August 21 2021 COVID-19 report

Nurses call on voters to vote for a healthy recovery for all

RNAO released on August 20 its policy platform for the federal elections. Here is the media release:

With a federal election happening on Sept. 20, 2021, the Registered Nurses’ Association of Ontario (RNAO) calls on Canadians to vote for health. RNAO’s policy platform for this election, released today, asks voters to choose health when they head to the polls. 

Health isn’t just about health care. Health is determined by a person’s economic, social and environmental circumstances.

“Elections matter, especially when it comes to individuals’ health. It’s critical that all major federal party leaders keep a healthy recovery for all Canadians at the forefront of their platform if they want to have nurses on their side,” says RNAO CEO Dr. Doris Grinspun. 

The next federal government must address with urgency the pre-pandemic societal ills for which COVID-19 has become a magnifying glass. 

Over the past 18 months: 

• The COVID-19 pandemic has exposed and broadened social, economic and health inequities.  
• Gaps in our health-care system have devastated vulnerable populations.  
• Old wounds have been opened and the Indigenous people of this land have been re-traumatized with the devastating findings of the remains of Indigenous children at former residential schools.
• The International Panel on Climate Change has released a damaging report on the state of global warming and the future of climate change. 

RNAO believes that during the COVID-19 recovery phase, we must build a better Canada for all. 

“Elected officials must protect all Canadians from the ravages of climate change. They must create and implement a comprehensive climate action plan, and protect water sources to ensure access to clean drinking water for all, especially those in Indigenous communities,” adds Grinspun. 

“Canada’s most vulnerable populations, especially long-term care residents, individuals experiencing homelessness, and those struggling with substance abuse must receive dedicated attention. Our injustices with racialized communities and Indigenous communities must be fully recognized and repaired,” Grinspun urges on behalf of Ontario’s nurses and nursing students. 

• To ensure a healthy recovery for all Canadians, RNAO urges candidates to commit to implementing national standards in long-term care homes, making housing a right and ending the opioid overdose crisis once and for all. Canada’s way forward must be one that fills the deep gaps in our health system and leads all toward a just recovery.
• To improve Canada’s publicly funded, not-for-profit health system, RNAO calls for a national pharmacare program and the expansion of Medicare to cover essential health services. 

As Canada works to heal its relationship with Indigenous communities, RNAO recommends:

• increasing the number of nurse practitioners and registered nurses in Indigenous communities. 
• full implementation of all 94 calls-to-action of the Truth and Reconciliation commission. 

These are two critical steps toward supporting our Indigenous sisters and brothers, and providing them with equitable access to health care.

“Before, during and post-pandemic, nurses hold elected officials accountable and are committed to providing each party with evidence-based recommendations to influence healthy public policy,” says RNAO President Morgan Hoffarth.

“Nurses are in direct contact with Canadians from all walks of life and know what changes need to be made locally and nationally. Nurses want to work collaboratively with federal leaders to ensure their policies are informed by key health issues – opportunities and challenges – that nurses and their patients face every day,” adds Hoffarth.

“If our recommendations are fully realized by elected officials, the health of Canadians and our health-care system will be more equitable and accessible,” Hoffarth says. “This is why we again ask to reinstate Canada’s chief nursing officer role, to tackle the serious health human resources needs and influence federal health policy to serve all Canadians – especially vulnerable ones. Nurses work in all health sectors and settings, and must be at every decision-making table.”

RNAO’s policy platform is one of many ways the association and its more than 46,000 members will speak out during the 2021 election campaign. RNAO has also asked the federal parties’ leaders for their views on four priority areas and will provide updates on their responses.

Ontario’s nurses welcome the province’s announcement and call for a stronger vaccine mandate and action on vaccine certificates

RNAO issued the following media release in response to the government’s August 17 announcement on vaccination policy.

The Ontario government’s new directive to implement vaccine policies in hospitals, ambulatory services, and community and home care services – added to the earlier directive on long-term care – is a step in the right direction, says the Registered Nurses’ Association of Ontario (RNAO). However, the association says it doesn’t achieve the goal of mandatory vaccination that is necessary to protect patients against the dominant Delta variant, as it allows anyone who wishes to substitute vaccination with rapid testing and an educational session. RNAO also says the directive must be applied to all health-care workers in all health sectors, including primary care. It is also missing the implementation of a vaccine passport / certificate that is essential for the safe reopening of the economy.

“Proof of full vaccination must be provided and the only exception should be for people with a medical exemption,” says RNAO President Morgan Hoffarth, adding that “medically exempted staff must be required to present proof of a negative test, a minimum of twice a week (or 24 to 48 hours prior to work for part-time and casual workers), not just once a week as the government indicated. These are crucial steps to prevent further spread of a highly transmissible variant,” insists Hoffarth. 

