March 11 2022 COVID-19 report
Dear Colleagues: Welcome to my Friday, March 11 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 Action Alerts and upcoming RNAO webinars.
Today we mark exactly two years since the World Health Organization declared a global pandemic. This date is now recognized as the #NationalDayOfObservance to honour people who have died from the virus. RNAO has worked tirelessly during these two unforgettable years to support nurses and other health professionals, to provide professional advise to politicians and government, and to ensure the health and safety of Ontarians.
Please see below RNAO’s statement marking this observance and further down, the latest RNAO media release regarding the premature measures announced by the Ontario government to drop the mask mandate in most public places, and to end the vaccine mandate in long-term care. See also a Lancet study providing evidence on the benefits of persisting with mask use after vaccination.
I know that you, and we all, are shocked witnessing the brutal invasion of Ukraine by President Putin. The suffering of the Ukrainian people gets worse with each passing day. In response to the unfolding humanitarian crisis in Ukraine, RNAO has partnered with Canadian Medical Assistance Teams (CMAT) to send volunteer registered nurses (RN) and nurse practitioners (NP) to Poland. As you are undoubtedly aware, more than one million refugees have arrived in Poland from Ukraine, and they need our help. Please see below information about how you can support as well as a Q&A with CMAT Executive Director Valerie Rzepka.
This week we share: 1) RNAO commemorates the #NationalDayOfObservance marking two years of pandemic; 2) calling registered nurses and nurse practitioners to volunteer for mission to help Ukraine; 3) CMAT and RNAO members depart to Poland – how you can help their urgent appeal; 4) RNAO says Ontario’s decision to drop mask mandate puts politics ahead of science, risking gains made; and 5) persisting with masks after vaccination has major economic, health benefits, Lancet study says.
RNAO commemorates the #NationalDayOfObservance
March 11, 2022, marks two years since the World Health Organization declared COVID-19 a global pandemic. This date is now recognized as the National Day of Observance to honour people who have died from the virus.
Since the onset of the pandemic, more than 12,600 Ontarians have lost their lives due to COVID-19. Of those individuals, 4,284 were long-term care (LTC) residents and 13 were LTC staff members. We must always protect and prioritize the health of vulnerable populations, yet the pandemic has resulted in too many tragic, preventable deaths, exposing gaping holes in all sectors of our health-care system. And it’s not over just yet.
Nurses and other health-care workers have fought COVID-19 over the past two years despite the devastation they faced every day – and they continue the battle. They’ve sacrificed time with their family and put themselves at risk to try to save lives and treat the hundreds of thousands of Ontarians who contracted COVID-19. We commend nurses and all other essential workers for their unfailing giving, expertise and compassion.
RNAO invites you to take a moment to pause, reflect and honour the memory of the people no longer with us, and to support their families and friends.
The path toward recovery requires a rear-view mirror to ensure we never let anyone, especially vulnerable communities, fall through the cracks of our system again. Please do your part to prevent more losses. Get vaccinated. Get boosted. Wear your mask. Be safe.
Mission to help Ukraine - Calling registered nurses and nurse practitioners
In response to the unfolding humanitarian crisis in Ukraine, RNAO is partnering with Canadian Medical Assistance Teams (CMAT) to send volunteer registered nurses (RN) and nurse practitioners (NP) to Poland. As you are undoubtedly aware, many refugees are arriving in Poland from Ukraine and they need our help.
We need RNs and NPs on the ground in Poland to provide primary health care, mental health care, parental/newborn care and other areas of nursing practice as needed.
If you would like to volunteer, please apply directly through CMAT by visiting their volunteer page. CMAT will organize teams of health-care professionals to provide professional practice and logistics. If you volunteer, you’ll need to pay your airfare to the destination, but CMAT will cover all other expenses on the ground.
Can’t go but want to help somehow?
CMAT gratefully accepts tax-deductible donations to support their humanitarian work. You can support a specific volunteer to help them with expenses by donating directly on the CMAT web site, or make a general donation.
Tax-deductible donations can be made by Interac e-transfer or PayPal to firstname.lastname@example.org.
Or you can donate directly online. Look for “2022 Ukraine Conflict Humanitarian Response”. If you are donating in honour of a specific CMAT volunteer, be sure to enter their name at the bottom of the donation form.
RNAO and CMAT thank everyone who can either volunteer or donate to support this crisis.
See next responses from CMAT Executive Director Valerie Rzepka – a Polish-Canadian and RNAO member – to questions about CMAT and the ongoing mission to Poland and Ukraine.
