We Cannot Let This Happen Again!

An Investigation into the Impact of the COVID-19 Pandemic on Nurses

Mary C. Vrtis, Ph.D. MSN, RN, OCN, NEA-BC, FCN

Table of Contents




Really bad superbugs

Nurses are the front line

It only takes one nurse to break the chain of transmission

The Kindness of Strangers

  • Help Started to Arrive, the Impact of Ordinary People Who Came to Our Rescue
  • Craftivists versus COVID-19 the DC/Maryland/Virginia “Million Mask Challenge”
  • #GetUsPPE Distributes Millions of Units of Personal Protective Equipment to Healthcare Organizations and Schools
  • Apple Produced and Donated Millions of Masks and Face Shields
  • References Cited

COVID-19: A Path to Death and Destruction

  • China – December 2019 to February 2020
  • Advanced Technologies, Genetic Sequencing and Global Sharing of Information
  • Deadly Mutations: Probable Zoonotic Origin of SARS-CoV-2
  • Why Did the Virus Spread so Fast?
  • Humans Spread the Virus Throughout the World
  • Modes of Transmission – SARS-CoV-2 (COVID-19) in 2020
  • The Situation in China and the World Worsened January 2020
  • China Published an Epidemiological Study February 2020
  • Fatalities in China February 2020
  • U.S. COVID-19 Study – Outcomes in March 2020
  • COVID-19 Rages Uncontrolled
  • References Cited

A Global Shortage of Personal Protective Equipment

  • COVID-19: Guidance for Personal Protective Equipment
  • U.S. Nurses on the Front Lines did NOT Have Adequate Protective Equipment
  • Nurse Surveys
  • National Nurses United Nurse Survey and Press Conference March 5, 2020
  • The American Nurses Foundation Survey, May 2020
  • The American Nurses Foundation August, 2020
  • Reuse of N95s: The Science Did NOT Support Practices
  • National Nurses United Surveys March and September 2021
  • Inadequate Protective Equipment: Nurses at Risk
  • The Consequences of Failure to Protect Healthcare Providers
  • Disruption of Global Personal Protective Equipment Supply Lines
  • Emergency Authorization for Use of Non-NIOSH Approved Respirators in the U.S.
  • Changing Standards of Care for Staff Protection
  • Consequences of Required Prolonged and Reuse of Disposable PPE
  • Rapidly Rising Costs and Price Gouging
  • Counterfeit Personal Protective Equipment Floods the Marketplace
  • International Fraud
  • A European Scam
  • A U.S. Scam
  • The Situation in Other Countries
  • Moving Toward Solutions
  • Acceleration of Personal Protective Equipment Production Worldwide
  • Defense Production Contracts: General Motors and the Ford Motor Company
  • A Return to Conventional Capacity Standards of Care
  • A Sustainable Public Health Supply Chain
  • Recommendations
  • References Cited

The U.S. Response: Too Little Too Late

  • Introduction
  • The U.S. Had a Disproportionate Number of COVID-19 Infections and Deaths
  • Deadly Delays: The U.S. Governmental Response
  • A Closer Look
  • Public Refusals to Follow Basic Infection Control Recommendations
  • From Zero to 1 million Cumulative Cases in Four Months
  • Nurses and Other Healthcare Professionals were NOT Protected!
  • Pre-pandemic Readiness
  • What DID happen?
  • Political Divisions and an Inability to Fight Against a Common Enemy
  • The U.S. Plan to Withdraw from the World Health Organization During the Pandemic in April of 2020
  • Superspreader Events Compound the Problem
  • References Cited

Dangerous Mutations: the Continuous Emergence of SARS-CoV-2 Variants

  • Variants of Concern
  • Front Line Staff Nurses are an Invaluable Resouce
  • Emerging Variants Change Everything
  • SARS-CoV-2 Variants and the Impact on the U.S. Healthcare System: Looking Back so We Can Move Forward
  • Basic Concepts
  • Reproduction Number and Transmission
  • The Ancestral Wuhan SARS-CoV-2 Variant
  • Case Fatality Rates/ Mortality Rates for the Ancestral Variant
  • Was there an Unamed Variant October 31, 2020 to February 27, 2021?
  • The Alpha B.1.1.7 SARS-CoV-2 Variant, February 27 to July 3, 2021
  • Reproduction Number and Transmission for Alpha
  • Case Fatality Rates/ Mortality Rates for Alpha
  • Nurse and Other Healthcare Worker Deaths During Alpha
  • Hospitalizations/ Severity of Illness During Alpha
  • Mitigation Strategies February 2021 to January 2022
  • The Delta B.1.617.2 Variant June 5, 2021 to January 1, 2022
  • Reproduction Number and Tranmission for Delta
  • Case Fatality Rates/ Mortality Rates for Delta
  • Nurse and Other Healthcare Worker Deaths During Delta
  • Hospitalizations/ Severity of Illness During Delta
  • Omicron Variants, Multiple Variants of Concern, December 2021
  • Omicron B.1.1.527 and BA.1, December 28, 2021 to April 2, 2022
  • Reproductive Number and Transmission
  • Omicron BA.5, June 4, 2022 to December 31, 2022
  • Mitigation Strategies: Vaccinations and Omicron
  • Omicron XBB.1.5, December 4, 2022 to August 5, 2023
  • Omicron EG.5 (Eris), Omicron FL.1, and Omicron HV.1, September/ October 2023
  • Vaccinations
  • COVID-19: The Public Health Emergency Has Ended, COVID-19 Has Not
  • References Cited

After Action Analysis Sample Report

  • Sample of an After Action Report

Pandemic Preparation, U.S.

  • Pre-COVID-19 Pandemic Preparations, United States
  • Bad Decisions and Factors that Fueled the Pandemic
  • Pandemic and All-Hazard Preparedness Laws and Reports
  • Governmental Agencies, Institutes, Offices and Entities Involved in Infectious Disease and Pandemic Preparation and Response
  • Centers for Disease Control and Prevention/ Health and Human Services
  • The National Institutes of Health (NIH)
  • U.S. Department of Defense
  • State and Territorial Health Departments