Dear Florence,

So much has happened since I last wrote three weeks ago. The emergence of the novel coronavirus and the disease it causes, COVID-19, has brought our bustling city of more than 8.5 million people to a screeching halt. New York City has become the epicenter of this disease and more than 5,000 people have died here. Our health workers are desperately trying to cope with the influx of critically ill patients. Ventilators and protective equipment such as masks are in short supply. Despite all our modern technology, our hospitals are quickly being overwhelmed. There are more than 60 hospitals in our city, but right now these are not enough. I never imagined this happening here.

Just a few weeks ago, many people did not see the urgency and downplayed what the emergence of a highly infectious, potentially lethal novel virus could do.  Now we know all too well.  It has been a hard lesson in the necessity for investing in a strong public health system equipped and empowered for such an outbreak.

Health workers are adapting on the spot, with innovative solutions to provide care for the long lines of people outside the hospital doors. Hobbyist 3D modelers are creating blueprints to adapt existing medical equipment to increase capacity for ventilators. As I write, a convention center has been converted into a hospital.

In the midst of our response to this outbreak, which has been likened to the great war of our generation, I think often of something that you said as you reflected on your work near the battlefields of the Crimean War: “How very little can be done under the spirit of fear.”

Despite big changes to our daily lives and routines, our health workers soldier on. Our nurses, doctors, and hospital staff are putting their patients’ needs first and continue to go to fight this battle to protect us all. I think you would be proud.

Until next time,


Dear Florence is an online space to spark conversation on the role of nurses in global health. Named for the founder of modern nursing, Florence Nightingale, it seeks to advocate for nurses as leaders in the international health sector and encourage discussion on how the global health world can better leverage nurses’ unique connections to the communities they serve.

Dear Florence is written by Susan Michaels-Strasser, PhD, MPH, RN, FAAN, senior director of human resources for health (HRH) at ICAP, and is a special initiative to commemorate the International Year of the Nurse and Midwife.

Learn more about our work with, and for, nurses on our campaign page, #ThisNurseCan.

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