As the year 2020 has officially drawn to a close, the measure of the COVID-19 pandemic’s toll on health care workers has been nothing short of devastating and far higher than reported by the US Centers for Disease Control and Prevention (CDC). According to the most recent analysis published on December 23 by the Guardian and Kaiser Health News (KHN), more than 2,900 US-based health care workers have died from their infections since March. Many of these infections are directly attributable to insufficient personal protective equipment (PPE) and hazardous working conditions such as long hours and high patient loads.

A December 10 report by the National Academies of Sciences, Engineering, and Medicine addressed to the assistant secretary for preparedness and response at the Department of Health Human Servies, Dr. Robert Kadlec, titled “Rapid Expert Consultation on Understanding Causes of Health Care Worker Deaths Due to COVID-19 Pandemic ,” notes that “the COVID-19 pandemic has created both acute and chronic stresses on the health care system and the health care personnel nationwide. At present, the nation lacks a uniform system to collect, collate, and report illnesses and deaths among health care workers due to COVID-19.”

They continue, “Evidence suggests that COVID-19 infection is more prevalent among health care workers who lack appropriate PPE [personal protective equipment] or in work settings without a universal mask mandate. Whether an individual health care worker’s infection originated in the workplace or the community may be uncertain. Only a few studies report on efforts to improve the health and well-being of health care workers during the COVID-19 pandemic.”

In September, the National Nurses United (NNU) published a report titled “Sins of Omission,” placing the death toll at 1,718 by September 16, of which 213 were registered nurses. By comparison, the CDC had reported only 574 health care worker deaths by August. According to the NNU, at the time there had been at least 258,768 cases of COVID-19 infection among health care workers, 166 percent higher than the official tally of 156,306 cases according to the CDC. At the time, the US had 6.9 million infections, representing 2.1 percent of the population. Health care workers then accounted for 3.8 percent of all infections.

That governmental agencies such as the CDC are unable to track health sector infections and deaths accurately or in real-time is in itself not only an abdication of their responsibility to a most valued sector of society but demonstrates a complete disconnect between the responsibility of government and the role of protecting the population from the pandemic. The bureaucratic inertia inherent in many of the government institutions attests to this.

In a Morbidity and Mortality Weekly Report released on October 30—looking at data for COVID-19-associated hospitalizations among 6,760 health care personnel, across 13 states over the period from March 1 to May 31—6 percent of adults hospitalized with COVID-19 were health workers, of which 36 percent were in nursing-related occupations. Obesity affected 73 percent of these admissions. They also stated that 28 percent had been admitted to intensive care units, 16 percent needed mechanical ventilation and 4 percent had died.

Included as accomplices in this are hospital systems and health care industry executives who have washed their hands of any accountability for their inept mismanagement and unpreparedness in the face of the pandemic in their drive for profits. Despite the billions in COVID-19 relief funds funneled into lucrative health systems, little has been done to improve health workers’ conditions as the winter surge is pushing hospitals to the brink.

The exposure by the NNU with regards to COVID-19 infections and deaths among health workers is certainly welcome. However, they also have to be held accountable for the impact of the pandemic on the rank-and-file.

Repeatedly, when nurses and health care workers have sought to take their fight to the health systems, decrying the intolerable conditions they had faced in their hospitals during the pandemic, the unions channeled this outrage into isolated media-opportunity walkouts to vent steam. They then quickly urged nurses to acquiesce to the demands imposed by the health systems with none of their demands met.

Yet, these findings are not unique to the United States. Every nation that has faced an extensive and exhaustive struggle with the pandemic has seen health care workers bear the pandemic's brunt, precisely because their health systems, local governments and the unions representing the workers have done little to protect them from the coronavirus.

An International Council of Nurses’ (ICN) analysis published at the end of October found that more than 1,500 nurses had died from COVID-19 in 44 countries. They estimated that the health care worker COVID-19 fatalities worldwide were possibly higher than 20,000. Approximately 10 percent of all COVID-19 infections worldwide are among health care workers. The World Health Organization noted that though health care workers make up less than 3 percent of the population, they have accounted for around 14 percent of all COVID-19 cases.

Speaking at the Nightingale 2020 virtual conference on October 27, ICN Chief Executive Officer Howard Catton said, “The fact that as many nurses have died during this pandemic as died during World War I is shocking. Since May 2020, we have been calling for the standardized and systematic collection of data on health care worker infections and deaths, and the fact that is still not happening is a scandal. … I genuinely believe that global has never been more local in terms of the challenges we are facing, the lessons we need to learn and the solutions we seek. For example, getting personal protective equipment across borders requires governments to work together on customs and control issues, and when we have a vaccine, getting it to everybody who needs it, rather than just those who can afford to pay for it, will require multilateralism and cooperation.”

Forbes published an article on November 17 noting that almost 300,000 health care workers had been infected worldwide as of August 15. At the time, the United States led with 114,500 COVID-19 infections among health care workers. By November 15, just three months later, that number had risen to 216,049 health care worker infections, according to the conservative estimates provided by the CDC.

If present estimates hold for the United States, by the end of March 2021, another 210,000 deaths will pile on to the catastrophic 360,000 deaths that have taken place since the pandemic swept across the nation just 10 months ago. With the new variant of the coronavirus likely to become the dominant strain of the SARS-CoV-2 virus, the increased transmissibility will mean further intensification of the infections, which are already bringing many health systems across the US to the point of collapse and continuing to endanger the health and livelihood of frontline workers.