CMAT gets ready to head to Poland and Ukraine – how you can help their urgent appeal
2022-03-03 – Canadian Medical Assistance Teams’ Executive Director Valerie Rzepka explained why providing health and medical help is extremely important for countries facing conflicts or refugee crises. The charity has spoken about its work to provide vital medical and healthcare support for the Ukrainian people following the invasion of their country by Russia – and how Canadians can help.
CMAT, which is made up of volunteer health professionals from across Canada, has responded to major global disasters for the past 15 years. The team is preparing to deploy to the Polish border with all-important medical supplies and skilled healthcare providers. It is looking to help the hundreds of thousands of people who have fled Ukraine since Vladimir Putin launched a brutal attack on the country.
The team also hopes to potentially gain entry to Ukraine to be able to provide medical support to those who have yet to cross the border. Today the charity launched an emergency appeal for Ukraine and gave thanks for the generosity of Canadians who have already come forward to offer funds, while also explaining why its work was important.
What is CMAT doing to help the Ukrainian people?
CMAT will shortly have two members of staff on the Polish border looking at the problems the authorities there are going to be facing as huge numbers of people enter the country from Ukraine. At the same time it has partnered with the Registered Nurses’ Association of Ontario to launch an emergency appeal to raise funds to provide emergency healthcare, and recruit additional health care volunteers. The charity says the situation in Ukraine and for those who have fled is desperate, with freezing temperatures at night and the World Health Organization (WHO) reports a serious shortage of oxygen in the embattled country.
CMAT Executive Director Valerie Rzepka said: “Poland is currently taking around 100,000 people a day across the border, which is just an enormous number. “At the moment the local health system is able to absorb these people but very quickly they will get overwhelmed.
“The usual pattern in conflicts is that the first wave of people who get out are often pretty well resourced, might have relatives or friends, and will disappear into the population, but the following waves of people are much more desperate and will have fewer resources, if any. The Polish state will have to deal with this and no doubt they will be requiring assistance.”
Once the response to help refugees has been started, Valerie said CMAT may look to cross the border into Western Ukraine to help people still living there.
What are the challenges facing the charity?
Valerie described how difficult CMAT’s work over the coming days and weeks providing vital health assistance will be. She said: “There are a whole load of challenges around getting into Western Ukraine, but there are more needs on that side of the border. The nearest big city to the border is Lviv and that has swelled in size. People have left to go to Western Ukraine from Eastern Ukraine and from Kyiv and the central area. Large numbers of people are clustering in Lviv. Some are trying to get out, others are staying where they are.
“That is putting enormous pressure on medical and all other public services in Lviv. There will be a need for intervention there, the only question is how. The NGO we partner with in Poland has managed to cross over and establish a corridor, so we will try to use that to try and access Western Ukraine.
Why is it important to provide healthcare and support the emergency appeal?
Since the Ukraine conflict began a whole host of fundraisers and material donation drives to help the Ukrainian people have sprung up, with many focusing on immediate needs for refugees such as food, water, warm clothing, shelter and sanitary products.
Valerie said healthcare sometimes gets overlooked in the minds of the general public but said it was really important to support CMAT’s efforts to get medical equipment and supplies to where they are needed. She also said there is a real need to get vaccinations to Ukraine to help prevent disease spreading as people find themselves living in crowded and poor conditions. She said: “Whenever you’ve got mass population movements healthcare is absolutely essential. I would say it’s the third most important thing after shelter and water. Underlying health conditions are exacerbated by stress, difficulties in living and poor food or inadequate shelter or warmth. Whether it’s running out of blood pressure pills or not having insulin for your child with diabetes, without these things substantial parts of the population will be in real trouble. Vaccinations are really important too, to stop outbreaks of disease in densely packed refugee conditions. This is particularly important as we are not yet out of the COVID-19 pandemic.”
“We have the capacity to provide primary health care, and emergency stabilization.
Valerie said the needs of people living in Eastern Ukraine are greater still but there are major safety questions around deployments there.
She also said it was clear that the full situation will not be apparent for some days yet and it is equally obvious the conflict and the humanitarian needs it generates are not going to be over quickly.
What has CMAT made of Canada’s response to Ukraine so far?
“Embracing our deep historical ties, and in many cases our roots in both Ukraine and Poland, Canadians have stepped up and have shown considerable sympathy for the Ukrainian people and have expressed a desire to help through their immense generosity,” said Valerie. “It makes me proud to be Canadian, and especially Polish-Canadian.”