With schools reopening in a few short weeks, RNAO is pleased the government announced mandatory immunization disclosure policies for the education sector but again insists the only exception should be for medical reasons. “We look forward to details from the ministry of education and ministry of colleges and universities regarding the new vaccine policies – and RNAO expects these to extend from daycare all the way through to universities and colleges,” adds Hoffarth urging that “the plan must include mandatory indoor masking for children ages two and up in kindergarten and daycare centres.”

RNAO says mandatory masking for all children and education staff, mandatory immunization policies for staff, alongside other essential measures such as physical distancing, cohorting and ventilation, will ensure a return to school that is as safe as possible in the face of what Ontario’s Chief Medical Officer of Health Dr. Kieran Moore calls a “difficult fall.”

“We commend the government for pausing the move out of step three of its reopening plan,” says RNAO CEO Dr. Doris Grinspun, adding that “now is the time to remain extremely vigilant and get vaccines into arms, not to relax any measures.”

While RNAO is pleased to see the focus on vaccination in health care and education, there was no mention of vaccine passports or certificates. “A #VaccinePassport is essential policy to protect Ontarians and businesses,” says Grinspun. “Mandating vaccine certificates to access risky indoor non-essential services and long-distance travel will keep the workforce safe, energize dormant sectors of the economy and protect businesses that implement these measures,” adds Grinspun.

As Dr. Moore noted, the drop in vaccine uptake and the rise in new infections requires action now. Speed is of the essence, and Sept. 7 – the date when the vaccine policies take effect – is a month too late. RNAO called for mandatory vaccination on July 15.

RNAO urges all eligible Ontarians to get vaccinated to protect themselves, their loved ones and our communities. RNAO welcomes a third dose for specific immunocompromised individuals and for those in high-risk settings. Immunization is our way out of this long, devastating pandemic.

WHO condemns rush by wealthy nations to give Covid vaccine booster

The following is adapted from an article by Agence France-Presse in Geneva that appeared in The Guardian on August 18.

The World Health Organization has condemned the rush by wealthy countries to provide Covid-19 vaccine booster shots while millions of people around the world have yet to receive a single dose.

“We’re planning to hand out extra lifejackets to people who already have lifejackets, while we’re leaving other people to drown without a single lifejacket,” said Dr Mike Ryan, the director of the WHO’s health emergency program. “The fundamental, ethical reality is we’re handing out second lifejackets while leaving millions and millions of people without anything to protect them.”

Earlier this month, the WHO called for a moratorium on Covid vaccine booster shots to help ease the drastic inequity in dose distribution between wealthy and poor countries. That has not stopped a number of countries moving forward with plans to add a third jab, as they struggle to contain the Delta variant.

US authorities, warning that Covid-19 vaccination effectiveness decreased over time, said on Wednesday they had authorised booster shots for all Americans from 20 September. The booster would be given eight months after an individual has been fully vaccinated. Washington had already authorised an extra dose for people with weakened immune systems. Israel has also begun administering third doses to Israelis 50 and over.

While the vaccines remain “remarkably effective” in reducing the risk of severe disease, hospitalization and death from the effects of Covid, said officials, protection could diminish in the months ahead without boosted immunization.

But WHO experts insisted the science was still not clear on booster doses of Covid vaccines and stressed that far more important was ensuring people in low-income countries where vaccination was lagging received jabs.

Dr Tedros Adhanom Ghebreyesus, the director general of the WHO, said: “What is clear is that it’s critical to get first shots into arms and protect the most vulnerable before boosters are rolled out. The divide between the haves and have nots will only grow larger if manufacturers and leaders prioritise booster shots over supply to low- and middle-income countries.”

Tedros voiced outrage at reports that the single-dose Johnson & Johnson (J&J) vaccine being produced in South Africa was being shipped for use in Europe “where virtually all adults have been offered vaccines at this point”.

“We urge J&J to urgently prioritise distribution of their vaccines to Africa before considering supplies to rich countries that already have sufficient access,” he said. “Vaccine injustice is a shame on all humanity and if we don’t tackle it together, we will prolong the acute stage of this pandemic for years when it could be over in a matter of months.”

South African NGOs have denounced the shipments as “vaccine apartheid” when less than 2% of 1.3 billion Africans have been fully vaccinated so far. Millions of doses produced in South Africa have been exported since March to Europe and the US, several NGOs said in a joint statement on Tuesday. “J&J are complicit in vaccine apartheid, diverting doses from those who really need them to the wealthiest countries on Earth,” Fatima Hassan of Health Justice Initiative told AFP. “It’s colonialist extraction, plain and simple.”

