Portside

Covid-19 cases were climbing at Michigan’s McLaren Flint hospital. So Roger Liddell, 64, who procured supplies for the hospital, asked for an N95 respirator for his own protection, since his work brought him into the same room as covid-positive patients.

But the hospital denied his request, said Kelly Indish, president of the American Federation of State, County and Municipal Employees Local 875.

On 30 March, Liddell posted on Facebook that he had worked the previous week in the critical care unit and the ICU – and now he had the virus. “Pray for me God is still in control,” he wrote. He died on 10 April.

Liddell’s death – along with the deaths of dozens of other healthcare workers – is prompting new questions about whether government regulators are doing enough to hold employers responsible during the pandemic. Since March, more than 4,100 Covid-19-related complaints regarding healthcare facilities have poured into the nation’s network of federal and state Occupational Safety and Health Administration (Osha) offices, tasked with protecting workers from harm on the job. The agency received five complaints about Liddell’s workplace in the weeks before his death, which described employees receiving “zero PPE”.

Roger Liddell. Photograph: Courtesy Bill Sohmer

A KHN investigation found that at least 35 healthcare workers died after Osha received safety complaints about their workplaces. Yet by 21 June, the agency had quietly closed almost all of those complaints, and none of them led to a citation or a fine. About 1,300 of the healthcare-related Covid-19 complaints remain open and about 275 fatality investigations are continuing, according to public records.

The complaint logs, which have been made public, show thousands of desperate pleas from workers seeking better protective gear for their hospitals, medical offices and nursing homes.

The quick closure of complaints underscores the Trump administration’s hands-off approach to oversight, said the former Osha official Deborah Berkowitz. Instead of cracking down, the agency simply sent letters reminding employers to follow Centers for Disease Control and Prevention (CDC) guidelines, said Berkowitz, now a director at the National Employment Law Project.

“This is a travesty,” she said.

Eugene Scalia, the lawyer Donald Trump appointed to lead the US labor department, which handles worker safety, spent years in private practice helping corporations fight health and safety regulations meant to protect workers. Now, Scalia, the son of the late conservative supreme court justice Antonin, oversees the federal agency tasked with protecting such regulations.

During a 9 June legislative hearing, Scalia said Osha had issued only one coronavirus-related citation for violating federal standards. A Georgia nursing home was fined $3,900 for failing to report worker hospitalizations on time, Osha’s records show.

Of the thousands of complaints closed nationwide, 21 alleged that workers faced threats of retaliation for actions such as speaking up about the lack of PPE. At a Delaware hospital, workers said they were not allowed to wear N95 masks “for fear of termination or retaliation”. At an Atlanta hospital, workers said administrators threatened to fire them if they “raise[d] concerns about PPE when working with patients with Covid-19”.

More than 100 cases were marked as resolved within 10 days. One alleged that home health nurses in the Bronx were sent to treat Covid-19 patients without full protective gear. In an Ohio nursing home, workers were reportedly not required to wear protective equipment when caring for Covid-19 patients. That complaint was closed three days after Osha received it.

It remains unclear how the agency resolved hundreds of complaints. A Department of Labor spokesperson wrote in an email that some were closed based on an exchange of information between the employer and Osha, and advised reporters to file Freedom of Information Act requests for details on others.

“The Department is committed to protecting America’s workers during the pandemic,” the labor department said in a statement. “OSHA has standards in place to protect employees, and employers who fail to take appropriate steps to protect their employees may be violating them.”

A 16 March complaint against Clara Maass medical center in New Jersey illustrates the life-or-death stakes. According to the complaint, workers “were not allowed adequate access” to personal protective equipment (PPE).

Days later, Barbara Birchenough, 65, a veteran nurse at the hospital, texted her daughter: “The ICU nurses were making gowns out of garbage bags. ... Dad is going to pick up large garbage bags for me just in case.”

Kristin Carbone said her mother was not working in a designated Covid-19 area, but patients with symptoms were under her care. Later that day, Birchenough texted that she had a cough and headache, adding that she and her colleagues had been exposed to six patients who were being tested for the virus.

“Please pray for all health care workers,” she wrote. “We are running out of supplies.”

By 15 April, Birchenough had died of the virus. “They were not protecting their employees, in my opinion,” Carbone said. “It’s beyond sad, but then I go to a different place where I’m infuriated.”

Osha records show six current investigations into a fatality or cluster of worker hospitalizations at the hospital. A labor department spokesperson said other initial complaints about Clara Maass remained open and did not explain why they continued to appear on a closed case list.

Birchenough’s colleague Nestor Bautista, 62, also died of Covid-19 on 15 April. Nestor’s sister, Cecilia Bautista, described her brother, a nursing aide, as a quiet and devoted employee.

Responding to allegations in the Osha complaint, a hospital spokesperson wrote: “Although the source of the exposure has not been determined, several staff members” contracted the virus and “a few” had died. “Our staff has been in regular contact with OSHA, providing notifications and cooperating fully with all inquiries.”

On 19 May, Osha advised its inspectors to place reports of fatalities and imminent danger as a top priority, with a special focus on healthcare settings. Separate from the complaints, Osha has since late March opened more than 250 of its own investigations into fatalities at healthcare facilities, government records show. Most of those cases are ongoing.

Nestor Bautista. Photograph: Courtesy Cecilia Bautista

According to the complaints against McLaren Flint, workers did not receive needed N95 masks and were not allowed to bring them from home.

The resulting inspection did little for Liddell, or for his colleague Patrick Cain, 52, a registered nurse, who was treating people awaiting the results of Covid-19 diagnostic tests without an N95 respirator. He was also working outside a room where potential Covid-19 patients were undergoing treatments that research has since shown spread the virus widely in the air.

At the time, there was a debate over whether supply chain breakdowns of PPE and weakened CDC guidelines on protective gear were putting workers at risk. Cain felt vulnerable working outside of rooms where Covid-19 patients were undergoing infection-spreading treatments, he wrote in a text to Indish on 26 March.

He fell ill in mid-March and died on 4 April. (McLaren has since revised its respirator policy, permitting workers on the Covid-19 floor to receive N95s and controlled air-purifying respirators, or CAPRs.)

Michigan’s Osha office closed all five complaints it had received about shortages of protective gear on 21 April, after the hospital presented paperwork saying problems had been resolved. There was no onsite inspection, the hospital and agency confirmed. The hospital’s written response was deemed sufficient to close the complaints, a local Osha spokesperson confirmed.

A spokesman for the McLaren Health Care system said the Osha complaints were “unsubstantiated” and that its protocols had consistently followed guidelines. “We have always provided appropriate PPE and staff training that adheres to the evolving federal, state, and local PPE guidelines,” Brian Brown said in an email.

Osha Investigations into Liddell and Cain’s deaths are continuing, according to a spokesperson for the state’s department of labor and economic opportunity.

KHN (Kaiser Health News) is a non-profit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation) that is not affiliated with Kaiser Permanente