You can make a tax deductible donation to the CMAT emergency appeal on CanadaHelps here: https://www.canadahelps.org/en/dn/70689
Tax-deductible donations can also be made by Interac e-transfer or PayPal to: email@example.com
Ontario’s decision to drop mask mandate puts politics ahead of science, risking gains made
Toronto, March 9, 2022. The Registered Nurses’ Association of Ontario (RNAO) says the government’s decision to drop the province’s mandatory mask mandate in most indoors settings is ill-conceived and puts politics ahead of science. And, so is dropping vaccine mandates in long-term care homes.
“It’s premature and runs the risk of undoing the gains made to contain the spread of COVID-19,” says RNAO CEO Dr. Doris Grinspun, adding “in addition to vaccination, the mask mandates are the most important defenses against the virus. Ontarians have grown accustomed to wearing masks, considering it essential to keep them and their loved ones safe.”
Less than a week ago, the province’s chief medical officer of health Dr. Kieran Moore admitted there may still be more than 20,000 new COVID-19 cases per day during his weekly press conference. At that time, he emphasized that masks “are protective” and that they “decrease your personal risk.” Grinspun says the province’s decision flies in the face of evidence, and that there isn’t enough data to support an end to masking.
While the province’s vaccination campaign has been largely successful, many in Ontario are still not fully vaccinated, including protection from a third dose. Moreover, “children under the age of five don’t qualify to be vaccinated, and the vaccination rate for those aged 5-11 remains stubbornly low with only 30 per cent having had the two doses recommended for their protection,” Grinspun says, adding that “dropping the requirement to wear masks in schools is particularly alarming given the ongoing lack of proper ventilation systems in schools.”
Further, Grinspun says “leaving the decision to wear a mask up to parents and children is very problematic in a school setting. Children heavily influenced by their peers may not have the tools to demonstrate the ‘kindness and compassion’ the government seems to be relying on from Ontarians at this time. And, telling people it is a matter of ‘choice’ leaves children who continue wearing a mask at school open to taunts and harassment from other children.”
RNAO says Wednesday’s announcement is equally troubling given that testing capacity still isn’t where it needs to be to ensure the province has an accurate measure of community spread. “Without concrete data on the number of new cases, Ontario opens itself up to a surge in cases and even more strain on our already overburdened hospital system,” says Grinspun. “Many Ontarians have had their diagnostic procedures and surgeries cancelled due to an overwhelmed health system. They run the risk of having their health further compromised as they wait for backlogs to clear and without a mandatory mask mandate in place.”
“As the nursing association that speaks out for nursing and health, we are deeply disappointed with Wednesday’s announcement. The province has relinquished its responsibility to protect people from this virus. That’s why we urge all Ontarians to continue wearing masks,” says RNAO President Morgan Hoffarth.
RNAO is equally alarmed with the decision to lift vaccine mandates in long-term care homes. “As of March 14, homes will no longer be required to have a mandatory vaccination policy for staff, essential caregivers and other visitors. A critical safety valve to protect residents is being removed,” says Hoffarth.
“All these public health measures were designed to save lives, protect the most vulnerable and take a responsible approach to virus containment. Without them, we could face a fifth wave of the virus. The government is leaving Ontarians to assess their own risk as Dr. Moore himself said. That suggests the province has lost interest in containing COVID-19 and has given up the fight,” says Hoffarth.
RNAO applauds restaurants and stores that have decided to keep the vaccine certificate system in place to protect their patrons and staff – even though the government announced it was no longer necessary as of March 1. Hoffarth says “requiring proof of vaccination is an example of continued vigilance and these businesses are doing the right thing to keep us all safe.”
Persisting with masks after vaccination has major economic, health benefits, Lancet study says
Face mask use in public indoor spaces for at least 2 weeks after achieving 70% vaccination coverage reduces hospitalisation and deaths, the study says.
New Delhi: With many countries ditching mask mandates, a modelling study published in The Lancet Public Health Tuesday said that continuing with masks in public indoor spaces and on public transportation for at least two weeks after achieving 70 per cent population-level vaccination coverage comes with economic and health benefits.
“Our study provides strong support for maintaining face mask use until and a short time after achieving various final vaccination coverage levels, given that maintaining face mask use can be not just cost-effective, but even cost saving,” said the paper by researchers from City University of New York, Baylor College of Medicine, US, among others.
“The emergence of the omicron variant and the prospect of future variants that might be more transmissible and reduce vaccine effectiveness only increases the value of face masks,” the researchers added.
India has decided to continue with the mask mandate even as the third wave is clearly on the wane in the country. Currently about 60 per cent Indians are fully vaccinated.
