When Jenny Managhebi comes home to her husband and two children these days, she wonders about the people she treated at UC Davis Medical Center — the ones who coughed and the ones who sneezed.
Ever since a patient with COVID-19 was brought to the Sacramento hospital Feb. 19, Managhebi, who has been a cardiology nurse for 13 years, has grown concerned about catching the new coronavirus, which causes the disease, and spreading it to other patients. She worries about whether she should still be volunteering in her 6-year-old's classroom. She worries about whether she is adequately protected.
"Our job is to go and take care of people when they're sick. I'm willing to take care of anyone. That's why we got into this line of work," she said. But if too many health care workers get sick, "we aren't going to have a shot at fighting this thing."
In widespread outbreaks of infectious disease, health care workers are almost always hit hard. During the severe acute respiratory syndrome (SARS) outbreak in 2009, the Ebola crisis in West Africa from 2014 to 2016, and the early stages of the new coronavirus outbreak in China, caregivers were more likely than other groups to become infected. Many became severely ill or died.
The health care system already has shortages of some critical personnel. As caregivers become infected or face isolation at home, maintaining the labor pool is one of the most important tasks that hospitals and nursing homes will confront in coming weeks, experts said, along with having enough face masks, moon suits and other protective gear.
"Equipment is only as useful as the people you have to use it," said Julie Fischer, who studies ways to protect front-line health care workers for Georgetown University Medical Center. "Every system is about people."
Already, the damage a single infection can do to a hospital staff has become alarmingly evident. The woman now being treated at UC Davis first showed up at a small community hospital in nearby Vacaville, Calif., on Feb. 15, unknowingly exposing staff members to the coronavirus. After the virus was diagnosed, 93 health care workers who had contact with her were placed in home isolation. About 34 began to show symptoms and were tested for the virus. Three tested positive.
NorthBay Healthcare, which operates the hospital, brought in workers from another of its facilities to fill in and paused nonessential services.
In Bronxville, N.Y., one man with the coronavirus arrived at NewYork-Presbyterian Lawrence Hospital on Feb. 27 and came into contact with doctors, nurses and others. An unspecified number have been quarantined, according to the Westchester County executive.
And at UC Davis, where Managhebi works, some personnel have been sent home to monitor themselves for symptoms, although the nurses' union and hospital administrators disagree on the number. The union said 124 people have been isolated; the hospital said that figure is inaccurate but declined to provide a total.
Some health care worker advocates say hospital administrators are not adequately protecting their staff members. This week, National Nurses United, the largest labor union for nurses, said that only 30% of the 6,000 nurses it has surveyed in 48 states think their workplace has sufficient protective gear to handle an influx of coronavirus patients. Only 29% said their hospital or clinic has plans for isolating patients if they are infected.