February 16 2022 COVID-19 report


Dear Colleagues: Welcome to my Wednesday, February 16 blog during this twenty fifth 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. Share this report and link broadly. Scroll down for upcoming RNAO webinars.

Dear colleagues,

Monday, February 14th, was a hugely intense day for Canada and for Ontario, and not exactly because of Valentine’s Day.

Two events took place:

1) The Emergencies Act was invoked. The Act is a law passed by the Parliament of Canada in 1988 which authorizes the federal government to take extraordinary temporary measures to respond to public welfare emergencies, public order emergencies, international emergencies and war emergencies. PM Justin Trudeau and his team announced their intention to use powerful actions such as freezing financial assets and revoking automobile insurance (in my view these will suffice to put a stop to the madness). PM also stated that the Act will be in effect for 30 days and no military action will be taken. NDP leader Jagmeet Singh supported the measure, and Premier Doug Ford expressed support for the measure.

There is an important aspect of invoking this act that has received little media attention and is critically important. Invoking the Act dictates the need to follow-up, within a year, with an inquiry and a report on why the act was invoked. On this later point, RNAO will be pursuing Police Reform.

Kindly, consider giving an RT to this tweet

2) Ontario government's announcement to ease more public health measures on Feb. 17 and again on March 1 (including the vaccine certificate system). RNAO's stance is as follows: "Given Ontario’s continued nursing crisis and the catastrophic backlog of surgical procedures, it is crucial the government maintains mandates to allow the health system to stabilize and resume health services for all, not only persons with COVID-19." Take a moment to read the full media release (scroll down to read).

Please RT RNAO's tweets here and here and here.

This week we share: 1) Register now: Queen’s Park Day is coming up on Feb 24; 2) Ontario government must maintain key public health measures to address catastrophic surgical backlog, says RNAO; 3) restoring community dialogue and resilience for the next COVID-19 emergency; and 4) a better post-pandemic future means not giving in to COVID-19 now.

Register now: Queen’s Park Day is coming up on Feb 24

You’re invited to RNAO’s 22nd annual Queen’s Park Day (QPD), happening virtually on Thursday, Feb. 24 from 3 – 7:30 p.m. ET.

This year’s event includes discussion of RNAO's provincial election platform and presentations from Ontario's political party leaders and health critics. Members will discuss the province’s nursing crisis, with a focus on the retention and recruitment of nurses as well as care delivery. RNAO will release its 2022 provincial election asks during a media conference the morning of QPD, at 10:30 a.m. ET.

Members of RNAO’s assembly have long appreciated the opportunity to take part in QPD. Given the ongoing COVID-19 pandemic, this year’s meeting will again be held virtually. This means we are opening registration to include all RNAO members for this event – spread the word.

Visit the official event page and register now using the online registration form.

If you have any questions, please contact policy coordinator Ann-Marie Morris at amorris@RNAO.ca.

Ontario government must maintain key public health measures to address catastrophic surgical backlog: RNAO says

RNAO issued the following media release following the Ontario government’s announcement of the lifting of public health measures.

TORONTO, Feb. 14, 2022 /CNW/ - With a COVID-19 positivity rate of 13 per cent and more than 1,300 Ontarians in hospital sick with the virus, the government's plan to ease public health restrictions on Feb. 17 and lift most on March 1, including proof of vaccination requirements, puts Ontarians waiting for procedure and surgeries in danger of further delays, says the Registered Nurses' Association of Ontario (RNAO). Given Ontario's continued nursing crisis and the catastrophic backlog of surgical procedures, it is crucial the government maintains mandates to allow the health system to stabilize and resume health services for all, not only persons with COVID-19. 

On Feb. 9, Minister of Health Christine Elliott said there weren't any imminent plans to remove the vaccine certificates, yet today the government changed its course. "Nurses recognize the importance of lifting public health restrictions when evidence indicates it's safe to do so, however, at a time that hospitals continue to be taxed and most health resources are occupied with COVID-19 patients, it's wrong to drop key public health measures like vaccine certificates," says RNAO CEO Dr. Doris Grinspun. "Proof of vaccination and masking must continue until surgeries and other procedures deemed non-urgent are no longer delayed," Grinspun urges.

Premier Ford announced businesses can choose to maintain the proof of vaccination requirement in their establishments after the mandate is lifted, but RNAO says the onus should not be placed on businesses. "Business owners have faced enough hardship throughout the COVID-19 pandemic and should not be subject to the harassment of non-compliance if they choose to request proof of vaccination from patrons, especially during these volatile times," Grinspun adds.

