Time to meaningfully invest in health care worker safety

Two weeks ago, as my eight-hour nursing shift ended, I learned that Kious Kelly, RN had perished from COVID-19, the disease caused by the SARS-CoV-2 virus. He was 48 years old. 

Kelly is not the last American health care worker or first responder to perish from COVID-19. In my home community of Metro Detroit, three nurses have perished. Hundreds more health care workers are sick across the United States, a statistic likely out of date by press time. Amidst the scramble to ramp up testing, uncover treatments, and develop vaccines, we are neglecting the fourth leg of the stool: protecting health care workers from contracting this devastating disease.

From the Crimean War to Ebola, nurses and other health care workers have placed their own health and safety behind the needs of patients. And yet a poorly protected health care workforce threatens any attempt to manage the alarming swiftness and lethality of the current pandemic. As a cancer nurse, I have decided to risk my personal health to care for my patients. Yet I am terrified that I could unwittingly transmit this stealthy disease to one of them.

Protecting health care workers is hard in routine instances. My research team studies how to protect nurses when they give chemotherapy drugs. Similar to caring for patients with COVID-19, nurses who handle chemotherapy need to wear gowns, masks, and gloves to avoid health risks. Nurses have told us that equipment shortages, inadequate training, and product discomfort are common barriers to adequate protection.

This pandemic has exposed decades of neglect. Nurses wearing garbage bags and goggles to care for patients. Hospitals forced to launch donation drives for basic supplies. A flurry of social media posts with sewing patterns for homemade masks. Doctors, nurses, and respiratory therapists bruised by mask irritation. And little to no relief is in sight, as supplies dwindle, cases surge, and manufacturing plants sit idle, awaiting instructions.

For Fiscal Year 2020, the NIH budget exceeds $40 billion. In contrast, the National Institute for Occupational Safety and Health (NIOSH), the nation’s agency that solely studies worker protection received $342 million, with a fraction of that focused on health care. With an estimated 18 million Americans employed in health care, our nation’s annual investment in their health is less than $19 per worker.

The three federal bills enacted in response to COVID-19 provided no additional funds to NIOSH. While the third bill directs the government to boost the nation’s Strategic National Stockpile before the next pandemic strikes, this effort relies on a decades-old product pipeline that is clumsy to manufacture and even harder to wear. I have worn the same uncomfortable protective gear throughout my 22-year nursing career.

The neglect is not just from the government. Foundations and other non-profits rarely fund protective gear or innovative methods to prepare health care workers for the next pandemic.

The public is exhilarated by the prospect of novel drugs, devices, and technology to detect and cure devastating diseases. Masks, gowns, and gloves are not sexy topics. Yet if our health care workforce is depleted due to inadequate protection, who will be there to administer life-saving treatments and deliver care to those in need?

It is time to reconsider the social contract with health care workers. If we invested $50 per health care worker for the next five years, we could develop and test sustainable and scalable equipment that protects health care workers fully and is easy-to-use. Novel design and advanced manufacturing methods exist to solve this problem, but without the prospect of adequate capital, firms have ignored this sector in search of more lucrative markets.

As a fourth stimulus bill is considered, a modest investment of $50 per health care worker —  relative to the trillions allocated toward the stimulus — will assure that we have a safer health care workforce when, not if, the next lethal pandemic strikes.

Christopher R. Friese, Ph.D., RN, is the Elizabeth Tone Hosmer Professor of Nursing, Health Management and Policy at the University of Michigan, and staff nurse at the University of Michigan Rogel Cancer Center.