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Arlene W. Keeling and Kenneth R. White column: Bandanas are not enough
The Coronavirus — Health Care Perspectives

Arlene W. Keeling and Kenneth R. White column: Bandanas are not enough

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By Arlene W. Keeling and Kenneth R. White

As hundreds of millions of Americans are being asked to self-isolate or shelter in place, thousands of nurses (and physicians, respiratory therapists and other health care personnel) are being told to report to work at hospitals, clinics and nursing homes across the nation.

The pandemic is real; by now, there are hundreds of thousands of cases of the coronavirus around the world, and tens of thousands have died from it. Like the influenza pandemic of 1918, COVID-19 soon will spread in waves throughout each state, and over the next few months, the need for health care personnel will only increase. The war on COVID-19 has been declared and nurses are among those on the front lines.

Nurses need support now. The federal government must go into war-time production of ventilators, personal protective equipment and medical supplies. It is not enough to have the war-time production act signed. It must be set in motion. In the face of already severe nursing and supply shortages in New York City, the mayor is begging for help on national television — asking retired nurses to volunteer to help and asking the government to move supplies and production.

Meanwhile, the Centers for Disease Control and Prevention (CDC) is telling nurses to reuse masks or, if necessary, “use a bandana.” This is an outrage, and as health care professionals who respect the CDC, we know that they know it is an inadequate response. This is the 21st century, yet the federal response to the need for nurses is reminiscent of its response in 1918.

History repeats itself. On Sept. 26, 1918, with people dying of influenza in droves, the commissioner of health for the commonwealth of Massachusetts telegraphed the American Red Cross national headquarters in Washington, D.C., asking for nurses: “SITUATION SERIOUS [STOP] DEATHS INCREASING AT ALARMING RATE. [STOP] MANY DOCTORS AND NURSES ILL. [STOP] FEDERAL ASSISTANCE NECESSARY [STOP] FIVE HUNDRED DOCTORS AND ONE THOUSAND NURSES NEEDED AT ONCE [STOP]”

Massachusetts was desperate for help. But the reply from Washington was terse: “CAN SEND ALL THE DOCTORS YOU WANT BUT NOT ONE NURSE.” Most registered nurses had volunteered to serve in World War I and were in Europe. Too few were left on the homefront.

Newscasters have been reporting that the public could help by finding patterns on the internet to sew masks for nurses and other health care workers at home. In 1918, the National Red Cross mandated that local Red Cross chapters gather to make “gauze masks ... to be used constantly when doing anything for the patient” ... to protect caregivers from “the bacteria floating in the air.” Over the next month, volunteers in Boston worked seven days a week to produce 83,606 gauze masks. Their efforts were laudable, especially as it was an emergent response from the public in the early 20th century.

More than a century later, is this the best we can do? Effective leadership from the federal government is needed immediately. Nurses are risking their lives, many are begging for help. The least we can do is get them the supplies they need.

Arlene W. Keeling is a nurse historian and a professor emerita at the UVA School of Nursing. She also is president of the American Association of the History of Nursing. Contact her at: Kenneth R. White is a palliative care nurse practitioner and associate dean for strategic partnerships and innovation at the UVA School of Nursing. Contact him at:

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