Furloughs proposed, then scrapped at Jackson in the midst of COVID19

Was it just a bad dream?

Furloughs proposed for healthcare workers at Jackson Memorial Hospital in the middle of the national coronavirus pandemic, with thousands of Miami-Dade residents testing positive only on the rise, have been called off. Thankfully. At least for now.

“It won’t happen,” said Jackson Public Health Trust Chairman Joe Arriola on Saturday. “It’s already been resolved. No doctors or nurses are getting laid off.”

But what almost happened?

Jackson President and CEO Carlos Migoya wrote a memo to the staff Friday that warned of a severe financial crisis. He said he and the executive team would take a 20% pay cut (easy when you make a million bucks) and that management would take a 10% pay cut. But nobody balked at that. He said no doctors or nurses from the COVID19 area would be cut, so everyone was still ok. But then he said that there were to be furloughs starting at the end of the month — up to two unpaid days off a week — for up to 40% of the hospital staff, including nurses from other departments that could support the intensive care and COVID nurses.

Arriola told Ladra on Saturday that Migoya’s intent was good. “I know what he’s trying to do. He is trying to prepare us for what’s coming. He is trying to protect the hospital financially.

“But I told him that we are the service hospital, we are the last resort for the people of Miami-Dade County. If we go broke, we have to find the money someplace. But we cannot lay off any healthcare workers,” Arriola said, adding that non-medical personnel may be furloughed if it’s needed.

This appears to be the treaty after what some called World War III, with the labor union and county commissioners and Arriola and his board members pushing back on what many said was a totally unexpected move. Nobody was on board. It almost seems like Migoya — whose background is in banking, not healthcare — had a momentary lapse of reasoning. He has tested positive for COVID19 and is in self quarantine. Could a symptom be the temporary loss of faculties?

This is not the time to be proposing any cuts at the public hospital in Miami-Dade, where the Florida Department of Health reported Saturday that 3,890 Miami-Dade residents had tested positive for coronavirus, including 940 new people in the last 48 hours. As of Saturday, 31 Miami-Dade residents have died in about three weeks. Miami-Dade represents about a third of the statewide 11,173 cases. In Florida, there have been 195 deaths, including one longtime Jackson ICU nurse who got COVID19 and died suddenly last week.

“Wrong time, wrong message,” tweeted Commissioner Daniella Levine Cava, who is running for county mayor. “Our healthcare workers are on the frontlines of a growing battle.”

Levine Cava said she wanted to put the potential furloughs on the agenda for Tuesday’s meeting, and even though Arriola said it is resolved — for now, because we don’t know how long this pandemic is really going to last — Ladra is certain county commissioners are still going to want to talk about it.

COVID nurses and doctors and healthcare workers have become heroes nationwide. People isolated at home applaud to them from the balconies and windows of high-rises. An instagram account called covid_nurses has almost 5,000 followers already and has had some photos go viral.

But the hospital is losing money. The public health emergency has made them cancel all the elective surgeries — the moneymakers — and other patient follow-up care that would have been billed to insurance companies and the clients. They’re burning through protective equipment daily and paying overtime to overworked doctors and nurses. And the worst is yet to come.

On Saturday, Jackson Health System tweeted that there were 111 patients in its hospitals being treated for COVID19. Ladra was told that the entire emergency room has been turned into a COVID-exclusive unit. Each ICU nurse has to work with four patients rather than two. The system is already stressed. And Miami-Dade is supposed to peak in between three and five weeks.

Also, because the state reported that 243 Miami-Dade residents who were positive were hospitalized, that means another 132 are in other area hospitals, including Baptist’s Kendall Drive facility and Palmetto General in Hialeah.

On Saturday, Miami-Dade Mayor Carlos Gimenez issued another executive order requiring area hospitals to report twice daily with the number of beds, supplies and number of COVID19 patients beginning Sunday.

These reports to the County must include the following:

Current staffed inventory of General Acute Care beds (does not include OB, pediatric or specialty/rehab)
Current staffed inventory of Intensive Care Unit (ICU) beds
Total number of unused beds at the hospital that could be converted for use as ICU beds
Total number of beds that can be converted to General Acute Care beds
Total number of ventilators available for immediate deployment
Total number of ventilators on standby
Total number of respirators and/or anesthesia machines that can be converted to serve as ventilators
Total COVID-19 patients admitted
COVID-19 positive patients in ICU beds
COVID-19 positive patients in non-ICU beds
COVID-19 patients currently on a ventilator
New COVID-19 patients admitted since the prior day’s reporting
COVID-19 patients discharged since the prior days reporting

None of the information will identify individual patients who are protected by federal laws. “The order will help the county deploy limited resources during the COVID-19 pandemic,” the order says.

