THE
GATHERING STORM
Nurses have always
been on the front
line of health
care, tending to
sick and
contagious
patients. We have
always risked
exposure to
disease in our
work. In
providing care to
infected patients,
nurses have
contracted
Hepatitis,
Tuberculosis, SARS
(Severe Acute
Respiratory
Syndrome) MERS
(Middle East
Respiratory
Syndrome) Malaria,
Dengue Fever, Zika
Virus, HIV, H1N1
(Swine Flu) Avian
and other zoonotic
flus, Hansen’s
Disease (Leprosy)
and many other
serious
illnesses. Some
of those nurses
have died.
Exposure to
pathogens is an
inherent risk of
the job. It
should not be part
of the job,
however, to be unnecessarily
placed at risk.
The novel
SARS-CoV-2 virus
that causes
COVID-19 only
represents the
current danger. It
will not be the
last. New and
emerging pathogens
with increasing
virulence are the
new normal for
many reasons:
- Warming
temperatures
are melting
the permafrost
and releasing
frozen organic
materials –
including
pathogens.
Warming
temperatures
also increase
the population
for
vector-borne
pathogens in
supporting
larger
populations of
ticks and
mosquitoes and
in altering
the migration
patterns of
birds.
- The world’s
human
population has
experienced an
unsustainable
growth rate.
The resultant
overpopulation
causes crowded
conditions.
Population
density
facilitates
the
transmission
of
communicable
diseases.
- We now can
wake up in one
hemisphere and
go to bed in
another.
Pathogens are
no longer
localized.
Intercontinental
travel also
allows viruses
to be in one
hemisphere in
the morning
and another by
night. This
allows
endemics to
become
epidemics to
become
pandemics.
- Short
staffing in
health care
facilities
increases
infection
rates in
health care
providers and
patients
alike. Sick
nurses cannot
work,
exacerbating
the shortage.
Nurses who are
now
self-isolating
to protect
others have
temporarily
left the
workforce just
as the need
for them is
intensifying.
- Short
staffing is
also an issue
in our
schools.
Underfunding
has left many
schools
without nurses
– the front
line in
recognizing
emerging
epidemics and
in responding
to them. It
was a school
nurse in
Queens, New
York who
suspected an
outbreak and
put the
epidemiology
wheels into
motion with
the H1N1 virus
(Swine Flu).
Thank you,
Mary Pappas.
It is school
nurses keeping
students safe
from measles
and other
re-emerging
diseases.
Cutting them
now that we
most need them
is endangering
our children,
and therefore
the entire
population
with regard to
contagious
diseases.
- Many
Americans are
without health
insurance, or
are
underinsured.
This is a
deterrent to
obtaining the
basic primary
care necessary
to stay
healthy.
- Even with
insurance,
many Americans
cannot afford
to buy the
medications
they need.
Unconscionably
high prices
make
pharmaceuticals
inaccessible
to a
considerable
amount of the
population.
- We are in an
era of
truth-resistance
when too many
Americans
don’t trust
science and
get
misinformation
about health
care from
social media
or
fictionalized
television
shows.
- Vaccine
exemptions and
the lowering
of herd
immunity from
those who
refuse
immunizations
leaves us all
more
vulnerable.
This is a perfect
storm and the
country needs to
use this public
health emergency
to make a paradigm
shift. We need to
move our solitary
focus from
individual illness
to population
health. We need
an actual health
care system, not a
disease management
system. This
requires emergency
preparedness for
new and
emerging/novel
pathogens. This
is completely
foreseeable and we
should have
systems in place
including regular
coordinated
drills.
Employers need to
protect their
nurses. No nurse
should be exposed
because he or she
did not have
access to personal
protective
equipment. No
nurse should be
exposed because he
or she did not
have adequate
training. No nurse
should be exposed
because our health
care system is
unprepared for
this or any future
viruses; because
it fails to test
and contain while
it is still
possible; and
because it fails
to protect its
providers.
I am really sick
of hearing our
elected leaders
talk about the
need for more
ventilators, the
need for more ICU
beds, the need for
more hospitals,
etc. The FDA &
CDC are working to
provide more
ventilators.
Politicians are
talking about
bringing in the
Army Corp of
Engineers to
construct new
facilities or to
convert existing
buildings to
medical use. Much
media and
political
attention had been
focused on
increasing the
supply of those
machines, beds,
& facilities.
Seriously ill
patients don’t
just need
equipment &
facilities,
however. Every
ventilator
requires a nurse
to take
care of the
patient on it.
Every bed in an
existing or newly
makeshift hospital
requires a nurse
to take care of
the patient in it.
Increasing the
supply of
ventilators
increases the
demand for
Respiratory
Therapists. This
and every future
pandemic require people
to take care of
our sick. Where
is the discussion
of bolstering the
workforce? Of
fast-tracking
reentry programs
for retired nurses
or those who have
been out of
practice so they
can provide some
relief for those
nurses who will
soon be
overwhelmed? Of
adequately funding
our educational
system so there is
a school nurse in
every school?
This gathering
storm is a
national security
issue. As always,
nurses will be at
the front. Let’s
protect them.
Additional
resources
- Health Care
Workers at
high risk
- Hospitals
still not
providing
adequate PPE
or
training/planning
- Human
drivers of
ecological and
evolutionary
dynamics in
emerging and
disappearing
infectious
disease
systems
- Nina Pham
infected with
Ebola because
hospital
failed to
provide
adequate PPE
and training.
- Nurses
contract
hepatitis
- Self-isolation
of health care
workers
exacerbates
shortage
- School nurse
spots Swine
Flu
- Short
staffing
increases
infection
- Staffing
shortages and
infection
control
- Wuhan nurses
infected with
Corona virus
- Liu Zhiming,
director of
Wuhan’s
Wuchang
Hospital dies
from
coronavirus
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