Pandemic Characteristics
Pandemic: epidemic spreading across multiple countries/continents. Influenza pandemics: novel strain, no immunity, global spread. COVID-19: SARS-CoV-2, novel coronavirus. Emerging infections: novel pathogens, zoonotic, environmental. Stages: recognition, containment, mitigation, suppression. WHO pandemic phases: 1-6. Attack rate: proportion of population infected. Case fatality rate: proportion of infected who die. Reproduction number (R0): average secondary infections from one case. R0 >1 = epidemic growing, <1 = shrinking.
Infection Control
Standard precautions: all patients. Transmission-based: contact, droplet, airborne. PPE: gloves, gown, mask (surgical for droplet, N95 for airborne), eye protection. Cohorting: group infected patients. Staff: screening, furlough if symptomatic, exposure management. Visitor restrictions. Environmental cleaning: frequency, products. Ventilation: negative pressure, HEPA. Surveillance: testing, reporting. Education: staff, patients, public. Vaccination: development, prioritization, administration. Treatment: antivirals, antibodies, supportive care.
Nursing Role
Frontline: direct patient care, surge capacity, triage. Infection control: PPE, cohorting, isolation. Surveillance: screening, testing, reporting. Education: patients, families, public, colleagues. Advocacy: for PPE, staffing, safety. Leadership: charge nurse, incident command. Psychosocial: fear, anxiety, grief, isolation. Self-care: physical (sleep, nutrition), emotional (support, therapy), moral distress. Innovation: telehealth, workflows. Ethics: resource allocation, duty to care. Recovery: debrief, reflect, prepare for next wave. Advocacy: public health, healthcare system improvement.
Important Notes
- R0 >1 means epidemic is growing, <1 means shrinking — public health measures aim to reduce R0 below 1.
- N95 respirators are required for airborne precautions (TB, measles, chickenpox) — surgical masks are for droplet (influenza, COVID).
Clinical Tips
- Nurses experienced significant moral distress during COVID-19 — advocate for adequate PPE, staffing, and psychological support.
- Cohorting infected patients and staff reduces cross-contamination during pandemics with limited isolation rooms.
Summary
Pandemic response requires understanding transmission, infection control (PPE, cohorting, isolation), surveillance, education, and nurse self-care and advocacy.
