Nursing workers: Covid-19 pandemic and social inequalities

Abstract

The declaration of COVID-19 as an international emergency concentrated the attention to the need of collective efforts and State action to protect life and health. Soon it was evident that the effects of the pandemic hit unevenly on individuals and social groups. That was also clear among health professionals and particularly nurses, as the distribution of cases and deaths showed unequal frequencies. The International Council of Nurses (ICN) has called on authorities around the world to monitor infections by the new coronavirus and the deaths of nursing and healthcare professionals. In June 2020, ICN estimated that about 7% of all COVID-19 cases, internationally, were among health professionals, which represented 450 thousand cases, with the death of 600 nurses at the time. The organization recognized, however, the immense variation between countries and questioned among many interrogations, why mortality rates among nurses seem to be higher in some countries in Latin America (1). The Brazilian Federal Council of Nursing also warned that the country was responsible for 30% of the global deaths of nursing professionals by COVID-19, and was achieving the sad mark of being the country killing more nursing professionals on the planet (2). Countless news in newspapers of great circulation, in social networks and other sources, lament the loss of colleagues in this pandemic. Among us, professors at a public university, there is enormous consternation while at the same time, a sense of responsibility to answer a haunting question: Why does this country kill more health workers, including nursing staff, than any other? To answer this question we must follow the thread of social inequalities, an expression of the structure of class division in our society, markedly impacted by the neoliberal features of the Brazilian State, and its imprinting in state policies. In particular, it is necessary to follow the thread of the elements of these inequalities, both in working conditions and in the characteristics of the nursing workforce. The nursing workforce in Brazil encompasses approximately 2,300,000 workers, 24.5% of whom are nurses, 57.4% are nursing technicians and 18.1% are nursing assistants (3). These different categories represent the division of labor in nursing, constituted based on the social class inequality as well as on the split between conception and execution (4). The multiple training itinerary and diverse performance fields of nursing professionals in health services set apart the heterogeneous profile of an expressive workforce. This workforce is often indiscriminate in their technical differences, since different professional categories, such as nursing assistants and technicians perform equivalent work, frequently receiving remuneration that does not correspond to specific professional training. Racial and gender