LAUSR

100 years on: the Spanish Flu, pandemics and keeping nurses safe This year marks the 100th anniversary of the Spanish flu, the grotesque black flu, that over the course of about a year infected up to one in three people in the world and killed 5 per cent of the global population (Taylor 2018). The death toll of Spanish flu is hard to fathom. It has been reported that ‘This virus killed more people in 24 weeks than HIV killed in 24 years and has been described as the greatest medical holocaust in history’ (Taylor 2018). Influenza remains the top global health security threat. The devastating influenza pandemic of 1918–1919 was a pivotal moment for nursing, and its impact on our profession is still felt today. Records of the period reveal that caregivers could do little to relieve suffering and stop the spread of the virus. Even so, nursing care was crucially important, the clearest predictor of survival (Hanink 2018). The first wave of the pandemic struck as many developed countries were ramping up their involvement in World War I. Most skilled nurses had left their native countries to support their armed forces, resulting in widespread nursing shortages. At the end of the war in 1918, the nursing shortage became even worse as returning troops carried with them a new and more virulent strain of the disease, which took a deadly toll on nurses. Nurses were not (and still are not) immune to contracting deadly diseases. We must ask ourselves, with advances in medicine and the changes to nursing and healthcare policies, is today’s nursing profession ready to deal with another pandemic this size? In short, no. We need only to look at recent outbreaks of the Ebola virus, SARS and H1N1 influenza to know that we are not providing enough protection and resources to nurses. The 2014–2016 outbreak of the Ebola virus in West Africa resulted in over 11 000 deaths, many of whom were health workers. In fact, in 2015, the Lancet reported that ‘by May 2015, 0.02% of Guinea’s population had died due to Ebola, compared with 1.45% of the country’s doctors, nurses, and midwives. In Liberia and Sierra Leone, the differences are more dramatic, with 0.11% and 0.06% of the general population killed by Ebola versus 8.07% of the health-care workers in Liberia, and 6.85% in Sierra Leone’. (Evans et al. 2015). At that time, ICN called on governments to create safe workplaces and, along with the European Federation of Nurses Associations, called for full protection of the nursing workforce. Likewise, the SARS outbreak in 2003 also raised concerns about protection of healthcare workers. Globally, 20 per cent of confirmed SARS cases were healthcare workers. In Canada, healthcare workers made up 43 per cent of SARS cases. (Branswell 2013) So much has changed in the delivery of modern health care over the past 100 years. Advances in technology, research and science have all had a significant impact on the way we communicate with, care for and manage our patients. These advances may seem to have an obvious advantage when fighting fatal epidemics; however, on a broader scale, there is an urgent pressing need to ensure nurses and midwives always have safe, supportive and empowering work environments. Unfortunately, health workplaces of the modern world continue to expose nurses and midwives to many risks. These