The state of Hawaii is on the verge of a COVID outbreak as the Hawaii Department of Health reported 129 new COVID-19 cases on Monday, bringing the state total to 24,482 cases and a death toll of 322. Metrics compiled by rt.live shows that the state’s virus effective reproduction rate stands at 1.12 and warns that the state is on the precipice of a major outbreak. This means that every COVID positive person is spreading the virus to 1.12 people, making it the worst state after Washington, with a growth rate of 1.15.

It is under these conditions, and months of demands for safe working conditions, that some 700 nurses at Kapiolani Medical Center for Women & Children voted by 93 percent in early January to authorize strike action. The nurses are represented by the Hawaii Nurses’ Association (HNA) Office and Professional Employees International Union (OPEIU) Local 50, who reported that an unprecedented 96 percent of the membership cast their vote, showing widespread support for strike action in support of patient and staff safety.

The strike was announced on January 10 by OPEIU Local 50, and within days the union had announced it reached a tentative deal with Kapiolani. As of now only the union highlights have been shared, consisting of minor wage increases of 2 to 3 percent, and 82–84 percent of health care premiums for family members to be covered. The OPEIU states that the tentative agreement addresses PPE and safety concerns, but the specifics have not been released. OPEIU Local 50 is pushing through a vote, asking health care workers to ratify the agreement on Wednesday and Thursday of this week. It is unclear if nurses will even have access to the full contract before voting on it.

For Kapiolani nurses, as for nurses and other health care workers across the US, the primary concerns they are striking for are to improve patient and staff safety. Workers presented a list of proposals to keep themselves and their patients safe to Kapiolani management in September, but these were rejected. Since last year, nurses have been asking for a COVID task force which includes nurses to ensure hospital staff have what they need.

The main issue nurses report is their being forced to reuse personal protective equipment (PPE), which the hospital sterilizes with a UV light. But health care staff say that the N95 masks do not properly fit after sterilization, placing them and their families at risk.

Kapiolani Medical Center CEO and executive vice president of Oahu Operations for Hawaii Pacific Health Martha Smith has continued to downplay concerns, stating that PPE can be used up to 10 times according to CDC guidelines. “We sterilize them with ultraviolet light, we’re using the CDC and manufacturers’ recommended guidelines, which say that you can use those masks and sterilize them and reuse them if they’re in good condition, up to 10 times.”

Since last year Kapiolani nurses have been demanding the creation of a COVID task force that includes nurses to ensure hospital staff have what they need. They are worried about safe staffing and a rising number of cases among health care workers.

Astoundingly, Smith and Kapiolani management have been responding to cases of infection among staff by blaming health care workers. Nurses report that the hospital is blaming them for contracting the virus and not properly wearing PPE, which they claim if worn properly should prevent them from contracting it.

Paulette Vasu, a Kapiolani nurse, told Hawai’i Public Radio, “We are pretty confident that one of our nurses and one of our residents did contract COVID from a patient, but the management said no, it’s community acquired.” Vasu said that management pressured staff to answer if they had worn proper PPE and if they washed their hands. If so, management is classifying the infection as being acquired from within the community and not from their COVID patients.

The movement by Hawaii nurses for patient safety and safe work conditions is connected to the demands by health care workers across the country and internationally who are raising the same demands. Hawaii nurses must be warned that the OPEIU as well as the HNA is working not only with hospital management but with the highest levels of the state and Governor David Ige to prevent a strike that could quickly spread across industries, as cases are rising in the state.

Just last month, SEIU Local 121RN betrayed a struggle by nurses at three Southern California hospitals owned by the health care giant Healthcare Corporation of America and smothered a planned strike by some 2,500 nurses in Los Angeles and Riverside counties. Within days they called off the action and pushed through a vote which did nothing to stop the deadly short-staffing and high ratios. The SEIU had workers vote on a contract which they did not even get to read. The WSWS published a statement urging them to reject the vote, demand to see the contract in full, create independent rank-and-file committees and link up with other sections of workers to put a stop to the spread. Only a halt to the spread of the virus will alleviate the horrific conditions in the hospitals.