“Our findings emphasise that vaccination alone is not enough to control the pandemic and that overlapping layers of protective measures are needed to limit economic impacts and deaths. The newly released recommendations from CDC (Centers for Disease Control and Prevention) come at a time when many places in the USA are also beginning to consider easing mask requirements, and the choice to wear a mask will come down to individual decisions or decisions of private businesses,” senior author Bruce Y. Lee, of the CUNY Graduate School of Public Health and Health Policy, US, said on the study.
“Our model represents the US population, but the breadth and scale of the simulated scenarios mean the results are also applicable to other countries,” he added.
Masks will remain an important tool
The study emphasised that going forward, masks will remain an important non-pharmaceutical intervention even as newer and possibly more infectious Covid variants emerge and vaccine immunity wanes over the long run.
The authors developed a computational model representing the spread and impact of Covid-19 among more than 327 million people in the US. They simulated the use of maintaining face mask use before and after achieving different vaccination coverage levels under a variety of circumstances.
Scenarios varied the final population Covid-19 vaccination levels and the date these targets were reached, as well as levels of face mask use and the date face mask use ended.
“The results of this study re-emphasise that vaccination alone is not enough to control the pandemic and prevent deaths and suffering, as well as the importance of multilayered interventions. As has been described previously, each available intervention has different limitations,” the researchers wrote.
“Combining several layers of interventions can not only cover up these gaps but also further enhance each layer. Our study shows that face mask use can be cost-effective and, in many cases, cost saving, meaning that face mask use would pay for itself. This finding provides strong support for governments, third-party payers, and other organisations to provide face masks to the general public,” they said.
“Moreover, our study showed face mask use should not end as soon as certain amounts of vaccination coverage are achieved, even if these coverages exceed herd-immunity thresholds,” the researchers added.
Peter Hotez of the National School of Tropical Medicine at Baylor College of Medicine, and co-author of the study, said: “Our findings offer some light at the end of the tunnel, suggesting that face mask use doesn’t have to continue forever, but that it remains an important tool to stop the spread of COVID-19 as we enter the next phase of the pandemic.”
ACTION ALERTS AND MUST JOIN EVENTS – OPEN TO ALL
#IENaction: letter and social media campaign
In the midst of Ontario’s nursing crisis, thousands of internationally educated nurses (IEN) remain unable to practise while their applications to the College of Nurses of Ontario (CNO) languish, often for years.
In a letter, RNAO has called on the CNO to immediately address the backlog of more than 20,000 IEN applications from nurses eager to join Ontario’s workforce at a time of dire need. RNAO has long urged the CNO to adopt a more streamlined approach to process these applications.
As part of its advocacy on fast-tracking the IEN application process, RNAO is launching a social media campaign. RNAO invites IENs to send RNAO a picture with a sign telling us your country of origin, if you practiced there as an RN, RPN or NP, and how long you've been waiting for your nursing credentials to be validated in Ontario. Watch RNAO's video for more information.
COVID-19 Webinar Series - Ontario is opening up again: What is most important now?
March 14, 2022, 2- 4 p.m. ET
During this month’s COVID-19 webinar, we will do a “pulse check” with participants about the issues on their minds as the province opens up and public health measures are lifted. What is going well? What concerns do you have for your workplace, your families and communities?
We will also take time during the webinar to update you on RNAO initiatives that address failings and inequities exposed during the pandemic, for example, the nursing crisis, systemic neglect of seniors, burnout among nurses and systemic racism. We will walk you through RNAO’s provincial election platform, which you can use to advocate for a just recovery from COVID-19 and make informed decisions about how to vote in the upcoming provincial election.
April 11, 2022, 2- 4 p.m. ET
Details coming soon.
Feb. 14, 2022, 2 - 4 p.m. ET
Watch the webinar here.
Topic: How internationally educated nurses can help solve the nursing crisis: A panel discussion and stories from IENs
Over 20,000 internationally educated nurses (IEN) are eager to be registered in Ontario to help fix the nursing crisis exacerbated by COVID-19.
Our panel discussed the following topics:
- the lived experiences of IENs who are facing an arduous process to meet registration requirements and practice as registered nurses in Ontario
- overview of the various roadblocks to registration in Ontario
- why temporary initiatives such as the Long-Term Care Staffing Pool Program are unhelpful and short-sighted
- actions RNAO is taking to expedite the path to registration in Ontario
Other archived webinars can be found here.
NP LTC Council webinar: Assessment Tools in LTC
Mar 17, 2022, 12:00pm - 1:00pm
Our nurse practitioner (NP) long-term care (LTC) council webinar will be held on March 17, 2022. This is our regular monthly NP LTC Council that is an important forum for NPs working in LTC to discuss clinical, operational, and policy-related issues in LTC, build networks, exchange knowledge, and inform RNAO’s advocacy work related to NPs and the LTC sector.
