Petition to U.S. House of Representatives, U.S. Senate, Donald J. Trump, Vice President Mike Pence
US Physicians/Healthcare Workers For Personal Protective Equipment in COVID-19 Pandemic
As cases of COVID-19 escalate around the country, physicians and other healthcare workers (HCWs) are facing severe shortages of personal protective equipment (PPE). This shortage is already a major crisis and will place an insurmountable strain on the health system of this country as cases continue to rise and more people require hospitalization for complications of COVID-19. As a result of this shortage, recommendations from the Centers for Disease Control (CDC) for appropriate PPE for HCWs on the frontlines have shifted. This shift does not come in response to overwhelming evidence, rather to a supply chain issue. As quoted directly from the CDC website: “PPE recommendations for the care of patients with known or suspected COVID-19: Based on local and regional situational analysis of PPE supplies, facemasks are an acceptable alternative when the supply chain of respirators cannot meet the demand."..."When the supply chain is restored, facilities with a respiratory protection program should return to use of respirators for patients with known or suspected COVID-19."(1) These statements in no way suggest that droplet precautions are adequate, supported by the statement that as soon as the supply chain has been restored, we should go back to using N95 respirators. As a result of these recommendations, many hospitals have taken the CDC recommendations to mean that facemasks are the preferred PPE, rather than a less desired (and potentially less safe) alternative. They have thus rationed respirators to be made available only for procedures, such as intubation and bronchoscopy, during which the virus is more likely to become aerosolized. This is putting our HCWs in tremendous danger of contracting and spreading COVID-19, which is unacceptable in the country with the most expensive health care system in the world. The evidence that droplet precautions are acceptable is lacking. CNN recently published an article titled “Health care workers getting sicker from Coronavirus than other patients”.(2) This statement is corroborated by data from a Harvard Study in China that suggested HCWs were at a 20% increased risk of severe infection compared to the general public. This risk decreased once the Chinese implemented full gear: protective suit, medical goggle, face shield, N95 mask and gloves – following this change there were no further reports of infected HCWs.(3) The debate is still ongoing as to whether or not COVID-19 can be transmitted via droplets vs. aerosols, yet as we speak, HCWs around the world continue to get infected, end up in critical condition, and die while using “appropriate PPE”. According to an ahead of print New England Journal Article on aerosol and surface stability of COVID-19, the virus can be detected up to 3 hours after aerosolization.(4) According to Dr. Milton, professor of environmental health at University of Maryland, “you cannot tell epidemiologically between something aerosol transmitted by weak sources and large droplet spray”, and he suspects the capability of long distance transmission will be dependent on the degree of symptoms.(5) Considering the mortality risk and lack of data to support a step-down to surgical masks, N-95 masks should continue to be the standard PPE for care of COVID-19 patients. As a physician, I do not know how long it takes to make an N95 mask, but I do know how long it takes to train a physician, a nurse practitioner, a physician’s assistant, a respiratory therapist or nurse. We are the supply chain that needs to be protected. Our friends from Italy have described the loss of infected HCWs as a critical hit to an already strained system. Infected HCWs are of no benefit to patients – in fact, they pose a serious risk.(6) They not only endanger the health of their colleagues, families, and communities, they also serve as a vector to infect the most vulnerable among us – the patients they care for. China, Italy, and S. Korea have more experience with this virus than we do and are taking the protection of their HCWs seriously. In France, Dr. Benjamin Davido, Infectious Diseases and Clinical lead for COVID-19, explains the importance of protecting HCWs against the severity of the illness, by using FFP2, the European equivalent of N95 masks.(7) “If we don’t do all we can to protect them (HCWs), they will quickly transition from providers to patients… Governments must support private-sector manufacturers in providing N95s and other equipment to HCWs.”