More than 600 nurses around the world have died from COVID-19 and approximately 230,000 health-care workers have contracted the virus, according to the International Council of Nurses (ICN).

The ICN, which represents 130 national nursing associations and more than 20 million nurses, released the figures in a bid to convince governments to collect accurate data on infections among health-care workers in order to protect them.

“We have called very, very clearly for governments to work together to collect this information in a standardized and systematic way,” Howard Catton, ICN CEO, told during a telephone interview from Geneva on Thursday. 

“We need a central database of reliable, standardized, comparable data on all infections, periods of quarantine and deaths that are directly or indirectly related COVID-19.”

Catton continued that, without this data, it will be impossible to know the “true cost” of COVID-19 and it will hinder efforts to respond to other pandemics in the future.

“It’s not data for data’s sake,” he said. “We genuinely believe that the analysis of the data would help inform our better understanding of coronavirus, how we improve infection prevention and control measures, and ultimately how we better protect patients and save the lives of nurses.”

When asked how countries could collect data on COVID-19 deaths and infections among health-care workers in a standardized and systematic way, Catton said there needs to be agreement on who is considered a health-care worker for the records. For example, are they only counting nurses in hospitals or are nurses working in care homes and other facilities included in the tallies as well?

Catton said all countries should be collecting information on where health-care workers are employed, whether they’re treating coronavirus patients, their ages and ethnicities, and if they are infected with the virus, when that might have occurred.

“If we had that data, it would improve our understanding of how people had become infected, who the most highest-risk groups are and the local settings that might be at risk,” he said.

The ICN’s estimation of more than 600 deaths among nurses and more than 230,000 infections came from data from national nurses associations, official figures, and media reports from a “limited number of countries.”

According to the analysis, the death toll has more than doubled since May 6, when the ICN reported more than 260 COVID-19 deaths among nurses and 90,000 infections worldwide.

While 600 deaths is a startling figure, Catton said he fears the actual death toll is higher because they have not been able to collect data from every country and there are variances in how countries are collecting that information.

“It may be that some of the countries who are reporting lower numbers are grossly underestimating the extent of health worker infections,” he said.

What’s more, Catton said when the coronavirus outbreaks around the world began, there was already a shortage of six million nurses globally.

“The last thing we can afford to do is to lose more of our nurses or health workers who have to go off sick because they’ve contracted the disease,” he said. “If we hit a second wave, a second peak… we risk simply not having sufficient numbers of nurses and health-care workers to look after people who might get sick in the future.” 

The ICN said that 7 per cent of all COVID-19 cases around the world are among health-care workers. Extrapolating from more than six million cases worldwide, the federation said this means that an estimated 450,000 of those cases are among health-care workers.

The ICN stressed, however, that the proportion of health-care worker infections varies widely between countries because many of them aren’t recording this data, which “makes meaningful international comparisons extremely challenging.”

Because of this lack of data, the ICN said that a number of questions concerning infections among health-care workers still can’t be answered.

Some of those questions include:

What is contributing to the range in infection rates among health-care workers between countries? For example, cases are less than 1 per cent in Singapore, but 30 per cent in Ireland.

Why is there a low death toll in some countries with large outbreaks, such as Germany and Spain?

Why is there a higher death rate for nurses in Latin American countries?

Why are some countries reporting disproportionate deaths among black, Asian, and minority ethnic health-care workers?

How do health-care worker infections rates vary between different settings, such as hospitals and long-term care homes?

 The ICN said those questions won’t be answered until all countries keep comprehensive, standardized data that is collated centrally on a global scale.

“Nursing is looking like one of the most dangerous jobs in the world at the moment,” Catton said earlier in a press release Wednesday..

“We need to get this data for every country and work out exactly what is going on that explains the variations that are evident with even a cursory glance at the figures. Only then will we be able to learn how best to keep our nurses safe and prevent any repeat of these terrible statistics in the future.”

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