A Fifth Of California's Nurses Are Filipino. Their Burden Of The Coronavirus Pandemic Is Fast Emerging

Angela Gatdula, a nurse at Providence Saint John's Health Center in Santa Monica, tested positive for COVID-19 in April. (California Nurses Association/National Nurses United)

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After a week of quarantining himself on the first floor of his house, ER nurse Marcial Reyes was so short of breath from the coronavirus burrowing into his lungs that he made an emergency call.

He FaceTimed his wife upstairs. Rowena Reyes — also a nurse — ran downstairs and stopped mid-way when Marcial said he was driving himself to the hospital. She began to cry.

In the emergency room of the Kaiser Permanente medical center in Fontana, where the 46-year-old Reyes is normally a charge nurse, he became the patient.

His breath became so labored over the next several days that doctors hooked him up to a ventilator for 10 days.

Marcial Reyes had to be put into a medically-induced coma and intubated for 10 days. (Photo courtesy of Marcial Reyes)

Reyes' last thoughts before he was placed into a medically-induced coma were about leaving his wife and 5-year-old son on their own.

"We never even hugged one another when I went to the emergency department because I don't want to infect them," Reyes said.

CALIFORNIA HAS THE MOST FILIPINO NURSES OF ANY STATE

Reyes would later find out that both his wife and son also had contracted COVID-19. It's the nightmare scenario facing many Filipino nurses in California who, according to a 2016 survey, make up nearly 20 percent of the state's nursing ranks — the highest anywhere in the country.

No other country has exported so many front-line health care workers to California and beyond as the Philippines. The reasons are various and steeped in colonialism and immigration policy.

It's not uncommon for many Filipino families to produce multiple healthcare workers, be they nurses or home caregivers, doctors, pharmacy technicians or phlebotomists.

Filipino nursing leaders in California say they're thankful that the state has so far escaped the surge in coronavirus cases that is devastating New York and New Jersey and hitting large concentrations of Filipino American healthcare workers there hard.

Yet through news reports, obituaries and social media, they know the pandemic has struck nurses and other healthcare workers in the community.

Marcial Reyes, a charge nurse in the emergency department of the Kaiser medical center in Fontana, seen here with fellow Filipino American nurses. (Photo courtesy of Marcial Reyes)

Unknown numbers have gotten sick and at least one Filipino nurse in L.A. succumbed to the virus.

Celia Marcos, a 61-year-old nurse at Hollywood Presbyterian Medical Center, died April 17 — two days after she was diagnosed. Her co-workers, who said she was not given adequate protective equipment by their employer, held a vigil for her outside the hospital Wednesday night. Her son plans to take her ashes back to the Philippines.

The pandemic is truly testing Filipino nurses, said Marlon Saria, a member of the Southern California chapter of the Philippine Nurses Association of America. But he added that nurses from the Philippines are uniquely prepared for disaster.

"We see about 20-plus typhoons a year," Saria said. "We have major earthquakes every other year. And yet we bounce back — really fast."

Cris Escarrilla at the San Diego chapter of the association agreed, saying that nurses come to the U.S. focused on making a better life for themselves and their families.

"We don't really complain that much," Escarrilla said. "We are able to adapt and we just want to get things done."

FROM COLONY TO NURSE EXPORTER

The oldest of the Filipino nurses working today came after the U.S. liberalized its immigration laws in 1965.

But to understand how the Philippines became the top exporter of nurses to the U.S. means looking back more than a century, when it became a U.S. territory after the Spanish American War of 1898, said Catherine Ceniza Choy, a professor of ethnic studies at the University of California Berkeley and author of Empire of Care: Nursing and Migration in Filipino American History.

This Michael Reese Hospital and Medical Center ad in a 1969 issue of the Philippine Journal of Nursing targets its former exchange visitor nurses from the Philippines for permanent employment. (Photo courtesy of Catherine Ceniza Choy)

During a period that lasted until the end of WWII, Americans took their system of educating nurses to the Philippines.

"What this training and English-language fluency did was to create preconditions that enabled the mass migration of Filipino nurses that we have been observing for 60 years now," Choy said.

California came to have its large concentration of Filipino nurses, Choy said, because many hospitals in the state recruited from the Philippines. The pioneers who arrived first then started to encourage family members and nursing classmates to come work with them.

Many worked in underserved areas to alleviate nursing shortages, such as in inner-city and public hospitals, and were critical during other health crises, like during the AIDS epidemic, Choy said.

"They're needed when they're useful," Choy said. "They're also needed when it's critical, when it's dangerous, when your life is on the line."

THE NEXT GEN

The first wave of Filipino nurses have helped cultivate a new crop of second and third- generation nurses, such as Angela Gatdula.

Members at a recent gathering of the Philippine Nurses Association of Southern California. (Photo courtesy of Philippine Nurses Association of Southern California) (Photo courtesy of Philippine Nurses Association of Southern California)z)

The 31-year-old Filipino American nurse, who was born in Panorama City, works in the medical-surgical unit of Providence Saint John in Santa Monica. She's one of seven cousins on her mom's side who became nurses.

"We joke around that we could probably start our own skilled nursing facility," Gatdula said.

Gatdula said her Filipino upbringing instilled a kindness that makes her a good nurse. But she said her American side really came out after she got sick with the coronavirus, waking up one morning with severe body aches and joint pain.

Even as she quarantined at home, Gatdula joined other nurses in publicly criticizing the hospital for having them treat COVID-19 patients in March while wearing surgical masks, rather than the more effective N95 respirators. Ten of her colleagues were suspended for refusing to care for those patients without the N95 masks.

Gatdula said some of her relatives worried about her coming forward, so her mother's reaction was especially heartening.

"I had my mom actually congratulate me for speaking up," Gatdula said, her voice wavering with emotion.

FROM NURSE TO PATIENT TO NURSE AGAIN

Gatdula has since recovered and is back at work. Recovery has been slower for ER nurse Marcial Reyes because he was in a coma on a ventilator.

Colleagues at the Kaiser medical center in Fontana sent encouragement to Marcial Reyes. (Photo courtesy of Marcial Reyes)

He needs to regain strength in his legs and he struggles to write. His wife and young son fared better, and have recovered without hospitalization.

In spite of his ordeal, Reyes can't wait to return to the patient station in the ER, and to reunite with colleagues who've supported him and his family with phone calls and meals through their ordeal.

It's been 14 years since he moved to the U.S. on a work visa to be a nurse, eight years since he became a U.S. citizen, and he said his job in his adopted country is really more of a vocation.

"I know I'm touching the lives of my patients every time I take care of them," Reyes said. "It's just amazing."

And now, he said, he understands his patients that much more.