COVID-19: Lessons from Florence Nightingale
By Maureen Rafa, BS, RN, PMHBC, Elder Care Coordinator
I would like to tie in some history with the current COVID-19 Pandemic. May 12, 2020 is Florence Nightingale’s 200th birthday. She was a British social reformer and statistician and the founder of modern nursing.
With William Farr, a mentor and noted government statistician, she gathered data from military hospitals in Constantinople that verified what she had long suspected: Nearly seven times as many British soldiers had died of disease in the Crimean War than in combat, and the deaths dropped dramatically once hospitals at the front were cleaned up. She also collated data from military hospitals in Great Britain, which revealed that these facilities were so poorly ventilated, filthy and overcrowded that their mortality rates far exceeded those at Scutari (another facility) following the changes implemented by the Sanitary Commission. “Our soldiers enlist to death in the barracks,” she wrote. In “Notes Affecting the Health, Efficiency, and Hospital Administration of the British Army,” published in 1858, she and Farr displayed their findings in graphic illustrations known as coxcombs—circular designs divided into 12 sectors, each one representing a month—that clearly laid out the direct relationship between improved sanitation and plummeting death rates. These innovative diagrams, she said, were “designed ‘to affect thro’ the Eyes what we may fail to convey to the brains of the public through their word-proof ears.”
Swayed by her presentations, the military improved hospitals throughout Great Britain, and Parliament voted to finance the first comprehensive sewage system for London. “She was a one-woman pressure group and think tank,” says David Spiegelhalter, a University of Cambridge statistician and author.
Though often bedridden in London hotels and rented flats over the years, Nightingale continued to gather data on every aspect of medical care. She sent questionnaires to hospital administrators, collected and analyzed results, wrote reports, established investigative commissions. She produced findings on the proportion of recoveries and deaths from various diseases, average disease recovery times according to patients’ age and gender, and high rates of communicable disease such as septicemia among hospital workers. Nightingale came to believe, says Spiegelhalter, that “using statistics to understand how the world worked was to understand the mind of God.” In 1858, she became the first woman to be made a fellow of the Royal Statistical Society.
— Smithsonian Magazine, March 2020
I compare her to Dr. Anthony Fauci, an Immunologist and Director of the National Institute of Allergy and Infectious Diseases and Dr. Deborah Birx, a physician and diplomat, who specializes in HIV/Aids immunology, vaccine research, and global health. They address the issues of sanitation and human crowding and the changes that we must implement to prevent the spread of COVID-19.
During this pandemic, researchers are studying this new virus, compiling and analyzing data to learn everything about it. They hope it will also teach us how to prevent new viruses. Their studies are looking at how it began, how it’s spread, and the varied symptoms, and they are working diligently to provide accurate testing to determine who has it, had it, or is a carrier.
The researchers are also looking at timelines; the time when someone exposes another and the time it takes for the number infected to exhibit symptoms and then the number they infect.
What we keep hearing from the task force is “stay home and wash your hands, and now, wear a mask.” The common thread from Florence’s statistics during the Crimean War and today’s COVID’s is that hygiene and social distancing reduce contagion and therefore reduce the number of deaths.
This is how we who aren’t in the front lines helping those that are ill or doing research can believe that we are doing enough. We are not spreading the virus to anyone else by staying home and washing our hands.
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