1918 Redux: Supportive Nursing Care for the Coronavirus Pandemic Is Courageous Care

Litter carriers at Red Cross Emergency Ambulance Station in Washington, D.C., during influenza pandemic of 1918.

The lessons of the past.

As we struggle to make sense of unfolding data, announcements, and public health directives about the current coronavirus pandemic, appreciating the lessons from past pandemics can help us understand the effectiveness and challenges related to quarantines and social isolation, as well as the need for reliable and timely communications.

In times of public health uncertainty, nurses and nursing care have played a critical role in saving lives and relieving suffering. We now know a great deal about the role of nursing during the 1918 influenza pandemic. Some lessons need heeding now.

Historian Nancy Bristow’s American Pandemic (New York: Oxford University Press, 2012) presents the historical facts clearly. For example, public health officials’ 1918 prohibitions on public gatherings, the sharing of such (then) new personal items as toothbrushes, and school attendance and religious services met acceptance as well as resistance. […]

2021-01-21T11:05:06-05:00March 18th, 2020|infectious diseases, Nursing, nursing history, Public health|1 Comment
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COVID-19 for Nurses: Skip the Rumors and Stick to the Basics

(Published: February 28. Editor’s note: much information in this post is now dated and the post should be read only as a response to a particular moment in time. COVID-19 is now officially a pandemic and has rapidly spread worldwide. While rumors and misinformation were, sadly, already very much in play when this was written, and the overall tone of this post was neutral and descriptive according to our knowledge at that current moment, the post only remains live for archiving purposes. Our most recent posts on the crisis can be found here.)

In the U.S. at the time of this writing, the major risk presented by the current novel coronavirus (COVID-19) is not from the disease itself but from misinformation. Rumors, misinterpretations, and conspiracy theories are being transmitted at a rate far greater than that of the coronavirus itself. While the situation is evolving rapidly and things can change quickly, our understanding of the illness has also grown in a remarkably  short period of time.

So, is this a pandemic?

In an NPR interview this week, WHO director-general Tedros Adhanom Ghebreyesus said the term is used to suggest that the spread of a new infection is out of control and doing significant damage worldwide. We are not quite there yet. COVID-19 transmission in China appears to have plateaued, and, while the virus has been detected in numerous other countries this week, several countries have also been successful in controlling the spread of COVID-19 within […]

2020-03-19T14:34:33-04:00February 28th, 2020|infectious diseases, Public health|13 Comments
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As Another Coronavirus Begins to Spread, Follow Reasonable Precautions and Avoid Fear-Mongering

(Editor’s note: Published January 24. The situation has considerably changed in the intervening weeks, during which the virus has rapidly spread across the globe. We obviously now know a great deal more about the dangers it presents.)

Emerging infections are part of our world—more evident these days because we have the tools and global communication networks to quickly identify them. This month, we’ve begun another crash course in the initial management of a new pathogen.

Short timeline from first cases to screening test availability.

Rumors of a concerning cluster of undiagnosed pneumonia in Wuhan, China, surfaced on social media on December 31. The patients weren’t responding to antibiotic therapy, but tests were negative for the usual viral suspects. World Health Organization staff quickly connected with Chinese health officials and testing and epidemiological investigations kicked into high gear.

Many of the infected patients had worked at a fish and live animal market in Wuhan, suggesting that the illnesses might be zoonotic (passing from animals to human) in origin. On January 7, the pathogen was identified as a new coronavirus, related (though not closely) to the coronaviruses that cause SARS and MERS. The viral genome was quickly sequenced, and on January 12, China shared the genetic sequence with the global scientific community. By […]

2020-03-19T17:12:45-04:00January 24th, 2020|infection control, infectious diseases, Nursing, Public health|1 Comment
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A Matter of Public Health: Physicians Make Case for Vaccinating Immigrants in Custody

For three days last week, physicians from around the country led demonstrations and a vigil outside of Customs Patrol and Border Protection (CBP) facilities in the San Diego area. After receiving no response to their repeated offers to the departments of Health and Human Services and Homeland Security to provide free flu vaccinations to immigrants in custody, the physicians (and a few NPs) had come to the border with donated influenza vaccine to press for a pilot vaccination program. CBP officials finally said they would pass the request up their chain of command.

Preventable deaths, plus a matter of the larger public health.

Three migrant children died in CBP detention centers during last year’s flu season. The last hours of 16-year-old Carlos Gregorio Hernandez Vasquez, who died in May of influenza, were documented on a grim surveillance camera video that recently circulated widely on the Internet. But the issue of influenza vaccination for migrants is not “merely” one of such preventable deaths; it is a  public health issue. This year’s flu season has ramped up in recent weeks, and a “window of opportunity” for vaccinating this vulnerable population is closing.

The CDC recommends that everyone six months of age and older receive influenza vaccination each year. […]

2019-12-19T14:10:39-05:00December 19th, 2019|infectious diseases, Nursing, Public health|1 Comment
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What Can We Do About Vaccine Misinformation?

“ . . . schools reported immunization rates ranging from 19% to 100%, with an average of 91%. . . . Alarmingly, one school reported that none of its students had been vaccinated.”

This year’s measles and mumps outbreaks are a reminder that many of us still think of vaccination as only a personal health practice. We forget that it is also something we do as a member of a community. When a vaccine-preventable disease starts to circulate, every vaccinated or otherwise immune person is a transmission dead end. It’s as though the virus skids to a stop in front of us, unable to pass through the closed door of our immunity to continue to replicate and spread disease.

In “Countering Vaccine Misinformation” in this month’s AJN, Lindsey Danielson and colleagues discuss vaccines, health literacy, and the ease with which misinformation can proliferate on social media. They emphasize the importance of understanding different kinds of opposition to vaccination:

“Vaccine hesitant describes a person who is hesitant about vaccines but still receptive to scientific evidence, while vaccine denier refers to a person who is against vaccination, denies scientific evidence, and uses rhetorical arguments to give the false appearance of legitimate debate.”

[…]

2019-10-21T07:57:26-04:00October 21st, 2019|infectious diseases, Nursing, nursing roles, Public health|1 Comment
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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