BE SAFE OR BE SORRY: The New York State Nurses Association March 11 opposed guidance from the U.S. Centers for Disease Control and Prevention that advised health-care staff treating coronavirus patients to wear face masks instead of N95 respirators, potentially putting the nurses at risk. Lisa Baum, NYSNA's occupational health and safety representative, explained that face masks ‘do not protect the wearer from exposure because there’s not a seal around the face, so air can get in.’

The New York State Nurses Association March 11 slammed a U.S. Centers for Disease Control and Prevention directive that loosened its recommendations for protective equipment worn by health-care workers to prevent them from being infected by coronavirus.

Until recently, the CDC recommended that health-care staff treating patients with the novel coronavirus should wear N95 respirators, which are masks that filter airborne particles. But on March 10, it changed its recommendations due to concerns that there will be a shortage of N95 respirators nationwide.

‘Face Masks Acceptable’

The CDC website states that instead, “face masks are an acceptable alternative,” and that “respirators should be prioritized for procedures…that pose the highest exposure risk,” such as intubation.

Judy Sheridan-Gonzalez, an Emergency Room Resident Nurse at the Bronx’s Montefiore Hospital and President of NYSNA, said that having the proper protective gear was necessary to prevent hospital staff from becoming infected.

“We cannot have the Federal Government saying that the standards can be reduced because of scarcity. It should be based on science,” she said at a press conference held at the union’s New York City headquarters in Midtown.

Lisa Baum, NYSNA's Occupational Health and Safety Representative, explained that face masks “do not protect the wearer from exposure because there’s not a seal around the face, so air can get in.”

N-95 Offers ‘Good Seal’

“An N-95 respirator is made from different material, which is more filtering, and you have to be fit-tested to wear it to make sure you have a good seal, and that will protect you from exposure,” she said.

NYSNA Executive Director Pat Kane believed that finding other supply chains of N95 respirators, such as those used in the construction industry, would be a better solution. “The first thing you have to do in any kind of epidemic is protect the health-care workers, because they’re going to be taking care of folks who do get this,” she said.

CDC spokesman Richard Quartarone said that keeping nurses and all healthcare workers safe and healthy was “a priority for CDC.”

“Based on what we now know, we are making recommendations that are appropriate for infection control in healthcare settings and offer pragmatic options to deal with the very real challenges faced by our healthcare systems as they navigate the current supply chain disruptions,” he said.

In a survey of NYSNA members that was released two days earlier, 49 percent of the nurses who responded said that their facility does not have enough respirators to treat potential coronavirus cases. Thirty-nine percent said that their facility expected staff to reuse the respirators, a policy the union opposes.

NYC Health + Hospitals, the city’s public hospital system, disproportionately serves uninsured and low-income patients, who have higher rates of diseases such as diabetes and asthma.  Those with chronic conditions, such as kidney disease and heart disease, were most at-risk of getting seriously sick from coronavirus.

Conserving Respirators

Judith Cutchin, president of NYSNA's Health and Hospitals Executive Council, said that staff have been conserving respirators. “We do have large populations that we serve in Health + Hospitals that are vulnerable—they’ve got a lot of co-morbidities that would make them at-risk—so we want to make sure that we have stock of the N95s, that we have the space, which I believe we do, and that we continue our protocols,” she said.

NYC H+H President and Chief Executive Officer Mitchell Katz has stated that the public-hospital system has been finding spaces beyond the 376 negative-pressure rooms that can be used to isolate coronavirus patients.

Beyond equipment and rooms that can be used to isolate suspected coronavirus patients, the union called for safe-staffing, which it has advocated for years.

“We have other sick patients, so we can’t devote everybody just to the COVID-19,” Ms. Cutchin said. “We need to make sure that we have adequate staffing so we can have a COVID-19 team and then we have a team to take care of the rest of the illnesses.”

Harsh Words for Hospital

Kathy Santoiemma works at Montefiore New Rochelle in Westchester, which is where 108 of the state's initial 173 coronavirus cases were located. She stated that the hospital’s emergency department was short-staffed, and that nurses sometimes had to take care of 15 patients or more. Making matters worse, Montefiore plans to close its nearby hospital in Mount Vernon, which was already medically underserved.

“We are disgusted how Montefiore in the face of this pandemic can possibly justify the closing of a hospital in the second-most densely populated city in New York State,” she said.

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