National Nurses United

O C T O B E R | N O V E M B E R | D E C 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 11 INTERNATIONAL G lobal nurses united (gnu), a federation of the world's pre- miere nurse and health care worker unions and of which National Nurses United is a founding member, on Nov. 19 sent a letter to the World Health Organization (WHO), demanding that the WHO strengthen its guidance on Covid-19. "Nurses and other health care workers in many countries still do not have the personal protective equipment (PPE) and basic safety precautions that they need to care for their patients safely," the letter reads. "Since Janu- ary, WHO has neglected the precautionary principle—the idea that we should not wait for proof of harm before taking action to protect health—and has refused to recognize the amassing scientific evidence that SARS- CoV-2 is spread through airborne/aerosol transmission. WHO's weak guidance has left nurses, health care workers, and patients unprotected, exposed, and infected." The letter was addressed to WHO Director-General Dr. Tedros Adhanom Ghebreyesus and signed by GNU affiliates in 24 nations: Australia, Brazil, Canada, Costa Rica, the Dominican Republic, Greece, Honduras, India, Israel, Italy, Kenya, Malawi, New Zealand, Paraguay, Peru, Philippines, Portugal, Rwanda, Spain, Sri Lanka, Taiwan, Uganda, the United States, and Uruguay. On Jan. 30, 2020, nearly two months prior to WHO's official declaration of a pandemic, GNU member unions called upon WHO to strengthen guidance on infection prevention and control, includ- ing that airborne precautions be implemented when health care workers care for suspected or confirmed Covid-19 patients. Implementation of such precau- tions would have saved an untold number of lives, say nurses. Instead, as the letter points out, "WHO's guidance on [personal protective equipment] and infection control ignored the precautionary principle, remains unprotective, and continues to endanger nurses, health care workers, and their patients." In the letter, GNU calls on the WHO to fully recognize the updated science, recog- nizing that airborne/aerosol transmission of SARS-CoV-2, the virus causing Covid- 19, is a significant mode of transmission. GNU also calls on the WHO to strengthen recommendations on PPE, and update its infection control and other applicable guidance to fully and protectively address the risks of transmission from asympto- matic and pre-symptomatic cases. The letter also calls on the WHO to rec- ognize the expertise of those on the front lines, encouraging the organization to "engage direct care nurses and health care workers and their unions in developing guidance on SARS- CoV-2 and Covid-19." —Kari Jones each additional dollar increase in list price, insurers paid an additional 15 cents to hos- pitals. Hospital executives have conceded that the goal of the charge master is prof- itability. And when the insurers pay more, their cost is typically passed along to employers, their employees or individual patients in higher premiums, deductibles, and co-pays. Uninsured patients have the least negoti- ating power when slammed with the full charge, a major reason why medical bills have sparked a huge leap in medical debt lawsuits and bankruptcies. As in so many other areas of society, there is a racial disparity in the impact of the high charges. In 2019, Latinx and Indigenous people were three times, and Black people nearly twice as likely, to be uninsured as white people. Similarly, 19 percent of com- munities of color, compared to 15 percent for whites, had medical debt in collections. Hospital partnerships with other health care industry sectors, such as physician staffing firms, often result in "out-of-net- work" surprise medical bills and supplemental charges such as "trauma" or "facility" fees, which intensify the crisis for patients. Studies show that up to four of every 10 ER trips result in surprise medical bills, in some cases with hospitals sharing the higher profits. Similarly, hospitals have increased the practice of big hikes in rou- tine, supplemental fees, an 87 percent jump over six years in trauma fees. While some hospitals claim they will lower those charges for these patients, or mitigate the burden through charity care, hospitals have steadily reduced the amounts of financial assistance and charity care offered to patients around the country. Medicare is the most effective system at limiting price gouging through its bulk pur- chasing power to set the price it will pay. "Nurses know that the best way to rein in these outrageous charges that create such grievous harm for our patients is with Medicare for All, as other countries have proven," said Ross. "Medicare for All will not only guarantee health care coverage for every person in the United States, it will end medical bankruptcies, medical debt law- suits, and the health insecurity faced by millions who make painful choices every day about whether to seek the care they desper- ately need." —Charles Idelson Global Nurses United urges WHO to strengthen Covid-19 guidance

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