. Yet, we are being asked to battle a microscopic enemy with disgracefully inadequate personal protective equipment (PPE). We know that using PAPRs (powered air-purifying respirators) would be the best practice when working with highly infectious air-borne diseases. But, PAPRs are uncommon in our institutions, so the guidelines were relaxed. An N95 disposable mask was suggested as the next line of defense even though we knew it was insufficient to filter the COVID-19 virus when aerosolized. When N95 masks became in short supply, we were told to re-use these disposable masks over and over. And we were told that simple surgical masks were good enough in most cases. When the simplest of surgical masks became scarce, the CDC suggested that as a last resort, we use bandanas and scarves to cover our nose and mouth while caring for patients. Our loving friends and family started sewing homemade cloth masks to protect us. The year is 2020, not 1920. It is unfathomable that the Centers for Disease Control and Prevention compromised their high standards to include measures that are known to neither control nor prevent this disease. Compromises such as this do nothing to safeguard health care workers, but merely provide absolution to those who would keep us working in unsafe conditions. It is hypocritical that government agencies which, in the name of protecting the public from us, have made health care the most regulated industry in our country, have now loosened their standards to keep us working to care for the public without protecting us. It is unconscionable that our lawmakers in Washington, DC passed the Families First Coronavirus Response Act on March 18, 2020, to provide paid sick leave for many who become ill or quarantined due to COVID-19 but intentionally excluded employed health care providers and emergency responders from receiving the same protections. It is outrageous and antithetical to free-market principles that our health care equipment and drug supply chains are being held hostage by legalized racketeering given safe harbor by our lawmakers. The artificial shortages and climbing prices are the consequence of sanctioned kickbacks collected by the large PBMs (pharmacy benefit managers) and GPOs (group purchasing organizations). In the face of looming critical health care equipment and drug shortages, maintaining the status quo of profiteering by these middlemen entities is nothing short of scandalous. It is criminal that around the country, some hospital administrators, emboldened by the inconsistency of the CDC’s guidelines, are insisting that masks and other PPE are unnecessary for all but certain high-risk procedures and patients. They are deliberately ignoring that COVID-19 is now wide-spread in communities, highly infectious, and may be present in patients with few to no symptoms. Frontline workers are being denied access to hospital stockpiles of PPE, being asked to take off their self-provided masks and other PPE in the name of “not scaring the patients,” and being threatened with the loss of employment or reputation if they disrupt business as usual. We are not superfluous. We are physicians, nurses, physician assistants, respiratory therapists, X-ray technicians, environmental service workers, and so many others who chose to serve our fellow humans. Health care cannot run without our service and sacrifice. But martyrdom was never in our job descriptions. We are not replaceable. We are someone’s child, sibling, partner, parent, best friend, mentor, colleague, and someone’s love of a lifetime. In this battle, some patients’ lives will be lost despite our best efforts. Some of us in the firing line will lose our lives due to the lack of others’ best efforts to plan, prevent, provide, and protect. The loss of health care workers’ lives should not be the collateral damage to our nation’s unpreparedness. We are not expendable. Mercy Hylton is a pediatric emergency physician. Source
