Maureen Zeman was a registered nurse for 29 years at a hospital in San Jose, California, before she was laid off with dozens of other nurses – amid the coronavirus pandemic. Many states across the US have stopped elective medical procedures as part of emergency shutdowns to curb the spread of the coronavirus. As a result, hospitals and medical clinics are implementing layoffs, furloughs and cuts to salaries and work schedules in response to declines in revenue. The for-profit company that owns the hospital where Zeman worked decided to shut down the maternal delivery department at the end of March. It put Zeman and many others out of a job, and left patients with far fewer options. “They say it’s not related to Covid-19, but it’s a huge disservice to the women of the east side of San Jose. Doing this during a pandemic is terrible,” said Zeman. “They said it wasn’t financially stable to keep the unit open, and so they’re closing. Our big concern is we’re a trauma center and there are no hospitals in this area that can take care of women and children’s services.” Healthcare is a trillion-dollar industry in the US, where hospitals and clinics are overwhelmingly run as businesses, and patients are the core of their revenue cycle. Americans are expected to have means to pay for their treatment, usually through expensive insurance linked to their jobs, though about 28 million people were uninsured in 2018, according to Kaiser Family Foundation. “If you run healthcare as a business, if someone isn’t profitable for you, you lay [people] off. And that’s what we’re seeing,” said Dr David Himmelstein, distinguished professor of public health at City University of New York’s Hunter College and a lecturer in medicine at Harvard medical school. “The hospitals – exactly during a time of greatest need – are saying they don’t need these people. “We have a healthcare system where you excel in normal times by stressing what’s needed the least, and then when we have an emergency and the need is greatest, you’re in financial trouble because you’re geared to do what’s profitable.” According to the Bureau of Labor Statistics, 43,000 healthcare jobs were lost in March 2020, and the job losses in healthcare have increased as shutdowns persist through the pandemic. The HealthLandscape and American Academy of Family Physicians issued a report estimating by June 2020, 60,000 family medical practices will close or scale back, affecting 800,000 workers. Corey Mertz, a registered nurse for nearly 21 years at a for-profit hospital in McMinnville, Oregon, saw his work schedule go from full-time – 32 to 40 hours a week – to less than 12 hours a week. He said: “For the last two to three weeks, we’ve cancelled all of our elective surgeries, most of our outpatient processes, and this has had a gigantic impact on our hospital.” Mertz filed for unemployment benefits last week, but had not received benefits or been able to get in contact with the state unemployment agency. Mertz’s hospital initially started training nurses to help departments with anticipated surges in coronavirus patients, but the training was stopped because the hospital had not seen a significant influx of cases severe enough to be admitted. “We all have a lot of uncertainty and angst about how long this will go on,” Mertz added. The cuts and layoffs facing healthcare workers began as many areas of the US experienced surges in coronavirus patients, while hospitals struggle with shortages in supplies and protective equipment for workers. Elizabeth, a medical assistant at a hospital in Fall River, Massachusetts, who asked not to use her last name for fear of losing her job, was furloughed in late March 2020, but was still waiting to receive information from human resources last week on how to maintain benefits and what to expect through the furlough process. “We have no clue [about] the headaches we’re getting into. This has never happened. I’ve been in the medical field for 21 years,” she said. “They want us to use our paid time off to cover our health insurance benefits, but if you’re collecting unemployment they’ll think you’re taking a paycheck, so that is going to interfere with unemployment and the unemployment benefits are already minimal. It’s not even half of our check.” Fairmont regional medical center, the only hospital in Marion county, West Virginia, closed down at the end of March. A few days after the closure, West Virginia’s first coronavirus-related death occurred there. “I think not having a hospital in this community, it means death for a lot of people,” said Patty Snyder, president of Retail, Wholesale and Department Store Union Local 550 which represented 120 employees at the hospital. Alecto Healthcare Services, which operated Fairmont, did not respond to a request for comment. Snyder, one of hundreds of employees laid off due to the closure, worked as a cashier at the hospital for nearly 30 years. “This is going to have a catastrophic effect on this community. In the middle of this pandemic, we don’t have time to wait 20 to 30 minutes for an ambulance, and [then] drive 20 to 30 minutes in either direction to a hospital.” Alex Hlumyk, a certified medical assistant in Hubbard, Ohio, began his job at a physicians’ practice in a healthcare system owned by a private equity firm eight months ago, but was recently laid off after he was told there was not enough money to keep him on the payroll. Before being laid off, Hlumyk was screening patients for coronavirus and was frustrated he was not offered any guidance on how to continue helping on the frontlines of the pandemic. “I have the skills to help people during this pandemic and right now I can’t,” said Hlumyk. He filed for unemployment the day he was laid off, but was still awaiting benefit payments to begin, while worrying about being able to pay rent and payments on his car. “These furloughs make the case that now more than ever our healthcare system should not be for-profit. We are among the most vital workers in the country right now, and there should be no reason that some people on Wall Street should determine the worth of our jobs when thousands upon thousands of lives are at risk.”