Filipino Health Care Workers and Their Battle Against COVID-19

by Ronnie Estoque

Clea Patriarca Alverio-Hume, 57, served as the medical records director at Queen Anne Healthcare, a skilled nursing facility, and she also worked for Swedish Medical Center where she was the lead admission coordinating assistant at the Transfer and Operations Center.

On May 21, 2020, Alverio-Hume developed a harsh cough. Initially, it was attributed to her allergies due to the cottonwood trees that were shedding at the time. Her allergy medicines and inhalers were filled, but they didn't seem to help much according to her husband, David Hume. Four days later, Alverio-Hume went to a clinic to get tested as she had a minor fever and was vomiting. Her cough had gotten severely worse.

"I ended up calling the paramedics that Tuesday evening because she was having difficulty breathing," her husband said.

She was transported to the Swedish Edmonds Campus where she found out that she was positive for COVID-19, but was sent home that same night. "Clea ended up getting the infection from a coworker at Queen Anne Healthcare," Hume said. Clea and David isolated from each other and communicated via Messenger but her symptoms only worsened with vomiting, fever, and body aches.

Alverio-Hume, like many Filipino nurses and health care workers in the Seattle area, have been on the front lines of the pandemic since it began earlier last year, and it is taking a heavy toll.

Nearly one-third of U.S. nurses who have died from COVID-19 are Filipino even though they make up just 4% of the nation's total nursing population, according to a report from National Nurses United, the largest nurses' union in the country.

"I feel like I'm putting my own health and my family's health at risk just by stepping through the hospital doors to do the job that I normally do, and that brings a whole different level of stress to me," said another Filipino nurse who has worked at the UW Medical Center in Montlake since 2017 and asked to remain anonymous. "It hits closer to home when you know that one-third of the friends and family that you know that work in healthcare might be part of that statistic."

The U.S. has a long history of importing Filipino nurses from abroad, largely due to the colonization of the Philippines in 1898. Nursing schools that taught western medicine were established in the Philippines, and after the U.S. faced a nursing shortage post-World War II, a large influx of Filipino nurses immigrated via the exchange visitor program. The 1965 Immigration and Nationality Act also made it easier for hospitals in the U.S. to recruit Filipino nurses, who also largely immigrated in the 1980s during the height of AIDS.

Alverio-Hume immigrated to the United States in 1994 with her then 1-year-old daughter. In August of 2017 she married David Hume, who spoke about Alverio-Hume's life in an interview with the Emerald. The couple had met in 2015 through a mutual friend and had plans to visit Alverio-Hume's hometown of San Pedro Laguna, Philippines.

"Clea had one of the biggest hearts that I've ever witnessed in my life," Hume said when asked about his wife's legacy. "Clea was a very very giving person."

But the virus took its toll.

"She was in a lot of pain, there was pneumonia that developed," Hume said. "The constant coughing and the pressure on the chest from the pneumonia was quite painful."

Hume himself tested negative for COVID-19 even though he had been exposed, and no one else in Alverio-Hume's family had contracted the virus. On May 26, Hume called the paramedics once again for his wife due to her experiencing more difficulty in breathing, but she was sent back home after she was sent to the hospital.

After her symptoms continued to worsen, Alverio-Hume was finally hospitalized on May 31. The next day, on June 1, the Washington State Department of Labor and Industries Division of Occupational Safety and Health sent a letter to Queen Anne Healthcare in regards to the surge of COVID-19 cases in their facility. The letter expressed concerns about the COVID-19 outbreak in which 64 residents and 18 staff members had tested positive. Three workers had been admitted to hospitals to treat COVID-19 symptoms.

On June 12, Alverio-Hume passed away from complications of COVID-19 and asthma, losing her battle against a virus that has already claimed millions of lives across the globe.

As coronavirus cases continue spiking in the U.S., there is concern that more Filipino nurses and healthcare workers will contract the disease. "Today again elective surgeries requiring hospitalization have been canceled, only day or outpatient surgeries are happening," said a Filipino nurse who works in the 'Surgery-Pre Admission' department at the Swedish Issaquah Campus who also requested to remain anonymous. "We are bracing for a repeat of last spring's events."

"We lost one male Filipino RN to the virus this year," the Swedish nurse said. "One loss is still too many, and we are well aware that Filipino nurses have been hit hard as far as 'casualties' are concerned."

The Swedish nurse immigrated to the United States during the 1980s, and believes that other Filipino nurses that immigrated then are old enough to be at high risk for low survivability if infected with COVID-19.

"Now that many RNs have tested positive and are home being quarantined, the lack of staffing has gone from bad to worse. … We fear that if the surge continues, we won't only run out of beds but staff as well," she said. Swedish started vaccinating its workers with the Pfizer vaccine on Dec. 29.

"Prior to the pandemic, I usually didn't hear or see anything medical related once I got home," said the Filipino nurse who works at UW Medical Center in Montlake. "The boundary between my home and work life is basically nonexistent at this point, and that's mentally exhausting."

