On Wednesday morning, nurses and healthcare workers begin a five-day strike at three hospitals run by Alameda Health System (AHS) in Alameda County. These frontline healthcare workers face understaffing, lack of equipment and a proposed wage freeze as Alameda County continues to experience widespread COVID-19 transmission.

The strikers include over 3,000 workers in the Service Employees International Union 1021 (SEIU) at Highland Hospital who have been working without a signed contract since 2017. They are joined by 300 registered nurses in the California Nurses Association (CNA) at San Leandro and Alameda hospitals. These hospitals frequently serve as health care providers of last resort to the uninsured, homeless, and impoverished sections of the East Bay. This has put health care workers face-to-face with many of the 21,637 confirmed cases of COVID-19 in Alameda County, while facing chronic understaffing and shortages of personal protective equipment (PPE).

In response to the looming strike, AHS sought an emergency injunction with the Public Employment Relations Board. The board president cited the dependence of low-income and homeless populations on these hospital services as reason to prevent the strike. In reality the essential character of this work emphasizes the disgrace that hospital workers are being ordered to accept unsafe conditions and pay cuts.

AHS is a public health system that was run directly by the county until the late 1990s, when it was spun off as a separate entity. This entity operates with a county-appointed CEO and board of directors, but is financed by loans from the county that it must pay back. Unable to turn a profit serving an increasingly impoverished East Bay, the AHS has sought to balance its books with increasingly aggressive cuts to labor costs.

These structural financial problems were exacerbated by the pandemic and now AHS is facing a deficit of $90 million for 2021. An AHS budget presentation from July listed some of their planned cuts including ending cost of living adjustments for all staff. Other cuts demanded by AHS included cuts to employee health care and an end to guaranteed hours.

Since the beginning of the pandemic, hospital staff at AHS have complained about the lack of PPE and management’s efforts to ration them in the face of an escalating pandemic. In March, nurses at Highland Hospital held a protest demanding that the county resume direct control of AHS as a public service. Rebecca Gonsalves, a senior resident physician at Highland Hospital, told news station KTVU at the time: “I’m worried for my life, I’m worried for my nurses. I’m still worried for the patients. And I don’t want to have to choose between my safety and theirs. I want us all to be safe.”

The county refused to resume control of AHS, but the protesters were able to secure paid time off for employees who were exposed to the virus at work and became ill. However, this was quickly followed by the cost saving measure of firing Highland’s only Emergency Room nurse educator, a position responsible for training hospital staff in new techniques and equipment.

Hospital workers at AHS face the same systemic problems as health care workers across the country, like workers at Allina in Minneapolis who took part in a two-day strike which ended yesterday, or the thousands of University of Illinois medical workers who struck last month. Even before the pandemic, Kaiser Permanente workers across California have intermittently struck over the same increasingly dangerous conditions confronting AHS workers.

So far, the unions have succeeded in keeping these strikes isolated and impotent. The SEIU, CNA and other unions have conspired with management to constrain all these struggles into strict “unfair labor practice” disputes, where central questions like the social right to health care, or the government’s criminal neglect in handling the pandemic are legally inadmissible.

The fact that nurses across the country, and in fact the world, are facing the exact same crisis handling the pandemic shows that the problem is not local negotiations but the political decision to allow the pandemic to spread unhindered so as not to disturb corporate profit-making.

Whatever their occasional verbal sparring, Joseph Biden and California Governor Gavin Newsom, both endorsed by SEIU 1021, have joined their democratic colleagues and Trump in efforts to reopen the economy without containing the pandemic. The California state guidelines allow for the reopening of schools and some businesses while the test positivity rate remains as high as 8 percent and the daily average of new cases is as high as 70 per million.

To secure safe working conditions, health care workers must break out of the SEIU’s straitjacket and form rank-and-file committees to prepare for a nationwide strike alongside teachers and other workers. For help forming a rank-and-file strike committee, contact the World Socialist Web Site.