March 28 2022 COVID-19 report
Dear Colleagues: Welcome to my Monday, March 28 blog during this twenty sixth 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.
Dear colleagues,
In response to the catastrophic humanitarian crisis in Ukraine, RNAO has partnered for the last month with Canadian Medical Assistance Teams (CMAT) to send volunteer registered nurses (RN) and nurse practitioners (NP) to the border between Poland and Ukraine. More than two million refugees have arrived in Poland from Ukraine, and they need our help. You can read about the mission in a CBC news article here and see an interview with CMAT Executive Director and RNAO member Valerie Rzepka here.
If you would like to volunteer, please apply directly through CMAT by visiting their volunteer page.
Can’t go but want to help? CMAT gratefully accepts tax-deductible donations to support their humanitarian work. You can support a specific volunteer to help them with their travel expenses or make a general donation. You can donate directly online. If you are donating in honour of a specific CMAT volunteer, be sure to enter their name at the bottom of the donation form.
This week we share: 1) Media release: RNAO applauds federal Liberal/NDP partnership to improve health and wellbeing of Canadians; 2) Omicron BA.2 subvariant becoming dominant, representing potential risk; and 3) RNAO sends letter to Ontario political parties on systemic racism against Black nurses.
Media release: RNAO applauds federal Liberal/NDP partnership to improve health and wellbeing of Canadians
Toronto, March 23, 2022. A federal pledge to put aside partisan differences and work together for the benefit of Canadians is drawing praise from the Registered Nurses’ Association of Ontario (RNAO).
This week, Prime Minister Justin Trudeau and NDP leader Jagmeet Singh reached a historic agreement that would see the NDP support the minority Liberal government on caucus votes in exchange for movement on a number of NDP policy priorities, most notably a national dental care plan and progress on a national pharmacare plan.
“We have witnessed how politics can easily divide people. Canada is at an important crossroads in its history and this agreement represents a way forward to improve the health and wellbeing of Canadians. While there are many details still to be worked out, this is something that we should champion,” says RNAO’s CEO Dr. Doris Grinspun, adding that “people expect their elected representatives to collaborate and implement healthy public policies.”
RNAO says a three-year plan to provide dental care is especially welcome and is a longstanding recommendation of the association. “Oral care is health care. Too many Canadians do not have access to dental coverage and this agreement paves the way to help millions of people who have been denied or do not have access to dental care, simply because they don’t have the means to pay for it,” says Grinspun.
Nurses are also pleased to see a commitment on progress towards a national pharmacare program. The country’s Medicare system is one of the country’s greatest achievements as championed by Tommy Douglas. However, 30 per cent of the country’s total health expenditures remain excluded from coverage. “Access to medicine is a human right. Every developed country around the world with universal health-care coverage includes pharmacare. No Canadian, especially in these precarious economic times, should have to choose between getting a prescription filled and putting food on the table or paying the rent,” says Grinspun. “We urge both parties to ensure such a plan is fulsome so it meets the needs of Canadians who have to make choices they shouldn’t have to make.”
In addition to expanding Medicare, RNAO is heartened by the parties’ commitment to table a Safe Long-Term Care Act and to work with the provinces and territories to deliver better health outcomes for Canadians. Although the agreement is short on specifics, the NDP and Liberals say this would include more primary care nurses and physicians, mental health support, and investments to support older Canadians who wish to remain in their homes longer.
RNAO’s President Morgan Hoffarth says “nurses will take comfort in this commitment because COVID-19 has taken a tremendous toll on nurses right across the country. Ontario was already facing a deficit of 22,000 registered nurses before the pandemic. That led to critical shortages two years later and compromised care,” adds Hoffarth who says “focused attention and collaboration among provincial, territorial and federal governments is needed to solve the health human resource crisis.”
RNAO is also pleased the agreement between the NDP and the governing Liberals addresses critical social and environmental determinants of health. The extension of the Rapid Housing Initiative and the promise of significant investments in Indigenous housing are necessary responses to a housing crisis that affects urban, rural and remote communities across the country. “Increasing investments in affordable housing is essential. Housing is a fundamental determinant of health,” says Hoffarth. “We need to address the reality that across the country, more than 250,000 people have no place to call home and that puts them at great risk of illness and disease,” Hoffarth adds.
Responding effectively to the global climate emergency is also of great urgency and will require the parties to ensure that the benefits and burdens of greenhouse gas reduction measures fall equitably across Canadian society.
RNAO says the agreement raises expectations among Canadians that politicians can set aside their differences and work across party lines. “We applaud the prime minister and the leader of the NDP for coming together and demonstrating the courage and leadership this country needs. We urge the Liberal and NDP not to let this great opportunity for Canada slip away,” adds Hoffarth.
The agreement means the current Liberal minority government would remain in power until the next federal election set for 2025.
Omicron BA.2 subvariant becoming dominant, representing potential risk
“We are moving from a BA.1 wave to a BA.2 wave." This is an article by Elizabeth Payne published by the Ottawa Citizen on March 16. You can read the original article here.
