National Nurses United

J A N U A R Y | F E B R U A R Y | M A R C H 2 0 2 2 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 11 T he phrase on everyone's lips these days is "getting back to normal." That seems to be the goal now, but, as nurses, we ask, "At what cost?" and "What is normal?" Nurses understand that people long to return to what their lives were like before the pandemic. But this spring, the United States will record the most unthinkable milestone: our millionth Covid death. One million is more than the population of Fort Worth, Texas or Jacksonville, Fla., the 12th and 13th largest U.S. cities, respectively. One million is more than U.S. military casualties in World War I, World War II, the Korean War, Vietnam War, Persian Gulf War, Iraq War, and Afghanistan War combined. One million is more than any other country's total Covid deaths. One million is 16 percent of all Covid deaths worldwide. So as everyone talks about getting back to normal, we nurses want to say loud and clear: This many unnecessary and avoidable deaths is not normal. Every single Covid death is a tragedy, not a statistic. They are someone's beloved friend, child, parent, relative, partner, or spouse. We believe in preventing death and hospitalization, and that means preventing transmission and infections in the first place. So if we are forced to "live with Covid" and want to "get back to normal," here's what our version of normal looks like. Normal is universal masking, especially in indoor spaces, crowded outdoor spaces, and spaces where people have little to no choice about congregating—such as students who attend school, patients and visitors in a health care setting, and travelers on public transit, airplanes, and other modes of transportation. The SARS-CoV-2 virus and all its variants is transmitted through the air, and well-fitting masks are simple, cheap, and effective at stopping its spread. Normal is regular and robust testing, including data collection of all results. We know that, historically, almost half of Covid- 19 cases are asymptomatic. So it's imperative that we continue to routinely test people, especially those who work in higher-risk settings, like health care and education. Home test results need to be reported to public health agencies. Sadly, testing sites are largely being shut down as the govern- ment convinces the public that Covid is "over" and people stop utilizing testing facil- ities. Normal is isolating and quarantining for up to 14 days if we have been exposed to Covid, have been in large, public gatherings, traveled, or suspect we might have contracted Covid. Instead, our public health agencies such as the Centers for Disease Control and Prevention (CDC) have issued guidance shortening the quarantine period to just five days and have even told us health care workers that we can work while posi- tive and that there's no need to quarantine if exposed but vaccinated. And part of figuring out exposure requires contact tracing. Remember good old contact tracing? Our employers and public health agencies have abandoned this basic infection control measure. Normal is encouraging and making it easy for people to get vaccinated against Covid-19. A huge percentage, more than one-third, of the United States population is still completely unvaccinated and many vaccinated people's immunity is waning. Normal is for the federal Occupational Safety and Health Administration to have enacted a standard that employers must follow to ensure safe workplaces that protect nurses and all health care workers as we fight to save lives—not for the agency to still be soliciting public comments when we are already two years deep into this pandemic. Normal is following science, acknowl- edging that the pandemic is not over, and for our federal, state, and local governments to invest in the public health infrastructure we know is necessary to prevent unneeded infections, unnecessary suffering, and avoid- able deaths. It is not magical thinking, by simply changing the standards, that communities with significant transmission have become low transmission overnight, and failing to fund testing, treatments and vaccines, Covid care, vaccine development, and public health surveillance. The bottom line is that "normal" means following the multiple measures of infection control that science has proven is effective in preventing the spread of Covid-19. We know we cannot rely on any one method; we must stack together many measures to reduce the risk of transmission. It's sad and frightening that our public health agencies no longer seem to have the goal of preventing transmission, only the most severe outcomes of hospitalization and death. As scientists, nurses know this is folly because, with high transmission comes more opportunities for the virus to mutate and particularly to mutate into variants that can evade our Covid vaccines. Additionally, Covid infections—even if relatively mild— have led to serious long Covid symptoms, conditions, and complications that can damage people's health for the rest of their lives. So, no, nurses say none of this is normal. If we must adjust to a new normal, it's one where we take infection control measures seriously and practice them regardless of whatever political winds are currently blow- ing, blowing that virus right into our communities. Bonnie Castillo, RN is executive director of National Nurses United. Bonnie Castillo, RN Executive Director, National Nurses United New Normal Nurses know that any return to previous routines must incorporate the multiple measures of infection control that work

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