Coronavirus First Responders
Petition to State and Federal Governments
Respiratory Therapists To Be Categorized As First Responders
The purpose of this action is to see that respiratory therapists working in hospitals be recognized as first responders. Due to the coronavirus situation, our profession has been dealing first-hand with patients who have, and are suspected of possibly having Covid19. Respiratory therapists are among the first responders within the hospital setting of any patient having significant distress and are frequently putting their own health at risk in order to serve and heal others. These licensed professionals are currently undervalued, underappreciated, and there is a general lack of understanding regarding the importance of their career field. Respiratory therapists deserve to be recognized as first responders not only during this health pandemic, but also during times of economic normalcy for all of their life saving skills in critical settings. #respiratorystrong Mark J. Gilbert, RRT-ACCS, EMT-P
Petition to NYS Department of Health: Bureau of Early Intervention
Approve COTAs to provide Teleheath services to NYS Early Intervention Families
To: The NYS Department of Health, Bureau of Early Intervention, It is with great appreciation that the NYS Bureau of Early Intervention has indeed allowed the provision of services to our most vulnerable population via Telehealth during the COVID-19 outbreak. This however does NOT apply or give authorization to Certified Occupational Therapy Assistants (COTAs) to currently provide this service to the Early Intervention families they are serving. These families are currently not receiving necessary and crucial Occupational Therapy services for their child causing a concern for significant regression and lack of necessary contact/training for the family itself. In addition, these COTAs are currently unemployed and unable to work due to the restrictions implemented by NYS regarding “social distancing” ie: school closures, and the recent order from Governor Cuomo to keep all non essential workers to complete their work at home. COTAs work under the Supervision of the Occupational Therapist but are not required to be under direct line of sight supervision. According to The NYS Office of the Professions, “The amount and type of supervision provided should be based on the ability, level, and clinical experience of the occupational therapy assistant and the setting in which the occupational therapy assistant is providing the services. Good practice suggests that the occupational therapist supervisor participate in the services delivered by the OTA including: -Initial Evaluation -Intervention Planning and Goal Setting -Final Evaluation/Discharge Additionally, the supervisor should periodically assess each patient's progress, and review and sign treatment notes and reports prepared by the occupational therapy assistant.” Therefore we are asking that the Telehealth act be amended to allow COTAs to provide Telehealth sessions to Early Intervention families, under the continued supervision of a Registered Occupational Therapist. We care deeply for the wellbeing of the children receiving Early Intervention services and wish to continue working with these families despite the hardship the COVID-19 virus has inflicted upon us all. We thank-you for your time and swift attention to this matter. Sincerely and respectfully, New York State Early Intervention Providers and Families, specifically Occupational Therapists and Occupational Therapy Assistants
Petition to Charles E. Schumer, New York State Senate, New York Governor, U.S. Senate, Andrew M. Cuomo, Mayor Bill de Blasio
Change requirements to get more nurses licensed
The field of nursing is severely understaffed. Many times one nurse is performing the tasks of two or three nurses. As Governor Cuomo stated; now more than ever more nurses are needed to help battle this growing pandemic. There are many of us who would like to be on the front lines helping to serve both our medical and home communities but cannot due to entrance exams being cancelled, small over competitive nursing programs, and nursing clinicals being cancelled. I’d like to petition for the removal of entrance exams into nursing programs, increasing the size of nursing programs and the amount of students accepted, and excellerate the restart of nursing programs. While this may not directly help in this pandemic it does assure that many more nurses will enter the workforce, be trained and able to assist in the near future.
