Just the Essentials, Please
By Ashley Arvind
*The following interview was conducted with a healthcare worker who came forward to tell their story. To protect my source, I am not disclosing their identity.
It’s springtime in Chicago, one of my favorite times of year. People are normally looking forward to many things, from warmer weather to Easter Sunday or Passover, and of course, brunches. Only, there’s a new normal in 2020. Celebratory gatherings this weekend should be virtual, and takeout orders will have to do. With the Stay at Home order extended to April 30th, there is an abundance of caution and uncertainty in the air.
Yet, the goodwill of the people is resurrected in difficult times. Ordinary people are being asked to do extraordinary things for their country, for their community, during the pandemic. While many of us are at home, either working, or taking care of each other in what ways we can, the essential workers and businesses continue to do what is required for society to function at a minimal level.
My friend is a pharmacist at a retail pharmacy chain in Chicago, Illinois. How this employee approaches every work shift is sobering: “Treat everything as positive, [with Coronavirus] unless otherwise. Do everything I can to protect my family and everyone else.”
It sounds like a soldier going off to war, rather than the carefree friend I grew up with. But it is a war zone out there. Essential workers are more exposed to the Coronavirus than perhaps the public knows.
Hopes of flattening the curve abound, but projections of the Coronavirus peaking continually change. As NIAID Director Dr. Anthony Fauci said on CNN in March, “…You don’t make the timeline. The virus makes the timeline.”
One of the hazards that is less spoken of, is how these essential workers are coping psychologically. Compounding things further, are how the human factor and the corporate model are clashing over purported safe working conditions during this crisis. Supplies are distributed unevenly to employees, resulting in the haves and have-nots. Issues that are more reminiscent of the American factory worker’s condition during the industrial era.
In the past few days it was revealed a co-worker tested positive for COVID-19 at a Chicago store. Another pharmacist there who has been in close contact with the infected person, still continues to work instead of quarantining, and has yet to be tested. This is becoming an industry norm, as similar reports of potentially sick employees at other pharmacies circulate among the workers themselves, affecting morale. A few are sounding the alarm. But what will it take for them to be heard in the din of so many alarms already ringing?
Ashley Arvind: What was your reaction to the news from management?
Pharmacist: I recently learned that a coworker tested positive, and a pharmacist who knew that, spent a lot of time with that person. I originally thought everyone would be tested at the store. That we’re going to clean the store. But I had no information regarding that. They said we’re not high-risk.
Ashley Arvind: What are you concerns about this situation?
Pharmacist: There’s possibly a positive person working who may be exposing us. … So, it’s scary just coming in.
Ashley Arvind: Do you currently feel safe working at your store?
Pharmacist: No, because of the lack of the PPE. On top of that, they’re not going to test everyone. Maybe people are carriers, but may not have symptoms, and they’re still working. Then they can pass it on to us, or to customers. I just don’t feel safe working. … There’s no plan in place, saying we’re going to get everyone tested, [that] we’re going to shut down the store. Like, there’s nothing.
Ashley Arvind: Is there any sign posted in your store that someone tested positive for COVID-19?
Pharmacist: No. I don’t think they have to reveal that information to the public. … But it’s definitely not what I expected, in making sure we all get tested and disinfecting the place. Those are the two things that I thought would happen because other places have done that too.
Ashley Arvind: In your opinion, what should the store have done after finding out that an employee has Coronavirus?
Pharmacist: I know they’re trying to consult the CDC or public health. The best thing is to test everyone. No matter what, we’re in a closed environment talking to each other. If people are positive, then they can stay home and quarantine, so that will keep the team safe. Versus not testing everyone. We don’t know and we’re still working.
Ashley Arvind: What PPE supplies do you currently have at your store?
Pharmacist: Masks: limited. It’s understandable, the nation’s short on PPE. Gloves: they ran out. The XL gloves are not fitting well. Most of us need medium or small.
Ashley Arvind: When is your store going to provide more PPE?
Pharmacist: They say that they’re going to, but they say a lot of things. We were supposed to have the sneeze guards. Certain stores have more priority than others, like corporate headquarters. Other areas may not have it yet. My technicians that work there [corporate store] have the masks, the gloves and the plexiglass sneeze shield. I was kind of surprised.
Ashley Arvind: Even one of our local grocery stores has a big, clear shield at the cash registers. Have you seen the company’s sneeze guard?