NP colleagues working in LTC are invited to join a discussion about assessment tools in LTC: cognitive tools, tools embedded in RAI - Point Click Care and more.
- to gain increased understanding of assessment tools in LTC
- to discuss assessments tools used in different setting and difficulties in using these tools
Presenter: Wendy Dunn, NP
Strategies For Teams Who Lead Change
Mar 22, 2022, 11:00am - 11:45am
Many change initiatives are led by a team of committed champions or change agents.
In this presentation, we will describe the key components of an effective change or implementation team including:
- shared leadership
- the ability to work together and collaborate
- the engagement of staff and other stakeholders
- the management of risk associated with the change
Content and practical resources from the Leading Change Toolkit™ will be highlighted. Examples of change teams from across health sectors will also be included.
During this presentation, participants will learn how to:
- be strategic and recruit individuals for the change team
- define roles and responsibilities of the change team that reflect shared or horizontal leadership
- apply elements of social movement action (such as the urgent need for change, framing and shared purpose) to engage colleagues and others in the change
- develop trust within and beyond the change team to navigate risks associated with the change
- manage common problems faced by change teams with suggested strategies for resolution
Katherine Wallace, RN, MHS, RNAO senior manager, implementation science, project lead – Leading Change Toolkit™
Related links: Core leadership structures
NP Insider: Nurse practitioners as Clinical Behavioural Response Specialists
Mar 22, 2022, 12:00pm - 1:00pm
The nurse practitioner (NP) Insider is a Nurse Practitioner Interest Group (NPIG) regular webinar exclusive to members of the NPIG. This particular event will highlight the unique role of nurse practitioners working with Behavioral Supports Ontario (BSO) as well as demonstrate how NPs can refer to BSO and the benefits this will have for their patients.
Many NPs in community practices may not be aware of the unique services provided by BSO, nor how and when to involve them in the care of patients. BSO provides consultative services to support older adults in Ontario with, or at risk of, responsive behaviours/personal expressions associated with dementia, complex mental health, substance use and/or other neurological conditions. They also provide support to family care partners and health-care providers across sectors.
NPs working with BSO have a unique role. They are considered clinical behavioural response specialists (CBRS). However, unlike other CBRS team members, NPs can work in their full scope to provide an even more comprehensive assessment (including full Lab and DI work up) as well as medication reviews and tailored comprehensive interventions. Their knowledge and expertise is well respected and not confined by a medical model of care.
The NPs with BSO also enhance and encourage the collaboration of services between the BSO team (which includes care of the elderly physicians, psychiatrists, CBRS, psychogeriatric resource consultants (PRC) and family support services) and the community partners providing services for the client and their family.
During this presentation, participants will:
- gain a better understanding of the unique role of the nurse practitioner with North East Behavioural Supports Ontario
- understand what responsive behaviours/personal expressions are and the comprehensive person-centred approach BSO uses to understand them
- be informed on how to access NEBSO as a consultative service with OTN and a referral service to support clients
- understand how to locate BSO regional services across Ontario
Shannon Clausen, NP-PHC MACP, NPIG co-chair
Shannon Cadieux, NP-PHC BScN, NP with North East Behavioral Supports Ontario - North Bay Region
Stephanie Jarvis, NP–Adult, BScN, MN, GNC (c), NP with North East Behavioral Supports Ontario - East Algoma Region
Best Practice Champions Virtual Workshop Session 1
Mar 24, 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.
For further details and registration go here.
Register for the NP Institute happening April 21
Calling all NPs, NP students and RNs aspiring to be NPs: Join RNAO on Thursday, April 21 from 9 a.m. – 4:30 p.m. ET for the NP Virtual Institute.
The institute will:
- inspire NP connections to foster resilience and self compassion
- ignite your passion for clinical excellence
- build your leadership and advocacy skills to drive meaningful practice and policy enhancements
- spotlight unique NP practice roles from a case-based perspective
Save your spot: register for the NP Virtual Institute now.
Call for abstracts
Do you have research or a quality improvement project you would like to have featured at the NP Virtual Institute event? Apply today for the chance to present your findings.
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 #633 for March 10, the case count was as follows: 1,119,564 total, +2,125 change from yesterday; 12,638 deaths, +14 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 <firstname.lastname@example.org> and copy to < email@example.com>. 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
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We have posted earlier ones in my blog here. I invite you to look.