Petition to U.S. House of Representatives, U.S. Senate, Donald J. Trump, Vice President Mike Pence
US Physicians/Healthcare Workers For Personal Protective Equipment in COVID-19 Pandemic
www.frontlineppenow.org As cases of COVID-19 escalate around the country, physicians and other healthcare workers (HCWs) are facing severe shortages of personal protective equipment (PPE). This shortage is already a major crisis and will place an insurmountable strain on the health system of this country as cases continue to rise and more people require hospitalization for complications of COVID-19. As a result of this shortage, recommendations from the Centers for Disease Control (CDC) for appropriate PPE for HCWs on the frontlines have shifted. This shift does not come in response to overwhelming evidence, rather to a supply chain issue. As quoted directly from the CDC website: “PPE recommendations for the care of patients with known or suspected COVID-19: Based on local and regional situational analysis of PPE supplies, facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand."..."When the supply chain is restored, facilities with a respiratory protection program should return to use of respirators for patients with known or suspected COVID-19."(1) These statements in no way suggest that droplet precautions are adequate, supported by the statement that as soon as the supply chain has been restored, we should go back to using N95 respirators. As a result of these recommendations, many hospitals have taken the CDC recommendations to mean that facemasks are the preferred PPE, rather than a less desired (and potentially less safe) alternative. They have thus rationed respirators to be made available only for procedures, such as intubation and bronchoscopy, during which the virus is more likely to become aerosolized. This is putting our HCWs in tremendous danger of contracting and spreading COVID-19, which is unacceptable in the country with the most expensive health care system in the world. The evidence that droplet precautions are acceptable is lacking. CNN recently published an article titled “Health care workers getting sicker from Coronavirus than other patients”.(2) This statement is corroborated by data from a Harvard Study in China that suggested HCWs were at a 20% increased risk of severe infection compared to the general public. This risk decreased once the Chinese implemented full gear: protective suit, medical goggle, face shield, N95 mask and gloves – following this change there were no further reports of infected HCWs.(3) The debate is still ongoing as to whether or not COVID-19 can be transmitted via droplets vs. aerosols, yet as we speak, HCWs around the world continue to get infected, end up in critical condition, and die while using “appropriate PPE”. According to an ahead of print New England Journal Article on aerosol and surface stability of COVID-19, the virus can be detected up to 3 hours after aerosolization.(4) According to Dr. Milton, professor of environmental health at University of Maryland, “you cannot tell epidemiologically between something aerosol transmitted by weak sources and large droplet spray”, and he suspects the capability of long distance transmission will be dependent on the degree of symptoms.(5) Considering the mortality risk and lack of data to support a step-down to surgical masks, N-95 masks should continue to be the standard PPE for care of COVID-19 patients. As a physician, I do not know how long it takes to make an N95 mask, but I do know how long it takes to train a physician, a nurse practitioner, a physician’s assistant, a respiratory therapist or nurse. We are the supply chain that needs to be protected. Our friends from Italy have described the loss of infected HCWs as a critical hit to an already strained system. Infected HCWs are of no benefit to patients – in fact, they pose a serious risk.(6) They not only endanger the health of their colleagues, families, and communities, they also serve as a vector to infect the most vulnerable among us – the patients they care for. China, Italy, and S. Korea have more experience with this virus than we do and are taking the protection of their HCWs seriously. In France, Dr. Benjamin Davido, Infectious Diseases and Clinical lead for COVID-19, explains the importance of protecting HCWs against the severity of the illness, by using FFP2, the European equivalent of N95 masks.(7) “If we don’t do all we can to protect them (HCWs), they will quickly transition from providers to patients… Governments must support private-sector manufacturers in providing N95s and other equipment to HCWs.”