The Danger of Silencing Health Workers in a Pandemic

There is a dangerous new hazard facing health workers who speak out about the health risks posed by inadequate resources necessary to safely treat COVID-19 patients: intimidation and even termination by their employers.

Across the United States in recent weeks, reports have surfaced of doctors and nurses who have lost their jobs in reprisal for publicly criticizing perceived safety lapses at the health facilities where they work. These include three doctors and a nurse in Mississippi reportedly fired earlier this month “after raising concerns about COVID-19 safety measures in hospitals,” including insufficient supplies of personal protective equipment (PPE), such as N95 respirators. There have been similar firings or disciplinary measures against  health workers who have spoken out publicly about what they perceived as unacceptable risks to themselves and their patients due to inadequate PPE supplies in Washington State, Chicago and New Jersey.

Some hospitals or their managers are threatening or punishing health workers who bring to work their own PPE in response to insufficient availability of such equipment in their workplaces. Weill-Cornell Medical Center in New York has reportedly suspended an emergency room physician after she brought her own PPE to work. It is currently uncertain whether the physician will retain her job. The California Nurses Association and National Nurses United warned last month that Kaiser Permanente has threatened to fire health workers at its hospitals and clinics in California who respond to PPE shortages by bringing their own supplies to work.

The shortages of PPE for frontline health workers during this pandemic is an international crisis. Shortages of surgical and N95 masks and equipment rationing for health workers have become the hallmark of the deficient government preparedness and response to the crisis. Those shortages are forcing some doctors and nurses to create homemade masks of dubious efficacy. But health workers can and should have the freedom both to speak out publicly about the health implications of those shortages and to take measures to protect themselves, not least because the nature of their work in the pandemic means that lax safety measures can be life threatening. New Jersey-based Dr. Frank Gabrin on April 6 became the first U.S. emergency room physician to die of COVID-9. Gabrin died two weeks after expressing concerns to a friend that he didn’t possess “any PPE that has not been used.” New York-based Mount Sinai Hospital intensive care unit nurse Tre Kwon calls such tragedies “absolutely preventable deaths” due to their link to inadequate PPE.

Some hospitals are also proactively seeking to prevent their health workers from speaking out about those concerns with gag orders backed by threats of punishment for expressing their complaints publicly. New York City’s NYU Langone Health management has warned its employees that they risk “disciplinary action, including termination,” for speaking to media without authorization. Another New York hospital firm, Montefiore Health System, has likewise warned its staff that they are forbidden to speak to the media “without pre-approval.”

Physicians for Human Rights strongly condemns any retaliation against health workers who seek to expose the truth based on facts about unsafe conditions that they and their patients encounter when their concerns go unaddressed by employers who turn a deaf ear to those issues. Health workers’ professional associations are likewise outraged. The Washington State Nurses Association (WSNA) on March 28 declared that “no health care worker should face being disciplined or fired for speaking the truth” and urged that they be free to expose “where our health care system is falling short in its response to COVID-19.” That same day, the American Academy of Emergency Medicine likewise defended the right of health workers to speak out about perceived safety lapses in their workplaces by asserting the “essential duty of a physician to advocate for the health of others.” The American Medical Association declared on March 31 that health workers should have the right to use their own personal PPE “when these critical resources are unavailable and not provided by their employer.” The American College of Physicians the Council of Medical Specialty Societies have all echoed that call and supported the right of health workers to expose health and safety lapses in their workplaces “without fear of retaliation.”

We need to stand with the doctors, nurses, public health specialists, and others on the front lines of this pandemic and demand that hospital administrations respond to their concerns. This unprecedented public health crisis requires us to  wash our hands, maintain safe “social distance,” and ensure that our health workers are supported, not silenced.

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