NYC's healthcare workers are at a greater risk of getting the novel coronavirus. They're also not getting tested.
Steve Pfost/Newsday RM via Getty Images
Health care professionals take a break awaiting patients as they test for COVID-19 at the ProHEALTH testing site in Jericho, New York, March 24, 2020.
- Healthcare workers on the front lines of the coronavirus response are being exposed to the virus and falling ill.
- Mount Sinai Health System in New York City is opting not to test healthcare workers if they start coming down with symptoms consistent with the novel coronavirus, such as cough, fever, and shortness of breath.
- Instead, the health system is asking them to stay home for seven days and allowing them to come back after their symptoms subside.
- At least one New York health system is telling some employees with coronavirus to keep working.
- The city has been hard-hit by the virus, already filling hospital beds across the city and putting strains on the front lines of workers, many of whom have already fallen ill.
- Visit Business Insider's homepage for more stories.
Diana Torres, a registered nurse at Manhattan's Mount Sinai West hospital, knew she was being exposed to the novel coronavirus in her work treating patients.
She didn't realize she was working with someone who had a confirmed case of the COVID-19 virus until her assistant manager, Kious Kelly, 48, died from the disease last week.
Torres attributes the risk of exposure to a lack of proper equipment that might protect her from the virus. She's currently staying in the attic in her family's home to avoid exposing them as she fights the pandemic.
"They're going to kill us because they failed to protect us in the proper way," Torres told Business Insider. "Because they failed to acknowledge we had a problem."
Healthcare workers are at a high risk of catching the coronavirus
"We are deeply saddened by the passing of a beloved member of our nursing staff," the health system said in a statement posted to Twitter that didn't name Kelly. "Today, we lost another hero - a compassionate colleague, friend and selfless caregiver."
Healthcare workers in the US risk being exposed to the novel coronavirus virus in great numbers and falling ill because of it.
Already, in Spain and Italy thousands of healthcare workers have fallen ill from the novel coronavirus over the course of the outbreak, accounting for a large percentage of the overall cases. More than 40 healthcare workers in Italy have died.
In New York City, the area in the US hardest hit by the pandemic, some healthcare workers aren't being tested if they come down with symptoms. Others are being told to work even if they have the coronavirus.
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Mount Sinai Health System isn't testing many healthcare workers who have symptoms of the coronavirus, according to two doctors in the health system. Instead, the health system is sending them home, and allowing them to return after seven days, the doctors said. The doctors asked not to be identified because they weren't authorized to speak publicly, but Business Insider has confirmed their identities.
'They just won't have any staff members if we all stay home'
Mount Sinai's testing decisions are in line with guidelines from New York City about who should be tested for coronavirus, though some other health systems are testing more of their workers. The US Centers for Disease Control and Prevention says testing healthcare workers should be a top priority, but that its guidelines can be adjusted by local authorities.
"Mount Sinai is strictly following all NYC Department of Health and CDC guidelines," a spokesman for the health system told Business Insider.
New York University Medical Center is allowing some healthcare workers who aren't showing symptoms of the coronavirus to keep working after testing positive, a nurse who works in the emergency department told Business Insider in March.
NYU declined to comment on the matter.
"They just won't have any staff members if we all stay home," the nurse said.
On March 20, New York City's Department of Health said to stop testing for the coronavirus in non-hospitalized patients and in patients where testing wouldn't change how they're cared for, including healthcare workers. The goal is to limit how much equipment hospitals are using.
The consequences of not testing healthcare workers
"Even though we're sick, we have to be really sick in order for us to get tested," Torres said, speaking to the community of first responders and healthcare workers on the front lines of the pandemic.
Other organizations, such as the Infectious Disease Society of America, say that testing healthcare workers should be a top priority.
Mount Sinai's decision not to test workers has two problematic consequences, the doctors said. It's straining staffing, because doctors who'd work through a minor illness are required to stay home, one of the doctors said. Other doctors may choose to work through what they think is a minor illness, potentially exposing patients and their colleagues to coronavirus, one of the doctors said.
"I think it's completely inappropriate," one of the doctors said. "A lot of people who are sick are still seeing patients."
Dr. Craig Smith, the chairman of the Department of Surgery at NewYork-Presbyterian's Columbia University Irving Medical Center, wrote in a letter to colleagues on March 16 that the organization's policy had shifted. Exposed workers, he wrote, who are not showing symptoms are asked to keep working and won't be tested unless they are "unequivocally exposed and symptomatic." NewYork-Presbyterian didn't respond to a request for comment on its policies.
A case of mild symptoms
Business Insider spoke with a physician at Mount Sinai who started feeling symptoms like a cough and mild fever and said she couldn't get tested.
"I found out that, basically, if my symptoms are too mild I'm just not going to be tested," she told Business Insider.
She had good reason to think she might have been exposed. Early on in the outbreak, she had seen a patient who had been tested for the coronavirus but hadn't gotten results yet. While the doctor was wearing protective gear when she saw the patient, it wasn't fitted properly. That put her at high risk of exposure.
By the time the patient had been tested, Mount Sinai's policy was that she could stay on and work so long as she wasn't showing symptoms, a change from an earlier policy of staying home two weeks after a potential exposure.
Soon after, her symptoms began. She said she hopes to eventually be tested to see if her body has antibodies related to the COVID-19 virus, a test the health system is developing.
When she returns, she'll plan to keep wearing protective gear. Without a test result telling her whether she's had the virus, she either risks being exposed or spreading the virus to others.
"I would feel much more comfortable if I go back and I test positive," she said. "If I don't, then it's very scary."
Northwell Health is testing staff
As the patient count grows and staff continue to fall ill, keeping staff on hand will get even more challenging. The New York Times reported Monday that two nurses in the city have died after contracting the virus, and hundreds more workers are out sick.
"Staffing is the biggest issue we face right now," Dr. Mark Jarrett, the chief quality officer at Northwell Health System, which operates 23 hospitals in New York, told Business Insider in March. "If we get more cases, that'll be even more of a problem."
Northwell Health, which has hospitals in New York City, on Long Island, and in suburbs north of the city, is testing healthcare workers who have coronavirus symptoms.
Northwell staffers who test positive for the virus must quarantine for seven days either from time of illness or from the positive diagnosis, a spokesman for the health system told Business Insider. They are only allowed back after being fever-free for 72 hours. Upon return, they must wear a mask at all times.
The rate of infections, Columbia's Smith noted in a March 29 letter to staff, will contribute to more staff from other areas of the hospital being deployed to help fight the pandemic.
"I'm sure you recognize that COVID-19 will continue to infect health care workers at a significant rate. That contributes to the demands for redeployment, even though mitigated by the COVID+ people who are just beginning to return."
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