(6) This letter serves to urge our government, industry, media and general population, to assist HCWs in obtaining immediate access to critical PPE, including N-95 masks. Our HCWs are already on the front lines, taking care of patients without appropriate protection, and our COVID cases and we are nowhere near the peak. Many hospitals are already running out of protective supplies. (NY Times, 3/9/2020) Recommendations to protect HCWs should not be based on what’s available; availability should be based on what is necessary. We urge the government to access the Strategic National Stockpile, and to utilize both the public and private sector to immediately increase production of PPE supplies. In addition, we urge our hospital systems to maintain the highest level of PPE standard for our HCWs, and demand the supply of N-95 masks. Sincerely, Dr. Milla J. Kviatkovsky Dr. Constance Chace Dr. Supraja Thota https://www.frontlineppenow.org/ #frontlineppenow #getmeppe References: 1) https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html 2) Howard and McLaughlin, ‘Health care workers getting sicker from coronavirus than other patients,’ expert says, CNN Health, March 12,2020 3) Xihong Lin, ‘Analysis of 25,000 Lab-Confirmed Cases in Wuhan: Epidemiological Characteristics and Non-Pharmeceutical Intervention Effects, Department of Biostatistics and Department of Statistics, Harvard University and Broad Institute 4) N Doremalen et Al, 2014, Aerosol and Surface Stability of HCoV-19 (SARSC-CoV-2) compared to SARS-CoV-1, New England Journal of Medicine 5) Souchery, ‘Unmasked: Experts Explain Necessary Respiratory Protectin for COVID-19’, Center for Infectious Disease and Research Policy, Feb 13, 2020 6) Osterholm and Olshaker, ‘Health-Care workers are the front-line warriors against coronavirus. We must protect them’, The Washington Post, Feb 14, 2020 7) Duqueroy, COVID-19: Advice From a French Doctor on the Frontline, Medscape, 3/16/2020
Petition to Florida Governor, Donald J. Trump, Marco Rubio, Rick Scott, Donna E. Shalala, Carlos A. Gimenez, Debbie Mucarsel-Powell
MASS TESTING for Covid before any orders for social distancing are relaxed!
Experts are unanimously and universally recommending MASS TESTING of the population for the COVID 19 virus as a prerequisite to "restarting" the economy or relaxing social distancing orders. The US is testing at a rate of less than 3.2 per thousand, in eleventh place among industrial nations. This is unacceptable, as mass testing is the only way to isolate the COVID 19 virus in our communities and slow its spread considerably. Social distancing alone, without testing, is just a momentary pause (at considerable expense both socially and economically); but premature loosening measures will be counterproductive, and will only result in further harm to the population and economy. The people demand that our local, state and federal leaders commence a massive project (with the help of private industry and capital) for universal testing across the country before any relaxation of standards are considered. Time is of the essence. The people are living in a state of permanent anxiety and it doesn't help when we see the lack of coordination across the spectrum to tackle this severe health crisis. People are dying and suffering unnecessarily while we spend valuable time bickering about the details. There will be time for that AFTER we defeat this pandemic. The urgent and most consequential action to be taken right now is MASS TESTING - let's get it done!
Petition to Bill Dodd, Gavin Newsom, DIane Feinstein, Kamala D. Harris, Mike Thompson
Armer Law; They take care of us. We need to take care of them.
Santa Rosa Police Detective Marylou Armer was denied COVID19 testing twice before she went into the emergency room, was put into a coma and died alone. Armer spent two weeks with a fever, aching body and shortness of breath. Armer asked twice to be tested for COVID-19. Armer was denied by Kaiser Permanente’s Vallejo Medical Center. She was not considered vulnerable because of her age and no underlying medical conditions. Armer was finally cleared to be tested on March 23, when her husband brought her to the emergency room. She was sedated, intubated, and placed in a medically induced coma. She died on March 31. Armer was with the Santa Rosa Police Department for 20 years and her death is devastating to all who worked with her to help victims of crimes that include domestic and dating violence, sexual assault, stalking, child abuse and elder abuse. But this is not an isolated incident. There have been several first responder deaths as a result of COVID-19 in the past few weeks – and there will be more. To date more than 20 law enforcement personnel alone, as well as nurses, doctors and firefighters have died from COVID 19. Athletes and Celebrities, and those with money at their disposal have been getting tested when they have no symptoms. Marylou knew something was wrong and was denied access to healthcare that may have saved her life. "Armer Law" would allow that during any epidemic or pandemic, first responders which include but are not limited to; law enforcement, social workers, healthcare, and EMS workers, can NOT be denied testing, and should automatically be approved at the first sign of symptoms. They are on the front lines, entering people’s homes and having to make physical contact with the public, and they have the highest risk of exposure. Also provided would be regular, continued testing if necessary, and treatment covered by worker’s compensation, not sick leave. This death was preventable. Our first responders take care of us, it is time to take care of them.
