January 26 2022 COVID-19 report


Dear Colleagues: Welcome to my Wednesday, January 26 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. Feel free to share this report and links with anyone interested. Scroll down for upcoming RNAO webinars.

This week we share: 1) Listening to internationally educated nurses (IENs) living in Ontario and eager to work in our health system; 2) RNAO’s letter to the College of Nurses of Ontario regarding IENs; and 3) RNAO’s response to the government’s plan to start lifting public health measures soon.

Listening to internationally educated nurses living in Ontario and eager to nurse

The following is an article contributed by a group of internationally educated nurses (IENs) who live in Canada and are anxious to work as RNs in Canada but who have endured years of an arduous and seemingly interminable process to meet the requirements. Scroll down to see RNAO’s letter to the College of Nurses of Ontario (CNO) on this issue.

Never giving up has always been this group’s mantra ever since we met. All of us, like every other immigrant, dreamed that someday, we can have a better life or provide a better future for our children and our families. We watch stories on television or read articles of what life is like at the other side of the world, how you have opportunities that your home country can’t offer and how to fulfill your aspirations for your family and for yourself. We all came here with hopes and dreams of becoming Registered Nurses (RNs) in Ontario.

We are a group of internationally educated nurses who came to Canada to work as caregivers. Becoming a caregiver for elderlies or children was the fastest way for us to enter the country so even if we are fully trained nurses in our home countries, we decided to grab the chance while telling ourselves that this is just temporary and that we will transition to becoming Canadian RNs soon.

We all know that getting licensed in Canada is a very arduous process. Not only that there are many requirements to meet – it is also quite expensive. Working as a caregiver is one of the hardest jobs there is. We wake up early in the morning to start tending to an elderly or child’s daily needs and at the same time help cleaning the house or run errands. Because we are tired working the whole day, we barely have time to take care of ourselves. We got stuck in this same loop for more than two years and yet we managed to find time to study and pass the registration examinations, the language proficiency exam, and meet most of the requirements asked by the College of Nurses (CNO). Finally, after working hard and with so many sleepless nights, we are now licensed RNs in Ontario. But wait, our story doesn’t end there.

Despite being licensed, we are not yet entitled to practice nursing in the province because we lack one requirement: we do not have a permanent resident status or an open work permit to legally authorize us to practice nursing as our work permits are tied specifically to work in the caregiving sector. Our dreams of becoming RNs and RPNs seemed to slip through our hands because we know how lengthy immigration processing times are. Albeit the situation, there was this small voice telling us that this is the last hurdle in the obstacle course and that we must not give up. So, we met via social media last year and we started letting everybody know that we are internationally educated nurses who are ready to practice but are unable because we lack permanent residency. We found comfort in each other; we are not alone in this journey. There are so many – indeed, thousands! – of internationally educated nurses who are going through the same ordeal.

This pandemic also intensified our desire to help. The country is now facing a nursing crisis. There are so many Canadian nurses who are exhausted and burned out but keep fighting and doing excellent work as they care for their patients. This sense of urgency fueled us to let people know that thousands of IENs are ready to help. Sometimes we feel so frustrated because we are just watching from the sidelines knowing that we can help. After making noise for months and after trying to find people who can help us, finally, we were able to let people know that we exist. We were able to find an organization willing to bet on us getting that much coveted unrestricted RN license. The Registered Nurses’ Association of Ontario spearheaded by their CEO, Dr. Doris Grinspun, has been so helpful. The moment we met her on social media, she didn’t waste time and connected us to people who can help our cause. She and her fellow advocates continuously let the world know that IENs are also essential.

All of us are qualified to work as Registered Nurses/ Registered Practical Nurses here in the province. Many of us have done additional courses to add to our toolkit of expertise. We are internationally educated nurses equipped not only with knowledge and skills – but also equipped with the desire to help in any way we can! Now that our voices are heard, we hold on to that glimmer of hope that someday we will be working hand in hand with fellow Canadian nurses, saving the world, one patient at a time. 

RNAO’s letter to the College of Nurses of Ontario regarding IENs  

RNAO sent the following letter on Jan. 24.

Anne Coghlan, Executive Director and Chief Executive Officer

College of Nurses of Ontario

Re: Internationally educated nurses (IEN)

Dear Anne,

We are writing to express our grave concerns about the speed with which the College of Nurses of Ontario (CNO) is processing applications for registration of internationally educated nurses (IEN). CNO’s application process is taking up to seven years, sometimes more, to complete and has resulted in a pool of over 20,000 IEN applicants at a time when the province has a severe nursing shortage.  

Anne, we are disappointed that even the onset of the pandemic seems not to have motivated the CNO to speed up its slow application process. The latest report from the Office of the Fairness Commissioner suggests that the pool of IENs applying for registration has grown while Ontario has plunged into a full-blown nursing human resource crisis.    

Much could have – and still can be – done to expedite IEN applicants through the registration process and into our health system to join our now critically short nursing workforce as nurse practitioners (NP), registered nurses (RN) and registered practical nurses (RPN). The creation of temporary initiatives such as the Long-Term Care Staffing Pool Program will not accomplish this. Indeed, exploiting this pool of skilled applicants as a reserve of lesser-skilled labour in a time of crisis is unhelpful and shortsighted; it’s a disservice to Ontarians in desperate need of nurses for both COVID- and non-COVID-related health care. IENs have a significant contribution to make to Ontario’s health system in their capacity as nurses. The CNO should focus on expediting their applications for registration instead of facilitating their use in lower-skilled roles.    

