Nurses’ Hands is an international association for nurses. The organization is FREE to join. As we grow we will have advertisers to help defray the costs.
The idea for Nurses’ Hands was born several years ago as I looked at videos of nurses in Mexico trying to care for patients in a hastily erected tent “hospital,” after the brick and mortar hospital collapsed in an earthquake. I wanted to find a way to support other nurses when natural or man-made disasters caused incredible challenges. Unfortunately, life got in the way and I never found the time to do more than talk about this.
This site was launched on April 6, 2020 as worldwide cases of COVID-19 were at 1,347,676 and deaths due to this global pandemic at 74,744 (JHU). COVID-19 got in the way of helping this organization grow. As a nurse executive I was desperately trying to keep our staff and patients safe. Our agency was no longer able to order any type of personal protective equipment through our regular suppliers due to the global shortage. When I got home and watched the news at night, tears would pour down my face as my emotions raged from fear to anger to despair like a turbulent, lightning filled thunder cloud.
During one of the amazing COVID-19 educational sessions our Clinical Educator had put together for our staff she stated: Years from now, when this is all over, I want to be able to look back and ask, did I do everything I could have? I want to be able to say yes.
On April 10, 2020, there were over 500,000 confirmed COVID-19 cases with 30,000 dead Americans. The U.S. had the dubious distinction of leading the world in COVID-19 cases and deaths (WHO Situation Reports), see figure 1.
By April, 2020, nurses and other healthcare providers were working without N-95 respirators and other PPE because of a global shortage. Nurses were catching the deadly virus en masse. There was no end in sight and there were no good answers. China, one of the top producers of PPE was on lockdown and the supply chains were terribly broken.
Here in the U.S. there were not enough nurses to care for the rapid influx of patients. There were not enough hospitals or hospital beds. There were not enough ventilators in the entire world to provide respiratory support for all the dying patients in desperate need. There were not enough morgues to hold the bodies of the dead. Crisis standards of care had to be implemented throughout the U.S. healthcare system. The only thing we had an excess of was very sick nurses and healthcare providers.
Tent field hospitals were being erected in major cities throughout the U. S. to create the extra beds needed to care for a massive influx of critically ill patients with COVID-19. Unfortunately, there was no magical way to create the volume of nurses needed to care for those patients as quickly as the structures were built. The military had to step in to help.
In New York, New York where the situation in April was ghastly, a nurse standing in front of a hospital held up a hand lettered sign written on a piece of cardboard that said: “who will take care of you when we are dead?” And nurses were dying…
As I watched the news on TV in April, while the number of COVID-19 cases skyrocketed, nurses and other healthcare providers who had worked 12 to 16 hour shifts day after day and week after week were protesting outside of their hospital. These nurses were taking time away from desperately needed sleep to protest due to the lack of personal protective equipment, including N95 respirators, medical grade masks, and disposable gowns. These products could have been made quickly and easily if pro-active actions had been taken when the World Health Organization announced that conditions were at epidemic status in China. Lack of adequate PPE during that time put patients and healthcare providers at extreme risk, and contributed to the deaths of many healthcare providers.
On May 3, 2020, not quite 1 month after this site was launched, there were 3,485,948 confirmed COVID-19 cases worldwide (compared to 1,347,676 on April 6th) and 246,126 deaths (compared to 74,744). United States confirmed cases at that moment were recorded as 1,149,197 (JHU).
When I updated this on October 25, 2020, the U.S. response to the pandemic was deplorable. Wearing a mask to prevent droplet and airborne transmission to others and social distancing were considered political issues for many people. A large segment of the population not only did not understand how lethal this virus was, but in some cases believed the COVID-19 pandemic was a hoax. At that time, the U.S. had 4% of the world’s population and 21% of global deaths. As of October 25th, 225,067 Americans were dead and 8,607,419 had tested positive for COVID-19. Case-fatality rates in the individual U.S. states were ranging from 2 to 8% (Connecticut). Worldwide there had been 1,152,065 deaths and 42,855,971 infections (JHU). The case-fatality rate was approximately 2.6%.
