National Nurses United (NNU), the largest union of registered nurses, sent a letter to the Centers for Disease Control and Prevention (CDC) on July 12, urging the agency to update its Covid-19 guidance and reinstate “the recommendation for everyone to wear masks in public or in physical proximity to others outside their own household.”
“NNU strongly urges the CDC to reinstate universal masking, irrespective of vaccination status, to help reduce the spread of the virus, especially from infected individuals who do not have any symptoms,” wrote NNU Executive Director Bonnie Castillo, RN, in the letter. “SARS-CoV-2, the virus that causes Covid-19 disease, spreads easily from person to person via aerosol transmission when an infected person breathes, speaks, coughs, or sneezes.”
The letter noted that the “Covid-19 pandemic is far from over,” with a 16 percent increase in daily new cases over the previous week and more than 40 states seeing an increase in daily new cases over the previous two weeks as well as 25 states seeing an increase in hospitalizations.
NNU stated that the rise in cases is not surprising due to “the rapid reopening of many states and the removal of public health measures, including the CDC’s May 13, 2021 guidance update that told vaccinated individuals they no longer needed to wear masks, observe physical distancing, avoid crowds, or get tested or isolate after an exposure, within only a few exceptions.”
Unfortunately, the “CDC’s guidance failed to account for the possibility—which preliminary data from the United Kingdom and Israel now indicates is likely—of infection and transmission of the virus, especially variants of concern, by fully vaccinated individuals,” the letter continued. The Delta SARS-CoV-2 variant is already dominant in the United States.
The CDC’s May 13 guidance “also failed to protect medically vulnerable patients, children, and infants who cannot be vaccinated, and immunocompromised individuals for whom vaccines may be less effective.” Asymptomatic or pre-symptomatic infected people “can spread infectious SARS-CoV-2 aerosols during breathing and speaking, without coughing or other respiratory symptoms,” the letter noted.
Covid-19 vaccines are an important public health tool, but multiple measures are necessary to protect public health, as NNU noted in a May 17, 2021 scientific brief. However, only 48 percent of the total U.S. population have been fully vaccinated as of July 11, 2021, according to the CDC. The vaccines are effective at preventing serious illness and death from the virus for vaccinated people. However, no vaccine is 100 percent effective and the emergence and spread of variants of concern may reduce vaccine effectiveness.
“Masks are a simple and effective tool, especially when used in combination with other measures to reduce the risk of Covid-19,” noted Castillo in the letter. On June 25, 2021, in response to the spread of the Delta variant, the World Health Organization urged fully vaccinated people to wear masks.
In the letter, NNU also called on the CDC to:
update health care infection control and other Covid-19 guidance to fully recognize aerosol transmission,
require tracking and transparent reporting of Covid infections among health care workers and other essential workers, and
track infections in people who are fully vaccinated, including mild and asymptomatic infections.
This is the first of several blog posts on nursing issues in the developing world contributed by MSc nursing students studying at the Karachi, Pakistan campus of the Aga Khan School of Nursing and Midwifery.
Their class assignment involved composing and submitting short research articles for publication in a recommended nursing blog or journal. The object: to help them hone their communication skills as future nurse leaders in Pakistan’s healthcare system. As their instructor put it, one of the goals of the exercise is to encourage nursing students to become “Change Agents” in healthcare settings and the world. DailyNurse thanks the instructor and all of the Change Agents who submitted articles. We hope you will find the selected posts informative and thought-provoking.
Developing countries have reduced burn cases by educating the public about safety guidelines, advanced safety fire safety tools, regulations, and raising awareness regarding this burning issue.
However, fire safety rules are either not enforced or people are unaware of fire safety precautions in developing countries, particularly in Pakistan. Furthermore, due to overpopulation, lack of education, social and economic problems, it is difficult to reduce the cases, which leads to increase health costs and years of life lost (YLL). Currently, Shalamar Hospital Lahore is pursuing a campaign to sensitize the public to the danger of serious household burns, particularly among children.
The following are some kitchen-based strategies that Shalamar Hospital is suggesting to help prevent and reduce the occurrence of burns in children.
Avoid holding a child while catering or carrying hot food or liquid.
Communicate to youngsters that hot things burn.
Avoid drinking any hot fluids or food while having a child in your lap.
