COVID-19 and the nursing labor market: lessons learned by analogies between historical events  <span class="so-article-trans-title" dir="auto"> Translated title: COVID-19 y el mercado laboral de enfermería: lecciones aprendidas por analogías entre hechos históricos </span> <span class="so-article-trans-title" dir="auto"> Translated title: COVID-19 e mercado de trabalho da enfermagem: lições aprendidas por analogias entre eventos históricos </span>

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Abstract

ABSTRACT Objectives: to reflect on the impacts of Brazil’s response to the COVID-19 pandemic demands on the nursing labor market in light of the recovery of experiences in the USA during the World War II. Methods: this is a discursive formulation, which discusses the nursing labor market, establishing analogies between historical events. Results: measures implemented in the World War II by the USA are similar to those that the Brazilian Federal Government has adopted, and, as in the USA, such measures strongly affected both professional training and the nursing labor market. In Brazil, the measures can also deepen problems in the national nursing labor market, reverberating in precariousness. Conclusions: a better way to meet the demand for nursing workers can be with the existing supply of trained and available workers.

Translated abstract

RESUMEN Objetivos: reflexionar sobre los impactos de la respuesta de Brasil a las demandas de la pandemia de COVID-19 en el mercado laboral de enfermería a la luz de la recuperación de experiencias en Estados Unidos durante la Segunda Guerra Mundial. Métodos: formulación discursiva, que analiza el mercado laboral de enfermería, estableciendo analogías entre hechos históricos. Resultados: las medidas implementadas en la Segunda Guerra Mundial por los Estados Unidos. Son similares a las adoptadas por el Gobierno Federal de Brasil y, al igual que en los Estados Unidos, estas medidas afectaron fuertemente tanto a la formación profesional como al mercado laboral de enfermería. En Brasil, las medidas también pueden profundizar los problemas en el mercado laboral nacional de enfermería, repercutiendo en la precariedad. Conclusiones: una mejor manera de satisfacer la demanda de trabajadores de enfermería puede ser con la oferta existente de trabajadores capacitados y disponibles.

Translated abstract

RESUMO Objetivos: refletir sobre os impactos da resposta do Brasil às demandas da pandemia de COVID-19 ao mercado de trabalho da enfermagem à luz do resgate de experiências havidas nos EUA por ocasião da Segunda Guerra Mundial Métodos: formulação discursiva, que discute o mercado de trabalho da enfermagem, estabelecendo analogias entre eventos históricos. Resultados: medidas implementadas na Segunda Guerra Mundial pelos EUA se assemelham às que o Governo Federal brasileiro tem adotado, e, assim como nos EUA, tais medidas atingiram fortemente tanto a formação profissional quanto o mercado de trabalho da enfermagem. No Brasil, as medidas também podem aprofundar problemas do mercado de trabalho da enfermagem nacional, reverberando na precarização. Conclusões: uma forma mais acertada de atender à demanda por trabalhadores de enfermagem pode ser com a oferta já existente de trabalhadores treinados e disponíveis.

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Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1

Neeltje van Doremalen, Trenton Bushmaker, Dylan H Morris … (2021)

