National Nurses United

which people were singing or exercising in enclosed spaces. Yet the CDC fails to acknowl- edge that singing or exercising indoors is not spe- cial, but a common life activity for millions of people, except when public health protections are in place. In recent months, news articles have revealed the unprecedented and large extent to which the Trump administration's political desires to downplay the Covid-19 virus have usurped and undermined the science and public health mission of the CDC. NNU wrote to the CDC Oct. 6, urging it to fully recognize that Covid-19 is aerosol transmitted and strengthen its PPE and infection control guidance immediately. As a result, nurses even now find themselves routinely denied access by employers to Covid-19 testing—even after confirmed expo- sures to Covid-positive patients and after they themselves have tested positive, but want assurances that they are no longer infec- tious and can return to work. Nurses are winning some victories here and there with testing, however. In September, the Sutter Health system announced, after fierce organizing and pushback by nurses, that it would begin test- ing exposed nurses even if they were asymptomatic. The companion problem to lack of testing of health care workers is lack of testing of patients. Today, only patients who enter the hospital for planned surgeries or certain procedures are tested for Covid-19. Katie Dawson, an ICU RN at Saint Mary's Regional Medical Center in Reno, Nev., explained during the roundtable why failure to rule out patients for Covid was such a huge problem. "Whether a patient gets tested depends on which doctor admits the patient," said Dawson. "In many hospital units, patients aren't even tested to see if they have Covid. We have no surveillance testing of staff. The notification process of staff exposure is very poor. Many times, exposed coworkers would be notified late or not notified at all. Contact tracing is not routinely done even though we need to be able to accurately identify patients and staff people who have been exposed. In turn, without a documented record you've been exposed, the hospital assumes you're not positive because you're not being tested! So testing is a huge patient safety issue. The fact is that when nurses aren't safe, patients aren't safe." O ne of the key, preliminary steps of the nursing process is to observe and collect data in order to understand what is hap- pening with the patient and formulate a care plan accordingly. Without data and information, the nurse cannot base her care upon science and hope to successfully heal the patient or—even worse— could harm the patient. But that's exactly what the U.S. government and hospital employers have done with Covid data: failed to collect it or even require its collection. In July, nurses and others in the medical community were shocked to learn that the CDC had been stripped of its Covid data collection role by the White House and that function given to the much more politically-driven U.S. Department of Health and Human Services. Though NNU agrees the CDC has been defi- cient in many ways about accurately and transparently collecting and publishing case data related to Covid-19, it is still the most appropri- ate federal agency to do so based on its clear subject matter expertise in infectious diseases response. What little data the U.S. government does collect has been obscured—managed by two private corporations, Palantir Technol- ogies and TeleTracking, that are not required to make it completely transparent or public. In September, NNU issued two documents, a report and a statement, that detailed and condemned the government's and hospital industry's failures to track and publicly report accurate, transparent, and timely data on Covid infections and deaths—particularly among health care and essential workers. (See companion article titled "Data Dodgers.") Without the government stepping up to record deaths of nurses and health care workers, media organizations, individuals, and groups like NNU have de facto assumed that role. Noticing a huge gap in nurse death data, NNU staff have been painstakingly scouring a variety of sources since the pandemic began to try and document every nurse and health care worker who has died of Covid-19. As of press time for this article, NNU has determined that at least 232 nurses have died, but the number is certainly an undercount. In July, NNU nurses in Washington, D.C. held a third memorial in front of the Capitol in honor of nurses who have died of Covid, lining up pairs of white clogs and reading each nurse's name out loud to be remembered. They were also urging the U.S. Senate to act on NNU's two longstanding demands of invoking the Defense Production Act to pro- duce PPE domestically and to direct OSHA to establish an emergency temporary standard on infectious diseases—both of which are already included in the HEROES Act that the U.S. House of Representatives passed in May. Yet the Senate did not vote. In October, the House passed a revised HEROES Act, but Trump shut down all negotiations on another Covid stimulus bill until after the November election. In addition to nurse deaths, NNU continued to fill a void in Covid workplace safety data by conducting nationwide surveys of all registered nurses, releasing the results of its third survey in late July. The survey, which garnered more than 21,200 RN responses, revealed the devastation of "reopening" states prematurely: health care workplace conditions remained dangerous and nurses are afraid of infecting their families with Covid-19. Only 24 percent of nurses surveyed think their employer is providing a safe workplace. J U LY | A U G U S T | S E P T E M B E R 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 17

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