The letter, dated Tuesday, was sent to Pennsylvania Department of Health Secretary Rachel Levine from Mark Warshaw, co-executive director of the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP).

“It’s not about the quantity of PPE locked away in a closet, but whether the hospitals are handing out the PPE to staff,” Warshaw wrote. “The consistent excuse hospitals have given when confronted about their lack of basic protections for worker safety is, ‘it’s a crisis; we can’t do it.’ Well, they can, and they must!”

PASNAP, which represents about 8,400 registered nurses and other medical professionals throughout the state, alleged in its letter that state officials were “being misinformed” about the PPE made available to health care workers. The problem of PPE availability for health care workers could get worse as hospitals begin reopening for elective surgeries, PASNAP said.

“Conditions remain unsafe for healthcare professionals, and this will further stress the availability of limited resources,” Warshaw wrote.

A spokesperson with the state’s health department told Newsweek the department has sent large amounts of PPE—including close to 5 million N95 masks—to hospitals, nursing homes and other long-term care facilities since the start of the pandemic. According to guidance the department shared with the state’s hospitals, a facility was permitted to allow elective surgeries to resume only if it was confident it could do so without endangering the safety of its patients and staff.

“It is essential that hospitals do not begin to allow these procedures if they cannot properly protect their staff or their ability to respond to the COVID-19 emergency,” health department press secretary Nate Wardle told Newsweek.

Pennsylvania began reopening its economy on May 8, when 24 of the state’s 67 counties transitioned from what Governor Tom Wolf called a “red” lockdown phase into a less restrictive “yellow” phase. An additional 25 counties had been approved to move into the intermediary phase by May 22, Wolf said during a news conference Friday.

As of Friday, more than 4,300 Pennsylvanians had died after contracting COVID-19, with 60,622 cases of the virus reported statewide. Among those cases were at least 4,349 health care workers in Pennsylvania who had tested positive since the pandemic began, Levine said during Wolf’s Friday news conference. Though state officials said Pennsylvania was already past its COVID-19 peak, Levine advised residents to practice caution as more counties embrace reopening.

“Regionally, case counts are trending downward over the last 14 days, but we are still seeing pocket outbreaks that are of concern,” Levine said during the news conference.

Wardle said state health officials have practiced caution when it comes to keeping track of the amounts of PPE at medical facilities, requiring hospitals since March 6 to report the status of their PPE stockpiles three times daily.

According to PASNAP, the efforts made thus far to protect health care workers have not been enough. “The Pennsylvania Department of Health must do more to protect the safety of healthcare professionals,” the letter said. “The CDC and DOH guidance have given hospitals an excuse and enabled them to ignore basic protections and safety standards for healthcare workers, and we are the ones suffering,” the letter added, referring to the U.S. Centers for Disease Control and Prevention.

In a response to the letter shared with Newsweek, Wardle said, “Secretary Levine appreciates the concerns raised in this letter and had the opportunity to discuss these details with PASNAP twice, and our team with PASNAP an additional time since the start of the COVID-19 response. Worker safety is essential, which is why the department adheres to best practices from the CDC, OSHA and our state epidemiologists.”