Coronavirus Casting Environmental, Climate Issues Into Sharp Relief

The COVID-19 pandemic highlights the vital link between public health and the environment.

Since 1970, April 22 has been designated Earth Day. The theme of this year’s observations, held digitally due to the pandemic, is climate action, with the organizers calling climate change “the biggest challenge to the future of humanity.”

The biggest immediate challenge facing humanity is coronavirus. Yet, just as the pandemic’s economic fallout highlights the interconnectedness of health and the economy, this crisis underscores the ongoing environmental emergency and its link to public health.

Air pollution and COVID-19 deaths.

Since coronavirus first emerged, there’s been speculation about a link between air pollution and severe illness or death. Early this month, a nationwide study conducted by researchers at the Harvard T.H. Chan School of Public Health offered evidence of a connection: even a small increase in long-term exposure to fine particulate matter—dangerous inhalable solids or liquid droplets in the air—is associated with a large increase in the COVID-19 death rate.

The inhalation of fine particulate matter is known to cause inflammation and damage to the lungs, making a person more susceptible to asthma, heart conditions, and other health problems. Fuel combustion—for example, automobile and industrial emissions—is one of the main sources of these microscopic […]

2020-04-22T08:31:24-04:00April 22nd, 2020|environmental health, Public health|0 Comments
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The U.S. Still Can’t Manage COVID-19 Testing: Why Is This Such a Big Deal?

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. Published April 20.

How is it that we in the U.S. make up 4% of the world’s population but account for more than 31% of global COVID-19 cases? Because at the start of the pandemic we weren’t prepared to test quickly and widely—and incredibly, after three months’ time, we still aren’t.

Coincidentally, both the U.S. and South Korea saw their first cases of COVID-19 on January 20. Two weeks later, South Korean scientists had perfected a diagnostic test for the virus, and infected people began to be identified and isolated.

Meanwhile, in the U.S. a series of problems and poor decisions held back test development. In early March, as the number of cases of COVID-19 exploded in parts of the country, Health and Human Services Secretary Alex Azar promised that by March 14, labs would be running four million tests per week. As of April 20, the total number of SARS-CoV-2 tests performed in the U.S. since the pandemic began was only 3.8 million, according to covidtracker.com. Our testing capacity is frighteningly low. Estimates of an adequate […]

2020-04-20T12:32:03-04:00April 20th, 2020|infectious diseases, Nursing, Public health|0 Comments
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COVID-19: Where Do We Go From Here?

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 […]

2020-04-16T10:26:04-04:00April 16th, 2020|Nursing|0 Comments
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Two Poems by an ED Nurse

Mask

         -from Latin, masca (specter, nightmare)

My borrowed face,

incorporeal,                blue—

I give you        only

my eyes.

First Sunday on the Ward, Pandemic

Deft swallows nest inside the thorny crown of a stone Christ.

I whisper Our Father . . .                   

twice

over the scrub sink.

 

-Editor’s note: These two spare poems were sent to us recently by Stacy Nigliazzo, an ED nurse and poet whose work has been featured in JAMA and the Bellevue Literary Review, as well as in AJN’s Art of Nursing column. We don’t usually publish poems on this blog, but make an exception here because they seemed to us urgent and yet timeless. Publishing them implies no affiliation of AJN with any particular religion. At the same time, it’s only natural that faiths and practices of every sort are likely to be a source of strength and meaning during this time for nurses around the world. 

2020-04-10T13:39:42-04:00April 10th, 2020|Nursing, nursing perspective|2 Comments
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As Conflicting Recommendations Sow Public Confusion, Nurses Still Lack Adequate PPE and Equipment

By Betsy Todd, MPH, RN, nurse epidemiologist and AJN clinical editor. April 3.

One problem central to the experience of nurses during this pandemic is the disastrous lack of essential supplies and equipment. How different would your work days be right now if you had plenty of PPE and ventilators? In the parts of the country with the most COVID-19 cases, this problem is far from being resolved. In many other cities and states, unbelievably (after three months), you are likely to be faced with it soon.

Where is our PPE?

For weeks, nurses and physicians in states that were initially hardest hit by the pandemic (New York, California, Washington) have reported severe shortages of personal protective equipment. (See, for example, this ICU nurse’s anonymously published note to AJN.) Respiratory protection has been in particularly short supply. In many hospitals, staff are reusing one droplet mask or N95 respirator for an entire shift or longer. These dire circumstances were predictable. A  2015 article from researchers at the National Institutes of Health predicted that in a pandemic in which only 20 to 30 percent of the population is infected, up to 7.3 billion N95 respirators would be needed. COVID-19 is likely to infect a considerably higher percentage of the population. Where are our masks? […]

2021-01-21T11:08:39-05:00April 3rd, 2020|infectious diseases, Nursing, Public health|3 Comments
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