While it sometimes seems like the coronavirus has been with us forever, it’s worth remembering that there are still parts of the country that are only now experiencing their first big spike in cases—that’s the nature of a “patchwork” pandemic working its way across a vast country.
One of our health system members in the Midwest, with whom we recently spent time, is in just this situation: they’re seeing their highest inpatient COVID census to date, just this month. As they shared with us, there are advantages and drawbacks to being a “late follower” on the epidemic curve. The good news is that they’re ready.
Back in March, like most systems, they stood up an “incident command center”, and began preparing for a wave of COVID patients, designating a floor of the hospital as a “hot zone”, creating negative pressure rooms, cross-training staff, developing treatment protocols, stockpiling protective equipment, and securing a pipeline of critical therapeutics and testing supplies. There was a moderate but manageable number of cases across the late spring and summer, but never to an extent that stressed the system.
Eventually, recognizing that they couldn’t ask their doctors, nurses, and administrators to stay on high alert indefinitely, they “stood down” to a more normal operational tempo, only to watch with dismay as the surrounding community seemingly forgot about the virus, and lessened precautions (masking, distancing, and so forth), wanting life to return to “normal”. And now, the post-Labor Day, post-return-to-school spike has arrived.
The challenge now is getting everyone, inside and outside the system, to stop talking about COVID in the past tense, as though they’ve already “gotten through it.” The preparations they’ve made are paying off now. Hospital operations continue to run smoothly even with a high COVID census, but the workforce is exhausted, and citizens aren’t stepping outside to bang gratefully on pots every night anymore.
Asking the team to return to war footing is no easy task, given the fatigue of the past seven months. A question looms: what is the trigger to restart “incident command”? As cases begin to increase again in some of the original COVID hot spots—New York, New England, the Pacific Northwest—healthcare leaders there will need to learn from the experiences of their colleagues in the newly-hit Midwest, about how to take an already virus-weary clinical workforce back onto the battlefield.
The healthcare sector shed hundreds of thousands of jobs this spring as many providers reduced staffing during the height of the pandemic. Across the summer, healthcare has a seen a wave of rehiring, as doctors’ offices and outpatient surgery and testing centers reopened. But despite the ongoing recession and high unemployment rates, competition for talent remains fierce. In particular, hiring into lower-level clinical support roles is more difficult than before the pandemic, as potential applicants weigh the risk of being exposed to COVID.
In the past, applicants for non-degree positions were attracted by good benefits and a clear career path, but “someone looking to make $15 per hour as an entry-level phlebotomist or patient care associate is now choosing the Amazon warehouse or delivering for DoorDash,” one health executive told us recently. “They’re worried about COVID, and they see the hospital as a place where they’re more likely to get it, even though that’s probably not the case.”
A second health system leader mentioned they have posted hundreds of new job openings in the past two months. According to the COO, “these may be the most important hires we’ve made in decades.” Ensuring this new class of recruits feels safe and supported in the pandemic, and is entering a culture of pride and respect, will lay the foundation for the “post-COVID generation” of the healthcare workforce.
Labor Day is a U.S. national holiday held the first Monday every September. Unlike most U.S. holidays, it is a strange celebration without rituals, except for shopping and barbecuing. For most people it simply marks the last weekend of summer and the start of the school year.
The holiday’s founders in the late 1800s envisioned something very different from what the day has become. The founders were looking for two things: a means of unifying union workers and a reduction in work time.
History of Labor Day
The first Labor Day occurred in 1882 in New York City under the direction of that city’s Central Labor Union.
In the 1800s, unions covered only a small fraction of workers and were balkanized and relatively weak. The goal of organizations like the Central Labor Union and more modern-day counterparts like the AFL-CIO was to bring many small unions together to achieve a critical mass and power. The organizers of the first Labor Day were interested in creating an event that brought different types of workers together to meet each other and recognize their common interests.
However, the organizers had a large problem: No government or company recognized the first Monday in September as a day off work. The issue was solved temporarily by declaring a one-day strike in the city. All striking workers were expected to march in a parade and then eat and drink at a giant picnic afterwards.
The New York Tribune’s reporter covering the event felt the entire day was like one long political barbecue, with “rather dull speeches.”