Petition to Dr. Mase, Kaiser Permanente Santa Rosa Medical Center, Sutter Santa Rosa Regional Hospital, Santa Rosa Memorial Hospital, Jim Wood, Mike McGuire, Gavin Newsom
Need for Appropriate PPE Provision for Sonoma County Health Workers
In Sonoma County, we have successfully flattened the curve to help our health care systems better prepare to address the COVID-19 pandemic. Kudos to the County leadership and populace for this success! HOWEVER, the risks of the pandemic are still very real for our community, and our health workers (doctors, nurses, CNAs, environmental services, techs, nutritional services, etc) need additional support in advocating for increased availability and usage of appropriate PPE. Without sufficient PPE, the lives of healthcare workers are at greater risk, and the crisis will be prolonged. To increase the chance to return to 'normal,' we must ensure their safety. The impact of the projected COVID-19 surge in Sonoma Country is expected to be very manageable by our current health care systems. We need to act to make the impact even less! Many of our health care systems are operating under the policies of resource scarcity--with the concern that if we use appropriate PPE, we will run out--an approach that is supported by inadequate CDC guidelines. For example, most prominently, Kaiser SR Hospital is not providing N95 masks for staff taking care of COVID+ patients and Patients Under Investigation (PUIs). More lax PPE policies save the health system money, but increase the risks to health workers, and increases the risk that WE become significant vectors in our community. We need to demand even more conservative PPE policies to provide MORE protection to our staff. Please note that some institutions are doing a better job than others. We need consistency and a set high standard of care. As health care professionals in Sonoma County, we have reached out to ask that the Public Health Officer, Dr. Mase, release a Public Health Order that requires all healthcare facilities in Sonoma County to follow the Stanford University Protocol or Cal/OSHA recommendations to better protect our frontline healthcare workers. We ask that the Public Health Department hold all healthcare facilities accountable to caring for our community, regardless of the higher-level policies created by their behemoth, multi-state health organizations. We ask that our state and local representatives fight to make sure our health care professionals are protected. And finally, we ask that you, readers, hold each of the above parties accountable to protecting the health professional heroes in Sonoma County, which by extension, enhances the protection of each of you. For healthcare professionals, please sign with your discipline. For general public, please sign and note your healthcare organizations you go to as a patient. Thanks!
Petition to Andrew M. Cuomo, Mayor Bill de Blasio, Phil Murphy
Safeguard the Right of All Laboring People to Have Support During COVID-19 Crisis
On March 21, the NYS Department of Health issued clear guidelines on treating patients in labor during the COVID-19 crisis. These guidelines determined a support person, whether a spouse, partner or other chosen person, is essential to care for the patient during labor, delivery and in the postpartum period. The World Health Organization (WHO) agrees. We agree. As of March 26, all New York Presbyterian and Mount Sinai affiliated hospitals, and Staten Island University Hospital in the New York City area will act against WHO, CDC and DOH guidance and ban all support people--including spouses--from Labor & Delivery and Postpartum units. This means people in labor will give birth alone and parent alone. Parents will miss the birth of their child. Fundamentally, risks for the people laboring alone will increase substantially. Not only can partners and spouses provide physical and emotional comfort during labor and postpartum, they are also essential in alerting staff when something has gone wrong and the laboring patient cannot notify nurses themselves, like in the event of an eclamptic seizure or a fainting episode. Timing is critical in these cases and monitors can be unreliable. We cannot expect nursing staff, already spread thin, to spend the limitless hours needed with each patient to ensure their health and their baby's health, to provide physical assistance and emotional support. We know the hospital system is overwhelmed in this crisis. However, the burden will only be increased by banning support people from Labor & Delivery. We must ensure no one gives birth alone. We must ensure the maternal mortality rate does not increase during this time.