Kitchen safety guidelines should be posted on a visible site and followed strictly.
Teach children to stay away from the kitchen stove.
Always use child-resistant lighters and avoid smoking.
Keep the play area away from the kitchen and keep close eyes on children.
Replaced all broken electrical wires and plugs, as soon as possible.
Make sure there is an essily accessible exit in each room, especially the kitchen.
Keep towels and other flammable material away from your kitchen stovetop.
Turn the handles of the pot towards the back of the stove.
Unplug small appliances when not in use.
Keep heaters at least three feet away from furniture or any other flammable materials.
Avoid leaving the kitchen unattended while cooking and making sure that you have stored all the hot recipes in a safe place and have locked the cupboards.
Use oven mitts when it is necessary to handle ovens and heaters.
Do not use tablecloths and place hot foods and liquids away from the table corner.
Never use petrol or kerosene oil for burning.
Do not warm the formula milk bottle to avoid burning a baby’s mouth.
Resources for Further Information on Household Burn Safety:
We honored Sandra Lindsay, DHSc, MS, MBA, RN, CCRN-K, NE-BC as Nurse of the Week just last week. Did we run out of outstanding nurses? No, our in-box is still overflowing with NotW suggestions (and please keep them coming!). However, after careful consideration, we bowed in the face of overwhelming evidence indicating that Dr. Lindsay is owed a two-week reign as Nurse of the Week. The nursing student who described her as “the [American] face of the Covid-19 vaccine” was merely being accurate, and the events of this week can certainly attest to Lindsay’s iconic status. What has Dr. Sandra Lindsay been doing since last Wednesday? Well, we can only account for perhaps a few hours last Friday and today — but it is clear that she will have to add Vaccination Icon Duties to her schedule from now on.
Last Friday, US President Joe Biden brought her closer to Elvis status (Presley was a dedicated crusader for the polio vaccine in the 1950s) by presenting the Jamaican-born Lindsay with the Outstanding American by Choice Award. “She represents the very best of us all,” said Biden during a special ceremony at the White House, and “pursued her dream of becoming a nurse to allow her to do what she wanted to do most: give back to her new country.” He also shared a bit more of Lindsay’s own pandemic story. “During the height of the pandemic, she poured her heart and soul into her work… With a grandson at home — prematurely — she did what she had to do. She kept her distance and kept him safe. He is safe, but she lost an aunt and an uncle to the virus.”
Linsday responded, “I came to this country for the opportunities – not only for myself but to be able to help others. As a nurse, I do everything to care for the sickest patients and lead by example. More than 24 years after becoming a naturalized citizen, I could never have imagined where I am today, at the White House receiving high honors from the President. It’s truly a privilege to be a part of this great nation and I will continue to lead and help those in need.”
After the White House ceremony, Lindsay was also asked to surrender her vaccination card, hospital badge, and a pair of scrubs into the custody of the Smithsonian Institution. The items will be on display at the Smithsonian’s Covid-19 historical exhibit (She naturally complied with the request, being as eager as all of us to see Covid-19 become History).
Lindsay had more Icon Duty on Wednesday, July 7, as she joined the ranks of Nurse Grand Marshals. For three hours, she presided over New York City’s Hometown Heroes ticker-tape parade. Lindsay was an obvious choice to lead festivities celebrating the courage and dedication of essential/healthcare workers caring for a city that is still trying to comprehend the loss of over 33,400 lives to the virus. “It is truly an honor and privilege to serve as the grand marshal in the Hometown Heroes ticker-tape parade and represent all health care and essential workers whose heroic efforts saved lives during the COVID-19 pandemic,” Lindsay said. Photos of the Grand Marshal smiling and waving from the back of a plush red convertible look suitably… iconic.
Dr. Lindsay, it is a pleasure to see a nurse knock The King back into his lane and take over as the US Vaccination Icon. Thank you!
Dr. Sandra Lindsay made headlines around the world (and in DailyNurse) for being the first person—and first nurse—in the US to hold out her arm for a vaccine that was regarded by many with uncertainty. How could they produce a vaccine at such a ferocious pace? (How? To paraphrase Samuel Johnson’s famous remark, when scientists fear that they or their loved ones will be killed by a virus, it concentrates their minds wonderfully). When people’s perspectives on the mRNA vaccines were clouded by fear and political biases coming from every angle, our Nurse of the Week stood up for non-immunocompromised nurses everywhere when she rolled up a sleeve and said, “I trust science.” The Jamaican-born nurse with many letters after her name is an important symbol and one that should be remembered. Nursing is about caring, but it is also about leadership, science, lots of hard work, and engaging in an endless war against ignorance.