Why was Labor Day invented?
Labor Day came about because workers felt they were spending too many hours and days on the job.
In the 1830s, manufacturing workers were putting in 70-hour weeks on average. Sixty years later, in 1890, hours of work had dropped, although the average manufacturing worker still toiled in a factory 60 hours a week.
These long working hours caused many union organizers to focus on winning a shorter eight-hour work day. They also focused on getting workers more days off, such as the Labor Day holiday, and reducing the workweek to just six days.
These early organizers clearly won since the most recent data show that the average person working in manufacturing is employed for a bit over 40 hours a week and most people work only five days a week.
Surprisingly, many politicians and business owners were actually in favor of giving workers more time off. That’s because workers who had no free time were not able to spend their wages on traveling, entertainment or dining out.
As the U.S. economy expanded beyond farming and basic manufacturing in the late 1800s and early 1900s, it became important for businesses to find consumers interested in buying the products and services being produced in ever greater amounts. Shortening the work week was one way of turning the working class into the consuming class.
The common misconception is that since Labor Day is a national holiday, everyone gets the day off. Nothing could be further from the truth.
While the first Labor Day was created by striking, the idea of a special holiday for workers was easy for politicians to support. It was easy because proclaiming a holiday, like Mother’s Day, costs legislators nothing and benefits them by currying favor with voters. In 1887, Oregon, Colorado, Massachusetts, New York and New Jersey all declared a special legal holiday in September to celebrate workers.
Within 12 years, half the states in the country recognized Labor Day as a holiday. It became a national holiday in June 1894 when President Grover Cleveland signed the Labor Day bill into law. While most people interpreted this as recognizing the day as a national vacation, Congress’ proclamation covers only federal employees. It is up to each state to declare its own legal holidays.
Moreover, proclaiming any day an official holiday means little, as an official holiday does not require private employers and even some government agencies to give their workers the day off. Many stores are open on Labor Day. Essential government services in protection and transportation continue to function, and even less essential programs like national parks are open. Because not everyone is given time off on Labor Day, union workers as recently as the 1930s were being urged to stage one-day strikes if their employer refused to give them the day off.
In the president’s annual Labor Day declaration last year, Obama encouraged Americans “to observe this day with appropriate programs, ceremonies and activities that honor the contributions and resilience of working Americans.”
The proclamation, however, does not officially declare that anyone gets time off.
Controversy: Militants and founders
Today most people in the U.S. think of Labor Day as a noncontroversial holiday.
The first controversy that people fought over was how militant workers should act on a day designed to honor workers. Communist, Marxist and socialist members of the trade union movement supported May 1 as an international day of demonstrations, street protests and even violence, which continues even today.
More moderate trade union members, however, advocated for a September Labor Day of parades and picnics. In the U.S., picnics, instead of street protests, won the day.
There is also dispute over who suggested the idea. The earliest history from the mid-1930s credits Peter J. McGuire, who founded the New York City Brotherhood of Carpenters and Joiners, in 1881 with suggesting a date that would fall “nearly midway between the Fourth of July and Thanksgiving” that “would publicly show the strength and esprit de corps of the trade and labor organizations.”
Later scholarship from the early 1970s makes an excellent case that Matthew Maguire, a representative from the Machinists Union, actually was the founder of Labor Day. However, because Matthew Maguire was seen as too radical, the more moderate Peter McGuire was given the credit.
Who actually came up with the idea will likely never be known, but you can vote online here to express your view.
Have we lost the spirit of Labor Day?
Today Labor Day is no longer about trade unionists marching down the street with banners and their tools of trade. Instead, it is a confused holiday with no associated rituals.
The original holiday was meant to handle a problem of long working hours and no time off. Although the battle over these issues would seem to have been won long ago, this issue is starting to come back with a vengeance, not for manufacturing workers but for highly skilled white-collar workers, many of whom are constantly connected to work.
If you work all the time and never really take a vacation, start a new ritual that honors the original spirit of Labor Day. Give yourself the day off. Don’t go in to work. Shut off your phone, computer and other electronic devices connecting you to your daily grind. Then go to a barbecue, like the original participants did over a century ago, and celebrate having at least one day off from work during the year!
