A Look at Two Crises: 9/11 and COVID-19

After the devastating attacks of September 11, 2001, our country rightfully valorized first responders. We built homages to firefighters, carving them from ice and snow, hung photos, and broadcast earnest recordings of our gratitude. 

Back then, emergency medical technicians got some of the recognition they have long deserved. We honored their work and their sacrifice, praising them for running into danger while most people ran away. 

The fact is, on this September 11, almost no one is supporting or protecting frontline workers.

What is more important: we supported them. We created funds and workplace protections for personal protective equipment (PPE), training, memorials, and ongoing health care for the lingering effects of exposure on the frontline. 

This September 11, we are in the ninth month of the COVID-19 pandemic. I am deeply disappointed, saddened, and angered that we are not doing more to protect frontline workers now.

I have worked in emergency medicine for twenty years, as an EMT and as an emergency and special pathogens nurse. Though I have worked in disasters and pandemics,  we have not seen a pandemic of this scale in most people’s lifetimes. As a nation, we were not prepared. As a result, our first responders, nurses, doctors, and other frontline workers were all woefully undersupplied in their attempt to respond as the waves of COVID-19 infections crashed over us. 

Frontline workers are stepping up during this time of crisis to protect our patients and the public from an ongoing global pandemic, but we do not see the same commitment from our employers, regulatory agencies, or lawmakers. Many have called us heroes, especially back in March and April. While we appreciate the appellation, we need more than words. 

Frontline workers are at much higher risk of contracting COVID-19, a risk that increases when workers have inadequate PPE or are forced to reuse single-use PPE. Even at well-equipped and well-prepared health care facilities, staff are frequently reusing PPE and are uncertain how long their employers’ PPE stock will last. Initially, we thought that uncertainty would be just for the first few months, until largescale response efforts could take effect, but we were mistaken. 

The fact is, on this September 11, almost no one is supporting or protecting frontline workers. OSHA, the CDC, the Joint Commission, and other organizations that are supposed to promote safety make good statements and provide what guiding information they can, but are not backing those pretty words with actions. 

They recommend reuse of PPE that is designed to be single-use, rather than addressing the shortage that makes reuse our only option. Their regulations are toothless, leaving much to the questionable discretion of employers rather than acting to ensure the safety of workers.

The federal government failed to maintain an adequate national stockpile of PPE, and much of what they did have was expired or otherwise unusable. In the past, a responsible government would have helped organize industry to respond to the nation’s immediate safety needs by ramping up the production of PPE, testing materials, vaccine research, along with a unified public awareness campaign. 

Frontline workers are still short of PPE. While there are facilities to decontaminate PPE for reuse, it is left to individual organizations to contract with them, and it still ultimately means reusing equipment intended to be single-use. Workers are also often running low on disinfectants for cleaning facilities and ambulances.

The 9/11 attacks killed 412 emergency workers, and hundreds more subsequently died as a result of their work at the scene of the destruction. Thousands more still suffer from illnesses related to their exposure to toxic materials at the site. 

In less than nine months, more than a thousand health-care workers and more than 200 first responders have died from COVID-19 in the United States alone. The United States has the highest number of COVID-19 deaths of all countries in the world, and the second highest number of health care worker deaths. 

In some states, almost a quarter of COVID-19 cases are among workers taking direct care of COVID-19 patients. We can and must do better for our frontline workers. 

As many Americans struggle with video conferencing or distance learning, frontline workers are dealing with life and death on a daily basis. As people try to get back to the old normal, they do so on the backs of workers who shoulder the burden of taking care of us: growing our food, staffing our stores, teaching our children, caring for our elderly, and providing health care. 

Across the country, frontline workers see the same frightening reality: COVID-19 cases are rising, yet we still lack adequate protection, resources, and support to safely do our jobs. 

Now is the time to rally and support the people who support all of us. We need to ensure that workers have sufficient PPE and cleaning supplies to do their jobs as safely as possible. And, first responders need stigma-free mental health care to support us as we shoulder the burden of caring for the sick and dying in numbers greater than we have ever seen before. 

Frontline workers need to be getting paid enough to provide for our families. We need to make sure all workers have adequate paid sick leave to be able to stay home when we are ill, without pressure or penalty. We need better health care coverage. We need line-of-duty death benefits so that there is something to aid the families of those of us who inevitably will die from COVID-19.

Such things are necessities, as it says on the 9-11 first responders memorial, “to those whose actions in our time of need led to their injury, sickness, and death.”

Emergency personnel and health-care workers should be truly supported. In protecting frontline workers, we help protect everyone. “Essential” does not mean expendable. Those we hail as heroes should have protections in place to prevent them from becoming names on another memorial.