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Editorial: Living in a New World

Welcome to the new world. Among the predictions offered for 2020, none included the invasion of an invisible enemy that would wreak havoc on all aspects of life as we knew it. COVID-19 took us by storm, upending and disrupting plans for everything from travel and education to buying groceries and how we greet one another (no more hand shaking or hugs). In fact, social distancing has become so embedded in our society, that I was momentarily alarmed when watching a movie

Healthcare workers find themselves fearful of going to work and more fearful of bringing the virus home to loved ones, but they have become heroes to a grateful nation. Google saw an increase in searches for "how to say thank you to essential workers at the front lines of the health crisis" (New York Post, 2020). Attention initially focused on acute care, but before long, COVID-19 arrived in the home care arena. The Centers for Medicare and Medicaid Services (2020) quickly provided guidance for home care agencies. Ideally before, but certainly at the immediate start of a home care visit, clinicians are tasked with screening for risk factors and COVID-19 symptoms of everyone in the home. The risk factors are: recent international travel, signs or symptoms of respiratory illness, and/or contact with another person diagnosed with COVID-19 or with suspicious symptoms. If screening is positive, the clinician should immediately place a mask on the individual if not already in place, and notify their supervisor. 

Home care workers must also be mindful of their own risk factors and act accordingly. It is very difficult for individuals with a strong work ethic to miss work, but it is critically important in a world with COVID-19. Workers who experience any signs or symptoms should not report to work and should immediately self-isolate. One thing that bothers me about this guidance though, is the following statement:

State and Federal surveyors should not cite home health agencies for not providing certain supplies (e.g., personal protective equipment (PPE) such as gowns, respirators, surgical masks and alcohol-based hand rubs (ABHR) if they are having difficulty obtaining these supplies for reasons outside of their control. However, we do expect providers/suppliers to take actions to mitigate any resource shortages and show they are taking all appropriate steps to obtain the necessary supplies as soon as possible.

We were a nation caught unprepared – akin to sending our military into battle unarmed. As a nurse friend wryly stated "Now I know how the canary feels while being lowered into the mine".  If one good thing comes from this pandemic, I hope it's that we will never again put health care providers in harm's way for lack of personal protective equipment. Our healthcare heroes deserve much better - and that is how we can best say thank you.


Centers for Medicare and Medicaid Services, (2020). Guidance for infection control and prevention concerning coronavirus disease 2019 (COVID-19) in Home health agencies (HHAs) and religious nonmedical healthcare institutions (RNHCIs). Retrieved from

New York Post (2020 April 8). How to say thank you to your favorite essential workers during coronavirus. Retrieved from

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