The lack of standardised reporting around the world of Covid-19 infections and deaths in nurses must be addressed as a matter of urgency, the chief executive of the International Council of Nurses (ICN) has warned.

In an interview with Nursing Times, Howard Catton said failure from country governments to collect and publicise this information in a uniformed way was a "huge omission" and could ultimately cost further lives.

“We are particularly alarmed that currently there is no standardised reporting" Howard Catton

Mr Catton stressed that he was not calling for data collection for “for data’s sake” but said this information would provide vital learning and could expose safety problems in systems of infection prevention and control.

He said it would also help to ensure that those who died were honoured and recognised.

“We are particularly alarmed that currently there is no standardised reporting by countries in relation to health worker infections and deaths and we think that needs urgently to be addressed,” he said.

As part of the data collection process, information should also be gathered on where nurses or health workers who died worked and when they became infected, stressed Mr Catton.

“The data would help with the science. It would help with improving measures of infection prevention and control. It would inform the best policies and practice for prevention, infection and control - which ultimately could save some lives if it helps to reduce infection rates,” Mr Catton told Nursing Times.

He added that collecting this information would also help “recognise, honour, mourn and in time celebrate those nurses who have made the ultimate sacrifice”.

“By not collecting the data we’re impeding the ability to do that, as well as having the data to improve the science and infection,” added Mr Catton.

“The data would help with the science" Howard Catton

In addition, the ICN chief executive stressed that “what gets measured counts”, adding that “nurses and health workers absolutely count”.

Nursing Times contacted the Department of Health and Social Care to seek clarity on what the process was for recording and reporting nurse infections and deaths from Covid-19 in the UK, but is yet to receive a response.

Health and social care secretary Matt Hancock told an inquiry of the Health and Social Care Select Committee last week that the government was currently receiving updated data on health worker deaths three times a week.

Chair of the committee Jeremy Hunt asked if he would commit to publishing this number three times a week, to which Mr Hancock replied: “Yes, I would quite like to get it to daily.”

Nursing Times has to date reported on more than 30 nurses and midwives who have died after a confirmed or suspected Covid-19 diagnosis, with numbers going up on a daily basis.

At the time of interview on Monday 20 April, Mr Catton said he was aware of more than 20 nurse deaths in the UK and said this figure “seems to be comparable probably with where Italy were at the height of their peak”.

Though he added that the UK number was “higher” than what had been reported in Spain where there had been “less than five” nurse deaths from Covid-19.

“The UK figures seem to be similar in terms of where Italy were, but then equally you have Spain that has had a significant number of infections generally and the numbers there are lower as well,” he said.

“But again, we don’t know what other factors may be going on here and that’s why the data could really help to explain some of the variations.”

“The UK figures seem to be similar in terms of where Italy were" Howard Catton

Nursing Times asked the WHO about how data on Covid-19 cases in health workers was collected internationally.

A spokesperson for WHO Europe said countries sent overall case figures to the WHO in a case report form (CFR) that is filled out by health authorities in member states and included a question on health workers.

“Although the CRF includes a question about whether the person is a health care worker, many countries submit CRFs without all questions being answered,” said the spokesperson.

“This means our data is incomplete on health care worker infections for many countries.”

They said they hoped to “make improvements to this in the future but appreciate at present our colleagues in countries are focusing all their energy on the pandemic response”.

The data set the WHO obtained from 6-12 April showed 16% of reported infections with information available were in a health worker.

According to the ICN, there has been more than 100 confirmed nurse deaths under the pandemic.

However, Mr Catton said he believed the overall figure was “probably an underestimation at the moment and is likely to be higher” .

He noted that the ICN was having to rely on its nursing associations and credible media reports to collate this data because governments around the world were not doing so in a uniformed way.

“There are a number of other countries in Latin America, in South East Asia and in the Gulf region…where we have received reports of [a lower number of] deaths of nurses and some of those countries are more challenged in terms of the freedom of the press and people to speak out as well,” said Mr Catton.

“The fact that these are lower numbers I tend to think ‘is it really that there are only one or two or three, or are those the numbers that we know of and the true extent could be greater?’.”

He said the ICN was doing the best it could to identify nurses who had died under the pandemic to ensure these staff members got the recognition they deserved, but stressed that “it should not be down to us to have to do”.

“This is something that there should be clear political leadership [on] and the governments should be acting for all the reasons that I have said,” added Mr Catton.

“But they are not, and we are calling it out internationally, we are bringing attention to it and we will continue to monitor the situation globally and report on it.”

Nursing Times has set up a page to remember the nurses and midwives lost during the pandemic.

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