Medical employees say they're getting COVID-19 on the job. Here's why hospitals push back
Days later, Moll said she began to develop a cough and grew so weak she could barely speak or climb stairs. She wound up hospitalized herself and tested positive for COVID-19. She became one of the first employees at
Officials with the hospital say they investigated Moll's case as a "possible exposure" but could find no records to support her claims. Moll was incensed at the suggestion by hospital administrators that she contracted the disease "in the community" and not at UC Davis.
"I did everything I was told to do and instructed to do," she said. "So that (to claim) I got it 'from the community,' unless it's in the wind, I got it at work. That's insulting. By saying that, you're implying even healthcare workers are ignoring the recommendations."
Moll's experience illustrates an increasingly tense situation between health care workers and hospital administrators as the coronavirus pandemic has deepened. Administrators insist their employees most likely aren't getting infected on the job, even though those same workers are dealing with COVID-19 patients on a daily basis and, as some contend, without proper protection.
Advocates for workers say there's a reason why hospitals are generally reluctant to acknowledge infections are occurring on their properties: money.
If workers can't prove they contracted COVID-19 at work, the hospitals can avoid paying workers' compensation benefits, which are generally limited to medical expenses and reimbursement of lost pay.
Medical workers are left with few options. Under
If the coronavirus pandemic spreads to large numbers of hospital workers, as it has in
"Workers' comp exposure is a real issue for them because of the costs involved," said
Cattermole said he was disturbed to see a hospital "put the burden on the workers to prove where, how and when they contracted the disease. ... I hope the Legislature does something or the governor does something to protect these people."
At UC Davis, the health system's CEO has said that some employees had tested positive for COVID-19 and "many" employees would call in sick in the coming weeks. But he insisted that any of those positive cases in the future were "very likely community-acquired infections" and not the result of working with sick people.
Employees at other hospitals said similar policies were in place where they worked.
"They're assuming that if any nurse becomes positive, there's no way to verify it, and it's community-acquired,"
Altaffer and some of her fellow nurses in their union held a candlelight vigil Wednesday night at the hospital to protest what they consider unsafe working conditions.
However, a day after The Bee inquired about Sutter's policies, hospital CEO
"Now that the virus has become so widespread in our communities, the chance of any of us becoming infected outside the workplace continues to rise," Alexander wrote in the memo obtained by The Bee.
"Nevertheless, in the unfortunate case an employee tests positive for COVID-19 and submits a workers' compensation claim, we will presume employees who work in clinical environments acquired the virus from a work-related exposure for compensation purposes unless definitively shown otherwise."
Hospitals respond
The
"If there is an infection acquired within the hospital, we want to know about it, as soon as possible, to reduce, or ideally, eliminate, the possibility of future spread," Garcia, the
He added: "Our decisions are informed by clinical evidence and delivering patient care -- not finance."
Garcia said the hospital has "dedicated, full-time teams that are committed to infection prevention and keeping our employees safe. As the region's largest hospital, we regularly treat patients with serious infectious diseases so we have well-established procedures and equipment to keep our employees safe, regardless of COVID-19."
The hospital is also separating COVID-19 patients from other patients and prioritizing protective equipment "for higher-risk care environments" in an effort to slow the spread of the disease inside the hospital.
"We don't have any information to provide at this time," Kaiser Permanente Northern California spokeswoman Chyresse Hill said Wednesday in an emailed response to a list of more than a dozen questions from The Bee.
The
At least 73 had tested positive by Friday.
Yet employees across health systems have told The Bee that managers have tightly guarded masks and other equipment or told staff not to wear masks, except in specific situations. (The association that accredits hospitals on Tuesday said workers should be allowed to wear their own masks as they deem necessary.)
Hospitals have administered relatively few COVID-19 tests, including many that take more than a week to get results from, making it impossible to know who is sick and whether employees were exposed.
Ill workers, like Moll, as they've recovered, have had to navigate a confusing maze of human resources departments and shifting hospital policies surrounding COVID-19.
Meanwhile, healthcare workers say their worries about not having enough equipment to protect them from the new coronavirus on the job are being met with skepticism by their supervisors.
"Mandatory masks for everyone in the hospital!" Dr.
Health care workers have also been asking unions to negotiate another death benefit insurance policy in case they die after contracting COVID-19, said
Nurses are worried about running out of sick time.
"Our members are afraid of taking the virus home to their families," Duncan said. "... All are concerned about the delay in screening, of failure to test patients and the slow turnaround of tests and finally the lack of approved treatments."