Translation: Buckle up. We’re in for a long ride.

Over the weekend, there were a few other COVID19 developments in Miami-Dade:

The Coral Princess cruise ship docked in Port Miami Saturday morning and shortly after, people started to get off. Two people on board had already died from the coronavirus. Two people were taken to Larking Community Hospital and three others were sent to St. Joseph’s Hospital in Tampa. Gimenez said 27 passengers and 38 crew members remained aboard. He also said that between 250 to 300 cruise ship crew members are leaving the port every day to go to their homes.
Miami-Dade announced the fourth drive-through testing site to be opened at the South Dade Government Center, in Lot E behind building at 10710 SW 211th St. in Cutler Bay. You must be symptomatic and have an appointment, which you can get by calling 305-499-8767 after 9 a.m. No word yet if Commissioners Joe Martinez and Jose “Pepe” Diaz, who have been asking for one in the West Dade area, are satisfied with that or want something further west.
Hialeah Councilman Jesus Tundidor and the city’s first responders gave out more than 700 12-ounce bottles of hand sanitizer — which is like gold now — to a steady line of grateful drivers like it was a Farm Stores. Everybody wore masks and stood six feet apart, according to social media posts (photo, right).
Miami-Dade Commissioner Esteban Bovo, also running for county mayor, reported on Instagram that the testing site at Hialeah’s Amelia Earhart Park had tested 458 people in 48 hours since it opened on Friday and that the positive rate was coming back at 20%, though that was fast when the tests were taking 4 or 5 days to get results from. Residents must be showing symptoms and make an appointment by calling 305-COVID19 (305-268-4319).
Miami-Dade received the “surveillance” tests that they are going to use “randomly” in a multi-week study with the University of Miami to see if they can track the community spread and identify hot spots where the virus may be. But the tests look for antibodies that show someone has had the virus. So wouldn’t that show where the virus has been? “Our goal is to be able to get a snapshot of where the virus is going and how many people are reacting to it,” Gimenez said during a virtual press conference Friday. The surveillance may allow the county to identify “clusters” of the virus, and could identify people who are infected but do not know it, Gimenez said. “Having that information will allow us to get ahead of what’s happening on COVID-19 and can guide us as to how to best use our resources to stop the spread of this virus. Disaster Management Group, which devised the blood test, will charge the county $340,000 for 22,000 tests. The surveillance will track 750 “volunteer” subjects over the course of several weeks. Another group of first responders will also be tested.
State Rep. Anthony Rodriguez and a bunch of volunteers (photo above, right) gave bags of food away to families at the Miami-Dade Youth Fair grounds — near a field hospital set up for overflow “non-COVID” patients.
Broward Schools Superintendent Robert Runcie announced that the kids aren’t going back to school this year. They’ll finish out the class of 2020 with home learning. Miami-Dade will likely follow. This is one of those things that is going to stick around post-COVID, when many students — mostly middle and high school — will opt to take classes virtually than go to an actual school.
The U.S. Department of Transportation awarded $25 billion from the CARES act funding to transit departments across the country, including almost $455 million to Miami-Dade, to buy help combat COVID19. Ladra hopes it’s to buy protective equipment for the bus and train operators and other transit workers that have been working without the adequate — or any real — protection from the coronavirus. It’s important to protect them, because they can infect others. Two bus drivers have already tested positive for COVID19. We have to keep an eye on that money because this county has a history with making earmarked funds disappear. Especially since it can be used for general operations.

But this state of emergency is in flux every day and there are new orders, developments and issues announced all the time. “Every day it changes,” Arriola told Ladra, adding that the hospital has applied for a $150 million line of credit to help keep them operating through the next few months.

“It’s just for now. A week ago, we had three patients and today I have more than 100,” Arriola said. “We really don’t know what’s going to happen.”

So please stay tuned. And stay safe!

Carlos Migoya, coronavirus, COVID19, Jackson Memorial Hospital, Joe Arriola

Furloughs proposed, then scrapped at Jackson in the midst of COVID19 added by Ladra on April 5, 2020
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