(6) This letter serves to urge our government, industry, media and general population, to assist HCWs in obtaining immediate access to critical PPE, including N-95 masks. Our HCWs are already on the front lines, taking care of patients without appropriate protection, and our COVID cases and we are nowhere near the peak. Many hospitals are already running out of protective supplies. (NY Times, 3/9/2020) Recommendations to protect HCWs should not be based on what’s available; availability should be based on what is necessary. We urge the government to access the Strategic National Stockpile, and to utilize both the public and private sector to immediately increase production of PPE supplies. In addition, we urge our hospital systems to maintain the highest level of PPE standard for our HCWs, and demand the supply of N-95 masks. Sincerely, Dr. Milla J. Kviatkovsky Dr. Constance Chace Dr. Supraja Thota https://www.frontlineppenow.org/ References: 1) https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html 2) Howard and McLaughlin, ‘Health care workers getting sicker from coronavirus than other patients,’ expert says, CNN Health, March 12,2020 3) Xihong Lin, ‘Analysis of 25,000 Lab-Confirmed Cases in Wuhan: Epidemiological Characteristics and Non-Pharmeceutical Intervention Effects, Department of Biostatistics and Department of Statistics, Harvard University and Broad Institute 4) N Doremalen et Al, 2014, Aerosol and Surface Stability of HCoV-19 (SARSC-CoV-2) compared to SARS-CoV-1, New England Journal of Medicine 5) Souchery, ‘Unmasked: Experts Explain Necessary Respiratory Protectin for COVID-19’, Center for Infectious Disease and Research Policy, Feb 13, 2020 6) Osterholm and Olshaker, ‘Health-Care workers are the front-line warriors against coronavirus. We must protect them’, The Washington Post, Feb 14, 2020 7) Duqueroy, COVID-19: Advice From a French Doctor on the Frontline, Medscape, 3/16/2020
Petition to Gary Herbert, Todd Weiler, Mike Schultz, Mike Lee, Paul Ray, Karianne Lisonbee, Utah State House, Utah State Senate, Melissa Garff Ballard
Require Utah to Classify all 911 Dispatchers as First Reponders
I am a Police Officer in the State of Utah. My goal with this petition is to bring legislation to require all state agencies to recognize Dispatchers as First Responders, and to introduce them into the same retirement plan that other First Responders belong (Public Safety). This would allow dispatchers to retire at 25 years of service, instead of 30/35 years. I would appreciate your support in this cause. It's a simple signature to show the State of Utah that the public recognizes dispatchers are on the front line. Recently I discovered that the the State of Utah does not require that 911 Dispatchers be classified as 'First Responders'. Even the Utah DPS Website states "Dispatchers are the critical link between callers and first responders." Utah DPS is, to put it simply, wrong. Dispatchers aren't the link between callers and first responders, they ARE first responders. Utah gives agencies the decision to classify 911 Dispatchers in the category of 'administrative/clerical,' or as ‘first responders’. Administrative and/or secretarial work is an honorable career. It's the career my mother has worked for many years, and one dear to my heart because of that. Many men and women across our state, and country keep businesses afloat with attention to detail that FAR surpasses my ability. Our dispatchers ALL possess this talent. But they are so much more. They are the front line of Utah's front line. The difference between the 2 catergories is that First Responders are placed into Utah’s “Public Safety Retirement Plan”, and are granted the opportunity to retire after 25 years of service as a Tier 2 employee (20 year retirement as a Tier 1). Administrative/Secretarial employees are classified into the “Public Employee Retirement Plan,” and are required to work 30 years (Tier 1) or 35 years (Tier 2) before retirement is allowed. To require an additional 10 years of service to receive the same benefits that other first responders receive paints a picture to dispatchers across the state that they are not First Responders. To allow agencies to not recognize them as such, shows that they may not be wrong in this feeling. Before any of Utah's first responders can "answer the call", Utah Dispatchers literally have to ANSWER THE CALL. They are first responders, in every sense of the word. To deny them the title of First Responder is dishonest, at best. Let me paint a couple of pictures for you, that I hope will illustrate my point, that they should be classified as first responders. It's summer - mid August and the days are long and hot. Kids are out swimming in the pool, and the worst case scenario comes to pass. I am dispatched to respond to the scene of a drowning victim. She is 7 years old. The parents are understandably heartbroken. I know the chance of bringing their angel back is next to impossible, but I make every attempt to perform a miracle. Today there is no such miracle. Their little child has passed away. I look at my partner. We both nod our heads to each other, silently reassuring the other that we did all that we could do, even knowing what the outcome would likely be. As the Medical Examiner arrives to the scene, the teary eyed parents thank myself, my partner, and the paramedics on scene for what we tried to do. It is at that point I realize they are still on the phone with our dispatcher. The dispatcher is also witness to the heartbreaking sobs from family members or friends. Unfortunately, they also heard the panicked screams of "PLEASE HELP MY BABY" long before I arrived on scene. Our dispatchers were the ones who stayed calm in this families worst nightmares, and convinced someone to get the child out of the pool so they could walk them through how to perform CPR; a stressful and intimidating technique to even us who were trained in a controlled classroom environment. The dispatcher guides them through the process until I arrive, and in many cases the dispatcher is forgotten as soon as I leave. I am more proud to call myself a First Responder than any other title I have heretofore held, however there was