Labor Day 2020 will occur on Monday, September 7. Labor Day pays tribute to the contributions and achievements of American workers and is traditionally observed on the first Monday in September. It was created by the labor movement in the late 19th century and became a federal holiday in 1894. Labor Day weekend also symbolizes the end of summer for many Americans, and is celebrated with parties, street parades and athletic events.
Why Do We Celebrate Labor Day?
Labor Day, an annual celebration of workers and their achievements, originated during one of American labor history’s most dismal chapters.
In the late 1800s, at the height of the Industrial Revolution in the United States, the average American worked 12-hour days and seven-day weeks in order to eke out a basic living. Despite restrictions in some states, children as young as 5 or 6 toiled in mills, factories and mines across the country, earning a fraction of their adult counterparts’ wages.
People of all ages, particularly the very poor and recent immigrants, often faced extremely unsafe working conditions, with insufficient access to fresh air, sanitary facilities and breaks.
As manufacturing increasingly supplanted agriculture as the wellspring of American employment, labor unions, which had first appeared in the late 18th century, grew more prominent and vocal. They began organizing strikes and rallies to protest poor conditions and compel employers to renegotiate hours and pay.
Many of these events turned violent during this period, including the infamous Haymarket Riot of 1886, in which several Chicago policemen and workers were killed. Others gave rise to longstanding traditions: On September 5, 1882, 10,000 workers took unpaid time off to march from City Hall to Union Square in New York City, holding the first Labor Day parade in U.S. history.
The idea of a “workingmen’s holiday,” celebrated on the first Monday in September, caught on in other industrial centers across the country, and many states passed legislation recognizing it. Congress would not legalize the holiday until 12 years later, when a watershed moment in American labor history brought workers’ rights squarely into the public’s view. On May 11, 1894, employees of the Pullman Palace Car Company in Chicago went on strike to protest wage cuts and the firing of union representatives.
On June 26, the American Railroad Union, led by Eugene V. Debs, called for a boycott of all Pullman railway cars, crippling railroad traffic nationwide. To break the Pullman strike, the federal government dispatched troops to Chicago, unleashing a wave of riots that resulted in the deaths of more than a dozen workers.
Who Created Labor Day?
In the wake of this massive unrest and in an attempt to repair ties with American workers, Congress passed an act making Labor Day a legal holiday in the District of Columbia and the territories. On June 28, 1894, President Grover Cleveland signed it into law. More than a century later, the true founder of Labor Day has yet to be identified.
Many credit Peter J. McGuire, cofounder of the American Federation of Labor, while others have suggested that Matthew Maguire, a secretary of the Central Labor Union, first proposed the holiday.
Labor Day Celebrations
Labor Day is still celebrated in cities and towns across the United States with parades, picnics, barbecues, fireworks displays and other public gatherings. For many Americans, particularly children and young adults, it represents the end of the summer and the start of the back-to-school season.
Amazon is looking to hire two people who can focus on keeping tabs on labor activists within the company.
Amazon is looking to hire two intelligence analysts to track “labor organizing threats” within the company.
The company recently posted two job listings for analysts that can keep an eye on sensitive and confidential topics “including labor organizing threats against the company.” Amazon is looking to hire an “Intelligence Analyst” and a “Sr Intelligence Analyst” for its Global Security Operations’ (GSO) Global Intelligence Program (GIP), the team that’s responsible for physical and corporate security operations such as insider threats and industrial espionage.
The job ads list several kinds of threats, such as “protests, geopolitical crises, conflicts impacting operations,” but focuses on “organized labor” in particular, mentioning it three times in one of the listings.
Amazon has historically been hostile to workers attempting to form a union or organize any kind of collective action. Last year, an Amazon spokesperson accused unions of exploiting Prime Day “to raise awareness to their cause” and increase membership dues. Earlier this year, the company fired Christian Smalls, a Black employee who led a protest at a fulfillment center in New York over Amazon’s inadequate safety measures in the early days of the COVID-19 pandemic. During a meeting with Amazon CEO Jeff Bezos, company executives discussed plans to smear Smalls calling him “not smart, or articulate.”
These job listings show Amazon sees labor organizing as one of the biggest threats to its existence.
