'‘They Want to Forget Us’: Psychiatric Hospital Workers Feel Exposed' diff viewer (8/9)

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‘They Want to Forget Us’: Psychiatric Hospital Workers Feel Exposed	‘They Want to Forget Us’: Psychiatric Hospital Workers Feel Exposed
2020-06-24 10:34:20 UTC	2020-06-24 11:06:20 UTC (32 minutes later)
By mid-March, the staff at the Rockland Psychiatric Center in Orangeburg, N.Y., was growing frustrated.	By mid-March, the staff at the Rockland Psychiatric Center in Orangeburg, N.Y., was growing frustrated.
Patients in the center’s two inpatient buildings were continuing to gather for daily group therapy sessions, making social distancing difficult, and some workers believed they needed to stop. There were not enough test kits or protective gear, workers said. And some worried that patients being transferred from hospitals in New York City had not been adequately screened for the coronavirus.	Patients in the center’s two inpatient buildings were continuing to gather for daily group therapy sessions, making social distancing difficult, and some workers believed they needed to stop. There were not enough test kits or protective gear, workers said. And some worried that patients being transferred from hospitals in New York City had not been adequately screened for the coronavirus.
The administration soon convened town halls to discuss the concerns. Employees were told that they should not be taking hand sanitizer or masks out of the hospital, but some complained that little of either was available anyway, according to people who were present. Soon patients and staff members began getting sick, including the medical chief.	The administration soon convened town halls to discuss the concerns. Employees were told that they should not be taking hand sanitizer or masks out of the hospital, but some complained that little of either was available anyway, according to people who were present. Soon patients and staff members began getting sick, including the medical chief.
Now, at least 30 Covid-19 deaths have been recorded in the state’s system of 23 psychiatric centers, and roughly a third of them have been at Rockland. State officials said 10 patients at Rockland had died, and union officials said one employee was also dead because of the virus.	Now, at least 30 Covid-19 deaths have been recorded in the state’s system of 23 psychiatric centers, and roughly a third of them have been at Rockland. State officials said 10 patients at Rockland had died, and union officials said one employee was also dead because of the virus.
More than 13 percent of Rockland’s patient population is confirmed to have or suspected of having Covid-19.	More than 13 percent of Rockland’s patient population is confirmed to have or suspected of having Covid-19.
The state’s other hospital hit hardest by the pandemic is the Pilgrim Psychiatric Center in Suffolk County, where nine patients have died, according to the state. Nearly a fifth of the patients are either confirmed or suspected cases of Covid-19.	The state’s other hospital hit hardest by the pandemic is the Pilgrim Psychiatric Center in Suffolk County, where nine patients have died, according to the state. Nearly a fifth of the patients are either confirmed or suspected cases of Covid-19.
The New York Times interviewed clinicians, union officials and employees with a wide range of jobs at the two hospitals, from nursing to food services, and reviewed a number of internal documents. Many of the employees spoke on condition of anonymity for fear of losing their state jobs.	The New York Times interviewed clinicians, union officials and employees with a wide range of jobs at the two hospitals, from nursing to food services, and reviewed a number of internal documents. Many of the employees spoke on condition of anonymity for fear of losing their state jobs.
“The staff is getting sick constantly. We are severely depleted in staff,” one Rockland clinician said.	“The staff is getting sick constantly. We are severely depleted in staff,” one Rockland clinician said.
Tyjuana Parker, the vice president of the union local that represents civil service employees at Rockland, has been working at the hospital because of staffing shortages. “All of us could be walking around here with it,” she said. “We don’t know. It’s a lot of fear.”	Tyjuana Parker, the vice president of the union local that represents civil service employees at Rockland, has been working at the hospital because of staffing shortages. “All of us could be walking around here with it,” she said. “We don’t know. It’s a lot of fear.”
Psychiatric hospitals present special challenges to the strictures of social distancing, since many patients are allowed to come and go in and out of the center, and once inside they are not cloistered.	Psychiatric hospitals present special challenges to the strictures of social distancing, since many patients are allowed to come and go in and out of the center, and once inside they are not cloistered.
Group therapy sessions are a central part of many patients’ routines. “Prior to this crisis, they would talk with their peers, play cards, play bingo, do normal recreational activities,” a nurse at Rockland said. Now such things are on hold.	Group therapy sessions are a central part of many patients’ routines. “Prior to this crisis, they would talk with their peers, play cards, play bingo, do normal recreational activities,” a nurse at Rockland said. Now such things are on hold.
The patient population is already at high risk. “Because of the medications they take, their immunity is already compromised,” the nurse said.	The patient population is already at high risk. “Because of the medications they take, their immunity is already compromised,” the nurse said.
James Plastiras, a spokesman for the state’s Office of Mental Health, which oversees the two hospitals, said in a statement that the agency “has taken numerous actions to protect staff and patients and reduce the risk of exposure in our facilities.” He said the state had provided face masks to staff members and patients, bolstered screening procedures for new admissions and eliminated group therapy sessions for the duration of the crisis.	James Plastiras, a spokesman for the state’s Office of Mental Health, which oversees the two hospitals, said in a statement that the agency “has taken numerous actions to protect staff and patients and reduce the risk of exposure in our facilities.” He said the state had provided face masks to staff members and patients, bolstered screening procedures for new admissions and eliminated group therapy sessions for the duration of the crisis.
