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transmissible diseases (ATD) standard, which applied to novel viruses like COVID-19. In addition, NNU wrote to state agencies, such as the California Department of Public Health (CDPH), and sent in detailed requests for information to every hospital employer, asking for their COVID-19 infection control plans to screen, isolate, and treat patients; for their plans on surveilling, notifying, and isolating employees; for their case surge plans; for information about their stockpiles of airborne, droplet, and contact precaution PPE and numbers of negative pressure isolation room; the list goes on. Many of the responses NNU received back from hospitals were spotty and showed they were unprepared for a potential viral outbreak. By the first week of February, NNU launched a nationwide survey among both union members and nonunion nurses to gauge pre - paredness. The questionnaire ultimately garnered more than 10,000 responses and showed the nation's facilities were woefully unprepared when NNU released the initial results Feb. 28: the vast majority of them had no plans in place to respond to COVID-19, communicated nothing to their employees, did not have sufficient stocks of PPE, nor had they educated and trained their staff on how to use PPE. Little did the United States and the rest of the world understand at that time that China's aggressive crackdown to contain the virus had bought them all precious time, time which they promptly wasted by delaying action on its containment. And the United States, with our predominantly privatized health care infrastructure and decades of defunded public health departments and facilities, was uniquely ill-equipped to mount a quick, coordinated public health response. The United States simply did not take COVID-19 seriously because, within our economic system, there was no financial incentive to do so. There's no money to be saved or to be made in "being ready, just in case." Never mind that lives were at stake. Borrowed from auto manufacturing work management models, hospitals had been practicing just-in-time inventory stocking of supplies for quite some time, so they had just enough PPE to last for the short-term, under normal usage conditions. "We wanted to sit down and talk with management about our COVID plans," remembered Ambar Maldonado, a nurse representative who works in the medical-surgical unit at Community Hospital of San Bernardino. "The managers laughed at us. They said, 'Guys, that's happening in China, not here!'" Hospitals' lack of preparedness soon resulted in avoidable exposures of nurses and other health care workers as COVID- positive patients started to enter hospitals. The precautionary 12 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G A P R I L | M AY | J U N E 2 0 2 0 "We can't even say that they failed to protect public health, because that would imply that they tried. On every level, they disregarded the health and safety of nurses and of patients. They treat us as if we are expendable. But if nurses aren't protected, patients aren't protected." DECEMBER 31 JANUARY 7 JANUARY 8 JANUARY 20 Pneumonia of unknown cause in Wuhan, China reported to World Health Organization Chinese authorities identified a novel coronavirus as causal agent for pneumonia cases NNU begins monitoring novel coronavirus 282 confirmed novel coronavirus cases in four countries