It is very worrisome that the CNO has allowed the pool of IEN applicants to grow to over 20,000 in the context of RN understaffing and, subsequently, a severe nursing shortage. RNAO is anxious to hear the CNO’s logic for deeming IEN applicants fit for immediate service as personal support workers and unregulated care providers in critically short-staffed long-term care homes through the LTC Staffing Pool Program, but unworthy of reasonably expeditious application assessments. The CNO’s treatment of IENs, in the context of current nursing workforce demands and opportunities, is inconsistent with its mission of regulating nursing in the public interest and the human rights of IEN applicants.    

RNAO is asking CNO to immediately amend the LTC Staffing Pool Program to incorporate a supervised practice model so that work done by IENs through the program is counted toward fulfilling the language proficiency and practice requirements of the registration application process. Such a model makes use of the skills and expertise of program participants and better serves the needs of participating long-term care homes and their residents in a time of critical nursing shortages.    

Anne, as we requested on Jan. 17, 2022, we would appreciate a technical briefing on the Fairness Commissioner’s report, CNO’s IEN application process, and current CNO programming related to the IEN applicant pool. Further, we are eager to discuss solutions to reducing the IEN applicant pool and bolstering Ontario’s nursing workforce with you. The IEN applicants for CNO registration have made Canada their home and seek to bring their expertise and skills to our health system at a moment of great need. We have an obligation to these applicants – and to our exhausted nursing workforce yearning for support and relief – to allow IENs to join Ontario’s nursing workforce.  

Warmest regards,

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

Chief Executive Officer 

Morgan Hoffarth, RN, MScN 



Hon. Christine Elliott, Deputy Premier and Minister of Health

Matt Anderson, President and CEO, Ontario Health

Sandra Robinson, President, CNO Council

Council of the College of Nurses of Ontario

Irwin Glasberg, Fairness Commissioner

RNAO Board of Directors

Prioritize health system pressures ahead of lifting public health measures: RNAO says

RNAO issued a media release on Jan. 20 following the government’s announcement that it plans to start lifting public health measures on Jan. 31.

The Ontario government’s announcement today to ease public health measures beginning Jan. 31 is premature and will prolong the current health system crisis, says the Registered Nurses’ Association of Ontario (RNAO). It is irresponsible to announce that gyms, indoor dining and other settings can open up to 50 per cent capacity and sporting events, concert venues and theatres will be able to have up to 500 people when people’s surgeries and procedures have been postponed, schools have only just reopened and ICU numbers continue to increase.

“We’ve already experienced the consequences of reopening too soon, yet today’s announcement shows the government hasn’t learned from its past mistakes. Last February, Premier Doug Ford lifted restrictions prematurely causing immense pressure on our health system, resulting in the spring 2021 lockdown – and here we are again a year later,” says RNAO CEO Dr. Doris Grinspun. “The government should wait until kids have been back at school for at least two weeks in order to make a decision that is measured and informed by data.”

RNAO urges the government to reverse course and maintain strict public health measures for the next few weeks to alleviate pressures on Ontario’s overworked nurses and a collapsed health system. We must improve the conditions so the thousands of Ontarians waiting for other hospital services – including postponed heart and cancer surgeries – start receiving them. This will not happen without addressing the nursing human resources crisis. Premier Ford must immediately repeal Bill 124 and fast track the process for internationally educated nurses (IEN). These are critical moves to address the staffing crisis in nursing.

“Nurses are beyond exhausted and haven’t slowed down since the start of the pandemic two years ago, yet the Ford government’s failure to repeal Bill 124 is a clear indication that this Premier does not respect nurses,” says Grinspun, referring to the government’s legislation that caps wage increases to just one per cent. “There are also thousands of IENs eager to join Ontario’s workforce, but they are forced to sit idle, not able to practise. Some hospitals are operating at more than 100 per cent capacity, and without a nurse, a bed is just a piece of furniture. As Minister of Health Christine Elliott acknowledged, the province’s health system will continue to experience challenges through February. Premier Ford, our health system needs more nurses now,” urges Grinspun.

On Wednesday, Ontario reported 60 deaths caused by COVID-19 – the highest daily count since Feb. 4, 2021 (when 88 were reported). “People are dying from COVID-19 and the government must keep that top of mind as they make decisions that impact transmission rates, hospitalizations and health system capacity,” says RNAO President Morgan Hoffarth. “These numbers represent real people with families left in anguish. And, they do not include those who will die as a result of untreated non-COVID-19 health conditions. Dr. Moore said recently we need to ‘slowly and cautiously remove public health measures,’ yet today’s announcement shows the government is back-peddling on their own advice and hospitals will become even fuller than they already are. It is tragic to see that Dr. Moore is backing decisions based on government politics rather than the precautionary principle and sound evidence.”

Ontario continues to observe climbing ICU numbers with 594 ICU patients today, compared to 589 yesterday. There is also an increase in the number of patients on a ventilator (347 today, 341 yesterday), further burdening the health system.

“Reopening schools is crucial but without slowing the spread of the highly transmissible and airborne Omicron variant, cases and clusters in schools will multiply. Furthermore, the current situation in our hospital system is unsustainable and prolonging that situation due to the inaction of the government should deeply worry Ontarians. Premier Ford seems to be more attentive to opinion polls than to the dangers of a collapsed hospital system resulting in more preventable deaths,” says Hoffarth.


Best Practice Champions Virtual Workshop - Session 2

Jan 26, 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 more details, please go here.

COVID-19 Webinar Series

Feb 14, 2022, 2:00pm - 4:00pm

When: 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:

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

Details coming soon. 


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 #602 for January 25, the case count was as follows: 1,004,879 total, + 3,424 change from yesterday; 11,068 deaths, 64 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


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.

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.

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