The corona virus is not just exposing us to contagion and illness. It is also exposing the cracks in our healthcare system, among other things. Take my experience. I am a healthcare worker. I have excellent private insurance through my employer. I am running a low-grade fever, and have fatigue, but then who doesn’t right about now? I wouldn’t think much of it except I just got a call from my boss that my work wife ( a dear colleague who works right next to me) had been exposed to the virus and is very ill. She was not told about her exposure until after she had been back at work with the rest of us for several days. In fact, as an interpreter, she found out randomly because the clinic “didn’t think to call” interpreter services about the exposure. Yet we are staff hospital employees. Imagine how the contracted agency interpreters will be treated. How likely is it they will be informed of specific exposures and testing needs, and who will test them? And what about all the rest of the self-employed, and others in our communities?
I sought testing, as our hospital website directed, by first contacting my own doctor’s office, and here is how it went for me, an educated, competent healthcare worker, very used to negotiating the healthcare system. When I get through the phone tree, they tell me I cannot talk to a nurse as I usually can, because they are overwhelmed. There is no way they could squeeze me in today for an appointment either (which is their usual policy for urgent needs and why I chose them as my provider). I will have to leave a message and then wait for a call, but no one can say when because they are overwhelmed. I argue to the point of rudeness about getting in, tell the person on the phone that my boss just called to say I have been exposed, and I have a low-grade fever. I need to get tested! Not just for myself, but for others, because I am a healthcare worker. Sorry, she repeats, but we are just slammed. You’ll have to wait.
So what, I posit, would happen if I just show up at your emergency room? Well, she says, they would treat you accordingly. Huh? What are you saying? What is your policy? I don’t understand you. What do you mean by treated accordingly? Will they charge me the thousand dollars plus for any emergency room visit? And if I go there, will they test me on the spot? Do they even have test kits? Well, she confesses, I really didn’t know how to answer that, so that’s why I just said they would treat you accordingly. But if we cannot help you fast enough and you want to try elsewhere, I can give you two hotlines to call. One for the County Public Health, one for the State Public Health. Wow. So my excellent, top of the line (“this is why we need the freedom of private insurance so we can choose to pay for the care we deserve”) insurance is giving me an 800 number for the historically underfunded, battered and beaten public health department.
I ask my doctor’s staff whether these numbers are actually offering testing to the general public, or whether they just have recordings of the general rules and guidelines, like wash your hands and stay home with a fever, and she guesses “a little of both” at which I wonder aloud why I would need to call Public Health and listen to a recording when I have excellent private insurance, and have gone to the same doctor’s office for over 20 years. She just offers me the numbers again and tells me I have to wait for a call from the nurse who “has piles of people to call.” Be patient and stand by.
The nurse calls me back late Friday afternoon at closing time and says I cannot come in today. It will have to be next week. I remind her that they have a Saturday clinic (another reason I chose them) but she tells me there is just one doctor for that clinic so they will not allow anyone to come in for testing on Saturday. They already decided. No exceptions! Sorry! But she can give me an appointment for Monday. That is “just as good” she informs me, because they would simply tell me to rest, drink fluids and isolate myself whether I tested today or Monday. So it should be just fine to wait three more days. Just stay home from work from now on, while we wait for the results that can take 3-4 days to come back.
There are many people in situations like mine, and worse, of course. I specifically took a half-time job at the hospital so I could get health insurance, because health insurance options for the self-employed can cost over a thousand dollars a month even with huge deductibles. So I have health insurance and even sick leave for my hospital hours. I will lose all my court pay for any missed shifts, but at least I have a halftime job with employee benefits for some kind of a safety net. For my many colleagues who exclusively contract, of course, they will get no sick leave, zero pay, and there is no system in place to cover their lost income. Contract medical interpreters are not alone in losing income, of course, but it is worth pointing out that they are exposed at work and still not allowed any recompense or even testing. It is cold consolation to my fellow health workers that eventually we will all be exposed, because people are not able to get tested, self-quarantine, and inform others of the exposure, in a timely and effective manner.
Back to my private doctor’s office and his nurse. We talk on for a few minutes regarding my exposure, risk and symptoms. I thank her for the appointment as if she were doing me a personal favor. I really am grateful, though! So glad I have this wonderful private insurance! As we are about to hang up, she adds, oh! What was your temperature? I carefully explain to her that my normal temperature is 96.7F which is 36C, not 37C which is more typical, so when I get a fever, it runs low, but it is a fever for me. My blood pressure is also 85/55 so I just run lower than the general population overall. I invite her to confirm in my chart (not that she has time) that even when I had pneumonia, my temperature never rose above 101F. Oh, dear, she exclaims! That is a problem.
She is so very sorry, but she has to cancel my Monday appointment after all! She understands that I want to be tested, am symptomatic, and that my boss called to say I was exposed, but I do not qualify to get tested under the government guidelines. We are “not allowed” to use a test kit on someone like you, she explains. There is such a shortage that we are just not allowed to! So I simply must find a way to develop a fever of at least 101.5 if I want to get tested. She ends on a upbeat hope: Maybe your fever will spike up to 101.5 over the weekend and then you can call in for an appointment next week! Fingers crossed for getting a good fever! Okay, thanks.
