National Nurses United

COVID also ushered in a new way of memorializing those nurses who had sacrificed their lives to the virus while caring for their patients. Because nurses could not gather together to mourn their colleagues, NNU held a number of online virtual candlelight vigils to record and remember these nurses–including a 1,000- nurse event to close out May 12, the last day of Nurses Week. As of late May, NNU had determined through media searches, obituaries, and the scant state data available that at least 138 registered nurses had died of COVID-19. That number is certainly an undercount given the severe lack of testing and stories that never get reported in the news. What's also disturbing is the high percentage of nurses of color, mainly black and Filipino, who anecdotally appear to be the ones dying of COVID. This racial and ethnic disparity among nurse deaths echoes the racial and ethnic disparity researchers are seeing among COVID deaths in the general population, with black and, in some areas, Latino patients disproportionately represented among the fatalities. What's most shocking is that the CDC did not begin regularly reporting health care worker infections and deaths until the end of May. The data is compiled from information voluntarily reported from states and U.S territories; there is no definitive reporting and recording mandate. And of course, there is no requirement for mass testing of health care workers. The second NNU survey also showed that a whopping 84 percent of nurses who responded had never been tested for COVID-19, much less undergo routine and ongoing testing as they continue to care for COVID-positive patients. Though both the PCR and serological types of testing have been often unreliable and registered many false negatives, a positive result is still a data point to work with. "The simple answer is they don't want to know," said Jean Ross, RN and a president of NNU. "Tracking health care worker infections is not just important for looking at infection control within facilities, but it is one of the measures of success or failure of a response to this pandemic. If they knew the real numbers, someone might actually hold them accountable." * * * * Probably the most tragic part of the pandemic is that things did not have to be this way. This many people did not need to get sick, suffer, or die. This many nurses and other health care workers did not need to fall to COVID. Infection control requires resources, people power, and vigilance, but it is not an unknown science. Early on in the pandemic, NNU participated in an international conference call with members of Global Nurses United (GNU), the group NNU helped establish that brings together nurses from more than two dozen countries to share knowledge, resources, and show solidarity in nurses' common mission to prioritize patients over profits. We learned from Taiwan and South Korea that it was possible, through aggressive testing, contact tracing, optimal PPE, and engineering controls in hospitals (such as outside hospital screening and establishing one- way-only controlled movement through clean, potential, and infected zones) that infections could be minimized. But, again, through lack of federal and state leadership and our country's predominantly private system of hospitals where such advice is suggested but not mandated through law or regulation, our hospitals largely did not adopt these lifesaving practices. Now, with many states and communities starting to "reopen" by dropping social distancing and stay-at-home orders and hospitals starting to "reopen" to elective procedures, nurses are wary about the future and bracing for round two of the virus. NNU does not support public reopening unless a number of conditions can first be met, which include criteria in the areas of meeting basic human needs for housing, food, sick leave, childcare; public health and safety by having equipment like PPE for workers; public health infrastructure by having things like free and readily available testing and contact tracing in place; and of course in the health care capacity and preparedness of our hospitals, which have already been shown to be woefully lacking. NNU is not aware of any states or communities that meet all these criteria. "As caregivers, nurses can't emphasize enough that we cannot return to the damaging way things were," said Castillo. "This time is instead an opportunity to reimagine how we can organize our society in ways that are beneficial to everyone, as opposed to a handful of billionaires. It's a time to focus on building an economy that's not based on consumption of things or building profits for the few, but rather on how well we care for all of our people." Lucia Hwang is editor of National Nurse magazine. A P R I L | M AY | J U N E 2 0 2 0 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 21 Nine states have shelter-in-place orders MARCH 23 $2 trillion stimulus bill enacted, does not protect health care workers MARCH 27 30 U.S. states have shelter-in-place orders MARCH 30 More than 1 million cases worldwide, more than 53,000 deaths APRIL 2

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