Open Letter to WHO demanding action to protect nurses from coronavirus

3 February 2020

Dr. Tedros Adhanom Ghebreyesus, Director-General World Health Organization
Avenue Appia 20

Dear Dr. Tedros:

The novel coronavirus, 2019-nCoV, which has spread rapidly since it was first identified a few weeks ago, poses a threat to public health around the world. Healthcare facilities at the epicenter of the outbreak are already overwhelmed. As more and more suspected cases are identified every day, the potential for a surge in patients seeking care in communities around the world is very real. Without sufficient preparation this could overwhelm more healthcare facilities, putting patients, their families, and nurses and other healthcare staff at even greater risk.

The World Health Organization (WHO) provides important resources that can guide healthcare employers’ preparedness to respond to potential cases of 2019-nCoV. However, WHO’s interim guidance on “Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected” (“interim guidance on infection prevention and control”) falls short in ways that endanger the health and safety of the nurses and other healthcare workers that patients and their families rely on for life-saving care.1 WHO should strengthen its interim guidance on infection prevention and control in the following ways:

1. WHO should call for airborne precautions to be implemented when healthcare workers are caring for patients with possible or known 2019- nCoV infections.

In the current situation where little is known about the transmission of 2019-nCoV, the WHO’s recommendation that only droplet and contact precautions be used for patients with possible 2019-nCoV infections is irresponsible and may endanger healthcare workers. The WHO interim guidance neglects the precautionary principle, which states that we should not wait until we know for certain that something is harmful before we take action to protect people’s health. This is a new virus whose transmission pathway is unknown. Furthermore, at least fourteen healthcare workers have been infected with 2019-nCoV in China. Under the precautionary principle and as recommended by the U.S. Centers for Disease Control and Prevention, WHO should call for airborne precautions to be implemented, in addition to contact and droplet precautions, for all patients with possible or known 2019-nCoV infections.2

2. WHO should explicitly call on healthcare employers to communicate clearly and transparently with nurses and other healthcare staff about 2019-nCoV cases and potential occupational exposure.

Workers have a fundamental right to a safe and healthy workplace. It is unacceptable for an employer to hide information from employees about their possible or known exposure to any hazard including 2019-nCoV.

We, the undersigned affiliated unions of Global Nurses United, which unites nurses’ unions in 28 countries around the world, call upon you to strengthen WHO’s interim guidance on infection prevention and control to protect the nurses and other healthcare workers who are at the heart of patient care and essential to the response to 2019-nCoV.

If you have questions regarding this letter or would like to arrange a meeting, please contact Kenneth Zinn, coordinator of Global Nurses United, at +1-240-235-2008 or at [email protected] We look forward to your response.


Annie Butler, Federal Secretary, Australian Nursing and Midwifery Federation Australia

Shirley Marshal Díaz Morales, Presidenta Federação Nacional dos Enfermeiros Brazil

Linda Silas, PresidentCanadian Federation of Nurses Union Canada

Nancy Bédard, Présidente Fédération interprofessionnelle de la santé du Québec Canada

Rodrigo Ml. López García, Secretario General Asociación Nacional de Profesionales en Enfermería Costa Rica

Johnsel Diaoen, President CBV Curaçao

Julio César García Cruceta, Secretario General Sindicato Nacional de Trabajadores de Enfermería (SINATRAE) Dominican Republic

George Tsolas, President and Thomai Aslanoglou, General Secretary Pan-Hellenic Federation of Nursing Staff (PASONOP) Greece

Luis Alpirez, Secretario General Sindicato Nacional de Trabajadores de Salud de Guatemala (SNTSG-FNL) Guatemala

Abogado Josue Jeremías Orellana Muñoz, Presidente Asociación Nacional de Enfermeras (os) Auxiliares de Honduras (ANEEAH) Honduras

Rince Joseph, National Working President United Nurses Association India

Dr. Edward Mathews, Director of Professional and Regulatory Services, Irish Nurses and Midwives Organisation Ireland

Seth Panyako, General Secretary Kenya National Union of Nurses Kenya

Mirna Gallardo, Presidenta Asociación Paraguaya de Enfermería Paraguay

Maristela P. Abenojar, National President Filipino Nurses United, The Philippines

Guadalupe Simões, Coordinator, International Relations Department Sindicato dos Enfermeiros Portugueses Portugal

Andre Gitembagara, President Rwanda Nurses and Midwives Union Rwanda

Na, Soon Ja, President Korean Health and Medical Workers Union South Korea

Manuel Cascos Fernández, President Sindicato de Enfermería (SATSE) Spain

Zxyyann Lu, Board Member Taiwan Nurses Union Taiwan

Justus Cherop Kiplangat, President mUganda Nurses and Midwives Union Uganda

Bonnie Castillo, RN, Executive Director
Deborah Burger, RN, President
Zenei Cortez, RN, President
Jean Ross, RN, President, National Nurses United, United States of America

Dra. Silvia Santana, Presidenta, Sindicato Único de Enfermería del Uruguay, Uruguay