What is required to put a halt to the pandemic is a lockdown with full provisions made so that nonessential workers can stay at home safe and small businesses do not face financial ruin. However, this demand cannot be realized by nurses alone, they must link up with other sections of workers and join a network of rank-and-file committees.

Nurses in Hawaii must be warned that the response of the Democratic Party that runs Hawaii and are tied to the trade unions will be just as brutal as in California. The response of the ruling class, which Governor Ige and California Governor Gavin Newsom represent, is to do everything possible to keep businesses and schools open despite the rate of infection and deaths.

Despite California’s skyrocketing death toll and morgues unable to keep up with the cremations, Newsom is still working to open all schools next month. This has been allowed to happen with the assistance of the trade unions. All industries are working with management and state officials to keep businesses and schools open, and will do everything in their power to prevent any action by nurses. This includes OPEIU Local 50. Health care workers must demand to see the full contract and at least a week to study it before voting on it.

Health care workers in California have sent in the following statements urging Kapiolani workers to draw the necessary conclusions, reject the efforts to sabotage their struggle and organize independently of the trade unions:

To the nurses at Kapiolani Medical Center for Women & Children, from a worker at an Adventist Health hospital:

We support your fight to strike! Management at our hospital does everything to deny hospital-acquired COVID-19 infections. It’s an insult to deny paid COVID leave to the frontline workers struggling to stem the pandemic, especially when we have to take time off to care for our own families, who in all likelihood have fallen ill because of our work exposures.

Workers and patients deserve the PPE needed to protect themselves and their families. Baking the same N95 to reuse over several shifts is not the standard of safety anyone should settle for, especially during a pandemic. They do the same at our hospital, too, using UV light as an excuse to not provide us with adequate PPE. Almost a year into the pandemic and we’re still short on N95s and face shields. And to (re)use an N95, we need approval from the charge nurse.

Our benefits here have been slashed for 2021, and we’ve been denied pay increases that keep up with the rising cost of living. It’s becoming ever more difficult to care for oneself or for one’s family. Especially in the state of Hawaii, with the highest cost of living in the country.

You nurses at Kapiolani Medical Center aren’t alone. HNA takes dues from 4,000 nurses—you have, at the bare minimum, 3,250 allies you can count on. Reach out to them! The union won’t—making you work without a contract since November is an absolutely shameful betrayal. Bring EVS/housekeeping and other clinical and nonclinical workers with you! Unite with all the workers at your hospital—and across hospitals throughout the state, and abroad. You make this hospital and the community, and these are your lives at stake. You have to fight for them, and you can’t fight alone. This is a struggle that health care workers face all across the world.

An acute care nurse from Riverside, California, sent the following message, “Stay strong during this time, with your collective voice you can achieve patient safety, settle for nothing less. The public will make you feel guilty for ‘abandoning’ patients, in truth you are putting patients first. All nurses recognize this and support you.”

A nurse from Long Beach issued the following warning and call for Hawaii nurses to begin forming rank-and-file committees: “To the nurses at Kapiolani Medical Center, do not allow the union and hospital management to shut down your voices and demands. They will try to deter you from your goals of advocating for safe patient care and safe working conditions. Hospital management actually prefers having a union hospital because they know the union will put to bed any dissension at the behest of hospital management. And hospital CEOs and political leaders will try to sabotage your voices and demands through a smear campaign and guilt because hospital corporations and the Democratic Party are tied to each other by campaign donations, your dues money, given to the Democratic Party.

“If political leaders were concerned for the welfare of nurses and patients they would have bailed out the American people, not corporations. Hospitals have profited during a raging pandemic through bailouts and have maximized their profits by understaffing hospitals, not providing enough PPE and cutting employee benefits. Stand strong against the pressure from hospital management and your union because they will attempt to sabotage your fight for safe patient care and safe working conditions. I recommend forming rank-and-file committees away from the union and take control of your working conditions and power.”

For help starting a rank-and-file safety committee at your hospital and workplace, contact us at wsws.org/contact and sign up for the WSWS Health Care Workers Newsletter.