Health Workers Demand Nationwide Protection Standards for Ebola Virus

The National Nurses United (NNU) stormed Washington on November 18, 2014, to demand unified protection standards from the U.S. Occupational Safety and Health Administration (OSHA) and other states regarding the Ebola virus. The NNU wants nationwide implementation of the recently established California protective mandates that resulted from nursing strikes calling for the protection of nurses, other health workers, and the public from the threat of the deadly virus.

Background

The Centers for Disease Control and Prevention (CDC) issued suggested guidelines in October 2014 that were considered not stringent enough and too late after Thomas Eric Duncan arrived in September at a Texas hospital from West Africa with Ebola symptoms. Duncan was initially sent home with antibiotics and aspirin. After Duncan returned to the hospital, health workers found themselves unprepared to handle his symptoms. Duncan passed away from the disease. Days later, the CDC guidelines were issued. Because one of Duncan’s nurses exhibited a fever slightly lower than the guidelines’ established temperature benchmark, but was found to have contracted the disease, the CDC issued another set of revised guidelines in November.

In the same month, 18,000 Californian nurses working for Kaiser Permanente (Kaiser) held a two-day strike against underdeveloped health care standards for Ebola. The nurses reported that the hospital refused to address inadeguate Ebola safety protocols and protective equipment training and refused to answer questions by the registered nurses (RNs). The strike against Kaiser reportedly impacted 21 hospitals and 35 clinics and helped bring forth the issue of health workers’ rights in the face of public health emergencies (see Ebola: Legal implications for the press, health care workers, providers, patients, employers, and employees, November 19, 2014).

After other strikes by the NNU and the California Nurses Association RNs (CNA) ensued, California state officials released updated Ebola standards for all California hospitals requiring an optimal level of personal protective equipment (PPE), comprehensive training procedures, and other protocols reflecting the standards the NNU and CNA represented. The California regulations, unlike those of the CDC, are mandatory.

Mandatory Standards

California’s Ebola standards were structured according to the existing California Occupational Safety and Health Administration (Cal/OSHA) regulations outlining proper steps to safely provide care for suspected or confirmed Ebola patients. CNA will be responsible for monitoring hospital compliance; those hospitals that don’t comply will face civil penalties.

CNA Executive Director RoseAnn DeMoro noted that in response to Ebola, NNU has advocated the precautionary principle “that absent scientific consensus that a particular risk is not harmful, especially one that can have catastrophic consequences, the highest level of safeguards must be adopted, and a sharp contrast to the profit principle that has guided the response of most hospitals.”

Representative of some of the California Ebola regulations are:

  • The requirement of hospitals to provide to all hospital staff caring for a suspected or confirmed Ebola patient full-body protective suits that meet the American Society for Testing and Materials (ASTM) F1670 standard for blood penetration and the ASTM F1671 standard for viral penetration and that leave no skin exposed or unprotected. The protective suits must be available to employees who clean contaminated areas and to staff assisting other employees with the removal of contaminated protective gear;
  • The provision of air-purifying respirators (PAPRs) with a full cowl or hood for optimal protection for the head, face, and neck of any RN or other staff who provide care for a suspected or confirmed Ebola patient; and
  • Whistleblower protection for employees who report hospitals that violate the regulations.

While California’s regulations may become the national benchmark for Ebola preparedness, David Gevertz, Vice Chair of Baker Donelson’s Labor & Employment Group, in an interview with Wolters Kluwer, pointed out that the current OSHA standards “offer limited protections to employees who refuse to perform a job if they believe in good faith that they are exposed to an imminent danger. The level of exposure necessary to qualify as an ‘imminent danger’ has not yet been defined.”