By Edward Nenedzhyan and Yasmine Cardenas

It was the midst of the night shift when medical staff and their patients clamored to clear the hallways of a small, overcrowded hospital in Los Angeles, making way for a group of nurses shouting as they transported a COVID patient from one ward to another. The entire interaction began with a booming voice echoing down the hallways to an audience of medical personnel, among them a man named Armen.

When Armen Aprahamian, a 21-year-old student studying medicine, signed up and trained to become an EMT, he accepted the risks of operating as a frontline worker during the pandemic, but what he did not foresee was a wide spectrum of inconsistencies in the protocols of healthcare facilities across the city, especially in a pre-vaccination pandemic world.

“Basically there'd be one nurse come out and he'd yell ‘Covid patient, clear the hallway!,’” recalled Armen. “And everyone would scramble with their patients to go to the side hallways. This guy would come in with a bunch of other people coming through and the patient would be on a ventilator.”

“Then there were other places where they had a COVID unit and they had a regular unit, but it was just kind of chaotic, disorganized,” said Armen. “I wasn't sure. You know, they weren't really clear and in some places, there wasn't even a separate ward for COVID patients.”

The undeniably grim aspects of working in the healthcare sector greatly contrasts with the sudden boom of businesses secretly operating in the midst of a heavy health and safety enforcement cycle. This is indicative of a larger scale trend of businesses that have averted lockdown protocols, not in defiance or ignorance of health and safety concerns, but rather, desperation rooted in the instinct of human survival.

These trends of businesses reveal a striking contrast between the inconsistent protocols of large essential businesses, like healthcare, with the general attitude towards small personal care businesses. Healthcare facilities continue to operate in a frenzy, with a chaotic response to employee safety, whereas small businesses face immediate shutdowns without the same risks.

The shutdowns of small personal care businesses throughout the state have initiated several contingent protocols crafted at the convergence of a multitude of bureaucratic institutions. These agencies include Los Angeles Public Health, the Center for Disease Control, and California Division of Occupational Safety and Health, who all have various roles in enforcing these pandemic-related rules and dealing with any businesses operating in illegal capacities.

This has led to existential fear amongst both employees and employers in businesses big and small alike, whether it be the employees of a swamped hospital or a barber seeking refuge in the most unlikely of places.

Small businesses across California have scrambled to maintain their workflow and stay afloat. With the reclassification of businesses into the two distinct categories of “essential” and “non-essential,,” many have resorted to staying open in direct violation of lockdown protocols, and have resultantly chosen to remain anonymous.

Jesse, a barber and small business owner from Woodland Hills, was in the midst of remodeling his barbershop in La Crescenta when the worst of the COVID-19 pandemic swept the nation, sending all non-essential businesses into the months-long lockdown at the start of March 2020. His life was suddenly put on pause with an abrupt stop to income. Shortly after, an unexpected opportunity arose.

“My church essentially offered their back room, which I’d previously used to teach barber lessons to the youth group anyways,” Jesse said. “For me to use and do my thing, I was very grateful.”

 His barbershop equipment was set up in the back of his church throughout the initial months of the pandemic, bringing customers in via appointment in order to minimize capacity. This led to a drop in revenue.  Jesse’s predicament is mirrored by a majority of small businesses who faced similar consequences and stakes.

“A typical good day of work is 10 or so haircuts,” Jesse said. “But at the beginning of the lockdown, I was lucky to get five a day, if that, even with home appointments.”

“A friend of mine, just across the street from me, got her salon shut down when they came at their door,” said Jesse, who has since moved out of the church and into his remodeled barbershop “I was constantly checking the security cameras of the church and looking out for health officials.”

This cat-and-mouse game between public health officials shutting down backdoor businesses has created a massive network of health and safety guidelines across the state, called  “Emergency Temporary Standards.”

These emergency mandates were initially passed at the state level in March 2020. These standards serve to protect the health and safety of employees working during the pandemic, and ensure that employers can be held accountable. The DIR defines it as the parameters through which Cal OSHA can efficiently cite and fine businesses that break the relationship between employee and employer, an ideal that the workplace safety agency holds sacred.

Upon contacting the DIR and Cal OSHA, their representatives provided a master list of citations given out to businesses that have violated the COVID-19 Emergency Temporary Standards, which encompasses a swath of different violations that all have varying degrees of severity, with “regulatory” and “general” violations being the least severe and “serious” violations pertaining to the most hazardous workplace conditions.

The list reveals an alarming disparity between the fines issued between businesses large and small, additionally insinuating that a business’s enforcement repercussions are highly dependent on where they fall on the hierarchical spectrum of local businesses.

Nicholas was a local tattoo and piercing shop owner based in Northridge, CA, who, upon seeing the rising threat of coronavirus, chose to take a different approach. Rather than averting lockdown procedures by staying open during lockdown, he opted to shut his business down three days before the mandate took effect in March 2020.

After remaining closed for nearly the entire year, Nicolas reopened for business in late January. A surprise visit from a COVID health board inspector came at a time where a poor rating or citation could potentially harm the business that had barely begun to restore its financial status.

“I turn people away at the door all the time,” Nicolas said. “I have to ask you to leave because literally what can happen is if a health board member sees extra people sitting in my shop, I can get a fine that's a couple thousand dollars.”

Following the inspection, he learned that his setup exceeded public health standards for Los Angeles. Despite this, his current situation is far from where he began at the start of the pandemic. Furthermore, his reopening consisted of obtaining the right documents and PPE for his work. 

“My biggest expenses are PPE now. Me and three or four shops got together, contacted a glove supplier manufacturer in Taiwan, made a deal to have a pallet of them, and spent thousands of dollars to get a pallet,” Nicolas said. “It made it to Long Beach and it was confiscated. They confiscated our PPE because they said, ‘well, it's not for a hospital, so you guys can't have it.’”

Nicolas’s sentiments echo the concern of small business owners who struggle to keep up with shifting COVID-related regulations, as most PPE and equipment are naturally reserved for healthcare facilities.

How healthcare facilities allocate their PPE remains to be a controversial subject.

In the master list of COVID citations issued by Cal OSHA, there is a pattern in the frequency and severity of workplace safety violations for employees of healthcare facilities across California. By thoroughly combing through the master list, which covers all citations issued since August 2020, it is apparent that almost all medical centers, large hospitals, and clinics have received no fewer than four violations, with at least one of those violations being categorized as “serious.” Additionally, all of the cited healthcare facilities on the list have had citations that were deemed “Accident-initiated” or “Fatality-initiated,” whereas most of the cited personal care businesses only received “regulatory” or “general” violations, with none of them being fatality or accident initiated.

“And you know, what's worse is the COVID surveillance protocols of our company were non-existent,” said Armen.  “If you wanted to get compensated, you had to figure out a third party way to get yourself COVID tested and our company was not regularly even testing us.”

Armen’s concerns point to a larger fault in the healthcare systems of California and how they are disproportionately capable of handling large fines from workplace safety violations, yet the small businesses that are already caught in fiscal jeopardy are crippled by fines of a lesser degree. For instance, Kaiser Permanente of California earned $44.7 billion in revenues over the first half of 2020, whereas small businesses that were deemed nonessential had to forcibly cease to exist.

In spite of the harrowing situation surrounding workplace safety in California’s healthcare sector, the rapidly increasing number of vaccinations and doses being administered statewide have proven to be a point of light at the end of a previously unfathomable tunnel. With a clear path to the end in sight, there is cause to be optimistic for the future of small businesses in the reconstruction of the global economy post-pandemic, but not without a serious reconsideration of how we treat employees during times of crisis.