So, what has Sandra Lindsay, DHSc, MS, MBA, RN, CCRN-K, NE-BC done in 2021? Well, she received her booster shot in January… We’re not certain about anything particular she did February through May, but she was probably preoccupied with her job as Director of Nursing at the Northwell Health Long Island Jewish Medical Center, waiting for the daily SARS-CoV-2 case rate to fall, and—because she really does trust science—preparing to add a Doctor of Health Sciences (DHSc) degree to her cv.
Then, this month, Dr. Lindsay responded to the request of a determined new grad, Tracey Smith, president of the Borough of Manhattan Community College (BMCC-SUNY) Nursing Students’ Association. Smith, who describes Lindsay as “the face of the Covid-19 vaccine,” was bent on getting the iconic nurse to speak at the pinning ceremony at the school, which is where she had earned her own first nursing degree in 1994 (and was valedictorian of her class, of course). “She can attest to the safety of the vaccine,” said Smith, who plans to earn a Master’s Degree in Pediatric Nursing. “She can help our new graduate nurses and the BMCC community at large to understand how this vaccine is working to protect us and the importance of mass vaccinations nationwide.”
After somehow finding time for her own new pinning, Lindsay spoke to Smith and the other BMCC nursing grads. She more than fulfilled Smith’s hopes: “It should be the natural choice for us to get vaccinated because it’s how we look out for each other. It gives us a chance to protect ourselves, our healthcare workers and our family and friends. It’s an opportunity to grab onto a much brighter future after a very dark year.”
During commencement, Dr. Lindsay was also awarded the BMCC President’s Medal for 2021, “which expresses the College’s admiration and appreciation for extraordinary service and leadership.”
At the ceremony, Lindsay said of Covid-19, “It’s not gone. I was vaccinated back in December and here I am today, feeling well, doing well. All BMCC graduates are role models. Nurses going out into the field are role models for patients who will look up to you as you model the behavior you want to see in the world.”
On June 10, National Nurses United welcomed the new Occupational Safety and Health Administration (OSHA) Emergency Temporary Standard (ETS) on Emerging Infectious Diseases to ensure safe workplaces for nurses and other frontline health care workers as “an important step forward that will contribute to safer health care settings for workers, patients, and communities.”
“After more than a year of the Trump administration’s refusal to require employers to provide enhanced infection control protections in health care settings in the face of the worst pandemic in a century, this is a monumental message that they will be held to account,” said NNU President Zenei Triunfo-Cortez, RN. “The ETS means new, mandatory requirements for employers, with penalties for those who violate those requirements,” she noted.
Upon preliminary review of the lengthy new temporary standard, NNU said there are significant requirements that will protect nurses and other health care workers and patients, and some areas that can still be strengthened as OSHA conducts updates.
Concurrently, NNU joined with other labor and health care activists in encouraging additional protections in other settings. “All workers, everyone, deserve to be safe — on the job, in their homes, and in their communities,” said NNU Executive Director Bonnie Castillo, RN.
In the health care arena, especially in acute-care hospitals, “this standard is testimony to the advocacy of registered nurses and our allies across the country who have fought with employers to demand safer workplaces, from optimal personal protective equipment, to stronger infection control measures, to corporate accountability from employers,” said Castillo.
“We now have an additional legal sanction for employers who continue to put their profits and budget goals over worker and patient safety. And we know that the test of the standard is dependent on our ability to enforce it to make sure our employers comply,” Castillo said.
Castillo noted that this is the first OSHA emergency temporary standard since 1983, was promulgated over the extensive opposition of and lobbying by the hospital industry and other corporate interests, and lays the groundwork for adoption of broad, permanent OSHA standards on infectious diseases for future epidemics. “We appreciate the strong support of Labor Secretary Marty Walsh, and many supporters in Congress, especially Rep. Bobby Scott, chair of the House Committee on Education and Labor,” she added.
Among the important new requirements included in the ETS:
All health care employers must have written infection control safety and implementation plans, developed in consultation with non-management employees and their representatives.
