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January 30, 2020

WHO must strengthen coronavirus guidelines, says Global Nurses United

Global Nurses United

The following letter was sent by Global Nurses United, signed by leaders of nurses unions from around the world, including CFNU President Linda Silas.


Dr. Tedros Adhanom Ghebreyesus, Director‐General
World Health Organization
Avenue Appia 20
1211 Geneva

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 We look forward to your response.


Annie Butler, Federal Secretary
Australian Nursing and Midwifery Federation

Shirley Marshal Díaz Morales, Presidenta
Federação Nacional dos Enfermeiros

Linda Silas, President
Canadian Federation of Nurses Union

Nancy Bédard, Présidente
Fédération interprofessionnelle de la santé du Québec

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

Johnsel Diaoen, President

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

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

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

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

Rince Joseph, National Working President
United Nurses Association

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

Seth Panyako, General Secretary
Kenya National Union of Nurses

Mirna Gallardo, Presidenta
Asociación Paraguaya de Enfermería

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

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

Andre Gitembagara, President
Rwanda Nurses and Midwives Union

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

Manuel Cascos Fernández, President
Sindicato de Enfermería (SATSE)

Zxyyann Lu, Board Member
Taiwan Nurses Union

Justus Cherop Kiplangat, President
Uganda Nurses and Midwives Union

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

cc: Ms. Elizabeth Iro, Chief Nursing Officer, WHO


[1] Organisation mondiale de la santé. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected.  (Consulté le 24 janv. 2020).

[2] U.S. Centers for Disease Control and Prevention. Interim Healthcare Infection Prevention and Control Recommendations for Patients Under Investigation for 2019 Novel Coronavirus.‐nCoV/infection‐control.html  (Consulté le 24 janv. 2020).

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