Do you work at Amazon, did you used to, or do you know anything else about the company? We’d love to hear from you. Using a non-work phone or computer, you can contact Lorenzo Franceschi-Bicchierai securely on Signal at +1 917 257 1382, on Wickr at lorenzofb, OTR chat at firstname.lastname@example.org, or email email@example.com.
After this story was published, Amazon deleted the job listings and company spokesperson Maria Boschetti said in an email that “the job post was not an accurate description of the role— it was made in error and has since been corrected.” The spokesperson did not respond to follow-up questions about the alleged mistake. The job listing, according to Amazon’s own job portal, had been up since January 6, 2020.
Dania Rajendra, the Director of the Athena Coalition, an alliance of dozens of grassroots labor groups that organize amazon workers, criticized the listing.
“Workers, especially Black workers, have been telling us all for months that Amazon is targeting them for speaking out. This job description is proof that Amazon intends to continue on this course,” Rajendra told Motherboard in a statement. “The public deserves to know whether Amazon will continue to fill these positions, even if they’re no longer publicly posted.”
On Monday, the Open Markets Institute, a nonprofit that studies monopolies, published a report on Amazon’s employee surveillance efforts, claiming that these practices “create a harsh and dehumanizing working environment that produces a constant state of fear, as well as physical and mental anguish.”
After a week of the jobs being posted online, 71 people have applied to the Intelligence Analyst position, and 24 people to the Sr Intelligence Analyst job, according to Linkedin. The first job was posted in the Amazon Jobs portal in January, the second job on July 21, according to the company’s site.
UPDATE Sept. 1, 12:04 p.m. ET: Shortly after this story was published, Amazon removed the listings from its job portal.
Healthcare is Hard: A Podcast for Insiders; June 11, 2020
Over the course of nearly 20 years as Chief Research Officer at The Advisory Board Company, Chas Roades became a trusted advisor for CEOs, leadership teams and boards of directors at health systems across the country. When The Advisory Board was acquired by Optum in 2017, Chas left the company with Chief Medical Officer, Lisa Bielamowicz. Together they founded Gist Healthcare, where they play a similar role, but take an even deeper and more focused look at the issues health systems are facing.
As Chas explains, Gist Healthcare has members from Allentown, Pennsylvania to Beverly Hills, California and everywhere in between. Most of the organizations Gist works with are regional health systems in the $2 to $5 billion range, where Chas and his colleagues become adjunct members of the executive team and board. In this role, Chas is typically hopscotching the country for in-person meetings and strategy sessions, but Covid-19 has brought many changes.
“Almost overnight, Chas went from in-depth sessions about long-term five-year strategy, to discussions about how health systems will make it through the next six weeks and after that, adapt to the new normal. He spoke to Keith Figlioli about many of the issues impacting these discussions including:
- Corporate Governance. The decisions health systems will be forced to make over the next two to five years are staggeringly big, according to Chas. As a result, Gist is spending a lot of time thinking about governance right now and how to help health systems supercharge governance processes to lay a foundation for the making these difficult choices.
- Health Systems Acting Like Systems. As health systems struggle to maintain revenue and margins, they’ll be forced to streamline operations in a way that finally takes advantage of system value. As providers consolidated in recent years, they successfully met the goal of gaining size and negotiating leverage, but paid much less attention to the harder part – controlling cost and creating value. That’s about to change. It will be a lasting impact of Covid-19, and an opportunity for innovators.
- The Telehealth Land Grab. Providers have quickly ramped-up telehealth services as a necessity to survive during lockdowns. But as telehealth plays a larger role in the new standard of care, payers will not sit idly by and are preparing to double-down on their own virtual care capabilities. They’re looking to take over the virtual space and own the digital front door in an effort to gain coveted customer loyalty. Chas talks about how it would be foolish for providers to expect that payers will continue reimburse at high rates or at parity for physical visits.
- The Battleground Over Physicians. This is the other area to watch as payers and providers clash over the hearts and minds of consumers. The years-long trend of physician practices being acquired and rolled-up into larger organizations will significantly accelerate due to Covid-19. The financial pain the pandemic has caused will force some practices out of business and many others looking for an exit. And as health systems deal with their own financial hardships, payers with deep pockets are the more likely suitor.”