one group of people who responded to the call before I even knew about it. They are the dispatchers. In another scenario an officer is parked in his car writing reports. He has worked a long shift and has a momentary lapse of situational awareness which prevents him from constantly checking his surroundings. "SHOTS FIRED, I'M HIT!!!" The worst case scenario for a law enforcement officer blares over the radio. An officer has been struck by gunfire and is in need of immediate backup and medical attention. The officer can hear the sirens of his brother and sister first responders coming to help him, but he doesn't know if he will make it. If the dispatcher has any information wrong, more hands for the fight will not arrive in time. "Dispatch, please don't leave me. I'm scared." Countless times in our country, the last person to hear from, or speak to a dying officer is the angel on the other side of the radio. Dispatch is our voice in the dark. The group we reach out to for solace when all seems lost. It is they who respond first, even to police and medical personnel. During our Covid-19 crisis, dispatchers become the heroes to not only those who call for help, but guardian angels to those of us who are sent to render aid. A call for medical comes out, “Delta response” (this means life threatening, turn on the lights and sirens and get to the call NOW). A man can’t catch his breath and is turning purple. As I arrive on scene with fire & paramedics, I don my PPE because my dispatchers have done their due diligence and discovered this man has symptoms of the pandemic illness that has devastated our world. Without their quick work and thorough screenings, officers, EMTs, Paramedics and fire personnel across the state would be infected, and the virus would spread like wildfire across our departments. Inside of the New York Police Department, no fewer than 17% of their officers have tested positive for Covid-19. In my small department, that would be 3 full time officers who would have to be taken off the schedule to prevent spread to other officers. Overtime would become mandatory, stretching thin an already thin budget. Dispatchers are the unsung heroes of the first response community. Without them, we all (police and fire as well) are helpless and hopeless. While police and firefighters have battles, and visual memories that come to haunt us in the quiet of our lives, dispatchers have the same battles with memories of those calls that changed their lives. Those calls that the general public would not be able to handle, come in every day. The PTSD that they can, and often do endure should not just be "cost of the job" that the state of Utah should allow agencies to overlook. By classifying Dispatchers as First Responders, we are recognizing their daily sacrifice, and the stresses of the calling they have responded to. A number of counties across the Unites States, along with the states of California and Texas have all implemented legislation to recognize 911 Dispatchers as First Responders. It's time that Utah took this step and showed the front line of our first response team that we acknowledge them. We would be nothing without them, and they deserve to be in the same classification as other First Responders. My goal with this petition is to bring legislation to require all state agencies to recognize Dispatchers as First Responders, and to introduce them into the same retirement plan that other First Responders belong (Public Safety). This would allow dispatchers to retire at 25 years of service, instead of 30/35 years. I would appreciate your support in this cause. It's a simple signature to show the State of Utah that the public recognizes dispatchers are on the front line.
Petition to American Dental Association, New York State Dental Association, New York County Dental Association, Andrew M. Cuomo, Charles E. Schumer, Kirsten E. Gillibrand, Dr. Chad Gehani, Marko Vujicik
American Dental Association needs to promote COVID19 testing in the dental office
As part of the dental community, I have read countless postings about how impossible it will be to assure our patients that our dental offices will be safe once businesses are allowed to open again. Dental offices are different from most other small businesses. Our work requires us to create an aerosole in the mouth at almost every step. I contacted Abbott Labs and found out that it is both economically and physically feasible to use their 5 minute COVID19 testing machine in our dental office to screen ourselves and our staff at the start of each day and to screen every patient we need to treat. However, our malpractice insurance carriers will not insure us because as of now, COVID19 testing is not within the scope of dental practice. We need the American Dental Association to amend, at least until there is a vaccine, the scope of dental practice to include COVID19 testing in the dental office in order to assure patients that we are catching the asymptomatic patients at the door and sending them home, instead of spreading the virus to us as dental practitioners, to our families, our staff, their families and our subsequent patients and their families. This virus will not be eradicated soon. The vaccine will not be here soon. Please support this petition to have the American Dental Association add testing for COVID19 in the dental office as being within the scope of practice of all dentists. Thank you.
