National Nurses United

principle dictates that every patient should be suspected of harboring COVID-19 unless ruled out otherwise. A great percentage of COVID-positive people were also apparently asymptomatic, which would have made it even more important to proactively test patients, but because the United States had testing problems that led to a shortage and lag in testing capacity for months, many hospitals admitted patients who later turned out to test positive for COVID, but not before exposing dozens of nurses and health care workers first because the hospital did not take infection control precautions. In Northern California, what at the time was believed to be the first community-acquired case of COVID, exposed in late February nearly 100 health care workers at NorthBay VacaValley Hospital and then more than 36 nurses and 88 other health care workers at UC Davis Medical Center after the patient was transferred there. In the weeks that followed, nurses reported story after story of unnecessary exposures; no access or severely delayed access to testing; uneven policies about self-quarantining after exposures; spotty, delayed, or often no communication by management to nurses when they have been exposed to COVID-positive patients or coworkers; and, of course, nurses starting to become sick and show symptoms of COVID. Stories such as the one of a Northern California Kaiser RN who cared for COVID patients, got sick, and then was initially denied testing were common. "The public county officer called me and verified my symptoms and agreed with testing. But the national CDC would not initiate testing. They said they would not test me because if I were wearing the recommended protective equipment, then I wouldn't have the coronavirus," she wrote in a statement that was read at a March 5 NNU press conference. Later, they agreed to test her, but she had to wait because the CDC would only grant a limited number of tests. "So I have to wait in line to find out the results. This is not the ticket dispenser at the deli counter; it's a public health emergency! I am a registered nurse, and I need to know if I am positive before going back to caring for patients." Exposed nurses were denied tests, especially if they were not exhibiting symptoms. Some nurses who did show symptoms, but did not meet all of the criteria, such as a fever above a certain degree on the day of testing, were also denied tests. Many nurses were denied retests, even though they were showing common COVID symptoms and even though the standard PCR COVID test was notoriously unreliable and often registered false negatives. Patients started to die, first in Washington state and then California, though officials later learned that two Santa Clara County residents of California's Bay Area had died of COVID Feb. 6 and Feb. 17, meaning that the virus was circulating in the United States much earlier than anyone had thought. International news reports at the time also showed that COVID was spreading in early March at an alarming rate in Italy and Iran. On March 11, the WHO officially declared COVID-19 a pandemic. It became suddenly clear that the United States was not going to somehow escape COVID. Government and public health officials realized that, without mandatory social distancing orders to control the spread of the virus, the nation's hospitals and intensive care units would soon be overwhelmed with patients needing ventilators and care that we did not have the capacity to provide. The majority of states and public health departments issued shelter-in-place or stay-at-home orders by the end of March, closing A P R I L | M AY | J U N E 2 0 2 0 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 N A T I O N A L N U R S E 13 JANUARY 21 JANUARY 23 JANUARY 24 JANUARY 30 First travel-related coronavirus case in United States (Washington) NNU creates coronavirus fact sheet to keep members informed NNU and CNA/NNOC sends facilities requests for information to ensure their preparation Global Nurses United sends letter to WHO demanding it strengthen its guidance on prevention and control of novel coronavirus

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