We’re Fighting COVID, Budget Cuts And ‘Murderous Racial Inequalities’
Above photo: Yoni Golijov.
Sean Petty is a pediatric emergency room nurse at Jacobi Medical Center in the Bronx and the southern regional director for the New York State Nurses Association (NYSNA). In mid-March, he spoke to The Indypendent’s Danny Katch about how the coming coronavirus spike would overwhelm a public hospital system that had been decimated by budget cuts and closures. The subsequent weeks proved his predictions correct. The official virus death toll in New York City is over 18,000 as of this writing, a number that includes dozens of health care workers.
But Petty and his fellow nurses have also organized themselves into powerful political actors who have leveraged their moral authority to demand more personal protective equipment (PPE) and other resources from local and national officials. On March 28, Jacobi nurses protested outside the hospital against Centers for Disease Control guidelines that N95 masks weren’t required for treating COVID-19 patients and a New York City Health + Hospitals (H+H) policy allowing a single N95 mask to be reused for five days.
H+H responded with a statement that “reports of lack of personal protective equipment and ventilators in our system are false” and that “every healthcare worker in our system who needs PPE is able to receive what they need.” NYSNA continued organizing protests and press conferences until Gov. Andrew Cuomo mandated that hospitals supply medical workers with a new mask each day.
In this follow-up interview, Petty fills Katch in on what he and his co-workers experienced as his dire predictions came to pass, lessons learned and what lays ahead. It’s been lightly edited for clarity and concision.
When we spoke in March, you warned that “we should expect the worst,” and you were right. How did the situation in public hospitals evolve since then?
The last six weeks feel like a year. I’m still trying to piece it together. Every one of us is going to have some sort of post-traumatic stress scenario or disorder.
The biggest challenge as the patients started coming in were the twin concerns of the very disorganized response and the lack of personal protective equipment.
Every day was some new scheme — rushing around trying to put oxygen ports in units that haven’t had them in ten years, trying to move nurses from one unit to another, trying to reorganize entire structures of how medical teams are organized — that just took an incredible amount of time and effort. If we were a little more prepared for this crisis capacity-wise, we could have focused more on caring for patients and not as much on restructuring the hospital on the fly.
Then once we realized how short of supply the system was in terms of personal protective equipment, things began to get very scary very quickly. And it became very real when we started to lose our coworkers. My hospital had the second death of a nurse in the country, Freda Ocran. We heard the information right at the end of the rally that we organized to fight for PPE.
What was that moment like?
It was a contradictory feeling of demoralization and rededication. This is what we were hoping to prevent, but we were hoping we’d have more time. We didn’t have any illusions that a small action at a hospital would change the world. But we did think that we had an important spotlight to shine on the issue and that it might have the possibility of building up the pressure to change the policies that were putting us in such danger. So it was really hard to hear that we didn’t have that time.
But it was also a reminder that these are the stakes. This is why we don’t have an option not to do this, not to escalate and reach out to more nurses after this protest. This is why we had to make sure her death was recognized as not just an inevitable outcome but a result of policies and decisions that don’t fully value the lives of nurses and other healthcare workers.
Given the life and death consequences of those decisions, how do you think this experience may change the relationship between healthcare workers and hospital administrators moving forward?
The healthcare system couldn’t control how well the federal government stockpiled N95 masks, or how quickly they responded once they realized they didn’t have enough masks for healthcare workers in this country. But what it could control was not lying to us about it.
Administrators could have actually been transparent and joined us in raising the alarm bells. And when they implemented policies [rationing masks for healthcare workers] they could have said, “These policies are because of shortages, not because of the science.” But instead, they fudged it and said, “This is what the CDC recommends and it’s what the other hospitals are doing and that’s why we think it’s safe.” And when we protested they said, “No, we have enough,” which is a sleight of hand because yes, they had enough based on the unsafe CDC guidelines that they were following. But no, they did not have enough in terms of preventing the killing of healthcare workers.
So they could have not lied. I know why they lied. I know that there are some decent people in the system that lied because they had to protect the politicians who hired them. You see the same situation every day in Trump press conferences with [Coronavirus Task Force members Anthony] Fauci and [Deborah] Birx. But you also see it in New York with the Department of Health and H+H officials trying to justify what the mayor and the governor want you to hear.
You can understand their situation, but they rarely try to understand ours, which is that this is life or death. So no, we’re not going to shut up about it and no, we don’t have any obligation to protect the reputation of the head of the public hospital system, or the mayor, or the governor.
In previous periods where we would try to fight for more resources in the public system, we were caught in a situation where we didn’t want to completely reveal everything that was horrible with our system. We knew there were people saying that the public hospital system is worthless and it would be better if everything was private, and we didn’t want to give them ammunition to shut us down.
But in this life or death moment, that mentality changed for us. The reputation of our system, the people that run it and the politicians that fund it are far secondary questions to “somebody needs to get us the stuff we need and we don’t want to hear any excuses.”
NYSNA has been a leading voice exposing the shortage of PPE and the overall lack of preparedness in the healthcare system. Why do you think that your union has played this role?
Nurses and nurses’ organizations are specifically positioned to be speaking out about this. We’re the frontline of the frontline, and it’s a core feature of our profession to care and advocate for our patients. So that’s a baseline reason, but obviously all nursing organizations haven’t reacted in the same way. There are specificities to NYSNA that make that the case.