Pharmacist: Yes. I’ve seen photos and it looks totally ineffective. I imagined it’d be from register to register, but really it looks like a stand-up plastic. It looks so flimsy, like it could get knocked over and just crack.
Ashley Arvind: Can you currently get tested in Chicago?
Pharmacist: Due to limited tests, I don’t think we’re able to. There are certain locations where you can get tested, mostly for first-responders. Or, if you actually go to the doctor and have severe symptoms, they may test you.
Ashley Arvind: After you get home from work, what do you do to decontaminate?
Pharmacist: I go straight to the shower. I make sure to wash my hair. Then I put away the clothes in the washing machine or I put it in a basket and quarantine that. The usual; try to clean as much as you can. Disinfect any commonly touched areas like doorknobs, sink handles, refrigerator. Right now, I’m quarantined in my own extra bedroom. I have a little box where I put my shoes in, so it’s quarantined too. That it’s away from the family.
Ashley Arvind: What is it like being an essential worker, going out and working now?
Pharmacist: You come to terms with it. It is your job, something you have to do. … At first, it was nerve-racking, but over time I was able to deal with my anxiety. I try to protect myself as much as I can, like try to avoid touching my face. I would try to stand back and consult if I can, if patients don’t have a mask. That was the days before we had a mask. And now we have some masks. I can put on my mask and consult patients. So, I don’t have to necessarily stand far away.
Ashley Arvind: Before you had masks, how were you consulting patients who came in during the pandemic?
Pharmacist: I personally didn’t feel comfortable just standing really close to the patients, so I will consult further back. But it can’t be too far, because I still have to show them the prescription. I’d say it would be an arm’s length away. Before we would stand at the counter and consult the patients.
But lately, most of the patients have been wearing masks. If that’s the case, I’m able to go a little bit closer and consult them. If they are coughing and they don’t have masks, then I would stand farther back. But it’s not part of the policy. It’s up to you, whatever you want to do.
Ashley Arvind: Your store has no policy for its pharmacy workers on how to deal with patients who do not wear masks?
Pharmacist: No, because it’s law. Illinois law states that you have to consult all new prescriptions. We do encourage patients to go through drive-thru. We changed our store hours, so it limits traffic inside the store, but there’s still lots of prescriptions. We’re in contact with the patients all the time.
Ashley Arvind: You work long hours as a pharmacist. Going to the drug store is as a common routine as going to the grocery store.
Pharmacist: A lot of people come in and they think all we do is count pills all day, or slap a sticker on a bottle of medication. They don’t know what our job title entails. Like, how we have to check to make sure there’s no drug interactions, to make sure the dosage is correct, or sometimes we have to make sure if the drug is appropriate for that patient. So, the laypeople, they perceive us as pill counters. But we do so much more than that. Nowadays, because of the lack of primary care physicians, they’re putting more on us. With screenings: blood pressure, diabetes, cholesterol. Now we’re doing lots of immunizations.
We’re basically the first people they see, before they see the doctor. If they’re not feeling well, they’ll come to the pharmacy first, cause they don’t have to make an appointment. They just come in, ask the pharmacist questions. And we would either recommend stuff for them over the counter, or recommend they see the doctor, depending on the condition. We’re accessible.
Ashley Arvind: Many essential workers are on the frontline. A lot is being asked of people like you right now.
Pharmacist: If I had to put my risk versus a doctor working at a hospital, I would say the doctors and nurses right there treating people in the ICU, they’re the most likely to be exposed. So, I understand if we need to give all the PPE to them. They totally deserve it.
For us, I feel like all we need is masks, gloves and a shield, and we’ll be good. We’re not asking for much. We just want to feel protected. For example, doctors have to put patients on the ventilator or intubate them—that’s a very high-risk procedure. So, they need to be properly dressed. Pharmacists, we’re seeing hundreds of patients a day. We’re talking to them and consulting them. It’s some risk. If there’s some risk, we should at least feel protected, too.
Ashley Arvind: What does the lack of PPE mean for you and your co-workers?
Pharmacist: Some technicians…they feel more protected with gloves…But if they don’t feel confident, they’re always scared and they’re anxious. That’s going to make work even more stressful. And obviously we’re already all stressed—we don’t need additional stress. … For me, if I don’t have gloves, I’m fine with washing my hands all the time and not touching my face. … It’s an emotional thing, sometimes.