Dr Matthew Kavanagh of the Health Law Institute at Georgetown University said: “Global allocation of vaccines is currently not being made by public health officials but instead by a handful of company officials, who consistently prioritise Europeans and north Americans over Africans.”

Calling on Canada to back WHO Moratorium on Booster Shots and Donate Vaccines

The following article is adapted from the website of the Global Strategy Lab (GSL), a joint initiative of York University and the University of Ottawa. It excerpts from an August 16 opinion article in the Toronto Star by GSL Research Fellow Dr. Roojin Habibi, GSL Director Dr. Steven Hoffman and University of Toronto Professor Dr. Lisa Forman. As I wrote in a previous blog, RNAO supports at this time giving COVID-19 booster shots only to individuals with weak immune systems and those over 80 years old and we oppose the mainstreaming of booster shots to broader populations, for the reasons detailed by the authors.

The authors argue that Canada should support the World Health Organization’s (WHO) moratorium on COVID-19 booster shots and exercise its contractual obligations to purchase 400 million COVID vaccine doses and donate them immediately and exclusively to low- and middle-income countries (LMICs).

In the article, the authors write that wealthy countries like Canada have contributed to a growing vaccine apartheid: 83% of the 4.5bn COVID-19 vaccines administered have gone to people in high- and upper-middle-income countries, while 99% of people in LMICs have yet to receive even a single dose. In early August, the WHO called (see article above) for a moratorium on COVID-19 vaccine booster shots until at least 10% of people in every country, including all health workers, have been vaccinated.

This opinion is not to question the efficacy of booster shots. Booster shots are often effective in protecting against vaccine-preventable diseases, and they may eventually be needed for COVID-19. But experts do not yet agree on whether COVID-19 boosters are necessary for most people and, if so, when or how often.

In the coming weeks and months, country leaders must make tough choices in the face of scary trends, including the more transmissible Delta variant, and vaccine hesitancy. Yet a precautionary approach to hoarding potential booster doses denies their productive use in places where they are desperately needed today. This could create conditions for new variants to emerge, increasing the likelihood that 4th and 5th booster doses will be needed, and possibly requiring the invention of new COVID-19 vaccines.

Like vaccine nationalism, booster nationalism is an ineffective, divisive and self-defeating approach to stopping a mercurial virus that could soon evolve faster than we can contain it. But it’s more than just bad science for countries to be thinking of hoarding vaccines at a time when much of the world remains unprotected — it also undermines the collective duties of responsible countries with human rights obligations that transcend national frontiers.

Drs. Habibi, Hoffman and Forman call on Canada and other G7 countries to show support for WHO’s moratorium and speak out against mainstreaming booster shots until each country has received enough vaccines to cover their health workers and most vulnerable populations. Furthermore, they argue that Canada has a unique opportunity for leadership in global health. The country has options to purchase 400 million more COVID vaccine doses. The authors argue that Canada should exercise its contractual options for those vaccine doses in order to immediately donate them to the countries with the least access. Declining these contractual options will mean the extra doses end up on the open market where they will almost certainly go to other rich countries with a renewed appetite for bulk purchasing in light of booster nationalism

They close by writing that redirecting this massive vaccine supply to where it is most needed would be an important redemptive act that could help save millions of lives.

Read the full piece here.

POLICY UPDATES FOR ALL TO ACT ON & MUST JOIN EVENTS – OPEN TO ALL

RNAO Action Alerts

Take action to implement the 3 Mandatory Asks of Nurses: mandatory vaccination for health-care workers; mandatory vaccination for teachers and educators; and implement a vaccine passport mandatory for access to non-essential services. Sign our Action Alert. 

Take action on global vaccine access: Sign an Action Alert calling on Prime Minister Trudeau to ensure global vaccine access. Let’s also make sure we urge Prime Minister Trudeau to match President Biden’s commitments to Covax.

Take action on Bill 124 and sign the Action Alert. Add your voice to the 5,195 others calling on Premier Ford to exempt health-care workers from Bill 124. We join the call to #RepealBill124. This is urgent given the deterioration of nursing human resources as colleagues leave the profession or move to the United States. President Biden is eager to welcome our awesome RNs.

Call on elected leaders to step up and end the opioid crisis: Sign an Action Alert calling on politicians at all orders of government to work together to save lives and bring this crisis to an end.

Enshrine a nursing home basic care guarantee in legislation, premier, set the path forward! Sign an Action Alert! Call on the premier to enshrine in legislation RNAO’s Nursing Home Basic Care Guarantee.

Webinar: COVID-19 Webinar Series

September 13, 2021, 2:00pm - 4:00pm

When: Every second Monday of the month (except for August)

RNAO's CEO Dr. Doris Grinspun will be hosting COVID-19 webinars for health providers.