This is not the county jail nurse I am talking with. That kind soul has fewer resources and staff. It is not the public health department, historically strapped for money in our for-profit society. It is not even the county or the state hospital, where they struggle for full funding and resort to asking for donations (just like our public schools do). This is a private, nonprofit hospital recently bought out by the megalith Providence, a subsidiary of the even more megalith Catholic Church. But I cannot get tested for Corona exposure by my own doctor – as a symptomatic healthcare worker with excellent insurance and a documented exposure – because my body temperature runs low. I guess I can comfort myself that if I do succumb to the virus, at least I can die coolly, and well insured.
I call my hospital’s employee health office, and spend some time on hold with them. No doubt, they are overwhelmed as well. They tell me that I should “follow the guidelines online” and go to my own doctor, because they just cannot test everybody. My doctor won’t test me, I tell them. They repeat that my doctor “should” test me. When I explain that my boss told me I had been exposed at work, and they have a duty and an obligation to test me, an awkward pause ensues. Clearly, the runaround had been working pretty well for the person answering the phone, until now. I told her I had looked over our website, and done online searches, but could not find the specific place to find testing, apply for testing, or any contact information, but this number. She apologized and told me “it should be there”. I told her it was not accessible, and asked her to verbally instruct me as to what the procedure was, as far as she knew it. Presumably Employee Health had been given some training, some information, regarding employee testing? Where do I go? How do I get tested?
Oh, dear! She was sorry but could not tell me any details of the testing options for employees, as “that is being handled by another hospital” which is odd, as that “other hospital” is one recently bought in the series of shell game hospital buyouts and sellouts – by the state hospital where I work. Too bad the person on the phone – my coworker – has no information about how people who work at our hospital – like me – can be tested, how long it takes, or anything about the process, but can only direct me to a website. Why do I feel like I am calling Comcast Customer Service when I am calling my own Employee Health office – part of our Human Resources? Wouldn’t they be the ones to be informed and provide vital healthcare prevention and testing information for vital healthcare workers? But they have no information because a hospital “we” just bought is “doing the testing” so “we” don’t know. Thus, my own doctor refers me to 800-numbers for public health, and my own hospital where I was exposed refers me back to a website.
As of now, I have filled out the employee testing request form (not available to contract interpreters) and am waiting for a call back for a phone interview, to see if I can be granted the chance to waste a precious test kit on my humble nostrils. I would hope that my being a healthcare worker, exposed at work, and now running a fever, might weigh in on my side, and I can feel my fever rising as I type these words. If it rises enough, I may even qualify to get tested.
For the record, I will be as surprised as any of my readers if this becomes my last post, and I fade into the darkness and silence of the grave (especially as I plan to be cremated and have my ashes cast into the sea). My concerns are broader. If I cannot get tested, then who can? These barriers to testing, in the best of circumstances, are bound to increase people’s exposure to the disease. And what about the thousands of contract interpreters across our state and elsewhere, who roam from clinic to hospital, and don’t even have an “employee health” to turn to? Will they all stay home with no income, or just work unless and until very ill, as they unwittingly spread the virus among vulnerable patients? Who if anyone is arranging to have interpreters work via video remote or telephone as possible? And we are of course a miniscule slice of an immense pie.
I dread to think about those millions upon millions without health insurance in the midst of so much concentrated wealth. Those with compromised immune systems or weak lungs. Those who cannot afford to stay home for a week or two just in case. Those who cannot speak the language or for other reasons even begin to negotiate our complex healthcare system. Beyond health risks, the societal implications are unfathomable, with small businesses going under, schools closing, travel bans, and a huge swath of working people facing job loss and financial implosion.
As a contractor myself who pays at least 25% of my adjusted gross business income on taxes, it is surreal to be in a place where huge global corporations – the same ones that have lobbied to use our city as a tax haven while distressing our tax-supported infrastructures to the breaking point – are now considering using a slice of their astronomical profits to produce and deliver free Corona test kits to symptomatic residents as an act of “charity” – a task our public health department could have afforded, if we had a reasonable tax system that was fair and equitable across the board. One of many symptoms of a sick economic structure that the Corona virus merely highlights.
As a healthcare worker, I fervently hope that part of our recovery can be taking a better, closer look at our healthcare. Our patch-work business model healthcare delivery system, with its severe lack of coordination and financial barriers for patients, can turn into a literal death sentence for thousands almost overnight. I fervently hope that this virus may lead to fundamental change in healthcare delivery for our nation. It is past time to create and sustain a viable, funded, staffed and preventive public healthcare system. And no, it is not too late, because this is not the first and will not be the last pandemic. If nothing else, let us learn from our mistakes. Let this be our wake-up call for healthcare reform. Let the Corona virus be an eye-opening blessing in disguise – for those of us who survive it. And for those who succumb to it, rest in peace.