NEWS
February 27, 2020

This is What Nurses Need To Know About Coronavirus ( COVID-19)

Woman with a facemask and umbrella outside at night
Chaunie Brusie By: Chaunie Brusie

The first death due to COVID-19 in the United States was reported in Kirkland, Washington State, on February 29, 2020. In addition, the recent news that the U.S. has confirmed the first community-acquired case of COVID-19 virus (meaning it wasn’t from someone who had recently traveled or had any known exposure to anyone with the virus) in California, the spotlight is on the threat of a nation-wide pandemic more than ever. 

The timeline of the virus has been accelerating at a frightening rate—per NPR, the U.S. now has 15 confirmed cases, along with 45 Americans who were infected while onboard the Diamond Princess cruise ship or on flights from Asia.  

But just how big of a threat is coronavirus? Here’s what you need to know. 

Coronavirus Symptoms 

So far, the CDC says that 2019-nCoV causes “mild to severe respiratory symptoms” (thanks, CDC, that’s a super helpful range) which have included:

  • Fever
  • Cough
  • Shortness of breath

It’s thought that after exposure to the virus, you could develop symptoms in as few as two days, or as long as two weeks. The virus can prove fatal when it leads to other complications, such as pneumonia and kidney failure. 

We recommend continuing to practice good hand hygiene and standard PPE precautions. 

How Nurses Are Being Affected

The International Council of Nurses (ICN), along with the World Health Organization (WHO), has turned its focus onto the enormous toll that the virus is having on nurses caring for patients in affected areas. 

In the coming weeks, the WHO plans to issue guidance in supporting the mental health of the staff caring for people affected by the virus.  “Many nurses will be working long stressful shifts during which they are exposed to a great deal of human suffering,” the ICN explained in a statement. “Their mental wellbeing is extremely important if they are to be able to continue to provide the highest quality care possible.”

It’s hard to fathom what the nurses caring for infected patients—as well as patients who aren’t infected but are worried they have the virus and are flooding healthcare facilities—are going through right now. 

The New York Times detailed some of the overwhelming situations that nurses in China are experiencing right now, and the details are frightening: nurses are being forced to work, forced to shave their heads completely off for hygiene purposes, or dealing with a lack of supplies, like not enough masks to go around. And because the large majority of nurses are women, the nurses are also struggling to get necessary menstruation supplies, as only approved products are being allowed into the city right now—and of course, it’s men doing the approving. 

When supplies were finally allowed, it wasn’t tampons or pads, but adult diapers that were sent. On top of the fact that women are finding it hard to even use the bathroom at all in their PPE that is not fitting or adequate, the diapers just add one more (literal) layer of frustration. 

After working mandated shifts, nurses are then being quarantined away from their families for the two-week incubation period to ensure they aren’t passing the virus on. 

How The U.S. is Preparing

As the ICN outlined, one of the biggest threats that the U.S. will face if the coronavirus spreads as quickly as it did in China is a lack of personal protective equipment (PPE).

In an article for NPR, veteran nurse Maureen Dugan, who works at the University of California, San Francisco Medical Center, which treated two coronavirus patients this month, described how the Ebola crisis revealed how poorly prepared the healthcare community, in general, is to ensure the safety of healthcare workers.  

She pointed out how the gowns they gave in the face of the Ebola crisis did not protect workers’ necks. “The gowns that they're providing are inadequate," she told NPR. "I'm sorry — I get very passionate about this because we've worked so hard to make sure that our nurses were protected and therefore they can protect the public."

Unfortunately, most U.S. hospitals still are not adequately prepared with PPE, and a survey from the National Nurses United found that only 9% of hospitals had a specific plan on how to isolate infected patients. However, the White House has requested $2.5 billion in funding to prepare for the virus, so the hope is that hospitals and healthcare facilities will be more equipped to handle an incoming threat in the weeks and months ahead.

How Nurses Can Stay Protected

Currently, the CDC explains that there is no vaccine or treatment for the virus; care is limited to supportive measures only. The organization is not recommending any sort of universal screening at this time. Instead, they are really only recommended that patients who have recently traveled to Wuhan or have had close contact with a traveler from the infected area should be tested for the virus. However, the CDC does grant that a “case-by-case” evaluation and healthcare professional judgment should be used. 

The CDC says that the exact way the virus is transmitted hasn’t been completely confirmed just yet, but coronavirus, in general, is transmitted through the air (think droplets, sneezing, coughing, etc.), which is why it is so highly contagious. 

As of right now, there is no real reason to do anything other than standard precautions when caring for your patients. As with any suspected case of a respiratory virus (like the flu!), you can ensure you are following your hospital’s protocol of using face masks for patients who you suspect are infected. Above all, proper handwashing is always the most important step you can take. 

In the event that you do have a patient that meets the criteria for known or suspected 2019-nCoV, the CDC says that standard, contact, and airborne precautions should be used by all healthcare workers, and the patient should be placed into an AIIR immediately or transferred to a facility with an AIIR. 

In the event that neither of those things is available, they recommend isolating the patient as much as possible in a room where the air is not recirculated without HEPA filtration and placing a surgical face mask on them.

Above all, the CDC is also reminding everyone—nurses, healthcare workers, and the public alike—that the most important thing anyone can do to stop the spread of the virus and protect themselves is to continue to practice proper handwashing techniques, including using soap and water and scrubbing for at least one minute. 

Who Has Novel Coronavirus Affected? 

The deaths in China have seemed to be most prominent in susceptible individuals, similar to the flu, as it’s been reported that a 9-month-old infant and an 88-year-old man were both victims of the virus. And coronaviruses, in general, are associated with having higher mortality rates than the flu, so a lot remains yet to be seen to how the virus could affect the public.What is Coronavirus?

First of all, just in case I am not the only one who keeps reading this as “Corona Virus,” aka Corona Beer, you should know that the virus is actually not named after an alcoholic beverage, but is so aptly named because the large family of coronaviruses has distinct “crown-like” spikes along their surfaces (“corona” = crown in Latin). 

According to the CDC, there are actually seven different types of coronaviruses that can currently infect humans, as well as three identified types that infect animals (but of course, those can jump to humans, as history has taught us). The type that is currently causing the outbreak in China is a brand-new virus from that has been named the 2019 Novel Coronavirus, or 2019-nCoV, for short, and it is in the same family as the SARs virus. 

2019-nCoV has been described as a cross between the SARs virus and the MERs virus (both also coronaviruses), because it produces a very high inflammatory response in humans and infects both the upper and lower respiratory systems. 

The 2019-nCoV is thought to have originated specifically from the wild animal market in Wuhan, which sells seafood, processed meats, and live animals and a new study has theorized the virus most likely came from snakes and somehow made the jump into infecting humans. 

How Dangerous is Coronavirus?

The exact threat of the coronavirus is largely unknown to those of us in the U.S. right now. 

To put things into perspective, the CDC estimates that the influenza virus has already killed between 8,200 and 20,000 people this flu season, so the three cases of a brand-new virus in the country aren’t an immediate cause for widespread panic just yet. 

However, Hong Kong infectious disease expert Yuen Kwok-yung told TIME that the coronavirus should be taken “extremely seriously,” largely due to how contagious the disease is. 

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