Grim death toll for world nursing community 

17 September 2020

More than 1000 nurses have died from COVID-19 in 44 countries, reports the International Council of Nurses.

However, “as our dataset only covers 44 countries with recorded nurse deaths, ICN believes the number significantly underestimates the situation,’’ the Council says, adding that as many as almost three million health care workers (HCW) worldwide could be infected.

On average, it says 10% of all confirmed cases of COVID-19 infections are among HCWs, with at least 7,000 deaths recorded.

The ICN is a federation of more than 130 national nursing associations, including the ANMF, representing the more than 20 million nurses worldwide. The ICN said the findings from its new report, based on July-August surveys conducted among nursing associations worldwide, revealed the failure of governments in prioritising nurses and health care workers during the coronavirus pandemic.

The ICN notes that in countries with adequate reporting mechanisms, the data shows that nurses were the biggest health worker group with COVID-19 infection. In Mexico, nurses correspond to 42% of confirmed HCW infections: the highest percentage of nurse infections among HCWs in its dataset.

The ICN also found:
Only 48% of the National Nursing Association (NNA) members report that COVID-19 is recognised as an occupational disease for HCWs.

Approximately 45% of the NNAs report that compensation is available from the government for HCWs infected with COVID-19 following exposure in the workplace.

More than 70% of the NNAs have received reports of incidents of violence or discrimination against frontline health workers due to COVID-19.

Incidents reported include discrimination, verbal aggression, physical assaults and psychological harm.

Some NNAs report nurses have been refused housing rentals or have been turned out on the street. Retaliation within communities was reported based upon misinformation about the ability of HCWs to carry and spread the virus.

Particularly, increased numbers of attacks have been reported against nurses in Mexico; for instance, a nurse was sprayed with bleach in the street, HCWs’ houses and cars have been burned, and HCWs have been physically attacked.

According to a recent survey carried out by the Irish Nurses and Midwives Organisation, some respondents stated that they have encountered problems getting childcare due to their work as a nurse or midwife.

60% of the NNAs have sometimes or regularly received reports of mental health distress from nurses in COVID-19 response. Burnout, anxiety, depression and fear of stigma and discrimination are the common mental health issues reported to NNAs from frontline nurses.

Some reports of severe mental health impacts have been received by the Italian Nurses Association since the start of pandemic in Italy.

45% of the NNAs indicate moderate to severe shortages of personal protective equipment (PPE) in the long-term care facilities in their countries.

“This latest survey is a disturbing snapshot of how nurses and other health workers are still being exposed to Covid-19 and all its associated risks, including violence and prejudice, mental illness, infection and in what we now believe to be possibly thousands of cases, making the ultimate sacrifice by paying with their lives,’’ ICN president Annette Kennedy was quoted in the Nursing Times.

“We talk about the new norm created by the pandemic, but it has also confirmed some long-understood truths in the nursing community, that nurses are undervalued, underpaid and sometimes treated as expendable.”
She said this was a “scandalous situation which ICN urges governments to rectify”.

As a consequence, the ICN listed numerous recommendations:

  • Implement standardised data collection on HCW infections and deaths
  • Recognise COVID-19 exposure in the workplace as an occupational illness
  • Ensure sufficient provision of appropriate PPE and evidence-based IPC training for HCWs in all healthcare settings.
  • Commit to a zero-tolerance approach to violence and discrimination against nurses and other HCWs
  • Prioritise nurses and other HCWs for COVID-19 vaccines
  • Ensure HCWs have access to and are prioritized for COVID-19 testing
  • Scale up measures to provide mental health support and counselling resources to nurses and other HCWs

“There is a huge hidden mental health risk to our nursing workforce submerged below the surface of the pandemic,” ICN chief executive Howard Catton was quoted in the Nursing Times.

“ICN research indicates the real scale of the mental health legacy of COVID-19 will undoubtedly mean that sickness, absenteeism, burnout and nurses leaving the profession because of ill health will increase, making shortages even more severe and resulting in an unquantifiable loss of experience.”