Topics include:

• updates on COVID-19 and the health system: latest news and pressing issues
• guest speakers (as applicable)
• questions and answers
• calls to action

Health providers from Ontario, Canada, and anywhere in the world are welcome to join at no cost.

We are here with you in solidarity. Together, we will continue to tackle COVID-19 with the best tools at hand, including accurate information, calmness, determination and swift actions!

Upcoming webinar:

September 13, 2021, 2 - 4 p.m. ET – register here.

Details and registration link coming soon.

Watch and read about earlier webinars here.

MOH EOC Situational Report

We are posting each day the Daily Situational Reports from Ontario's MOH EOC at RNAO’s website. That way, you can access the Ministry’s guidance at any time.

For a more detailed Ontario epidemiological summary from Public Health Ontario, you can always go here.

Here is a segment from the last Situation Report #497 for August 20:

Case count as of August 20, 2021 / Nombre de cas le 20 août 2021
Area / Région	Case count / Nombre de cas	Change from yesterday / Changement par rapport à hier	Deaths / Décès	Change from yesterday / Changement par rapport à hier
Ontario*	558 101	+  650	9 450	+  2

 

No updates for today.

Staying in touch          

Keeping in touch remains important as we face the pandemic and other challenges in Ontario, in Canada and elsewhere – in particular, in Africa and Latin America – two of the continents most affected by COVID-19 and its variants – delta and lambda. Feeling that we are part of a community and that we have each other’s backs helps us get through these challenges, becoming better people in the process. We are eager to hear how we, at RNAO, can best support you. Send us your questions, comments, and challenges. Recommend ideas for articles and webinars. Write to me at dgrinspun@rnao.ca and copy my executive assistant, Peta-Gay (PG) Batten at pgbatten@rnao.ca. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!

Thank you for being there for your community – everywhere and in all roles! Together, in solidarity, we are strong and resilient. In Canada we see hope at the end of this long pandemic tunnel. Please keep encouraging your colleagues, their loved ones and your communities to be fully vaccinated. We must not forget, however, about our privilege. Canada has purchased more vaccines than what it needs, while 9 out 10 countries have almost nothing. Like in other challenges we face, such as racism, Islamophobia, and other forms of discrimination, we are not safe until everyone is safe. Vaccines for all – literally for all, across the world – must guide policy in the upcoming 12 months. Let’s learn from the 17-month pandemic and take real action to build a better world.

To everyone – THANK YOU! Please take care of yourself and know that RNAO always stands by you!

Here’s one constant throughout the pandemic. The silver lining of COVID-19 has been to come together and work as one people for the good of all. Let’s join efforts to demand political leaders bring about #Vaccines4All!

Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, FCAN, O.ONT
Chief Executive Officer, RNAO

RECENT BLOG ITEMS:

15 Aug - Why is Delta such a worry? – go here.

15 Aug - This is what we know about the Delta variant and kids – go here.

15 Aug - RNAO welcomes mandated vaccination for health care workers – go here.

8 Aug - COVID-19 vaccine boosters: is a third dose really needed? – go here.

8 Aug - RNAO calls to implement vaccine passports to help reopen Canada – go here.

8 Aug – School reopening plan: additional measures needed to stave off worst effects of fourth wave – go here.

1 Aug - RNAO’s continuing media profile: The July 2021 report – go here.

1 Aug - Preparing for the fourth wave – go here.

25 July - Action Alert: Mandate COVID-19 vaccination for all health-care workers, premier! – go here.

25 July - Are we preparing for a safe school reopening? – RNAO asks once again – go here.

17 July - Mandatory vaccination for healthcare workers – Exploring issues, challenges and supports – go here.

17 July - #FullyVaccinated campaign and mandatory vaccination for health-care workers – go here.

10 July - A Detailed Study of Patients with Long-Haul COVID – go here.

10 July - Prolonged brain dysfunction in COVID-19 survivors – go here.

3 July - RNAO’s continuing media profile: The June report – go here.

3 July - RNAO celebrates virtual 96th Annual General Meeting – go here.

26 June - Global herd immunity out of reach because of inequitable vaccine distribution – go here.

26 June - Canada is virtue signalling while waffling on global access to COVID-19 vaccines – go here.

20 June - Building your Twitter presence: Here are tips from RNAO – go here.

20 June - Let’s flatten the infodemic curve – go here.

12 June - RNAO statement on the terrorist attack in London, Ontario – go here.

12 June - Reducing the time interval for second dose after first AstraZeneca dose – go here.

12 June - AstraZeneca second dose: Should I get the same vaccine or Mrna? – go here.

5 June - RNAO’s continuing media profile: The May report – go here.

5 June - RNAO supports Premier Ford's announcement on schools as risk is too high – go here.

We have posted earlier ones in my blog here. I invite you to look.