One year of trauma: over 3,600 U.S. health workers died in first 12 months of Covid

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Nurses describe their hope and confidence after being fully immunized against coronavirus



Lost on the Frontline is the most comprehensive death toll of healthcare workers in the United States. The federal government did not fully track this data. But calls are mounting for the Biden administration to undertake a count as the KHN / Guardian project wraps up on Thursday.

The project, which tracked the people who died and why, offers a window into how America’s health care system works – and its failures – during the pandemic. A key finding: Almost 70% of deceased healthcare workers for whom we have data identified as people of color, revealing deep inequalities related to the race, ethnicity and economic status of US healthcare workers . Lower-paid workers who took care of day-to-day patient care, including nurses, support staff and nursing home workers, were much more likely to die in the pandemic than doctors.

The year-long series of investigative reports found that many of these deaths could have been prevented. Widespread shortages of masks and other personal protective equipment, lack of Covid testing, weak contact tracing, inconsistent mask advice by politicians, employer missteps, and lax enforcement of the rules of Workplace safety by government regulators have all contributed to the increased risk faced by healthcare workers. . Studies show that health workers were more than three times more likely to contract Covid than the general public.

“We rightly refer to these people without hyperbole – that they are real heroes and heroines,” said Dr Anthony Fauci in an exclusive interview with The Guardian and KHN. The deaths of so many people at Covid are “a reflection of what healthcare workers have done in the past, putting themselves in danger, respecting the oath they take when they become doctors and nurses,” said he declared.

Lost on the Frontline launched last April with the story of Frank Gabrin, the first known American emergency doctor to die of Covid-19. At the start of the pandemic, Gabrin, 60, was on the front lines of the outbreak, treating Covid patients in New York and New Jersey. Yet like so many others, he worked without proper personal protective equipment, called PPE. “I don’t have PPE that hasn’t been used,” he texted a friend. “No N95 masks – my own goggles – my own face shield. “

Gabrin’s untimely death was the first death recorded in the Lost on the Frontline database. His story of going through a crisis to save lives shared similarities with the thousands of people who followed.

Maritza Beniquer, an emergency room nurse at Newark University Hospital in New Jersey, saw 11 colleagues die in the first months of the pandemic. Like the patients they treated, most were black and Latino. “It literally wiped out our staff,” she said.

His hospital placed 11 trees in the lobby, one for each employee who died from Covid; they were adorned with keepsakes and gifts from their colleagues.

More than 100 journalists have contributed to the project with the aim of recording every death and commemorating those who have died. Project journalists filed public records, interconnected government and private data sources, scoured obituaries and social media posts, and confirmed deaths of family members, workplaces and colleagues.

Nurses describe their hope and confidence after being fully immunized against coronavirus

Among its main findings on the deaths for which detailed information was gathered:

• More than half of the people who died were under the age of 60. In the general population, the median age of death from Covid is 78. Yet among the health workers listed in the database, he is only 59 years old.

• More than a third of deceased healthcare workers were born outside the United States. Those from the Philippines accounted for a disproportionate number of deaths.

• Nurses and support staff have died in much higher numbers than physicians.

• Twice as many workers died in nursing homes than in hospitals. Only 30% of the deaths were among hospital workers, and relatively few were employed by well-funded academic medical centers. The rest worked in less prestigious residential establishments, outpatient clinics, hospices and prisons, among others.

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The death rate among healthcare workers has slowed considerably since the vaccine was made available to them last December. A study released in late March found that only four of 8,121 fully vaccinated employees at the University of Texas at Dallas’ Southwestern Medical Center were infected. But deaths lag behind infections, and KHN and The Guardian have tracked more than 400 health worker deaths since the vaccine began rolling out.

Many factors contributed to the high toll – but survey reports revealed ongoing problems that increased the risks for health workers.

The project found that the Centers for Disease Control and Prevention’s mask guidelines – which encouraged hospitals to reserve high-performance N95 masks for intubation procedures and initially suggested that surgical masks were adequate for daily patient care. patients – may have put thousands of health workers at risk.

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The investigation revealed how the Department of Labor, led by Donald Trump-appointed Eugene Scalia at the start of the pandemic, took a hands-on approach to workplace safety. It identified 4,100 safety complaints filed by healthcare workers with the Occupational Safety and Health Administration, the occupational safety agency of the Department of Labor. Most concerned shortages of PPE, but even after some complaints were reviewed and closed by regulators, workers continued to die at the facilities in question.

The report also found that healthcare employers did not report worker deaths to OSHA. Analysis of the data found that more than a third of Covid-related deaths in the workplace go unreported to regulators.

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Among the more visceral discoveries of Lost on the Frontline was the devastating impact of PPE shortages. Adeline Fagan, a 28-year-old OB-GYN resident in Texas, suffered from asthma and had a long history of respiratory illness.

Months after the start of the pandemic, her family said, she used the same N95 mask over and over again, even during a high-risk rotation in the emergency room.

Her parents blame both the hospital administration and the government’s missteps for the PPE shortages that may have contributed to Adeline’s death last September. Her mother, Mary Jane Abt-Fagan, said Adeline’s N95 had been reused so many times that the fibers began to break down.

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Shortly before she fell ill – and after being put on a high-risk emergency rotation – Adeline asked her parents if she should spend her own money on an expensive N95 with a filter that could be changed daily. The $ 79 mask was a significant expense on her resident’s $ 52,000 salary.

“We said, you buy this mask, you buy the filters, your dad and I are going to pay for it. We don’t care what it costs, ”said her mother, Abt-Fagan.

She never had the opportunity to use it. By the time the mask arrived, Adeline was already on a ventilator at the hospital.

Fagan’s family feels disappointed with the US government’s response to the pandemic.

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“No one chooses to go to work and die,” said Abt-Fagan. “We need to be better prepared and the government needs to be more responsible in terms of the safety of healthcare workers. “

Adeline’s father, Brandt Fagan, wants the government to start tracking healthcare worker deaths and looking at the data to figure out what went wrong. “This is how we are going to prevent this in the future,” he said. “Know the data, follow where the science leads. “

Adeline’s parents said her death was especially painful because of her youth – and all the stages in her life she never had the chance to live. “Fall in love, buy a house, share his family and his life with his siblings,” said Adeline’s mother, Abt-Fagan. “It’s all of those things that he missed that broke a parent’s heart. “

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