Since March, the world had watched Ebola spread through West Africa, infecting not only residents but also the health workers tasked with stopping the outbreak. During this time, the Centers for Disease Control and Prevention (CDC) has said that hospitals were prepared, and resolved to stop the virus if it made its way over the Atlantic. But health care workers have said otherwise; that hospitals are actually far from prepared — the virus’ spread to the Dallas nurses proved that. Over 18,000 nurses in Northern California feel similarly, and are planning a two-day strike this week to show it.

The strike, which begins Tuesday, involves nurses from the National Nurses United (NNU) labor union, who work in 21 hospitals and 65 clinics. Although an area of focus for the strike is a lack of Ebola preparedness, officials in the union say these concerns stem from an overall deficiency in patient care standards — an issue they’ve been trying to address during new contract negotiations with Kaiser Permanente, which owns the health centers. “In negotiations earlier today (Thursday), Kaiser continued to stonewall on dozens of proposals to improve patient care standards, as well as refusing to address the concern of Kaiser RNs about Ebola safety protocols and protective equipment,” a union press release said.

Their concerns are valid, especially over Ebola. The virus’ spread from Thomas Eric Duncan, the first Ebola patient diagnosed in the U.S., to two of his nurses exposed how unprepared the hospital was and how easily a system could fall apart. Duncan had originally visited the hospital with a low fever, and even told staff that he had been to West Africa recently, yet they sent him home with only antibiotics. Two days later, he was obviously sick with Ebola. The hospital failed again, however, by allowing nurses to care for him for two days without proper protective gear. And this was only one hospital; a survey from NNU found that 85 percent of nurses feel they’re unprepared, with many saying they haven’t been briefed on protocol.

At the same time, health authorities responded relatively quickly once the virus was transmitted to the two nurses. Both were flown to specialized facilities where they underwent treatment and subsequently survived. All of the possible contacts they made while sick were monitored for three weeks, and no one got sick. In New York City, where Dr. Craig Spencer is undergoing Ebola treatment, there are 357 people being monitored for Ebola. However, the doctor admitted himself to a hospital just before he could be considered contagious (under a 105-degree fever). Considering all of this, it’s clear that the fear of the virus spreading in the U.S. is over-exaggerated, even if the nurses fears are reasonable — they are, after all, the ones taking care of sick patients.

Kaiser said that it was the NNU, however, that was to blame for stalled negotiations. We are training our staff on how to use the right protective gear, to make sure they know how to use it,” spokesman John Nelson said, according to Bloomberg. “We have repeatedly asked union leadership to work with us on our Ebola strategy. They have refused. Instead, they continue to hold press conferences claiming hospitals are unprepared for Ebola.”

The hospital and insurance chain expects all business to run as usual during the strike. emergency and urgent care departments, primary and specialty care departments, and pharmacies and labs will be open, it said in a statement, according to The San Francisco Chronicle. Only some appointments and elective procedures would be cancelled.

In all, the virus has spread through every district of Liberia, Sierra Leone, and Guinea, and cases have appeared in Spain, Mali, Nigeria, and Senegal. As of Nov. 5, there has been a total of 13,042 cases and 4,818 deaths, according to the World Health Organization.