Racism is a Public Health Crisis

An Interview with a Chicago Nurse on the Frontlines of the Struggle

Elizabeth Lalasz interviewed by Rampant Magazine

A frontline health-care worker talks about the public health crisis caused by reopening and why fighting racism is essential to saving lives. 

You’re a nurse on the front lines of the crisis. Can you just tell us a little bit about what the reopening in the last month and a half has looked like from your perspective? What are some things that people outside of hospitals aren’t necessarily seeing?

The initial wave of positive cases created a swell of patients at my hospital. That was in April. And then May was really the most acute. Over the last month or so, we saw a dip in the numbers of cases, but with the reopening we’re actually starting to see, slowly but surely, an increase in the number of patients coming in. We have a lot of patients who are in critical care units. We’re starting to see an increase in the number of people in ICU beds.

I work in the biggest safety-net hospital in the city, and it’s the busiest in the state of Illinois. We had to open up one of our sections in the emergency room to start to take COVID patients since the reopening. 

Prior to the reopening a lot of those patients on my early COVID unit that I took care of were inmates from the Cook County Jail, which was an epicenter of COVID cases in the entire country because of lack of social distancing and sanitation. It is pretty impossible to do those things in an overcrowded jail. Now we’re starting to see the potential for cases from the community to rise, especially with the lack of planning and direction in Illinois. 

Two other things stand out: One is that we’re starting to see patients coming in who are sick but not with COVID. A lot of those people had delayed coming into the hospital because people think if they come to the hospital, they could get COVID. Unfortunately, that has not been totally untrue.

As a result people held off for quite a while getting treatments or procedures they needed, so now they’re coming into the hospital very sick. That in itself is a problem because we’re still dealing with the same staffing, which is really inadequate, and patients need more of our time because they’re really sick.

It’s just exhausting and we’re hurting. We also need to make sure that with every patient that comes in we are cautious about how we actually interact with them.

And that gets to the second thing: We now need to wear surgical masks and face shields to go and see every patient. You have to suspect that every patient that walks through the door could have COVID, even if they aren’t displaying symptoms like a cough or a fever. We were able to win some personal protective equipment in the months when the pandemic was hitting us hardest, but we had to fight for every single thing that we got. So we’re a bit scared about the limited PPE that we have right now and the transparency in the hospital about how much we’ll have in the coming weeks.

We’re waiting and watching, worried about these incredible spikes in cases in the South and now increasingly throughout the West Coast. We’re trying to be prepared, but it’s pretty scary.

We’re trying to be prepared, but it’s pretty scary

Speaking about things happening across the country, there’s been a lot of discussion about reopening school buildings for in-person classes this fall. In Illinois parents downstate are organizing a Millions Unmasked March to say that students shouldn’t have to wear masks in the fall. What are your thoughts as a health-care worker on whether real precautions and supports will be in place to make schools safe environments? 

My thoughts are that we’re not in a position to be able to reopen the schools in the way that President Trump or Betsy DeVos have been talking about, trying to sideline the CDC guidelines.

It is scary to think about what it would mean for schools to reopen, often in a space that doesn’t have the type of ventilation that you need, that doesn’t have the proper PPE for staff, that doesn’t have adequate testing and contact tracing in place. 

I’ve seen the problems in the hospital, to be honest with you, and it gets worse when you go to nursing homes and other places like that. We won proper PPE and tried to implement social distancing. And we had some testing, but it was only when you had symptoms, even though we know people can be asymptomatic and still transmit the virus. Luckily no one actually died in my hospital, but some became very sick. There were a hundred-plus cases that we know of in my hospital alone, out of perhaps nine hundred nurses, that tested positive.

In a hospital we have decent ventilation, but many schools in Chicago don’t even have proper air conditioning, especially when you think about some of the poorer funded schools on the South and West sides, which serve predominantly Black, Latinx, and other students of color. 

The whole idea that somehow children don’t get COVID as much is contentious and there haven’t been enough studies done to know the real impact on kids. And it may not be the kids that get sick, but what about the adults? And then what do you do about it? People are going to take COVID home and all that  played itself out in the hospital with many, many of my coworkers. 

I feel like the health-care system, as it’s playing out in other places around the country, is at capacity, which means we don’t have the ability to really be able to help people. And it’s not just the ICU beds and the ventilators, honestly, it’s about the health-care workers. We’re exhausted at this point.

And we’re just at the beginning of this thing. I don’t think we should reopen schools when it is not safe. Opening the bars and restaurants is making things worse. For schools either you had to do one or the other—either open schools or bars, but you couldn’t do both. The numbers are so high across the country and that will eventually impact Illinois.

In the city of Chicago, it is impossible to open schools safely

In the city of Chicago, it is impossible to open schools safely. I know a lot of teachers and educator unions are opposed to reopening school buildings, and I think that’s absolutely right. We should address the inequities of distance learning, and try to really figure out how you can educate kids safely during this period. 

Of course children should have some way to socialize. We all need social interaction for development. All of us should, as human beings, have some meaningful contact with people. It’s been very hard on all of us. But we’re not in a situation where we can reopen the schools at this point without a lot of harm. 

