COVID-19: what governments can do now to protect nurses

Deaths among healthcare workers match those in the first world war – and the risk must be recognised

The fact that as many nurses have died from COVID-19 during this pandemic as died during the first world war is shocking.

Each of these 1,500 deaths is a tragedy: a loved one taken from their family, a colleague sorely missed, and one less nurse able to contribute to the work that needs to be done to defeat the pandemic.

Failure to track nurse deaths worldwide is a scandal

Since May 2020, the International Council of Nurses (ICN) has been calling for the standardised and systematic collection of data on healthcare worker infections and deaths from COVID-19.

The fact that it is still not happening is a scandal.

‘It is likely that the final global death toll among healthcare workers will be measured in the tens of thousands’

As the second wave of the pandemic sweeps over many countries, and severe lockdown measures are applied to reduce the rate of growth of infections, memories of inadequate supplies of personal protective equipment (PPE) in the first wave are fresh in nurses’ minds.

And this time, nurses are stretched and exhausted from their efforts in the spring.

Governments say that they now have sufficient stockpiles of PPE, but our global survey shows there are still problems in some sectors, such as care homes, and nurses are struggling with the mental health effects of the pandemic.

There is no doubt that, even with the best defences, the lives of nurses and other healthcare workers are still a risk from this deadly infection.

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Data can help us manage the risk to nurses and others

This lack of data is important. Nursing has a long history of data collection going back at least as far as Florence Nightingale, who was an imaginative and innovative statistician and epidemiologist.

Just as Miss Nightingale used data to highlight the mortality rates for certain conditions, data on infections and deaths among the world’s nurses in this pandemic could be used to aid our understanding of risks to health, improve clinical practices and save lives – and not just those of nurses and other healthcare workers.

As no one else is doing it, the ICN has been collating data with the help of our national nursing association members.

Our data, and that figure of 1,500 nurse deaths, come from a survey of 44 of the world’s 195 countries, so we know they will likely turn out to be a gross underestimate of the true scale of this disaster.

‘The sad truth is that there is a chasm between the warm words of appreciation from governments and the action that needs to be taken immediately to save nurses’ lives’

These figures, combined with information from the World Health Organization (WHO), suggest that at least 10% of infections and deaths are among nurses and other healthcare staff.

At the time of writing, WHO says there have been 50,459,886 confirmed COVID-19 cases worldwide and 1,257,523 deaths, a case fatality rate of about 2.5%.

Therefore, it is likely that the final global death toll among healthcare workers will be measured in the tens of thousands.

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The actions that can protect nurses

The sad truth is that there is a chasm between the warm words of appreciation from governments and welcome accolades from the public and the action that needs to be taken immediately to save nurses’ lives.

For months we have been telling governments what needs to be done and it is deplorable that all the necessary action has not yet been taken.

Governments need to collect and analyse the data on infections and deaths among nurses, recognise COVID-19 as an occupational disease, ensure PPE is available in all healthcare settings, and ensure zero tolerance of discrimination and violence.

They also need to increase nurses’ pay, invest in training and education, prioritise nurses for vaccinations, ensure mental health support is available, and increase the number and authority of nurse leaders.

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Solutions need to be global – and that requires cooperation

I genuinely believe that global has never been more local, in terms of the challenges we are facing, the lessons we need to learn and the solutions we seek.

For example, getting PPE across borders requires governments to work together on customs and control issues.

When we have a vaccine, getting it to everyone who needs it, rather than just to those who can afford to pay for it, will require multilateralism and cooperation.

Nurses will have a major role to play in what comes after COVID-19.

Our experience, and the information we have, means we have an immensely powerful and legitimate voice that we must use to influence health systems of the future.

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But for now, we need to get through the pandemic, and to do that we need governments to take seriously the peril in which they have placed nurses and other healthcare workers.

They must vow to make sure that this second and any possible subsequent waves are dealt with in a way that protects one of their nations’ most valuable assets – their nursing staff.

Howard Catton is chief executive of the International Council of Nurses