A union representing Los Angeles County nurses argued Wednesday that specialized N95 respirator masks should be made widely available to health care workers on the front lines of the coronavirus, despite widespread shortages and predictions that critical cases will increase in the days to come.

Registered nurses are being asked to reuse masks and denied access to N95 respirators mandated by a state standard for airborne infectious diseases, according to the Service Employees International Union Local 721.

“It is our union’s position that much is still unclear about this virus and that the L.A. County (Department of Health Services) should err on the side of caution when it comes to ensuring that the critical workforce of nurses is protected so they can stay healthy and be able to tend to thousands of patients in the weeks to come when the public will need nurses more than ever,” according to a union statement.

The county Department of Health Services insisted it is committed to following health guidelines and protecting its workforce.

“Safety is always the focus of everything we do, and the Department of Health Services is deeply concerned for the safety and welfare of our patients and the 7,000 dedicated nurses working across the DHS health system in difficult and challenging settings,” Dr. Christina Ghaly, who runs the county’s hospital system, said in an email to City News Service. “Our nurses are the backbone of our system and the faces of compassionate care for every patient that comes through our doors.”

California Department of Public Health guidelines recommend the use of surgical masks — the type commonly seen in hospital hallways or on medical shows on television — for the routine care of all patients suspected of having COVID-19, according to the county department.

Masks with N95 respirators are recommended by the state for use when performing aerosol-generating procedures, such as intubation, when body fluids may splatter or splash.

The U.S. Centers for Disease Control and Prevention has focused on the transmission of the coronavirus via respiratory droplets and close contact with infected individuals. Dr. Barbara Ferrer, the county’s top public health official, has drawn a contrast between the coronavirus and airborne infections like the measles. However, Ferrer and others concede that much is still unknown about this virus.

Coral Itzcalli, a spokeswoman for SEIU Local 721, told City News Service the union met with county officials on March 11 and were told not to worry because plenty of personal protective equipment was available.

SEIU 721 accused county hospital administrators of stockpiling the N95 respirators and filed a complaint with the California Division of Occupational Safety and Health. The union demanded that the county immediately investigate the risk to health care workers.

“It is utterly disappointing that L.A. County would put frontline healthcare workers like myself in this kind of danger when it’s precisely in times like these that we desperately need all medical staff in top condition,” said Cynthia Mitchel, a supervising registered nurse at LAC+USC. “Instead of being proactive, the county is setting us up to become super spreaders while the coronavirus is brewing in our hospitals.”

One registered nurse who has long been a vocal critic of the county and DHS leadership sided Wednesday with the administration, making clear she was speaking as a private citizen and not as a member of the county’s Hospitals and Health Care Delivery Commission.

“You have nurses that are trying to raise trouble,” Genevieve Clavreul said, adding that she has seen nurses walking on sidewalks with protest signs instead of working in the hospital at a time of crisis. “That’s not helping patients. I am appalled.”

Clavreul said she believes nurses have the supplies they need to do their jobs.

Until the county provides what they deem proper personal protective equipment, the union has advised individual healthcare professionals that they may choose to refuse work assignments they feel are unsafe.

A shortage of masks at acute care hospitals across the country has led to a federal government push for increased production, calls for donations and even sewing circles working to make masks.

The CDC has approved the reuse of N95 respirators given critical shortages, according to DHS.

“DHS joins other statewide hospitals in advocating for the increased availability of PPE (personal protective equipment) in the supply chain,” Ghaly said. “DHS is closely monitoring supplies of surgical masks and N95 respirators, as well as state and federal guidance and will continue to work with its labor partners, as well as state and federal partners to increase supplies as all hospitals face critical shortages.”

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