In addition, only half of children ages 5-11 in Ontario have received one dose of the COVID-19 vaccine and approximately 20 per cent have received both, so the vaccine mandate must continue to be an important means to both protect children and encourage remaining Ontarians who have not already done so to get vaccinated.

"The government said it themselves only last week that they would reopen the province slowly, but yet again they're moving too soon and too quickly," says RNAO President Morgan Hoffarth. "Nurses continue to be on the forefront of care and urge the government to maintain vaccine passports as these encourage people to get vaccinated which must continue to be a key priority to allow the health system to stabilize."

Although the government didn't specify a date to lift its mask mandate, Hoffarth says "the government must continue to mandate masking in all enclosed public spaces for the foreseeable future. Well-fitted masks have shown to decrease transmission and are an effective layer of public health protection."

Restoring community dialogue and resilience: The next COVID-19 emergency

This is a February 9 article by Mélissa Généreux, Associate Professor, Faculty of medicine and health sciences, Université de Sherbrooke; Gabriel Blouin-Genest, Associate professor, School of applied politics, Scientific codirector, CIDIS (Centre interdisciplinaire de développement international en santé), Université de Sherbrooke; and Mathieu Roy, Professeur associé, Faculté de médecine et des sciences de la santé, Université de Sherbrooke. This article is republished from The Conversation under a Creative Commons license. Read the original article.

COVID-19 is not the first health crisis to affect Canada. Previous emergencies, like the Lac-Mégantic train tragedy in 2013, showed the importance of including the affected communities to promote better adherence to preventive measures and build resilient communities. Our research shows this is largely missing for COVID-19, with high costs on society as a whole.

Resilience is the ability of a community to continue to live, function, develop and thrive after a crisis. Key elements of enhancing resilience include maximizing social cohesion, collaboration, empowerment, participation and consideration of local characteristics and issues. This means dialogue with, and inputs from, the affected communities.

There is a major risk of a community becoming “corrosive” if these elements are not appropriately taken into account. Corrosive communities are at risk of division, polarization and psychological impacts such as anxiety and depression. These are the costs Canadians may have to pay for the divisive approach used in response to COVID-19.

Where are we heading?

The corrosive versus therapeutic pathway in crisis response. (Blouin-Genest, Généreux, Roy), Author provided

Our multidisciplinary research team at the University of Sherbrooke has been using surveys to evaluate and compare the different effects of the COVID-19 pandemic since February 2020. Different waves of national and international surveys confirm our original findings: the psychosocial impact of the pandemic and responses to it are immense.

Unfortunately, the governmental approach is still divisive, using arguments such as the 90 per cent vaccinated are paying for the inaction of the 10 per cent unvaccinated, that some might be subject to more restrictive measures than others, or that vaccine hesitancy is only prompted by conspiracy seekers and non-believers of science, which is contradicted by our data showing that one-third of unvaccinated people do not hold these beliefs.

This “us against them” strategy is amplifying social division and has major psychosocial impacts, including stress and mental health issues. Our data indicates that this strategy has resulted in a significant decrease in trust toward public health authorities and governments.

Pandemic fatigue

We conducted our most recent survey online from Oct. 1-17, 2021 among 10,368 adults from all regions of Québec and 1,001 adults in the rest of Canada. The results showed half of the adults from across Canada (and, in Québec, nearly two-thirds of young adults) suffer from “pandemic fatigue.”

Pandemic fatigue is a normal and expected response to chronic adversity, but when exacerbated, it can jeopardize not only how we, as communities, respond to the current crisis, as shown by our data, but also how we will react to future ones — a key ingredient in building resilient communities.

Our results showed pandemic fatigue manifests itself through anxiety, depression and suicidal thoughts, issues affecting 21.9 per cent, 25.6 per cent and 9.4 per cent of Canadians, respectively.

The ‘public’ in public health

There is an urgent need to rebuild a safe public space. The population and its representatives (including opposition parties, citizens’ groups and community leaders) need access to sufficient information to monitor the government’s actions, including real-time and raw COVID-19 data. They need to be able to offer criticism and propose alternative solutions, but also feel accepted despite their different viewpoints on the crisis. We must allow a return of the “public” in public health.

As underlined by the World Health Organization (WHO), governments should act in such a way that citizens and communities can regain some form of power and autonomy in their daily lives. They must feel and perceive that they are seen as legitimate citizens, even when they disagree with the government. This should be guided by five major principles: transparency, consistency, predictability, fairness and co-ordination.

Principles favouring compliance

The World Health Organization’s principles favouring compliance. (Blouin-Genest, Généreux, Roy), Author provided

The most important challenge, we argue, is one of coherence, where citizens’ questions and criticisms must be addressed directly rather than ignored, deemed irrelevant or used against those asking them. This will help increase the “sense of coherence” of affected populations, a key factor in building resilient communities.

We define a sense of coherence as a “psychological resource that helps to understand a stressful event, to give meaning to it, and to manage it.” The higher the sense of coherence is, the better we can face adversity and stressful events.

For example, our data shows that those with a high sense of coherence are three times less likely to experience anxiety and depression. The sense of coherence can be directly affected by the strategies put in place by governments and authorities to respond to crises. Our data suggests that, overall, Canadians’ sense of coherence decreased during the pandemic.

Dialogue with communities

The health emergency Canada still faces should not be underestimated, and as the WHO reiterates, the pandemic is far from over. However, not all policies and measures need to be implemented through “emergency” procedures or justified by the state of emergency, as seen widely in Canada right now. The response to COVID-19 must rely on a stronger democracy, where citizens and communities can express themselves, exchange and reflect and, by doing so, bring back meaning and coherence in their daily lives.

Dialogue with affected communities is still left aside in responses to the pandemic, amplifying skepticism and beliefs in erroneous information. Our research also underlines an increase in political polarization, deepening already existing gaps between communities.

Examples of citizen and community inclusion

A crisis strategy should not be based on information moving only in one direction. (Blouin-Genest, Généreux, Roy), Author provided

The spectrum of citizen participation can be quite diverse, but our data suggest that the current COVID-19 strategy based on the information moving only in one direction — in which citizens and communities assume very little responsibility — is a wrong one. The recognition of past mistakes, humility and better community involvement should be the cornerstones of our responses to this crisis, with citizen and community inclusion.

Bringing back dialogues between authorities and communities affected by the pandemic is a real emergency. The long-term health of individuals and communities is at stake.

A better post-pandemic future means not giving in to COVID-19 now

This is a February 6 article by Karen Mossman, Professor of Medicine and Vice President, Research, McMaster University and Matthew S Miller, Associate Professor in Biochemistry & Biomedical Sciences, M.G. DeGroote Institute for Infectious Disease Research, McMaster University. This article is republished from The Conversation under a Creative Commons license. Read the original article.  

This is no time to give in to COVID-19.

It’s understandable that after two years, everyone is tired of being afraid, staying home, wearing masks and queueing up for rounds of vaccines and tests.

With the virus finding the unvaccinated in greater numbers — as expected — and breakthrough infections affecting the vaccinated, a spirit of resignation threatens to take hold.

Some are even suggesting it would be best to stop trying, or even accelerate the spread of the virus to get it over with, in the same way parents of yesteryear used to put healthy and infected kids together to get chickenpox and be done with it.

They had no idea their “chickenpox parties” would ultimately lead to painful, sometimes debilitating, shingles outbreaks for many later in adulthood.

Omicron’s impact

Even if Omicron infections are typically milder than previous variants, there remains considerable uncertainty around the long-term consequences of COVID-19.

Further, the impact of a huge wave of any infection is severe, even when it is mild for many. We are seeing the devastating effects of infected workers being absent, not only in health care and long-term care, but also in businesses and schools that can’t run properly or in some cases at all.

As researchers in molecular virology and viral immunology, we are here to say in no uncertain terms that it would be wrong to give up now.

Vaccines have helped us to avoid near certain disaster during the current Omicron wave. The number of deaths and devastating illnesses would be much, much higher without them.

Already, we know that long COVID, with its sometimes very serious physical and mental health consequences, is shockingly common among COVID-19 patients, with symptoms affecting as many as one in three. We are also seeing some evidence that children are more likely to develop Type 1 diabetes after COVID-19. Those are not risks we can afford, either.

Our society may have become complacent about infectious diseases, even without COVID-19. Here in Canada, we have been lucky to live in a time when vaccines are so successful that almost no other public health measures have been necessary to protect us from infections like smallpox, polio and tetanus that have plagued humanity for most of its natural history.

Pandemics have always changed and improved the way people live afterwards. Cholera led to sewers and clean water. Yellow fever and influenza pandemics gave rise to the concept of public health.

Our new “normal” can be much healthier, with only the most subtle of changes.

A healthier ‘normal’

Last year there was barely any influenza, and the common cold went on hiatus because COVID-19 precautions also happened to provide a barrier to those familiar infections. The near absence of influenza probably saved about 3,500 lives in Canada alone, and those benefits can continue.

If we normalize mask-wearing by vulnerable people during peaks of influenza or other seasonal infections, we can save thousands of lives globally, even after the threat of COVID-19 recedes.

We learned early in the pandemic to wash our hands better and more frequently, which protects us from many forms of infection. Let’s keep it up. Likewise, improvements to building ventilation are long overdue and will continue to benefit our collective health going forward.

We have learned to stay home when we are sick, perhaps finally shedding the warrior mentality of slogging through infections as if it were somehow more productive than staying away from the workplace. It isn’t, especially when one outbreak can pull down a whole organization.

Now, there are much better ways to work remotely for those whose jobs permit it. The requirement to isolate when ill has also renewed public discussion around the need for improved paid sick leave policies to support vulnerable workers. Adopting these policies would improve the lives of many in the years to come.

COVID-19 has exponentially raised public awareness of infection control due to its constant intrusion into our everyday lives over the past two years. That can pay off in other ways, if we decide to take advantage of all the tools we have and lessons we have learned out of necessity.

All of this is certainly not to say COVID-19 is good. Far from it. But we can benefit from what we have learned so far, and we certainly should not give up now.

We have proven, effective tools. Using these tools effectively can keep us healthy, protect the most vulnerable members of our communities, allow businesses to operate safely and accelerate our return to “normal.” Simply being tired of the pandemic is not reason to let it burn through the population.


Best Practice Champions Virtual Workshop Session 1

Feb 15, 2022, 1:00pm - 4:00pm

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 each 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 details and registration, please go here.

Wisdom in Wound Care Webinar Series: Pressure Injury, Wound Bed Preparation and Debridement Options

Feb 16, 2022, 12:00pm - 12:45pm

The Wisdom in Wound Care Webinar Series offers 12 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. 

For details and registration, go here.

Caring for Residents with Vision Loss: Reducing Falls and Increasing Independence

Feb 16, 2022, 1:30pm - 2:30pm

Join RNAO’s Long-Term Care Best Practices Program and Vision Loss Rehabilitation Canada (VLRC) for an informative webinar.

This presentation with a panel of speakers will explore the impact of falls on long-term care (LTC) homes.

For details and registration, go here.

Best Practice Champions Virtual Workshop - Session 2

Feb 22, 2022, 1:00pm - 4:00pm

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 information and registration, go here.

Using Best Practice Guidelines to Support Diversity, Equity and Inclusion

Feb 24, 2022, 1:00pm - 1:45pm

This webinar is designed for all health-care professionals to hear our story of how our team has developed, supported and implemented a diversity, equity and inclusion plan. By creating this plan, we truly aspire to improve our team members and client experience.

This webinar will help participants focus on the issue of diversity, equity and inclusion and offer some insight into the ways in which changes can be made to policy, programs, client experience and organizational culture.

For details and registration, 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 #617 for February 15, the case count was as follows: 1,076,078 total, + 1,593 change from yesterday; 12,120 deaths, +19 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 <dgrinspun@rnao.ca> and copy to < ceo-ea@rnao.ca>. 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


10 Feb - Whose freedom is the ‘freedom convoy’ fighting for? Not everyone’s – go here.

10 Feb - The whole world should be worried by the ‘siege of Ottawa’. This is about much more than a few anti-vaxx truckers – go here.

10 Feb - Nursing report calls to end anti-Black racism and discrimination within the profession – go here.

10 Feb - Visit RNAO’s In Focus page on Black Nurses – go here.

2 Feb - Let’s not play Russian roulette with Omicron and embrace it as inevitable – go here.

2 Feb - RNAO calls out extremist and hateful actions driven by far-right on display in Ottawa – go here.

2 Feb - Honouring Black History Month 2022 – go here.

26 Jan - Listening to internationally educated nurses living in Ontario and eager to nurse – go here.

26 Jan - RNAO’s letter to the College of Nurses of Ontario regarding IENs – go here.

26 Jan - Prioritize health system pressures ahead of lifting public health measures – go here.

18 Jan - TousAntiCovid - France's contact tracing tool and health pass – go here.

18 Jan - RNAO’s submission to the Toronto Board of Health on return to school – go here.

12 Jan - A message as we begin 2022 amid a fifth wave – go here.

12 Jan - A health system on the verge of total collapse – An open letter to Premier Doug Ford – go here.

12 Jan - RNAO’s continuing media profile: The December 2021 report – go here.

12 Jan - Canada isn’t responding with foresight when it comes to COVID-19 – go here.

21 Dec - RNAO addresses nursing crisis, Omicrom-led wave and preventing health-system collapse – go here.

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.

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