Melanie Arciaga has been a union delegate for SEIU Healthcare 1199NW for over seven years and is currently a nurse at Harborview Medical Center where she has been working for 12 years. In March of 2020, she had been floated to a COVID-19 floor at Harborview, but she did not contract COVID-19 until April 3, when she was working in a room with a patient that was on a nebulizer.

"He coughed, and I felt a wet spray onto my face and onto my eyes," Arciaga said.

The following morning, she woke up to a message from a coworker that the patient who had coughed on her was COVID-19 positive and that she had been directly exposed. She eventually got tested for the virus a couple days later at Harborview and tested negative. She was told to quarantine herself for five days before coming back to work, and that's when her symptoms started to show.

"I had never experienced that kind of body aches before," Arciaga said.

The following weekend, she woke up with incredibly painful chest pains. Her husband took her to the emergency room due to the pain being unbearable.

"They swabbed me, and I was positive for COVID-19, and I had pneumonia," Arciaga said.

Since then, Arciaga has continued to have lingering symptoms over the nine months since her positive result. She still experiences nasal burning, loss of her taste and smell, and a persistent cough. While she has been away from work, she remains motivated to stay in contact with her coworkers, especially those that come from diverse ethnic backgrounds that are most institutionally marginalized in the health care industry. Arciaga serves as a member of Harborview Medical Center's Nurse Staffing Committee and spoke about challenges she has experienced as an advocating Filipino nurse in a predominately white setting.

"I'm just really frustrated because the equity isn't there," Arciaga said. "I've been called out a lot of times because of my tone; I don't know if it's [because] I'm a Woman of Color, and they're all white. I've been called out saying that I've been disrespectful because my voice was raised."

Negotiations between the SEIU Healthcare 1199NW and the University of Washington last March around their COVID-19 contract ensured that salaries would be guaranteed to workers, such as Arciaga, who have been unable to return to work due to contracting the virus.

Labor unions in Seattle have played a pivotal role in ensuring that health care workers receive adequate personal protective equipment (PPE), improved wages, and safe working conditions. Other local Filipino community organizations such as Anakbayan Seattle, a comprehensive national democratic youth and student organization, have showed solidarity by attending several protests for health care workers in the past year, such as the one that occurred in February of 2020 as reported by the Emerald.

"At the beginning of 2020, members of the SEIU Healthcare 1199NW wielded their people power and voiced their concerns through a mass demonstration. … Anakbayan Seattle was proud to stand alongside them then, and continues to support their efforts today," Anakbayan Seattle said in a statement.

Anakbayan Seattle believes that the current labor export policy in the Philippines is exploitative towards many Filipinos that are working abroad and that it is a system that is made possible due to the "lack of opportunities back home, immigration policies in other countries, and predatory placement programs." Filipino Overseas Foreign Workers (OFW), such as those that are health care workers, often send back money to relatives in the Philippines through remittances, which make up nearly 10% ($35 billion USD) of the Philippines' GDP annually.

"When you work abroad and you bring that amount of money back home [Philippines] you can send your brothers and sisters to college and give them a gift of freedom of not being in student debt," said a Filipino nurse who works at Overlake Medical Center and is an officer for the Washington State Nurses Association. She requested to remain anonymous. "We [Filipino nurses] also provide for all the needs of our parents, they don't have retirement or medical insurance in the Philippines."

The Overlake nurse worked four years in the Philippines as a nurse and six years in London before immigrating to the United States. Now, she is in constant communication with her family back in the Philippines and believes that Filipino nurses need to take time for self-care due to the toll and stress that working during a pandemic can have on one's mental health.

"We're all hard workers and very resilient, and we do this type of work to serve and provide for our families," this nurse said. "We tend to care so much for others because that's what our profession calls us to do, but then we realize we're not doing much self-care for ourselves."

The Filipino immigrant story is often one that is embodied by sacrifice, but during this pandemic, too many Filipino health care workers have lost their lives and deserve to be honored as heroes. Their stories must never be forgotten, and it is vital that we interrogate the systemic racism in our health care industry that has contributed to this sad statistical trend.

Alverio-Hume immigrated to the U.S. when she was in her early 20s. She worked at two jobs and consistently worked three 12-hour shifts at each job per week to provide for her family domestically and abroad. Her days were long, and in her free time she enjoyed cooking Filipino food such as adobo and lumpia with her family.

"I experienced a love that I had never experienced before," Hume said, remembering his late wife. "A kindness and an open heart, it's hard to put into words. It was remarkable to me to see that was what her whole life looked like from other people's perspectives as well."

Alverio-Hume's life embodied selflessness, and to the very end her mind was focused on her family.

"She said, 'If I don't make it, make sure you take care of my daughter and my mom.'"

Ronnie Estoque is a Seattle-based storyteller and aspiring documentarian. He is driven to uplift marginalized voices in the South Seattle community through his writing, photography, and videography. You can keep up with his work by following his Twitter and Instagram.

📸 Featured Image: A collage of three images. The first (left) was provided to the Emerald by Ronnie Estoque, the second is Clea Patriarca Alverio (middle; photo courtesy of Columbia Funeral Home), and the third is Melanie Arciaga (right; photo courtesy of Amy Clark, Communications Director at SEIU Healthcare 1199NW).