Hundreds of health care workers began a planned five-day strike Monday at Santa Rosa Memorial Hospital to protest what union officials said were an inadequate supply of protective gear, benefit cuts and “unsafe staffing levels.”

The walkout at Santa Rosa Memorial comes amid a surge of coronavirus cases around the region, state and nation that has retriggered concerns over hospital capacity, supplies of personal protective equipment and staff exhaustion. Across California, 107 health care workers have died from COVID-19 and nearly 20,000 have tested positive as of Sunday, according to state data.

Protests abound: Workers at Stanford Health Care demonstrated on Monday afternoon. On Tuesday nurses at Kaiser Permanente and HCA hospitals in San Jose plan to air concerns about virus testing for frontline workers to the Santa Clara County Board of Supervisors. Last week, workers protested at HCA Good Samaritan in San Jose.

The pandemic is squeezing hospitals financially. In California, hospital revenue has fallen more than a third since the beginning of the pandemic, and the losses have forced health care workers to take pay cuts or even furloughs to compensate in some cases. It’s an issue everywhere in the U.S.

“Right at the same moment that workers are facing greater risk, they are being asked to take cuts. It’s not surprising that you would see a pretty big reaction,” said Ken Jacobs, the chair of the Labor Center at UC Berkeley.

Santa Rosa Memorial Hospital, a branch of hospital chain Providence St. Joseph’s Health, is the trauma center for Sonoma County. Like everywhere else in the Bay Area, the county’s new case counts have risen over the past month. Hospitalizations of COVID-19 patients in Sonoma County were in the single digits just a month ago but now stand at 36.

The National Union of Healthcare Workers, which represents hundreds of nursing assistants, respiratory therapists and medical technicians at the Santa Rosa Memorial Hospital, alleges that the hospital’s management has put staff at risk during the coronavirus pandemic by failing to maintain proper staffing and provide sufficient personal protective equipment.

Hospital representatives described the decision to strike while the pandemic is surging as “deeply disappoint(ing).”

“The union has made clear in communications to our caregivers that this is not a strike about personal protective equipment (PPE) or workplace safety. Instead, this is an ordinary dispute over the terms of our labor contract. It is unfortunate and unfounded that the union is using COVID-19 as a platform for its negotiating tactics. We never deny a caregiver PPE,” the representatives said in a statement.

Tyler Hedden, the chief executive officer of Providence St. Joseph’s Health, said Santa Rosa Memorial Hospital has contracted with replacement caregivers for the five-day strike period to ensure uninterrupted care.

Union representatives also claimed that the hospital plans to increase health care costs for workers, including more than doubling annual premiums for the workers’ most popular family plan. Union members have gone without a contract for more than a year, and the workers’ representatives also said that the hospital plans to rescind one-third of a planned wage increase in retaliation for the strike.

“Obviously, there are large costs associated with going through a strike, and it is unfortunate that the union decided to do this during a pandemic,” Hedden said.

“The 2% (proposed wage increase) is now on the table — it is an increase that substantially could have been more” had the union not decided to strike, he added.

Taylor Davison, an emergency room staffer at Santa Rosa Memorial on the picket line Monday, said by telephone that the emergency room has been understaffed for months and workers at the hospital “are constantly putting ourselves at risk.”

Hedden disagreed. “It is false,” he said about Davison’s claim that the emergency room has been understaffed.

Davison is a single mother with an 18-year old son, and so she is especially worried by the hospital management’s proposal to increase health care premium costs. “My benefits cost would almost triple,” she said, adding that while those changes might not matter to administrators, “it matters to me.”

While Hedden could not speak to Davison’s specific situation, he said that the health care benefit options include affordable and effective plans.

Saying it wanted to avoid protracted contract negotiations after the coronavirus pandemic began, the NUHW reached one-year agreements with 3% raises for workers at a number of health care institutions to cover the course of the pandemic, according to Sal Rosselli, the union president. St. Joseph’s Health is the only institution that refused this contract plan, Rosselli said.

“It doesn’t make sense to negotiate a contract only to renegotiate a year later,” Hedden said in response.

The mayors of Sonoma and Petaluma and several Sonoma County supervisors issued letters of support for the walkout.

“It is unconscionable to demand cuts from frontline healthcare workers in the midst of a global pandemic,” Sonoma Mayor Logan Harvey said in a letter to Hedden. “Demanding cuts to employee benefits after reporting more than $200 million in operating profits over the last three years at Santa Rosa Memorial is an unacceptable affront to your workforce.”

Hedden said that Harvey and the Sonoma county government have not contacted St. Joseph’s Health about their concerns.

”I want to get back to the table again and get this behind us. We are going to still move forward,” Hedden said.

In another Monday demonstration, at Stanford Health Care, workers protested furloughs that they say forced employees to use up their paid vacation time if they wanted to avoid losing income. The protestoes say that workers are now unable to take paid vacations when they need it most to deal with the stress of their work during the pandemic.

“Through our Temporary Workforce Adjustment program, we were able to keep everyone employed and our staff at full wages with benefits intact, and provide options to maintain their earnings,” Julie Greicius, a spokesperson for Stanford Health Care, said in an email.