As COVID-19 cases continue to climb in the United States, unions representing 230,000 nurses across the country have joined forces to demand hospitals and the government follow strict guidelines before any further reopening measures are taken.

National Nurses United (NNU) (comprising the California Nurses Association (CNA), the D.C. Nurses Association (DCNA), the Minnesota Nurses Association (MNA), and National Nurses Organizing Committee (NNOC), which include RNs in Arizona, Florida, Illinois, Kansas, Maine, Missouri, Texas, West Virginia, and Veterans Affairs facilities in a dozen other states) along with the New York State Nurses Association (NYSNA), Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), and Massachusetts Nurses Association (MNA) strongly caution against premature calls to reopen the country.

To respond to this pandemic before loosening social distancing measures any further, nurses call on the government and employers to meet the following criteria:

• Nurses and other health care workers must have the optimal personal protective equipment (PPE) they need, including powered air-purifying respirators, coveralls that incorporate head coverings and shoe coverings, and gloves. Otherwise, hospitals will remain infection epicenters that continue to infect, sicken, and kill nurses and health care workers. Without them, who will care for the next wave of patients?
   
• President Trump must activate the Defense Production Act to order the mass production of PPE. Widespread use of various N95 decontamination systems have proven unsafe. Nurses and health care workers need to use PPE as it was intended, to effectively protect patients and the public.
   
• Health care capacity must be expanded, and people must be able to get treatment they need if they contract COVID-19— at no cost. Any vaccine developed with U.S. taxpayer dollars must also be provided to the U.S. public for free when needed.
   
• CDC, WHO, OSHA guidelines and standards must be strengthened. The risk for airborne transmission of the virus is now documented. Before reopening the country, nurses demand that the Centers for Disease Control and Prevention and the World Health Organization strengthen their guidelines accordingly. The Occupational Safety and Health Administration (OSHA) must also pass an emergency temporary standard for infectious diseases to mandate that healthcare employers provide protections needed for COVID-19.
   
• Public health infrastructure must be strengthened to include sufficient staffing, supplies, and space for robust surveillance, testing, case isolation, and contact tracing to ensure that the virus is effectively contained.
   
• Health care capacity and preparedness must focus on human need, not profit. This pandemic has exposed underlying problems in our society, and has illuminated the damage done by economic policies that benefit our for-profit health care system, instead of human beings.

• Basic human needs must be met. People in America must have enhanced unemployment benefits and paid sick time and family leave; food security; housing; healthcare; and other social supports for people who are unemployed or unable to work due to illness or quarantine and isolation measures

As caregivers, nurses emphasize that we cannot return to business as usual in a system skewed to benefit the wealthy.

“This is an opportunity to reimagine how we can organize our society in ways that are beneficial to everyone, as opposed to a handful of billionaires,” said CNA/NNOC/NNU Executive Director Bonnie Castillo, RN. “COVID-19 proves that it’s time to focus on building an economy that’s not based on consumption of things, but on care for people.”

“The COVID-19 crisis continues to shine a light on corporate healthcare’s dangerous practice of putting profits before patients and workers. Resuming some healthcare procedures in the midst of a pandemic must be a balance of ensuring that patients get the care they’ve been waiting for with the safety of those patients and the workers who care for them,” said Minnesota Nurses’ President Mary C. Turner, RN.

“Nurses and health care professionals who have spent months in the trenches of this pandemic caring for COVID-19 patients are the most critical voices as we decide how to safely operate healthcare facilities,” said Massachusetts Nurses’ President Donna Kelly-Williams, RN. “We have seen too many bad decisions by state and federal regulators and hospital administrators that have hurt our ability to safely care for patients and protect frontline staff; and in the rapid push to reopen the economy and to recoup lost revenue, we expect more bad and dangerous decisions will be made. It is time to listen to and protect those on the frontlines if we are to prevent a more catastrophic second wave of this pandemic.”

“Nurses know that caring for people evinces our humanity, a trait that is often discarded by those in the halls of power. We must stand by our fellow humans and strive for better health, safety and financial support for the voiceless,” said DCNA Executive Director Edward J. Smith. “As we continue to go to work every day fighting against this worldwide pandemic, we must remember our true selves: we help our neighbors. If we do this collectively, we will survive this pandemic and create a more just world.”

“New York has been the epicenter of the COVID-19 pandemic, and frontline nurses, as well as the patients we care for, have paid the price for the country's lack of preparation,” said NYSNA President Judy Sheridan-Gonzalez, RN, MSN, FNP. “From the beginning, nurses have been clear about what we need to keep ourselves and our patients safe—proper equipment, adequate staffing, widespread testing and tracing, and an enforceable infection control standard rooted in science. And for months, the concerns of frontline health care workers were ignored, and we were sent into battle without protections. Nurses must have a seat at the table as we start to reopen. This is the only way to protect our communities and for prepare for the next outbreak. Our experience and professional expertise are the key to ensuring this never happens again.”