To the Editor: A novel human coronavirus that is now named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (formerly called HCoV-19) emerged in Wuhan, China, in late 2019 and is now causing a pandemic. 1 We analyzed the aerosol and surface stability of SARS-CoV-2 and compared it with SARS-CoV-1, the most closely related human coronavirus. 2 We evaluated the stability of SARS-CoV-2 and SARS-CoV-1 in aerosols and on various surfaces and estimated their decay rates using a Bayesian regression model (see the Methods section in the Supplementary Appendix, available with the full text of this letter at NEJM.org). SARS-CoV-2 nCoV-WA1-2020 (MN985325.1) and SARS-CoV-1 Tor2 (AY274119.3) were the strains used. Aerosols (<5 μm) containing SARS-CoV-2 (105.25 50% tissue-culture infectious dose [TCID50] per milliliter) or SARS-CoV-1 (106.75-7.00 TCID50 per milliliter) were generated with the use of a three-jet Collison nebulizer and fed into a Goldberg drum to create an aerosolized environment. The inoculum resulted in cycle-threshold values between 20 and 22, similar to those observed in samples obtained from the upper and lower respiratory tract in humans. Our data consisted of 10 experimental conditions involving two viruses (SARS-CoV-2 and SARS-CoV-1) in five environmental conditions (aerosols, plastic, stainless steel, copper, and cardboard). All experimental measurements are reported as means across three replicates. SARS-CoV-2 remained viable in aerosols throughout the duration of our experiment (3 hours), with a reduction in infectious titer from 103.5 to 102.7 TCID50 per liter of air. This reduction was similar to that observed with SARS-CoV-1, from 104.3 to 103.5 TCID50 per milliliter (Figure 1A). SARS-CoV-2 was more stable on plastic and stainless steel than on copper and cardboard, and viable virus was detected up to 72 hours after application to these surfaces (Figure 1A), although the virus titer was greatly reduced (from 103.7 to 100.6 TCID50 per milliliter of medium after 72 hours on plastic and from 103.7 to 100.6 TCID50 per milliliter after 48 hours on stainless steel). The stability kinetics of SARS-CoV-1 were similar (from 103.4 to 100.7 TCID50 per milliliter after 72 hours on plastic and from 103.6 to 100.6 TCID50 per milliliter after 48 hours on stainless steel). On copper, no viable SARS-CoV-2 was measured after 4 hours and no viable SARS-CoV-1 was measured after 8 hours. On cardboard, no viable SARS-CoV-2 was measured after 24 hours and no viable SARS-CoV-1 was measured after 8 hours (Figure 1A). Both viruses had an exponential decay in virus titer across all experimental conditions, as indicated by a linear decrease in the log10TCID50 per liter of air or milliliter of medium over time (Figure 1B). The half-lives of SARS-CoV-2 and SARS-CoV-1 were similar in aerosols, with median estimates of approximately 1.1 to 1.2 hours and 95% credible intervals of 0.64 to 2.64 for SARS-CoV-2 and 0.78 to 2.43 for SARS-CoV-1 (Figure 1C, and Table S1 in the Supplementary Appendix). The half-lives of the two viruses were also similar on copper. On cardboard, the half-life of SARS-CoV-2 was longer than that of SARS-CoV-1. The longest viability of both viruses was on stainless steel and plastic; the estimated median half-life of SARS-CoV-2 was approximately 5.6 hours on stainless steel and 6.8 hours on plastic (Figure 1C). Estimated differences in the half-lives of the two viruses were small except for those on cardboard (Figure 1C). Individual replicate data were noticeably “noisier” (i.e., there was more variation in the experiment, resulting in a larger standard error) for cardboard than for other surfaces (Fig. S1 through S5), so we advise caution in interpreting this result. We found that the stability of SARS-CoV-2 was similar to that of SARS-CoV-1 under the experimental circumstances tested. This indicates that differences in the epidemiologic characteristics of these viruses probably arise from other factors, including high viral loads in the upper respiratory tract and the potential for persons infected with SARS-CoV-2 to shed and transmit the virus while asymptomatic. 3,4 Our results indicate that aerosol and fomite transmission of SARS-CoV-2 is plausible, since the virus can remain viable and infectious in aerosols for hours and on surfaces up to days (depending on the inoculum shed). These findings echo those with SARS-CoV-1, in which these forms of transmission were associated with nosocomial spread and super-spreading events, 5 and they provide information for pandemic mitigation efforts.

