By AJN editor-in-chief Shawn Kennedy

It’s mid-April and I feel like I’m in one of those B-rated movies of the 1950s—where the atomic bomb hit and everyone is sequestered in bunkers, only venturing out to forage for food.

I’m entering our 5th week following stay-at-home recommendations and I guess it’s paying off—New York (where I usually work) and New Jersey (where I live) seem to be seeing a slight “flattening of the curve.” (Does anyone not know about the COVID-19 curve? See this site by the University of Michigan for an explanation).

But that good news is tempered by the fact that some states have yet to see their peak. In addition, we’ve yet come with grips in how to deal with the spread of the coronavirus in nursing homes, prisons, and shelters.

It’s worrisome to me that there is already talk of relaxing stay-at-home orders and social distancing before we have sufficient testing to have a clear understanding of how the disease spreads, before some states have reached their peak, and before we have refined the process of supplying and protecting health care workers. No one doubts that the economic shutdown is causing tremendous suffering, but without a firm grasp on how best to contain this disease and prevent its spread in this period before we have a vaccine and enough herd immunity, we’re gambling with all of our futures.

A heavy health care worker toll in U.S.

We’re  just starting to realize the extent of the toll COVID-19 is taking on health care workers. A new CDC MMWR report released April 14 notes that between February 12 and April 9, there were 9,282 cases of COVID-19 among health care workers in the United States. The good news is that 90% did not require hospitalization; the bad news is that 27 people died. The other bad news: 8% did not have any symptoms, meaning they likely infected others, maybe colleagues, maybe patients, maybe family members.

The preparedness breakdown.

Their courage and commitment is beyond words—as, unfortunately, is the slow response in getting them the supplies they need. We have a National Response Framework that details the process by which the federal government works to support states and local governments, but somehow, it seems not to be working.

I spoke with disaster preparedness expert Tener Veenema, 2018-19 distinguished nurse scholar-in-residence, National Academy of Medicine, and professor of nursing and public health, Johns Hopkins University School of Nursing/Bloomberg School of Public Health​. (She and public health colleagues recently wrote a post on crisis staffing for this blog.) I asked her if she thought we were doing what we should be doing, given where we are at the moment.

She stressed that social distancing was key and that, of course it would have been better if all of what we’re now doing had been put into place earlier. And she said she sees three critical problems to bear in mind in the crucial days and weeks ahead:

  1. The lack of a national surveillance program to track cases across the country so we have an accurate picture of the disease spread.
  2. While some governors “get” the problems and have acted smartly, others haven’t, and there is no unified national plan that all governors can get on board with.
  3. The lack of national leadership at the top to direct efforts.

Listen to the podcast of our conversation here: