December 21 2021 COVID-19 report


Dear Colleagues: Welcome to my Tuesday, December 21 blog during this twenty third month of COVID-19 in Ontario. You can find earlier update reports here, including thematic pieces in Doris’ COVID-19 Blog. And, for the many resources RNAO offers on COVID-19, please visit the COVID-19 Portal where you will also find RNAO media hits and releases on the pandemic here. Daily Situational Reports from Ontario’s MOH EOC can be found here. Feel free to share this report and links with anyone interested. Scroll down for several upcoming RNAO webinars in January.

A message to wrap 2021 and welcome a healthy, better and brighter 2022

As 2021 wraps up and the holidays approach, I want to thank each and every reader of my blog for being part of the journey. This has been another tough year, and now with Omicron, we all feel we’ve had enough! Yet, we must continue fighting the virus. When necessary, we will also fight a system that adds rather than softens difficulties for the public and for nurses in particular.

On behalf of RNAO’s Board and staff, I thank you for being champions of care and responding to the call with knowledge, compassion, and courage. You save lives and you help grieve lost ones. You make a difference for people everywhere and every day. You endure scars and exhaustion. And sometimes you – and us all – find silver linings.

Please know that my biggest silver lining is YOU – the Ontario nurses – RNs, NPs, RPNs and nursing students. YOU inspire me to no end. My biggest sorrow is that YOUR unwavering and endless giving has NOT been matched by the respect you demand and deserve. Tragically – and I say this with sorrow – our premier seems to be guided as of late more by polls than by science and human resource needs. This is why RNAO took on the fight to #RepealBill124, and will continue the fight until this reprehensible bill is repealed. It represents a slap in the face to our nurses at a time when all you deserve is a standing ovation!

Colleagues, THANK YOU! Know that at RNAO YOU are being heard. Know that we stand with you and by you. Know that YOU inspire us. Know that in 2021 YOU inspired your patients’ and their families, your nursing colleagues as well as aspiring nursing students. YOUR commitment to care is present everywhere, and for that, we thank YOU!

Times continue to be tough, but we are tougher. As a profession, we are more together and cohesive than ever. TOGETHER -- we will face 2022 -- and make it a worthwhile year for us all. I love you nurses and nursing.

Dear readers, I expect the holiday will continue to be very busy for me with media calls and connecting with stretched-to-the-limit nurses and other health professionals. I am taking a break from the blog. The next one will come out on Tuesday, January 11.

Please join our holiday card campaign to #RepealBill124 - On Dec. 9, the Ontario legislature ended its fall session with Bill 124 still in place. That means Ontario’s nursing crisis will continue to deepen. Nurses will continue to leave their jobs and, in many cases, the profession. Patient safety will be impacted and the effectiveness of Ontario’s health system will continue to be compromised. But, RNAO’s efforts to repeal Bill 124 will not rest. Please join our campaign and send a holiday card to your MPP. We have designed greetings to send to MPPs who have committed to stand with nurses and repeal Bill 124. And, we have designed greetings for those MPPs who have yet to sign. Please go to RNAO’s website to send your card.

This week we share: In three media releases, RNAO addresses the government’s response to the nursing crisis, Omicrom-led wave and concerns about health-system collapse.

RNAO addresses nursing crisis, Omicrom-led wave and preventing health-system collapse

Three RNAO media releases during the last week addressed the current pandemic context in Ontario and the responses from government.

1. RNAO’s media conference - Nursing crisis risks patient safety and health of Ontarians: Premier Ford must #RepealBill124 to prevent health-system collapse

In a Dec. 14 media release, RNAO says the provincial government’s failure to repeal Bill 124 is wreaking havoc on the nursing profession, patient safety and Ontario’s health-care system. RNAO warns that the government must take swift action to confront the province’s nursing crisis, to make sure there are enough nurses – especially registered nurses (RN) – available to deal with the coming fifth wave of the COVID-19 pandemic and the backlog of procedures and surgeries.

At a media conference today (Dec. 14), RNAO laid out a grim scenario as Ontario recorded another 1,429 new infections and five COVID-related deaths. At issue is a major nursing human resources crisis exacerbated by Bill 124, the legislation passed by Premier Ford which caps salary increases to just one per cent. The increase actually results in a reduction in pay when inflation is taken into account. This is a slap in the face to nurses at a time when they are working harder and harder to care for Ontarians. 

“Bill 124 is having a detrimental effect on the profession, like nothing I have seen before. We are losing nurses of all categories and we are hemorrhaging RNs. Ontario had a shortfall of 22,000 RNs before this pandemic began. And, when you factor in the length of the pandemic and the exhaustion and burnout our colleagues have been experiencing, we desperately need a government that recognizes nurses’ efforts and brings hope by moving to immediately #RepealBill124,” urges Dr. Doris Grinspun, RNAO’s CEO.

RNAO outlined the gravity of the situation at a rally on Nov. 14, when nurses and allies gathered and implored Premier Ford to repeal Bill 124 within 30 days. “Today (Dec. 14) marks the end of the countdown. We are at day zero and nurses are stunned they have been met with complete silence from the premier. This is being perceived as a blatant lack of respect for nurses, who have been under tremendous pressure and who have sacrificed and risked their lives and the lives of their loved ones for the past 22 months,” Grinspun says, echoing nurses in the field.

While the government has taken no action, RNAO has been heartened by the support it is receiving from opposition MPPs. During today’s media conference, RNAO revealed that all of Ontario’s NDP, Liberal and Green party MPPs have signed a letter pledging that they will vote to #RepealBill124 if Premier Ford enacts legislation to repeal it.

“As health-care professionals grapple with two variants of COVID-19 – Delta and a galloping Omicron – and we are in a rush to get vaccines into the arms of as many Ontarians as possible, it is obvious the health system is once again at risk of collapsing. Thus, we implore once again to Premier Ford to #StandWithNurses and #RepealBill124,” says RNAO President Morgan Hoffarth.

“In the coming days and weeks, while people spend time with friends and family, nurses will continue the fight of their lives on the frontlines. Ontarians must understand the gravity of the situation because it ultimately affects their safety as patients and their access to health services,” says Hoffarth. “The province’s nursing crisis demands a fulsome plan, and a critical first step is to #RepealBill24.”

“As part of its campaign to #RepealBill124, RNAO is asking its 48,500 members and allies from other professions and the public to drop off cards at their MPP local constituency offices to thank those politicians who are supporting us and ask others to sign our pledge,” says Hoffarth. People can also join RNAO’s campaign online.  

2. Response to the Ontario government Dec. 15 announcement - RNAO welcomes plan to move up eligibility dates for third doses. Free rapid tests. Urges additional public health measures to slow down the spread of Omicron.

In its Dec. 15 media release, RNAO welcomes news that the province is expanding eligibility for COVID-19 booster shots to everyone over 18 years of age as of Monday (Dec. 20). Previously, the government announced those over 18 had to wait until Jan. 4.

“Omicron is explosive,” says Dr. Doris Grinspun, RNAO CEO. “Today’s tally of 1,808 infections and another nine deaths is alarming and vaccination offers the best protection against the galloping spread of Omicron. This is why we urge every Ontarian who is eligible to get vaccinated, and for all those who already have, get your booster shot.” 

Grinspun says she is also pleased Premier Ford is making millions of rapid antigen tests provided by the federal government available for free at various locations in communities across the province. This is another crucial step to fight the exponential case increases of Omicron. RNAO’s CEO adds that “efforts to lower capacity limits are insufficient, and missing in the announcement altogether are other urgent public health measures that RNAO and epidemiologists have been calling for.” These urgent measures include: 

  • making N-95 masks available immediately to all health-care workers across the system, starting with those in long-term care homes and retirement homes – given that COVID-19 is airborne
  • mandating vaccinations (three doses) for all health-care workers and all education staff
  • making public health units responsible for providing vaccine waivers to relieve family physicians and nurse practitioners from that burden, and incorporating these waivers into the QR system
  • imposing additional capacity limits for public venues and private gatherings, and reinforcing the need for vaccine verification in public venues
  • repealing Bill 124 immediately to retain nurses in Ontario’s health system

Grinspun says, “The shortfall of RNs is already compromising patient care and hospitals will not be able to cope with surges in intensive care units if these expert professionals continue to leave hospitals because of Bill 124.” This is why RNAO has repeatedly “urged Premier Ford and his government to understand the magnitude of the situation in critical care and that the pandemic has taken on a new urgency. Repeal this bill to retain RNs or risk a hospital collapse. The impact on Ontarians requiring both COVID-19 and non-COVID critical care services will be tragic.”

RNAO President Morgan Hoffarth also urges aggressive action to avoid even more dangerous variants in the future. She echoed the World Health Organization’s plea that “the emergence of the Omicron variant is the result of global vaccine inequity. The only way to stop the virus from mutating is to stop it running rampant among unvaccinated populations in poor and vulnerable countries.” “The federal government must forcefully act to address global vaccine inequity,” says Hoffarth.

Hoffarth adds, “That’s why RNAO is labeling the Omicron variant as the #VaccineInjusticeVariant. If there is no vaccine equity, there is no health for all.” She stresses that Prime Minister Justin Trudeau must act now. “Canada must lead in the effort to make vaccines available to everyone around the world now – not in a year or two. If everyone around the world is not safe, no one is safe.”

3. Response to Ontario public health measures announced Dec. 17 - RNAO says government’s new measures essential but not enough to blunt Omicron’s force

The public health measures announced Friday Dec. 17 are essential steps but not enough to contain the out-of-control spread of the Omicron virus or to prevent a collapse of the health system, says RNAO in its Dec. 17 media release.

The association says much stronger measures are needed to address the magnitude of the challenge facing the province. “Capacity limits provided today are too generous given the millions of Ontarians over the age of 18 still in line to get booster shots, and the demand for boosters outstrips our capacity to deliver them quickly,” says RNAO CEO Dr. Doris Grinspun, noting that nurses play a significant role in vaccine distribution.

Earlier this week, the association implored Premier Doug Ford to treat nurses with the respect they deserve. “Not only are they running on empty, they are working for less pay because of Bill 124, legislation that caps nurses’ salaries to just one per cent,” says Grinspun, adding the best way to ensure there are enough nurses to fight the explosive growth in new infections is to immediately repeal Bill 124.

“Nurses care deeply about their patients and they keep going to work facing insurmountable challenges. Their patient assignments have increased dramatically. Most still do not have the N95 masks needed to keep them and their colleagues safe given that COVID-19 is airborne, and they feel increasingly ignored by a government that does not care about their health and wellbeing,” says Morgan Hoffarth, RNAO President referring to Bill 124. Hoffarth added nurses and Ontarians can send a message to Premier Ford by contacting their local MPP.

Hoffarth also urges Ontarians to do their part by adhering to all public health measures for the sake of their own health and that of their families. “This is a virus that knows no bounds. We all have an obligation to look out for ourselves and for one another.”    


COVID-19 Webinar Series

Jan 10, 2022, 2:00pm - 4:00pm

Every second Monday of the month

RNAO's CEO 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 available)
  • 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 webinars:

Jan. 10, 2022, 2 - 4 p.m. ET

Details coming soon.


Additional dates:

Feb. 14, 2022, 2 - 4 p.m. ET

Details coming soon.

Strategies to Help Change Teams Successfully Implement the Person & Family-Centered Care (PFCC) Best Practice Guideline

Jan 18, 2022, 2:00pm - 2:45pm

Register Now

About this Event:

This virtual presentation is designed to provide organizations and health-care providers with an overview of our experiences implementing the Person and Family-Centered Care (PFCC) best practice guideline (BPG). We will share some of our successes and learnings, discuss some of the barriers we faced and highlight strategies that we have used to ensure the successful implementation of this guideline.

During the presentation, we will discuss:

1.    some of the barriers/challenges we faced when implementing the PFCC guideline
2.    key implementation strategies that we have used as an organization when implementing the PFCC guideline
3.    how we continue to ensure its sustainability during crises such as forest fire evacuations

We will also discuss how we have aligned the PFCC guideline implementation with our organization’s mission to improve Indigenous patient and family experience in our hospital. 


Meghan Gilbart, BScN, RN, Chief Nursing Executive, Red Lake Margaret Cochenour Memorial Hospital

Amanda Kaczmarek, Director of Quality and Risk, Red Lake Margaret Cochenour Memorial Hospital


Best Practice Champions Virtual Workshop - Session 1

Jan 19, 2022, 9:00am - 12:00pm

The Best Practice Champions Network team has established a new, two-part Best Practice Champions Virtual Workshop to replace the in-person champions workshops. This free, online educational opportunity consists of a brief pre-recorded introductory video, and two live virtual sessions to be completed in sequential order.

The Best Practice Champions Virtual Workshop series will be offered monthly, with Session 1 and Session 2 taking place once a month. This will provide you with ample opportunity to select the live session that best suits your work schedule. This online educational opportunity can be completed individually or as a group.

For further details and registration, go here.

Wisdom in Wound Care Webinar Series

Jan 19, 2022, 12:00pm - 12:45pm

The Wisdom in Wound Care Webinar Series offers 11 monthly, 45-minute webinars hosted by RNAO and facilitated by wound care experts in Ontario. The webinar series will cover best practices in relation to acute and chronic wound prevention, assessment and treatment. 

The mission of the webinar series is to reduce the physiological, psychological and the fiscal burden of wounds throughout Ontario by building clinical expertise using best practices related to wound care. 

By the end of the webinar series, attendees will be able to explain:

  • the appropriate best practices as they pertain to varying wound care issues; and
  • how they can influence optimal person-centered outcomes.

Recordings of previous sessions are available to watch.

For details and registration, please go 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 detailed Ontario epidemiological summary from Public Health Ontario, you can go here.

According to the latest Situation Report #579 for December 20, the case count was as follows: 653,727 total, +3784 change from yesterday; 10,113 deaths, zero change from yesterday.

Staying in touch          

Keeping in touch and being part of a community helps us get through challenging times. Keep telling us 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 <> and copy to <>. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!

Thank you for continuing to be there for your community, everywhere and in all roles! Together, in solidarity, we are stronger. Thanks for encouraging your colleagues, their loved ones and your communities to be fully vaccinated – including booster shots. Keep reminding them that COVID-19 is aerosol and that proper ventilation and N95 masking is not just preferred but necessary.

Let’s also be thoughtful and remember Dr. Tedros when he said that “#VaccineEquity is not an act of charity; it’s the best and fastest way to control the pandemic globally, and to reboot the global economy.” Canada has purchased more vaccines than what it needs, while the poorest countries in the world have almost nothing. Like with other challenges we face – systemic discrimination and climate change – we are not safe until everyone is safe. Vaccines for all – literally for all, across the world – must guide policy in the upcoming months. Let’s learn from the 22-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 that political leaders protect patients, students, and workers – and secure #Vaccines4All.

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


14 Dec - What we know about Omicron two weeks after it became a variant of concern – go here.

14 Dec - Omicron variant caseload expected to 'rapidly escalate' in the coming days, Tam says – go here.

14 Dec - Repeal Bill 124 – RNAO asks for pledge of support from Members of the Provincial Parliament – go here.

14 Dec - Ontario’s nursing crisis: Next steps in #RepealBill124 campaign – go here.

7 Dec - RNAO’s continuing media profile: The November 2021 report – go here.

7 Dec - South African envoy calls on Canada to support waiver on COVID-19 vaccines – go here.

7 Dec - RNAO welcomes expansion of boosters and says Omicron is the #VaccineInjusticeVariant – go here.

28 Nov - Omicron edition: Uncertainty, uncertainty, uncertainty – go here.

28 Nov - The NHS staffing crisis is killing people – and this winter it will be even worse – go here.

28 Nov - A note to Premier Ford: Repeal Bill 124! – go here.

21 Nov - I’m an infectious disease doctor. Yes, I’m vaccinating our 5-year-old against COVID-19. Here is why you should too – go here.

21 Nov - Rich countries only shared 14% of COVID-19 vaccine doses promised to poorer nations – go here.

21 Nov - Nurses gather in Toronto to rally: Recap of #RepealBill124 rally and next steps – go here.

14 Nov - Nurses celebrate National Nurse Practitioner Week and call for scope expansion to improve access to the health system – go here.

14 Nov - Congratulations to all NPs during National Nurse Practitioner Week – go here.

14 Nov - Ontario nurses discuss the crisis in the profession during RNAO’s Fall Tour – go here.

14 Nov - Ontario’s RN understaffing crisis: Impact and solution – go here.

6 Nov - RNAO’s continuing media profile: The October 2021 report – go here.

6 Nov - Ontario’s economic statement signals government’s concerns with nursing human resources – go here.

6 Nov - RNAO deeply disappointed with Premier Ford’s decision on mandatory vaccination – go here.

30 Oct - Hospitals ‘bleeding out’ as nursing shortage intensifies – go here.

30 Oct - The Lancet calls for emergency action to tackle climate change, restore biodiversity, and protect health – go here.

24 Oct - Big tech has a vaccine misinformation problem – go here.

24 Oct - RNAO is deeply disappointed with government’s reopening plan – go here.

24 Oct- Misinformation is an urgent threat that prolongs the pandemic and puts people at risk – go here.

17 Oct - Health organizations around the world: Urgent climate action required – go here.

17 Oct - Climate change the new public health emergency – go here.

17 Oct - A crucial moment for global public health: The Glasgow climate conference – go here.

10 Oct - RNAO launches new, evidence-based online implementation toolkit – go here.

10 Oct - Media release: Mandate vaccinations and establish safe zones – go here.

10 Oct - A renewed call: Prime minister, stop the court battle with First Nations children! – go here.

10 Oct - The inherent racism of anti-vaxx movements – go here.

3 Oct - RNAO’s continuing media profile: The September 2021 report – go here.

3 Oct - RNAO commends move to mandate vaccination for long-term care staff; urges for more – go here.

3 Oct - Action Alert – Stop fighting First Nation children in court: Concrete action on Truth & Reconciliation – go here.

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