In the U.S., September and October 2020 were filled with super spreader rallies and various other large events held throughout the country by people who denied the seriousness of COVID-19. Despite the pleas of exhausted nurses, physicians and other health care providers, these people refused to wear masks when together and crowded shoulder to shoulder. The result was a massive surge in confirmed cases, significant morbidity and deaths that could have been prevented. That winter, flu season, major holidays, COVID-19 fatigue, and an increase in indoor activities extracted a heavy toll.
As of November 19, 2020 it was reported that over 1,396 American healthcare providers had already died of COVID-19 (Kaiser). The real number was much higher, but the statistics for “healthcare workers” were reported separately from that for nursing home staff. By the day after Christmas of 2020, more than 3,000 U.S. healthcare providers were dead.
The number of confirmed U.S. cases was near 12 million and 252,514 Americans were dead. A total of 1,848 deaths were recorded in a single day for November 18th (JHU) The United States continued to have the dubious distinction of leading the world in COVID-19 cases and deaths.
Hospitals were already filled to capacity in many areas of the country and dead bodies were stacked inside refrigerated trucks that are served as temporary morgues. Funeral homes could not keep up with the volume of bodies. Patients who were very high risk, with active COVID-19 pneumonia, ground glass opacities on CT scan (indicative of significant alveolar damage), and asymptomatic hypoxemia were being cared for in their homes to open beds for the most critically ill patients. It was not unusual for overflow patients in emergency departments to be cared for in hallways. Non-urgent surgeries were cancelled for lack of beds and PPE.
As of December 16, 2021, the pandemic had claimed the lives of more than 802,510 Americans and 5,330,120 had died worldwide. On the other hand, more than 485,994,275 doses of COVID-19 vaccine had been administered in the U.S., and 8,549,236,696 have been administered across the planet (JHU).
There was hope. Vaccinated individuals may still get infected, but there is strong evidence that the risk of morbidity and mortality is significantly reduced. Monoclonal antibodies provided an effective treatment option for many SARS-CoV-2 variants, though there are some lineages were resistance to these treatments (CDC). Antiviral agents for COVID-19 are available. The challenges of COVID-19 led to emergence of nurse and physician experts in viral epidemiology, treatment for COVID-19 and improved infection control efforts in all settings from critical care units to home health. All of these efforts have led to improved outcomes. The U.S. case fatality rate went down to 1.59%. Unfortunately, there are still many countries with very high fatality rates (JHU), especially in the developing world.
According to the World Health Organization an estimated 80,000 to 180,000 healthcare workers may have died from COVID-19 infections as of May 2021 (WHO). Vaccinations, effective treatments, hospital beds and staff, and personal protective equipment are not readily available to our colleagues practicing in many developing countries.
On March 24, 2022, the U.S. reached a death toll of 1 million. By the end of July, 2023, over 1.13 million Americans and nearly 7 million global citizens were dead (CDC; WHO).
This organization is dedicated to nurses and other healthcare providers worldwide who are providing supportive care to patients with COVID-19 at the front lines of the battle with this invisible enemy. One day this will be over and we will be left with the memories and a much greater understanding of our global connections. Today, it is pretty clear that what happens in one location can very rapidly have a worldwide impact. Let’s join together to create a brighter future.
Mary C. Vrtis, Ph.D., MSN, RN, OCN, NEA-BC, FCN
Source for COVID-19 infections, deaths and case-fatality rates: Johns Hopkins University and Medicine (2020-2021). Coronavirus Resource Center. Retrieved from: https://coronavirus.jhu.edu/map.html
The Staff of Kaiser Health News and the Guardian (2020). Lost on the Frontline. https://www.theguardian.com/us-news/ng-interactive/2020/aug/11/lost-on-the-frontline-covid-19-coronavirus-us-healthcare-workers-deaths-database
World Health Organization (2020). Situation reports for: January 31 (#11), February 15 (#26), February 28 (#39), March 15, March 27 (#67) , April 15 (#86), April 30 (#101), May 15 (#116) , May 31, 2020 (#131). Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
World Health Organization (October 20, 2021). Health and care worker deaths during COVID-19. https://www.who.int/news/item/20-10-2021-health-and-care-worker-deaths-during-covid-19
CDC(December 1, 2021). SARS-CoV-2 variant classifications and definitions. https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-classifications.html#anchor_1632237683347