October 2022 Update

Aloha, my dear colleagues, and welcome to Autumn in the Land of Aloha!   Of course, there is no autumn or “leaf-fall” in Hawaii, where the weather is always warm, yet the indescribable pua alo alo always reminds me of the falling maple leaves of my first home in New England.

Anger is a destructive force, and it seems to me that the entire planet Earth is angry.  Two-and-a-half years of COVID-19 has stolen many loves and dreams – and made everything else worse.

Not so long ago, in a faraway land, an illness was observed and began to spread.  A respiratory virus that harmed humans and possibly was spread via exotic livestock, a delicacy.  Others wondered about a laboratory accident or, God forbid, something more deliberate.  As the number of people affected grew exponentially, the World Health Organization (WHO) upgraded the illness COVID-19 to a pandemic in March 2020.

March 2020 was the last time Hawaii Nurses gathered in Honolulu on Oahu for a professional conference.  Thankfully, the virus took a little longer to reach our distant isles, but it finally did, long after we had met.   Pandemics are known to cause large-scale social disruption, economic loss, and general hardship and COVID-19 has been no exception across the planet.

Now, we are in the third year of dealing with COVID-19.  While the virus that has been dominating our lives isn’t going away, we have a variety of weapons and shields effective in reducing the virus’ numbers and impact.  We have powerful recombinant immunizations, effective antivirals, new knowledge about virus transmission and enough effective personal protective equipment and antiseptic scrubs for all.  Do you remember when proning our vents patients was a new intervention for covid?  Or when people sourced antimalarials thinking they were antiviral?  We are much more knowledgeable now, and we will NOT be living through a pandemic forever. The hope is that advances like COVID-19 vaccines and new treatment options will help us move into a new state, an endemic state.

For example, many say that COVID-19 will likely lose its “pandemic” status to “endemic” status sometime in 2022, due largely to rising global vaccination rates and the widespread, less lethal, infection with the Omicron variant.

It is thought by many that the virus will come more seasonal, like the influenza viruses with which we are familiar.  “If the virus does become more seasonal, things like wearing a mask in public and indoors during COVID season could become the new normal.  Other simple prevention strategies, like regularly washing your hands and “keeping your distance” from others will, I think, persist.  They were considered common sense during the pre-antibiotic age of my grandparents.  As children, we were accustomed to washing our hands as soon as we came home and frequently throughout the day.

So, what is the difference between the three states of disease spread – endemic, pandemic and epidemic?  An epidemic isn’t a good thing, but it is preferable to a pandemic.  What does this change mean for us as nurses and for our patients, families, and other staff’s lives?

An epidemic is a sudden increase in an infectious disease in a certain geographical area.

A pandemic is an outbreak of disease across a large geographic area – several countries or continents. A far-spreading epidemic

Endemic: A disease outbreak that is consistently present but limited to within a certain area. Like seasonal influenza – there are cases all year round and a predictable surge in numbers happens  at certain times of year

If and when COVID-19 is declared endemic, it doesn’t mean the virus is less dangerous. It would mean that the virus is more predictable and cases will be more consistent, as opposed to spikes and drops in infection rates.  Vaccination remains the best way to make a viral infection less dangerous.

Nurses need to do everything they can to practice consistent infection control and teach these procedures to others.  Respiratory hygiene, hand washing and using antimicrobial gel are key.

Wear a mask when appropriate:

Anyone age 2 years and older should wear a well-fitting mask indoors in public indoor areas and in public transportation or transportation hubs.

Use hand sanitizer and wash your hands frequently.