U.S. nurses’ coronavirus survey: U.S. hospitals and U.S. government are unprepared to prevent virus spread

“The vast majority of United States hospitals and health care facilities are unprepared to handle and contain cases of COVID-19 (Coronavirus),” according to a survey of registered nurses conducted by National Nurses United (NNU) and released on March 5th.

As of March 9th, the U.S. Centers for Disease Control (CDC) reported 423 confirmed cases of the Coronavirus in the United States since January 20th including 19 confirmed deaths. The CDC says the virus has spread to 35 states.

The virus has infected more than 110,200 people in at least 97 countries.

Nurses and other health care professionals have criticized the low rate of Coronavirus testing in the United States which, they say, is leading to understating the extent of the outbreak and allowing the virus to spread.

On its website, the CDC reports that “As of March 8, 2020 1,707 patients had been tested at CDC. This does not include testing being done at state and local public health laboratories, which began this week.”

In contrast, South Korea, is testing 10,000 people per day, according to press reports.

The Korea Herald reported an innovative way to speed up testing. The newspaper said that in Gyeonggi Province checkups are performed at drive-thru facilities “about 20 minutes faster than the typical way done at hospitals or public health centers. About 100 people a day visit the temporary clinic in Goyang, which is set to run every day between 10 a.m. and 5 p.m….”

National Nurses United cited a nurse who was quarantined at a Kaiser facility in California, after coming down with Coronavirus symptoms, in which the U.S. Centers for Disease Control (CDC) refused to test the nurse.

NNU released the nurse’s plea for help:

“But the National CDC would not initiate testing. They said they would not test me because if I were wearing the recommended protective equipment, then I wouldn’t have the coronavirus. What kind of science-based answer is that? What a ridiculous and uneducated response from the department that is in charge of our health in this country. Later, they called back, and now it’s an issue with something called the “identifier number.” They claim they prioritize running samples by illness severity and that there are only so many to give out each day. So, I have to wait in line to find out the results. This is not the ticket dispenser at the deli counter; it’s a public health emergency! I am a registered nurse, and I need to know if I am positive before going back to caring for patients. I am appalled at the level of bureaucracy that’s preventing nurses from getting tested. That is a health care decision my doctor and my county health department agree with. Delaying this test puts the whole community at risk.”

News reports say the CDC failure to respond with adequate testing of suspected Coronavirus cases is in part related to insufficient and defective testing equipment that has allowed the virus to spread.

The NNU’s survey of American nurses found:

• Only 44% report that their employer has provided them information about novel coronavirus and how to recognize and respond to possible cases.
  
• Only 29% report that there is a plan in place to isolate a patient with a possible novel coronavirus infection. 23% report they don’t know if there is a plan.
  
• Only 63% of nurses’ report having access to N95 respirators on their units. 27% have access to PAPRs (Powered air purifying respirators)
  
• Only 30% report that their employer has sufficient PPE (Personal Protective Equipment) stock on hand to protect staff if there is a rapid surge in patients with possible coronavirus infections. 38% don’t know.
  
• Only 65% report having been trained on safely donning and doffing PPE in the previous year.
  
• 66% have been fit tested in the previous year; 33% have not been fit tested in the previous year.
  
• Only 14% report that their employer has an overflow plan to place additional, trained staff to enable safe care provision to patients on isolation for possible novel coronavirus. 43% report they don’t know.
  
• Only 19% report that their employer has a policy to address employees with suspected or known exposure to novel coronavirus. 43% don’t know.
  

At a March 5th press conference NNU says it has petitioned U.S. Occupational Safety and Health Administration (OSHA) to adopt an emergency temporary standard to protect health care workers, patients, and the public. Currently, no enforceable OSHA infectious diseases standard exists nationally.

Also, NNU says it “has heard discussion about the Centers for Disease Control (CDC) weakening its current guidance even further, including recommending surgical masks instead of respirators for nurses providing care to patients with COVID-19. NNU is opposed to these changes.”

“Nurses are confident we can care for COVID-19 patients, and even help stop the spread of this virus, IF we are given the protections and resources we need to do our jobs,” said Bonnie Castillo, RN and executive director of National Nurses United and the California Nurses Association. “This is not the time to relax our approach or weaken existing state or federal regulations. This is the time to step up all of our efforts.”

NNU said the survey was taken of 6,500 nurses in 48 states, including the District of Columbia and the Virgin Islands, and shows “ that high percentages of hospitals do not have plans, isolation procedures, and policies in place for COVID-19; that communication to staff by employers is poor or nonexistent; that hospitals are lacking sufficient stocks of personal protective equipment (PPE) or are not making current stocks available to staff; and have not provided training and practice to staff on how to properly use PPE.”

NNU is asking the federal government and Congress to take the following steps:

• All registered nurses and other health care workers must receive the highest level of protection in their workplaces, as determined by the precautionary principle.
  
• The CDC must improve screening criteria and testing capacity to ensure prompt recognition of and response to COVID-19 cases.
  
• The Occupational Safety and Health Administration must promulgate an Emergency Temporary Standard to protect healthcare workers from emerging infectious diseases like COVID-19 as soon as possible.
  
• Congress and the administration must ensure that any vaccine or treatment for COVID-19 that is developed with U.S. taxpayer dollars is provided to the American public when needed for free.