Petition to Donald J. Trump, Members of Congress, Nancy Pelosi, Steny H. Hoyer, Kevin McCarthy, James E. Clyburn, Steve Scalise, Hakeem S. Jeffries, Mitch McConnell, Charles E. Schumer
Support the COVID-19 Pandemic Physician Protection Act (CPPPA)
Colleagues, Friends, and Family, By now, many of you have been personally affected by the COVID-19 pandemic. In some households, it may be several family members, or even yourself. As physicians and healthcare workers, we have been called to the frontline of this war against COVID-19, and we do not take this responsibility lightly. However, we do need your support. We need more tools and assurances in this fight against COVID-19. After hearing the feedback of the grassroots physician community through online communities with membership totaling over 100,000 physicians, we have proposed the COVID-19 Pandemic Physician Protection Act (CPPPA), which outlines the areas where we need help the most. Highlights include: Ensuring that physicians and other healthcare workers have access to adequate Personal Protective Equipment (PPE), increasing access and removing restrictions for TeleHealth services, keeping our private practices financially solvent, ensuring mental health coverage for healthcare workers, canceling student loan debt, and creating provisions for our families if we die or become disabled during this pandemic. Please take a moment to sign our petition, which will also supports our proposed legislation (the CPPPA). We truly believe it will save lives - not only of physicians and other healthcare workers, but of patients throughout the United States of America. Respectfully submitted, Nisha Mehta, MD Carlos Vital, MD Karla Vital, MD
Petition to Health Care Workers, First line responders, Care givers for elderly, Hospice workers
Student loan forgiveness for those working the front-lines of the COVID-19 pandemic
First of all - I'm just a humble father thinking about his children during this time of need and self reflecting what can I do to help from the current position I am in? After reading social media and news reports around the duress concerning our healthcare system and the families at home fighting their battles. I came up with this idea. When the Economy recovers and the big business begins to go for profits again we will find ourselves struggling to keep up again and the worries we had all along will have caught up to us. We as a country need to give back to those front line workers that kept this country running outside of a minimum wage single month stimulus check. This goes beyond a mortgage companies forgiveness of payments while we are in crisis, you will only have to pay it back at the end of the term. It extends past Insurance companies giving you back $50.00 for a single month premium on your insurance rate - this is wonderful, but I would expect a bit more especially since most except for those that are deemed essential employees should not be on the road, and those that are deemed essential employees should be 'gifted' their expense for working anyway .. again .. keeping the country running for those of us that can work from home. This petition is focused on the health care industry and those sacrificing their lives to an oath to a passion or calling that they felt when they were younger never expecting to run into an invisible enemy call COVID-19. It is our turn to support them in any way possible and get the word out to our elected leaders that we respectfully request that they initiate a bill to erase ALL student loans incurred prior to March 15, 2020. In this time of uncertainty we have neighbor hero's that go to.work.everyday not knowing what their personal impact will be against this terrible situation They have a high possibility of exposing those around them as well as their family when they come home. You hear about stories of mothers and fathers coming home self-isolating to protect those they love the most and leave their youngest wondering "why mommy or daddy can't give them a big hug and play" These individuals are giving their all and some are even giving the ultimate sacrifice We as a United States of American can agree to put aside politics and come across colored isles in some ivory building in Washington DC and TRULY and FINALLY put the people first by having our elected legislation establish a bill to forgive all.student loans for those work the front line of the COVID-19 crisis. Filter out the wannabe scammers and TRULY help all those that sacrificed their and their loved ones well-being on a daily basis We need to forget the Blue and the Red of our country for the moment and finally stand behind doing what is right by a human being. Forgive the student loans for all front-line workers cheers to all.and please be safe and love your family Steven M. ** New to online petition making and this is the best photo I could find, please no offense to the person that might have copy-write ownership **
Petition to United States Department of Health and Human Services, U.S. House of Representatives, U.S. Senate
Allow U.S.-Based IMGs to Work in the U.S. for COVID-19 Support