Rockland and Pilgrim are among the oldest of the state’s psychiatric hospitals, with both opening in 1931. In the 1950s, Pilgrim alone had nearly 14,000 patients, its own power plant and fire and police departments. Rockland had a bowling alley and was decorated with W.P.A. murals. Both were referenced in Allen Ginsberg’s beat poetry classic “Howl.”	Rockland and Pilgrim are among the oldest of the state’s psychiatric hospitals, with both opening in 1931. In the 1950s, Pilgrim alone had nearly 14,000 patients, its own power plant and fire and police departments. Rockland had a bowling alley and was decorated with W.P.A. murals. Both were referenced in Allen Ginsberg’s beat poetry classic “Howl.”
Today, after decades of deinstitutionalization aimed at curbing the warehousing of the mentally ill, the hospitals are ghosts of their former selves, their sprawling campuses strewn with shuttered buildings (much of the show “Orange is the New Black” was shot at Rockland). The two centers have about 600 patients combined.	Today, after decades of deinstitutionalization aimed at curbing the warehousing of the mentally ill, the hospitals are ghosts of their former selves, their sprawling campuses strewn with shuttered buildings (much of the show “Orange is the New Black” was shot at Rockland). The two centers have about 600 patients combined.
As at so many facilities that house people closely together — in particular the nation’s nursing homes, where at least 7,000 have died amid the pandemic — workers find themselves unexpectedly on the front lines of a public-health crisis.	As at so many facilities that house people closely together — in particular the nation’s nursing homes, where at least 7,000 have died amid the pandemic — workers find themselves unexpectedly on the front lines of a public-health crisis.
“It just hit,” said Arnold Jones, who has worked at Pilgrim for 33 years and now heads the Civil Service Employees Association local that staffs the center. “New York is a hot spot, and Suffolk County is a hot spot within the hot spot. So there’s a lot going on here.”	“It just hit,” said Arnold Jones, who has worked at Pilgrim for 33 years and now heads the Civil Service Employees Association local that staffs the center. “New York is a hot spot, and Suffolk County is a hot spot within the hot spot. So there’s a lot going on here.”
At Rockland, like at other hospitals, supplies of personal protective equipment have been a flash point. On March 27, the executive director of the facility, Janet Monroe, emailed the staff: “We had a call from our central office where now we are required to account for PPE inventory and use daily,” she wrote, adding that the center “will not be giving out masks as a daily routine.” Instead, infection control nurses would guide how such equipment would be used.
Updated June 22, 2020	Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.	A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.	The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.	The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
	At Rockland, like at other hospitals, supplies of personal protective equipment have been a flash point. On March 27, the executive director of the facility, Janet Monroe, emailed the staff: “We had a call from our central office where now we are required to account for PPE inventory and use daily,” she wrote, adding that the center “will not be giving out masks as a daily routine.” Instead, infection control nurses would guide how such equipment would be used.
“They’ve got my members spraying Lysol on masks, and yet they’re saying everything is OK,” said Wayne Spence, the head of the Public Employees Federation, the union that represents nurses and clinicians at the center.	“They’ve got my members spraying Lysol on masks, and yet they’re saying everything is OK,” said Wayne Spence, the head of the Public Employees Federation, the union that represents nurses and clinicians at the center.
He said his union had given 1,500 masks to Rockland alone, taking on the unusual role of providing medical equipment to its members. The union has also spent nearly $170,000 on hotel rooms for nurses, he said, largely because the workers do not want to infect their families. Forty of the 238 nurses at Rockland are confirmed to have Covid-19.	He said his union had given 1,500 masks to Rockland alone, taking on the unusual role of providing medical equipment to its members. The union has also spent nearly $170,000 on hotel rooms for nurses, he said, largely because the workers do not want to infect their families. Forty of the 238 nurses at Rockland are confirmed to have Covid-19.
“Buying this stuff is almost like a drug deal,” Mr. Spence said of protective gear. “You’re worried people will outbid you.	“Buying this stuff is almost like a drug deal,” Mr. Spence said of protective gear. “You’re worried people will outbid you.
“So, securing the masks has been a problem. Even though the governor has said members are supposed to get one mask per day, it’s more like one mask per week. That’s what our members are telling us.”	“So, securing the masks has been a problem. Even though the governor has said members are supposed to get one mask per day, it’s more like one mask per week. That’s what our members are telling us.”
The civil service union has warmer relations with the Cuomo administration — its workers have a contract, while Public Employees Federation negotiators have been at loggerheads with the state over a new deal — and officials said they felt their workers had been provided with adequate protective equipment. But they were also struggling to maintain staffing levels.	The civil service union has warmer relations with the Cuomo administration — its workers have a contract, while Public Employees Federation negotiators have been at loggerheads with the state over a new deal — and officials said they felt their workers had been provided with adequate protective equipment. But they were also struggling to maintain staffing levels.
“There’s just a fear factor,” said Ms. Parker, the Rockland union vice president. “Those coming in here should get hazardous pay.”	“There’s just a fear factor,” said Ms. Parker, the Rockland union vice president. “Those coming in here should get hazardous pay.”