A week ago, Josh Masslon, a nurse in the intensive care unit at Maui Memorial Medical Center, was at work when he received an alarming text from his wife.

She had just watched a press conference streamed live on Facebook in which Maui Mayor Mike Victorino announced a cluster of at least 15 positive COVID-19 cases at the hospital.

“Everybody’s phones started going off and everybody was like, ‘Holy cow, there’s an outbreak at the hospital,’” Masslon said.

“This is not something we found out about from anyone in the administration or management,” he added. “We found out from our friends and family. We found out from social media.”

Maui Memorial Medical Center hospital. 3 aug 2016
A half dozen health care workers at Maui Memorial Medical Center say hospital executives have been secretive about the cluster of positive COVID-19 cases at the hospital. Cory Lum/Civil Beat

There are now 36 people linked to a coronavirus cluster at Maui Memorial. Those infected include 27 employees and nine patients, Hawaii News Now reported Tuesday, citing a letter from the hospital CEO.

All those affected with symptoms are in isolation and those without symptoms are in quarantine at their homes. The state Department of Health said the hospital has been provided with additional personal protective equipment for its employees.

But there has been no widespread testing of hospital staff who do not have symptoms, and health care workers interviewed by Civil Beat said they have not been notified by management if they had been working closely with a staff member who later tested positive. 

Now, Maui Memorial nurses and staff are fearful and stressed that no one knows who might have been infected because the hospital was not only slow to require health care workers to wear personal protective equipment but also told some staff not to wear it.

Civil Beat interviewed multiple health care workers who spoke only if their names weren’t used. But they confirmed the ongoing internal turmoil between hospital staff and executives over safety protocols and poor communication.

It’s Been Quite A Week

On Thursday, the day after he learned of the hospital’s COVID-19 outbreak, Masslon walked into the hospital for the start of his shift wearing an N95 mask that he bought on eBay. 

Masslon said he felt safer doing his job with the N95 mask, which blocks at least 95% of very small airborne particles, including the new coronavirus.

“We didn’t know who among us had it,” he said.

But shortly after he arrived at work, Masslon said, a top nurse ordered him to remove his mask. 

A hospital policy in effect at the time outlawed the use of non-hospital supplied masks. Masks were not being supplied to health care workers like Masslon who were caring for non-COVID-19 patients.

Masslon refused to remove his mask, saying that he didn’t feel safe or comfortable doing so.

The situation quickly escalated. 

“You’re not working anymore,” he said the nursing supervisor told him.

“We just kind of feel like what are the odds that we haven’t been exposed?” — Lydia Brandes, ICU nurse

Masslon said he spent nearly four hours trying to sort out the situation with the human resources department.

Then, suddenly, the hospital reversed its mask policy. Masslon was allowed to return to work that day — with his N95 mask intact.

Now yellow surgical masks are being supplied to health care workers at the door as they arrive at the hospital for their shifts.

“In an instant, they went from keeping the PPE under lock and key and banning employees from wearing masks brought from home to handing out surgical masks to employees at the entrance door,” said Masslon.

He said he plans to file a grievance with the nurses union over the incident.

“There’s no transparency and the policies are changing as they see fit,” he said.

Lydia Brandes, who has been a nurse in the hospital’s intensive care unit for 19 years, said she, too, was frustrated and concerned for her safety when she was told not to wear a mask earlier this month. But she said she was too intimidated to defy the policy.

“I felt safer at Safeway shopping with a mask on my face than I did at work,” Brandes said. “I wrote (CEO Michael Rembis) an email and said, ‘This doesn’t make any sense. I have nothing on my face if my patient sneezes on me.’”

She said she did not receive a reply from Rembis.

Maui Memorial Medical Center . Emergency room area. 3 aug 2016.
Maui Memorial Medical Center workers say that even a week after the virus outbreak in their hospital was widely publicized some protective gear and sanitation products are in short supply. Cory Lum/Civil Beat

Aaron Bear, an ICU nurse, said he is unsettled by haphazard policy changes affecting employee safety and a lack of transparency from hospital executives that he said borders on secrecy.

“A number of staff are extremely worried about their health because they were working consistently with coworkers who have now tested positive and they are extremely in fear to the point where they get sick before going to work,” Bear said. “They are going to attorneys over it. I believe there’s going to be a number of legal cases just over the stress. There’s just so much fear.”

Bear is the creator of an online petition that calls for the resignation of the hospital’s top four decision-makers: CEO Michael Rembis, Chief Operating Officer Debbie Walsh, Chief Executive Nurse Gary Keinbaum, and Director of Strategic Communications Lisa Paulson. The petition has garnered more than 5,500 signatures.

Rembis did not return requests for comment for this story made through the hospital’s communications director.

Health Workers Want Routine Testing

Apart from problems with the hospital’s shifting policy on mask-wearing, Bear said he and his coworkers want executives to require routine COVID-19 testing of hospital staff.

Other hospital workers interviewed by Civil Beat said they question the effectiveness of the surgical masks they are being supplied with and want the hospital to provide N95 masks for everyone.

The root of the problem, Bear believes, is ineffective leadership and a longstanding lack of communication and trust between hospital employees and executives.

Bear said he went to volunteer at a drive-thru testing for COVID-19 at Keopuolani Regional Park on Thursday. But he said he ended up getting tested himself because he had a fever. As of Monday evening he had not received the test result.

“It’s totally pathetic that Maui Health System has not said, ‘You guys can’t go back to work until you get swabbed,’” Bear said. 

COVID-19 Coronavirus screening / testing at Waianae Boat Harbor. Apirl 9, 2020.
The Department of Health said it is continuing to aggressively investigate every positive COVID-19 case at Maui Memorial Medical Center. Cory Lum/Civil Beat

There are other safety concerns.

While working in one of the COVID-19 units on Monday, nurses said the COVID-19 unit ran out of the foot covers that health care workers wear over their shoes to prevent the virus from spreading outside of the patient rooms.  

That same day, respiratory therapist Rasa Priya Thom said he was not supplied with proper PPE.

The incident involved a patient who came into the emergency room, where every patient who needs to be intubated for respiratory distress is considered COVID-19 positive until it can be otherwise substantiated. When Thom asked for a face shield, he said the nurse in charge of the procedure replied that there weren’t any. 

Thom said he was able to acquire a face shield from a stock of donated supplies from community members. But he said the rest of the staff involved was not properly protected. 

“If this patient had positive COVID, there were at least 10 nurses that could have been infected,” he said.

Thom said he’s in the process of filing a complaint about the incident to the Hawaii Occupational Safety and Health department.

Thom said he’s also concerned about sanitation wipes not being readily available.

“After we use ventilators, we’re supposed to wipe them down,” Thom said. “In some instances I’ve had to go get paper towels and dip them in the residue of the solution that’s left in the bottom of the container and try to wipe the ventilator down in that way.” 

Charmaine Morales, vice president of the union that represents about 850 Maui Memorial employees, including nurses, said that the union is negotiating for COVID-19 testing for all employees and an enhanced benefit package that would allow workers who test positive for COVID-19 to recover at home without eating into their vacation time.

Now that the mask policy has changed to allow employees to wear masks brought in from home when they aren’t provided, Brandes said she wants the hospital to adopt routine COVID-19 testing of hospital staff.

“We just kind of feel like what are the odds that we haven’t been exposed?” she said.

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