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Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic

Tait Shanafelt, Jonathan A. Ripp, Mickey Trockel (2020)

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Medical student involvement in the COVID-19 response

Daniel M Baker, Sanchita Bhatia, Samuel Brown … (2020)

Coronavirus disease 2019 (COVID-19) has been formally declared a pandemic by WHO, 1 reflecting an inability to contain its spread internationally. The associated harm of the COVID-19 pandemic to populations and health systems cannot be understated. In this unprecedented situation, perhaps one of the more under-recognised and enduring repercussions will be on medical student training worldwide. The paradoxical dual role of medical students is that, as the future health-care workforce, we potentially form part of a health-care system's response to public health emergencies but, conversely, are considered non-essential in clinical delivery and might be restricted from clinical learning. Medical schools have had various responses to date.2, 3 Some medical schools have cancelled teaching 3 and medical electives entirely, whereas others continue to encourage clinical placements. Although these measures felt appropriate to protect both patients and the health-care workforce, they nevertheless represent the loss of essential learning opportunities. A clear and unified response at national levels is needed to ensure that all students receive timely and consistent advice and that the impact on their future practice is minimised. Several governments have alluded that medical students could be used in health systems affected by COVID-19.2, 4 Although there is no question about their willingness, given no recent precedent, the lack of guidance for any students drafted is concerning. In particular, we find an absence of official and unambiguous statements on indemnity, governing body regulation, contractual agreements, expected roles and responsibilities, and the clinical supervision expected. Several health-care systems, such as in Italy and Iran, are in crisis, 5 and others expect substantial challenges in the coming weeks and months. In this context, students could be placed in challenging and compromising situations if asked to support health-care staff in providing care. The case of the British trainee paediatrician, Bawa-Garba, 6 who was convicted of manslaughter and temporarily lost her medical licence despite recognition of systemic failings and extreme pressure that she was under, has eroded trust from health-care professionals that they will be adequately supported in the event of potential mistakes under mitigating factors. These points must be explicitly addressed and conveyed on national levels before any student is used within clinical practice. Governments, regulatory bodies, and medical schools have a responsibility to both current and future patients to ensure that our future doctors are sufficiently trained and supported to deliver essential patient care, even in crises. Medical students, alongside all health-care staff, are prepared to contribute to patient care in the COVID-19 pandemic, yet in these uncertain times, forethought and transparency are essential.

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Author and article information

Journal

Journal ID (publisher-id): reben

Title: Revista Brasileira de Enfermagem

Abbreviated Title: Rev. Bras. Enferm.

Publisher: Associação Brasileira de Enfermagem (Brasília, DF, Brazil )

ISSN (Print): 0034-7167

ISSN (Electronic): 1984-0446

Publication date (Print and electronic): 2022

Volume: 75

Issue: 2

Electronic Location Identifier: e20200328

Affiliations

[1] Rio de Janeiro Rio de Janeiro orgnameUniversidade Federal do Rio de Janeiro Brazil

Article

Publisher ID: S0034-71672022000200400 Publisher ID: S0034-7167(22)07500200400

DOI: 10.1590/0034-7167-2020-0328

SO-VID: ce37e22b-7a66-445a-af2e-a5c5570c2d16

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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Date accepted : 09 May 2021

Date received : 22 April 2020

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Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 0

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SciELO Revista de Enfermagem

Keywords: História da Enfermagem,Mercado de Trabalho,Infecções por Coronavirus,II Guerra Mundial,Enfermagem,Mercado de Trabajo,Infecciones por Coronavirus,Segunda Guerra Mundial,Historia de la Enfermería,Enfermería,Employment,Coronavirus Infections,World War II,History of Nursing,Nursing

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Keywords: História da Enfermagem, Mercado de Trabalho, Infecções por Coronavirus, II Guerra Mundial, Enfermagem, Mercado de Trabajo, Infecciones por Coronavirus, Segunda Guerra Mundial, Historia de la Enfermería, Enfermería, Employment, Coronavirus Infections, World War II, History of Nursing, Nursing

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Most cited references 14

Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1

Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic

Medical student involvement in the COVID-19 response

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