I have to believe it will probably be more traumatizing for kids to see people they love get sick and die than it would be to not go to school in person.

Right. I think we need to continue to amplify the stories of health-care workers. It is really hard working in an environment like a hospital. So much trauma, trying to deal. I was on the COVID unit and everybody was on edge. Everybody was exhausted. Everyone was scared that they might be taking COVID home to their family. Just think about all that. Plus then you find out your coworkers get it, and it’s really devastating. And for kids, I can’t imagine. I can’t imagine what it will do to them, socially, emotionally, psychologically, to find out that people they know, their families and teachers, got sick because they went back to school. 

There are a lot of heavy things in this moment for sure. Thank you for being so candid. 

On another topic, you and your coworkers have been incredibly vocal, and I would say many nurses across the country have been vocal, about the intersections between fighting racism and fighting COVID-19. In fact, nurses like you helped organize a really incredible demonstration a few weekends ago here in Chicago explicitly connecting the fight against racism and the fight for health care and economic justice. What do you see as the connections between systemic racism and the current pandemic from your vantage point?

I think this is a really critical question for us given what the Black Lives Matter movement and the police murder of George Floyd has sparked in the country and the connections to the COVID pandemic and who it’s affecting.

It’s been well documented in the city of Chicago that African-Americans, Latinx people, and other people of color are disproportionately impacted by COVID. And it’s not just because they have a preexisting condition, though that doesn’t help. It’s about how people of color are treated at the hospitals. My hospital is underfunded and something like COVID that is somewhat universal becomes much worse when you think about what it means for our patient population and our lack of resources.   

Sometimes people of color are afraid to come to the hospital because of things that have happened to them in the past at hospitals, things like not being taken seriously with regard to their pain, not being taken seriously about their illness. I think that the murders of innumerable people, in addition to George Floyd, are endemic throughout every possible industry and system within our society under capitalism.

It takes really serious and sometimes uncomfortable conversations to talk about that, but we’re trying to come to terms with what needs change. That’s a really positive thing that’s reflecting the Black Lives Matter movement. We, as nurses, want to highlight that through a slogan we’ve been using: Racism is a public health crisis. 

Racism is a public health crisis

It also traumatizes people and what ends up happening to people in a regular way, their experiences with racism day-to-day, that all needs to be taken seriously. Racism makes people sicker. It makes people more traumatized. It makes their pain levels higher. When you don’t have access to proper schools, proper housing, or proper economic support, like the fact that so many essential workers are people of color, that all needs to change. We see the whole struggle against racism in health care as a systemic issue. 

Your union, National Nurses United, has been doing a lot of long-term political work, not only around things like single-payer health care, but also supporting Black Lives Matter and fighting for immigrant rights. Why is it especially important now for unions to organize around these broader issues and what do you think is the role of organized labor in this moment of political and social crisis?

Social justice unionism is one of the things that made me want to join the union. I specifically chose my job a decade ago so that I could be a member of a union that not only looks at the economic and workplace issues for health-care workers, but actually makes a connection to every aspect of people’s lives and the people who are some of the most underserved, because all of our patients matter, right? If you’re going to have a healthy society, you have to address everyone’s needs. And that includes fighting against racism for immigrant rights. Anybody who needs it should have access to health care regardless of whether they are an immigrant or have papers.

You can see the crisis in health care in the immigration detention centers, which predates the COVID crisis, but was one of the issues that we actually took on in my union about a year and half ago. We went to the border in Texas to protest the detention centers because people shouldn’t be housed in cages and treated that way. 

I think that these things need to be connected: the fight for economic justice, the fight against racism. This is a moment where unions need to be doing more of that. The Black Lives Matter movement has pushed unions to specifically address the issues of police murder, getting cops out of schools, defunding the police.

these things need to be connected: the fight for economic justice, the fight against racism. This is a moment where unions need to be doing more

Those are some of the things that I think we need to take up, and we have to get beyond just making statements saying I’m for Black Lives Matter. Within our unions, we need to really have discussions about racism with each other. We’re doing that currently around a couple of things that the union put out statements about, including what we need to be doing with police funding and going through a really serious discussion about what it would mean to defund police. 

Another big discussion in the labor movement right now is why we can’t have police organizations in our union federations anymore. We cannot regard police lodges as being the same as the rest of the unionized workforce in this country; they have special privileges, and they act on them. Cop unions protect murderers and  disproportionately go after people of color. 

We also have to be active out in the street, putting out demands and creating a different vision of the world: a world in which there is finally equality and racism doesn’t exist, homophobia doesn’t exist, oppression and discrimination are no longer tolerated in our workplaces and in the world in general. Labor playing a leading social role in the community is essential to getting there.

Elizabeth Lalasz is a registered nurse at Stroger Hospital in Chicago, a steward with National Nurses United, and delegate to the upcoming 2020 California Nurses Association/National Nurses Organizing Committee Convention. She contracted COVID-19 and then returned to work on a COVID-only unit that primarily served people incarcerated in Cook County Jail.