27% of U.S. physicians are internationally trained with 65,000 unlicensed IMGs in the country. AMOpportunities connects international medical trainees with clinical rotations in the United States and has a solution to our healthcare shortages. You can learn more at https://www.amopportunities.org We believe that an answer to the impending physician shortage in the United States and at present the global pandemic of COVID-19, necessitates U.S.-based international medical graduates. As such, we petition the United States healthcare system to allow IMGs to assist U.S. hospitals in any capacity. We're asking you to sign our petition to demonstrate your support and show the U.S. government and healthcare system the need for the expertise of IMGs. Our country is struggling to provide much-needed healthcare to the victims of COVID-19, which has infected more than 200,000 U.S. citizens. If we look at harder hit countries, it’s clear this number will only soar. Already, U.S. hospitals are calling on retired healthcare professionals and medical students to lend their support. Governor Phil Murphy of New Jersey recently signed Executive Order No. 112 authorizing the Division of Consumer Affairs to grant temporary licenses to doctors licensed in foreign countries. The rest of the country must follow suit. The 65,000 unlicensed IMGs in the U.S. are the answer to strengthening the healthcare workforce and ensuring we slow the spread of COVID-19 and eventually eradicate the virus. IMGs are limited to work by policy, geography, and cost. Many of them are unlicensed due to the lack of residency positions available. These 65,000 IMGs have medical degrees, and many have passed their board licensing exams, however these qualified near physicians cannot secure the necessary residency slots and thus can’t practice. In New York, IMGs that have completed three years of graduate medical education in a postgraduate training program accredited by the ACGME or the AOA can provide patient care services even if they’re unlicensed. This petition goes one step further. We ask all state officials and medical boards to pass policies that allow IMGs who are ECFMG certified to assist under the supervision of a licensed physician, regardless of whether they have completed any U.S. postgraduate training. The untapped knowledge and expertise of IMGs are precisely what frontline healthcare workers need to fight COVID-19. Join us as we petition the government and U.S. healthcare system to invite IMGs in the U.S. to lend their extensive medical experience. We all need to do our part to confront the uncertain time we find ourselves in. Thank you for your support. AMOpportunities https://www.amopportunities.org Here are other ways you can help us gain support for IMGs in the United States to practice in the U.S. during COVID-19. 1. Encourage your state to create an International Medical Assistance Program for a pathway to practicing in the U.S., similar to what Minnesota has done for IMGs. Washington is pushing similar action. You can see what other states have done to push a pathway for IMGs here. 2. Encourage universities to create programs that strengthen IMGs’ likelihood in matching into U.S. residency positions, similar to this program at UCLA. 3. Rural care has the greatest need of care from IMGs, and many live outside of major metropolitan areas, making it easier for them to practice in rural cities. Again, Minnesota has been working toward that same cause. You can also find more information here.
Petition to Andrew M. Cuomo, Mayor Bill de Blasio, Phil Murphy
Safeguard the Right of All Laboring People to Have Support During COVID-19 Crisis
On March 21, the NYS Department of Health issued clear guidelines on treating patients in labor during the COVID-19 crisis. These guidelines determined a support person, whether a spouse, partner or other chosen person, is essential to care for the patient during labor, delivery and in the postpartum period. The World Health Organization (WHO) agrees. We agree. As of March 26, all New York Presbyterian and Mount Sinai affiliated hospitals, and Staten Island University Hospital in the New York City area will act against WHO, CDC and DOH guidance and ban all support people--including spouses--from Labor & Delivery and Postpartum units. This means people in labor will give birth alone and parent alone. Parents will miss the birth of their child. Fundamentally, risks for the people laboring alone will increase substantially. Not only can partners and spouses provide physical and emotional comfort during labor and postpartum, they are also essential in alerting staff when something has gone wrong and the laboring patient cannot notify nurses themselves, like in the event of an eclamptic seizure or a fainting episode. Timing is critical in these cases and monitors can be unreliable. We cannot expect nursing staff, already spread thin, to spend the limitless hours needed with each patient to ensure their health and their baby's health, to provide physical assistance and emotional support. We know the hospital system is overwhelmed in this crisis. However, the burden will only be increased by banning support people from Labor & Delivery. We must ensure no one gives birth alone. We must ensure the maternal mortality rate does not increase during this time.
Petition to Mary Clark, Nadine Laurent, David White
Fair Compensation for BAART Healthcare Employees During COVID 19
Today there are thousands of people suffering from opiate addiction in Los Ángeles alone. There are clinics around the city that serve as a daily refuge for many people affected by this epidemic. Substance Abuse Counselors make direct contact with hundreds of recovering addicts every day in order to provide essential care. These counselors are the primary link to essential mental healthcare, crisis intervention, and medication assisted treatment. Substance Abuse Counselors are working in clinics during this pandemic, making one on one contact with countless people everyday. The counselors, nurses, and other healthcare workers in these clinics are offered very little to compensate them for the risk they take to serve the LA population. The health insurance packages are insanely overpriced and no hazard pay is offered. We must demand that BAART Programs, a multi-million dollar company, compensate the front line workers that risk their personal health to allow them to continue to operate. Working face to face with a high risk population is hazardous to the employees of BAART, and they deserve adequate compensation. Please help the healthcare workers of Los Ángeles continue to support the people of our great city. Sign this petition urging BAART, a Baymark company, to fairly compensate employees with affordable health insurance or hazard pay