Healthcare Workers on the Front Lines

MAPA News & Analysis, May 2020

Donna Kelly-Williams, Gladys Vega, Savina Martin, Vaughn Goodwin, Pam Adelstein, and Julie Levison
L to R: Donna Kelly-Williams, Gladys Vega, Savina Martin, Vaughn Goodwin, Pam Adelstein, and Julie Levison on Fund Healthcare Not Warfare webinar, April 19, 2020

by Jackie Dee King

An elderly man with a 103-degree fever and other Covid-19 symptoms was told by his daughter and son-in-law he had to leave their crowded family house in Chelsea because they had a three-month-old baby. The man had been denied tests and turned away from Mass. General Hospital twice; he was told to “go home and isolate.” The daughter, still recovering from a C-section herself, was crying but said she had to protect her baby. Now, he had nowhere to go. A community organization finally called 911 for an ambulance, and the man is now in Intensive Care at Boston Medical Center.

“Cases like this repeat every day – our situation is horrific,” Gladys Vega, executive director of the Chelsea Collaborative, told 85 people participating in the April 19th webinar On the Front Lines of Healthcare Delivery. The session was one of a series, Fund Healthcare Not Warfare!, sponsored by Mass. Peace Action, Our Revolution MA, Progressive Democrats of America (MA) and the Mass. Poor People’s Campaign.

Vega was joined by nurses, doctors, and health union reps, who gave powerful accounts of the dangerous, high-stress conditions under which they work – and their patients live – on a daily basis during the coronavirus epidemic.

Vega said the number of Covid-19 cases reported in Chelsea at the time—874—was far too low; she and her staff estimated the real numbers were up around 3,000 or more. Several days later, MGH researchers tested a random group of pedestrians in Chelsea and found that nearly a third of them were infected! This city of immigrants (though the official census years ago counted 40,000, Vega estimates 75,000) began making it on to the front pages of the New York Times, Boston Globe, and other publications as the epicenter of the outbreak in Massachusetts.

“Our community has contributed to building Massachusetts, right?” Vega said. “They are the front-line service workers. They work in the airport, in Boston cleaning offices, in nursing homes. I don’t have executives that are able to be quarantined…These are the people that get sick and they have the virus, not knowing they are bringing it home.”  The Chelsea Collaborative has mobilized to start food pantries, deliver diapers, help people file for unemployment insurance, and advocate for residents to be tested and properly treated at local hospitals.

Dr. Julie Levison, an infectious disease specialist at MGH Chelsea, said the high rates of infection in Chelsea were part of “a larger societal issue about the retraction of public health investment…I cannot emphasize enough. We know what can control an outbreak. You need testing, you need to be able to identify individuals who are infected, to contact trace and safely isolate people while protecting the healthcare force.” The Chelsea population is particularly vulnerable because so many are essential service workers and so many live in crowded, inter-generational housing. The response to the epidemic must be holistic, she noted, and must provide housing, adequate food, violence prevention, as well as health care.

Donna Kelly-Williams, president of the 23,000-member Mass. Nurses Association, said the nurses’ primary concerns, which they have communicated in seven weekly letters to the governor,  include lack of adequate personal protective equipment (PPE), lack of standardized, frequent testing at their work sites across the state, a possible developing shortage of beds (especially for intensive care), and staff layoffs at some facilities. “This is the absolutely worst time, during a pandemic, to be laying off anyone!” she noted.

Vaughn Goodwin, senior organizer for 1199SEIU Healthcare Workers East, organizes and develops personal care attendants (PCAs) – workers who provide home care for seniors and people with disabilities under MassHealth – in the Metro Boston area. He said PCAs, many of them low-income people of color with preexisting conditions themselves, are fearful of contracting Covid-19 from their clients, who are worried about contracting it from them. Many PCAs also work in nursing homes, where there is a shortage of PPE such as masks and gloves. The union has had to obtain PPE, set up distribution sites, train members in its usage, and put pressure on the federal government “because we realize that is where the problem lies.”

Dr. Pam Adelstein, a family medicine physician at Codman Square Health Center in Dorchester, described how the staff have had to drastically reorganize the center, setting up triage tents in the front, during the pandemic. After examining patients, they direct them to one unit or another, depending on whether they have Covid-like symptoms or not. “For the first time in the health center’s history, we’re having to tell our patients not to come. We’re doing telephone medicine. Certain parts of our health center are like ghost areas.” She noted the staff, as well as the patients, are scared of contracting the virus and giving it to their families. They have to strip and shower at the doorway as soon as they get home, and they consider their cars to be contaminated. “Our patients are getting sick, they are dying, they need medications, they don’t have thermometers or blood pressure cuffs, they come in for prescriptions and letters…And yet, they still have this amazing, amazing attitude.”

Savina Martin, coordinator of the Poor People’s Campaign in Eastern Massachusetts and a Mass. Peace Action Board member, explored the “preexisting conditions” of poverty, racism, and militarism in our society that are exacerbating the coronavirus crisis. “The Covid-19 pandemic has forced us into an unprecedented national emergency,” she said. “This emergency results from a deeper and much longer-term crisis. That of poverty and inequality and a society that ignores the needs of the poor and those who are $400 away from being poor. So I ask you, are the testing sites set up along the peripheries of the poorest communities? Are we assuring that somehow neighborhood markets and our little-to-no grocery stores are stocked with food items? In these marginalized communities, how are families obtaining transportation to stores? Or to work and then back home again? How many families have no internet? And are emergency urgent care centers open?”

Yet, while millions are losing their jobs and healthcare, while vital Covid-19 tests and personal protective equipment are scarce, our nation is spending $738 billion this year on the military—fighting wars abroad, maintaining 800 bases around the world, and launching a new nuclear weapons race. The Poor People’s Campaign has developed a Moral Budget, Martin explained, that calls for cutting $300 billion from the bloated military budget and transferring those funds to health and human needs. $300 billion would pay for all the tests, masks, gowns, and ventilators people need. The funds would speed the development of vaccines to prevent the disease and therapies to cure the infections. “We need to stop making war on people abroad and pivot to make war on the coronavirus,” she said.

Thanks to Rosemary Kean, retired RN, public health nurse, and co-chair of the Mass. Peace Action Board, for organizing and chairing the webinar.