Push-back from hospitals and other employers about where a health care worker acquired an illness also would be a major sticking point in coming months and years, said
On a call with reporters Tuesday, Garrido, who represents workers in
He said seven members of his union have already died from the disease.
"For people to be told, 'You are a nurse or a first-responder and you are dealing with this and you're perfectly healthy when you're in your 30s or your 40s and you passed away, and you probably got it in your neighborhood,' is an insult to all the workers who are putting their lives on the line," Garrido said.
Liability with COVID-19
Across the country, doctors and nurses have faced threats and retaliation from hospital administrators for speaking out publicly about the lack of protective equipment. A
"The idea that this person would be fired for complaining is really, truly unfortunate," said
"People get frustrated," Shortell said. "It's going to make very visible the leadership of our nation's hospitals and health care system."
The tactics hospital administrators are using come from a long-used playbook in how executives manage concerns around infection outbreaks, experts said. Officials want to keep people coming in the door and not give the impression that patients might get sick if they do. They also need employees to continue coming to work despite the risks.
"It's sort of like, 'There's danger out there. And we're dangerous, but we take precautions,' " said
In the back of a hospital administrator's mind, experts said, is also the risk of reporting a hospital-acquired infection or outbreak that could jeopardize funding and open them up to drawn-out lawsuits.
But Caplan said those liability risks are minimal. Hospitals are operating in uncharted territory when it comes to treating a surge of patients in the middle of a global pandemic. And it would be difficult for a plaintiff's lawyer to prove an accepted "standard of care" was violated if someone believed they were negligently exposed to the virus inside a medical center.
Nurses and doctors have been receiving a number of directives from hospital administrators based on rapidly evolving guidelines from the
"I know American litigation is nuts, but a lot of these lawsuits, it would be impossible to prove where you got infected," Caplan said. "When you're in a pandemic emergency, it's hard to say what the standard of care is."
Nevertheless,
"Things are going to come to a head when people die," he said. "I anticipate a great deal of litigation. Enough money, there's going to be a fight."
A UC Davis nurse speaks out
For weeks, Moll said, she had drawn on her nearly three decades of nursing experience to protect herself at the
Moll, 48, believes she was infected while she and her colleagues were restraining the confused and combative man.
Moll originally asked
Moll said at the time she feared retaliation. But in the days since, she said she wanted to share her story publicly so that people could know the profound risk frontline healthcare workers face from not having adequate equipment to protect themselves from the infection.
She said she also was extremely frustrated the hospital was downplaying the risk to workers like herself by claiming they almost certainly caught the infection outside of work.
She said doctors and nurses know better than most how to take "social distancing" precautions while out in the community. She said she remains deeply troubled by the risks to them.
"We all went into this profession for the desire to help people. I do not feel that it was a mistake to have entered into emergency room nursing. But I will admit that I am very scared," Moll said this week. "The uncertainty is difficult. If I have to put it in nursing terms on a scale of one to 10, 10 being very concerned, I would say it's a 10."
Moll said Wednesday no one from hospital administration has called to discuss the incident with her.
In his statement, Garcia, the
"While
He said employees are never "denied access to the necessary protective equipment to do their work."
"Supplies of protective equipment are immediately accessible whenever needed, but are kept locked up to protect against theft of these important supplies," he said.
'Litigate to the ends of the earth'
When it comes to legal claims, COVID-19 in the workplace is comparable to what often unfolds in hospitals: It's hard to prove where or how someone got sick.
"Proving that you got it at work, that's going to be the challenge ... given that it is publicly contractible right now," said
"They litigate, they are very tough .... The UC regents, they would much rather throw money at a defense attorney who will litigate to the ends of the earth," Rutkowski said.
Legal experts said workers' comp is, with the exception of extreme cases, an injured workers' only legal recourse; they generally can't sue their employer.
"We should have their backs, it's the right thing to do," Gov.
On
"Workers on the frontlines of the COVID-19 pandemic put their lives at risk just doing their jobs. If they are infected with COVID-19, the workers' compensation system must quickly provide medical and indemnity benefits -- such workers should not have to fight denials and delays while fighting for their lives," the federation said in a letter to Newsom.
Until now, the courts have made it hard for
In 1998 the state Supreme Court turned down the widow of a
In most instances, Rutkowski said she probably wouldn't bother filing a claim. If the worker recovers fairly quickly, the workers' comp benefits wouldn't amount to much; he or she would only be eligible for two-thirds of the lost wages, and that only kicks in after the worker misses more than three days.
"Why open a hornet's nest like that and have the UC regents come down on you? I wouldn't even bother filing it."
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