A major step forward in requirements for lifesaving respiratory protection against aerosol transmission of the virus for nurses and other frontline health care workers caring for suspected and confirmed Covid-19 patients.
New requirements on notification of health care employees exposed to confirmed Covid-19 patients in the workplace, and to provide pay and benefits for those who must take time off as a result of infection.
Mandates on screening, mask wearing, physical distancing, and barriers in the workplace.
NNU will continue to review the full ETS and encourage measures to strengthen its provisions, added Triunfo-Cortez.
Examples of areas for improvement include:
Moving away from reliance on screening through self-response from patients and employees as to whether they are experiencing Covid-19 symptoms, rather than on testing, for a disease in which more than half of transmissions are known to be caused by people who are asymptomatic.
Stronger provisions on aerosolized transmission and the risk of infection, and on ventilation requirements within health care facilities.
Provisions for full isolation of Covid-19 patients from non-Covid-19 patients, such as establishing dedicated Covid units.
Ensuring a multiple-measures approach where vaccines are one important measure in addition to mask wearing, physical distancing, ventilation, PPE, and other measures to protect nurses, other health care workers, and their patients.
“Still, this ETS is a major victory for those who have worked so hard to achieve this recognition of the terrible toll on nurses and other health care workers, against the malfeasance and resistance of employers and many elected officials,” said Castillo.
“This is still a dangerous and deadly pandemic. People in the United States continue to be infected and die. And nurses and other frontline caregivers remain in danger, especially with the pullback in safety measures across the country that will likely only increase the number of infections, hospitalizations, and deaths,” said Triunfo-Cortez.
As of this week, 405 RNs have died of Covid-19, among 3,908 health care worker deaths overall, according to NNU tracking data. Since the data has not been collected in many places, a full accounting may never be known. Nearly 900,000 health care workers have been infected, an increase of more than 3,000 from the week before.
National Nurses United is the nation’s largest and fastest-growing union and professional association of registered nurses, with more than 175,000 members nationwide.
When COVID-19 emerged early last year in the United States, we as a nation were ill-prepared to manage the virus and the ensuing pandemic that has claimed more than half a million lives in this country. As a critical care nurse in one of the largest health systems in Philadelphia, my colleagues and I were thrust into caring for patients sick with a virus we knew very little about. Unlike the COVID-19 pandemic, in which science is still evolving, our nation continues to ignore the proven science behind another lethal and ongoing epidemic: gun violence.
Recent events in Colorado and Atlanta have brought the devastating effects of gun violence back to the forefront of national media, which has been largely dominated by politics and COVID-19 in the last year. The science behind gun violence is unequivocal and has demonstrated the public health threat that firearms pose. While continued research on firearms and their effects will bolster our understanding of the problem, sufficient proof, from organizations like the CDC and the Pew Research Center, already exists. Here in Philadelphia, last year witnessed a 40 percent increase in people being shot, with over 2,000 residents harmed by firearm violence and over 500 people lost to homicide. This increase can be attributed to many factors, including COVID-19, which has led to increased intentional violent injuries, mostly from firearms.
Firearms and firearm violence are polarizing topics that our country historically has grappled with despite the litany of empirical evidence presented in scientific literature illustrating their destruction. It is alarming that our nation has leaders who deliberately fail to recognize the dangers of firearms in our society. We’ve seen members of Congress use their vote to block efforts to expand background checks on the same day in which two students were killed by gunfire in a California high school, and use their voice to mock victims of the Marjory Stoneman Douglas High School shooting in Parkland, Florida. Despite this blatant disregard for lives ruined by guns, I believe our country is now well-positioned to make traction on passing meaningful legislation. The convening of the 117th Congress coupled with the NRA’s Chapter 11 filing signal an opportunity to make real legislative changes that could begin to eliminate the terror that firearms cause.
Nurses need to be part of a multifaceted approach to decreasing the firearm injuries and traumas we see with our patients. This approach begins with nurses looking past partisan politics, and in doing so, to begin to see that attainable solutions are within reach. Nurses, who constitute the largest group of healthcare professionals, need to call upon our nation’s leaders to prioritize legislation allowing for the creation of formidable laws to curb both the violence and needless deaths resulting from the prevalence of firearms in our society.