Ashley Arvind: The public doesn’t know the psychological stresses of what essential workers are going through. Can you talk about that?
Pharmacist: Coronavirus … can infect any gender, any age, healthy people—it doesn’t discriminate. But we’re more afraid of passing it along to our loved ones, or the vulnerable population. We’ll have conversations: My tech will say, ‘I’m sharing a house with elderly people and I’m afraid everyday, that I’m going to come home and give it to them.’… I’m afraid of passing it along to someone who may not be able to handle it.
I even told [my partner] I’d rather die than passing it on to my loved ones. [Starts crying.] I’m sorry. I can’t imagine if I pass it along, and someone doesn’t make it. That’s the worst feeling. Take me instead. I don’t want to spread it to anyone.
Ashley Arvind: Don’t put that pressure on yourself, because that stuff if out of your control. You’re doing the best that you can.
Pharmacist: It’s so difficult. … But now, finding out that one of my team members is positive, the anxiety came right back. … I would feel so much better if they [store] implemented the things they’re supposed to do. But they’re not. So that makes me more anxious. … At one point, a tech was like, if they’re not going to give us any PPE or protection whatsoever, I’m not going to go to work. … It’s just crazy. Everyone’s so stressed.
We feel like we’re going to battle with water guns. Just sending us to slaughter. … For the first couple weeks, we didn’t have anything. No gloves, no masks. Nothing. … Once the CDC started saying people should wear masks, it forced the company to give us something.
Ashley Arvind: Did you have masks in March?
Pharmacist: No. We just had masks this past week. If techs had their own mask, then they would bring it and wear it. … They’re [the store] like, ‘try to reuse it as much as you can.’ There’s a shortage.
Ashley Arvind: Reusing masks has become the fallback-solution to shortages across healthcare. Are you able to take a new mask for every shift?
Pharmacist: So far, yes. But it’s running really low. I don’t know if it’s going to be enough for next week. Until the next shipment comes—if it does. This is so emotional, you know. I’m so angry at the company and how they’re treating everything. As if it’s not a huge danger at all.
Ashley Arvind: I want you to be safe at work and your co-workers. Your voice is important too.
Pharmacist: I want to talk to someone high up in the government and let them know what’s going on. … We’re all kind of hush, hush… I’m afraid of losing my job. I need it right now. We’re getting backlash for saying anything.
Ashley Arvind: Backlash from your company?
Pharmacist: Just in the industry. We can’t say anything about our condition at all. Everything’s supposed to be perfect. There’s this article another technician had from [a retail store] that said this person had Coronavirus symptoms. But since you can’t test, just keep working. I was outraged.
But it’s very true to about what’s going on in our culture. … We’ve told corporate we need more hours because customers are not happy. They don’t care. They just keep cutting. They measure everything by numbers. You’ve got to get this prescription done in this time. … Corporate’s thinking everything’s all rosy. It’s ridiculous.
Ashley Arvind: How do you think this is being handled?
Pharmacist: Terrible management. You can ask any pharmacist at large retail chains if they’re happy with their jobs. If you find a happy one, that’s the rare one. Everyone’s been complaining for years. I guess the reason we stay is because we have huge loans to pay off.
Ashley Arvind: As this is unfolding, you’re not even sure where the instructions to employees are coming from? Whether what you’re being told is directly from store management, or if it’s company policy or not?
Pharmacist: Totally correct. Also, I feel as if they’re minimizing our risk. They’re saying we’re low-risk, because we weren’t in extended contact with this [infected] person, such as conversation when they were doing meetings. To my point, we work in close quarters. The pharmacy is not large. … To me, how’s that different from just talking to a person for an extended period of time, if we’re crammed closely together and talking for the whole time [from] when the store opens until close. It’s a closed ventilation system. … Someone’s infected, so other people may be infected, too. … What if a bunch of us are infected and don’t even know it, because we don’t have symptoms either. It’s not a low-risk. This is how infection spreads.
Ashley Arvind: How do you feel about your work environment?
Pharmacist: If you really think about this scenario, it makes sense; it’s why there’s social distancing. We can’t social distance because we’re in the pharmacy all the time. Try to talk six feet apart. Basically, it never happens. We’re next to each other talking and working. It’s like a breeding ground for Coronavirus.