National Nurses United

who switched homes with her 20-year-old daughter, who had her own apartment, in order to protect her family and elderly mother- in-law. "Nurses are not scared to take care of patients; this is what we signed up for. But we feel like we are in the middle of a war, but no one is giving us the protections we need." * * * * talisa hardin, an rn who works in the burn ICU at University of Chicago Medical Center, had always been able to access N95 respirators and other PPE and cleaning equipment from her unit's supply room. "When the pandemic hit, hospital management took all of the supplies out of the room and told us that they wouldn't be stocked anymore," said Hardin in her May 21 testimony at a hearing of the Select Subcommittee on the Coronavirus Crisis of the House Oversight Committee. What happened to Hardin's unit also happened at hundreds of hospitals across the country. Because they followed just-in-time inventory management techniques to cut down on costs, hospitals already had on hand lower levels of PPE before COVID struck. Once they realized the seriousness of the pandemic, it was too late. The entire world needed PPE, now. Suddenly, every facility, hospital chain, state department, and federal agency was pitted against one another in a mad scramble to get their hands on PPE, particularly N95 respirator masks, which is the minimum needed to provide airborne precautions against COVID-19. Later, we learned through federal whistle-blower testimony that officials within the Trump administration repeatedly and willfully quashed efforts by some staff to address the nation's lack of PPE. The science-based answer in the face of a PPE shortage is to use what the country had on hand now and immediately ramp up production to manufacture more. That's exactly what NNU urged President Trump and Congress to do: use the Defense Production Act of 1950 (DPA), a law that the president could invoke to compel domestic manufacturers to produce goods critical for the defense and safety of the country, to direct companies to start cranking out PPE. The president did not and, as of this writing, still has not. He has invoked it to produce ventilators and to compel meat processing plants to stay open despite COVID outbreaks in the meatpacking industry, but not to make N95s, powered air-purifying respirators (PAPRs), and other desperately needed PPE. NNU urged congress members to include language compelling the president to use the DPA to produce PPE in its three various rounds of COVID-19 legislation; the provision, along with the OSHA emergency temporary infectious diseases standard, has finally made it into this fourth bill that the House of Representatives passed in May and is moving to the Senate as of this writing. But the hospital industry did not adopt a science-based approach to PPE. Instead of protecting nurses and health care workers with the highest standards of PPE available, the hospital industry lobbied the CDC to weaken its recommended standards for PPE so that it could justify giving staff flimsy surgical or droplet masks instead of N95s, the bare minimum level of protection, in order to "save the good PPE" for the worst phases of the pandemic, and to also limit their regulatory and legal liability for not providing adequate respiratory protection against the virus. The extent of any actual shortage of PPE at any given facility was also debatable, since hospitals were not transparent with their staff about exactly how much they had in stock. Hospitals used the weakened CDC guidance as cover for choosing to ration PPE even when they had PPE to offer. The CDC caved to industry lobbying. It even went so far as to suggest in one guidance that, in the absence of appropriate PPE, health care workers could fashion homemade face coverings out of bandanas and scarves. "That goes against everything we know about microbiology," said Joanne Imwalle, an RN at Kaiser Permanente Roseville in a video she self-recorded for NNU. In her video, she waves around the thin, pink droplet mask that she was issued for her shift to emphasize its uselessness against COVID. "So our government agencies have basically abandoned us . . .We need the federal 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 15 WHO names novel coronavirus COVID-19 FEBRUARY 11 50,580 COVID-19 cases, 1,526 deaths in 26 countries FEBRUARY 15 15 cases in the United States FEBRUARY 15 NNU sends letter to CDC to strengthen its guidance on prevention and control of COVID-19 FEBRUARY 19 "We wanted to sit down and talk with management about our COVID plans. The managers laughed at us. They said, 'Guys, that's happening in China, not here!'"

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