Back in 2011, we had a rank-and-file takeover of the union and nurses were elected on the basis of leading a more member-driven, militant union that was aiming to fight for Medicare for All, [nurse-to-patient] staffing ratios and other systemic reforms.
One of the big challenges was that many in our union had believed Governor Cuomo would help us get safe staffing and perhaps get us Medicare for All. But the failure of that strategy came to a head last year and that led to some internal political debate. The resolution was that we came out with a more accurate understanding of what Gov. Cuomo represented politically and how we needed to challenge his agenda.
In this crisis, when the federal government was failing to act in any serious way and state and city governments were also failing to meet the test of this moment, we were willing to challenge those political entities in a way that other unions simply weren’t.
What is it like watching Cuomo become a liberal darling because of his informative daily press conferences, even as he has pushed through a budget with $400 million in healthcare cuts in the middle of this pandemic?
It’s a nauseating experience. Cuomo could fix the budget crisis at the stroke of a pen if he was willing to tax the ultrawealthy. But he’s making us pay for this crisis even as the public sector nurses who are watching it on TV between patients are literally putting our lives on the line to fight this disease.
He’s cutting our hospital system by hundreds of millions while he’s putting on a show as the anti-Trump. And this is completely unnecessary because he has the ability to implement the Stock Transfer Tax, which would put into the state budget an extra 10 to 20 billion dollars directly from Wall Street in a tax that the state already collects but refunds every year.
He’s not doing everything wrong. He’s saying a lot of the right things about what needs to happen in terms of the management of social distancing and the development of testing and so on. But it’s really hard to stomach because of just how unrepentant he’s been. He says we’re doing all these great things to increase hospital capacity, but there’s no acknowledgment that he was the main driver of decreasing hospital capacity!
Now that the wave of infection has crested in New York, the conversation has turned to opening up the economy and getting people back to work. What public health challenges do you see in the coming months?
First and foremost is not opening any part of the non-essential economy until there is full-scale ability for the public health entities to widely test, contact-trace and comfortably isolate and treat individuals who contract COVID. That’s the public health prime directive in my view.
I feel like we’re in a déjà vu moment vis-à-vis Hurricane Sandy when our public healthcare system and disaster response systems were tested in an acute way and completely failed. Afterward, there was an opportunity to invest resources in the infrastructure of our city to absorb tidal flood surges and develop public health networks where people could be reached if they got stranded, but none of those got resolved. They failed the test of Sandy and then they failed the test of post-Sandy.
Now we’ve failed the test of the pandemic and it becomes a question of if we will fail the post-pandemic. Do we do what South Korea did in terms of having a testing, tracing and isolation infrastructure? Do we do what Germany did in terms of not cutting massive hospital capacity? There was a lot of political pressure in Germany because there were more doctors and nurses and hospital beds than were needed in the last decade, but it was explicitly argued that excess capacity is needed for these potential situations.
It turns out that the people who fought for and won keeping that excess capacity were absolutely correct. And that’s what we’ve been arguing in NYSNA for the last decade and longer, that these hospital closures that Cuomo was pushing were going to make this system massively vulnerable to any serious influx from infectious disease or climate-induced natural disaster.
So we have to learn that lesson, and we as people who are practitioners have to play a leadership role in fighting to make that change a reality. Obviously stopping these budget cuts is step one and fighting for Medicare for All is step 1A. Both of those things are about providing the financial capacity to equalize funding within the healthcare system and providing access for everybody to have care.
One of the other key things that has been so profoundly exposed by the coronavirus is the murderous racial inequalities that exist in our healthcare system. Medicare for All will go a good way towards dealing with that crisis, but there needs to be a more radical change in the way we view the interaction between racism and healthcare. It’s not only about funding streams and access to institutions. The astronomically high death rates of African Americans, in particular, should shine a light on the need to make “black lives matter” a key public health concern moving forward.
There is currently a tremendous amount of admiration and respect for healthcare workers, and nurses in particular. Do you have thoughts about how to start leveraging this support for political demands like Medicare for All that so many healthcare workers believe are necessary?
Many nurses understand that we’re the most trusted profession in the country, but we also know that we have little control of our working environments on a day to day basis. While we’re respected, we’re not listened to in our workplaces. What we’ve started to realize at Jacobi and others have started to realize at other hospitals, is that when you start to act publicly and collectively, even in small ways, your power can reverberate in ways that aren’t true for other groups of people.
Imagine if, once this immediate COVID crisis is over, we went from organizing socially-distanced speak-outs and press conferences to organizing a documentation strike where we don’t do any documentation related to billing in order to fight for Medicare for All? What if we had a national strike day for everything other than emergency services?
These are the things that we need to begin to think about in terms of what is going to begin to move the needle. We have Trump in the White House and that’s not going to change at least until January if not further. But we need a whole series of changes way before that.
We need to think about how we’re leveraging our power nationally, but then we also have to figure out how that starts in a very local way, in your unit and in your hospital. There’s no one-size-fits-all solution. It’s going to involve the classic axiom of organizing: agitate, educate, organize. But what has changed is that our horizons about our power in this moment need to be raised.