The rise of the more-contagious Omicron subvariant in Canada could represent a threat to the elderly and others who are vulnerable, warns a leading expert on BA.2.
The concern comes as Ontario and other provinces are dropping pandemic restrictions and immunity from third doses of COVID-19 vaccine is waning for many of the most vulnerable. Ontario is offering fourth doses to long-term care and other vulnerable residents.
The BA.2 subvariant, which is behind record case counts and deaths in some parts of the world, is on its way to becoming dominant in Ontario and across Canada. As of this week, about 50 per cent of new COVID-19 cases in the country are BA.2, squeezing out the original Omicron subvariant, BA.1, said Sarah Otto, a professor of evolutionary virology and mathematical modelling at the University of British Columbia. While cases of BA.1 are dropping across Canada, BA.2 cases are increasing slightly or remaining steady.
“We are moving from a BA.1 wave to a BA.2 wave,” Otto said.
Canada should fare better than many countries from BA.2 because there is so much immunity from vaccines and Omicron infections, she said. Instead of a steep spike in new infections, as happened when Omicron arrived in December, Otto expects to see something more like a bump. Canada is fortunate BA.2 is arriving here relatively late after BA.1. People who were infected with BA.1 are unlikely to become infected with BA.2, she said.
While she doesn’t expect case counts to be as high as in the original Omicron wave, the arrival of BA.2 does represent a threat to those who are vulnerable and might have waning immunity, she said, and are more likely to get seriously sick if infected.
Research shows that, three months after receiving a booster dose, the chance of becoming hospitalized with an infection roughly doubles.
“That is what I am concerned about,” Otto said.
The timing of BA.2 coincides with what is likely waning immunity from vaccines for long-term care and other residents, who were among the first to receive booster doses.
While thousands of eligible Ontarians have now received fourth doses of vaccine, thousands more likely have waning immunity. In Ontario, more than 115,000 people have received fourth doses, according to the health ministry. In Ottawa, just over 10,000 people have received fourth doses.
There is also a sizeable percentage of the population that is still susceptible to Omicron infection as the highly contagious BA.2 becomes more widespread.
The rise of BA.2 also coincides with the dropping of pandemic restrictions. Provincial vaccine mandates were dropped this week. Many institutions, including hospitals and long-term care homes, say they plan to leave vaccination mandates in place.
Next week, when Ontario students return from March break, there will be no mask mandates in schools. The organization representing pediatric hospitals and health organizations has asked the province to keep mask mandates in place in schools for at least two weeks after the break to prevent a resurgence of cases in schools and the community. Others are calling for masks to remain in place until the end of the school year.
In a letter to Premier Doug Ford, a group of health leaders and experts says masks are critical tools to keep long-term care residents safe, as are mandatory vaccinations and continued rapid testing.
The group also called on the province to actively encourage vaccination and boosters for seniors, essential caregivers and staff in long-term care, noting that evidence is emerging that vaccine effectiveness against infection decreases over time.
Long-term care chains and other large homes, as well as long-term care homes run by the City of Ottawa, will continue to require vaccines and masks, but doing so is more difficult for smaller homes that don’t have the same legal resources, says the organization representing not-for-profit and municipal homes in the province.
“It is just such a vulnerable population, why wouldn’t you continue (the mandates)?” asked Grace Welch, co-chair of the Champlain Region Family Council Network.
Dr. Benoît Robert, chief medical officer at Perley Health and head of the association representing long-term care clinicians in Ontario, said vaccines and masks represented freedom for long-term care residents who had been isolated and had their lives disrupted during the last few years. Perley will continue to require vaccines for staff and masking for staff and visitors. It will also screen visitors.
“At this time, it is wise to continue with masking inside the long-term care home.”
Long-term care outbreaks spiked during the Omicron wave and have since dropped, but there are still outbreaks, including at a handful of Ottawa long-term care homes.
Given what is on the horizon with BA.2, Otto said she would like to see masking continue across the country.
“It is one thing we are doing that really helps reduce transmission.”
What we know about BA.2
1. It is different from BA.1, the original Omicron subvariant, in its genetic sequence, but it doesn’t appear to be able to evade immunity from BA.1. That means people who were infected with BA.1 are unlikely to be infected with BA.2. Up to one out of every fourth person in Ontario is estimated to have been infected with BA.1.
2. It spreads more easily than BA.1. Studies are ongoing to understand why.
3. It doesn’t appear to cause more severe disease than BA.1. Its more rapid spread, though, could result in high rates of hospitalization in places with low immunity from vaccines or prior infection.
4. Canada is in a fairly good spot when it comes to BA.2, according to Sarah Otto, a professor of evolutionary virology and mathematical modelling at the University of British Columbia, because it arrived after an intense BA.1 wave which built up immunity in addition to high vaccination rates.
5. About a dozen nations around the world are now seeing spikes in infections driven by BA.2. In places that had so-called Zero COVID policies, outbreaks are severe and rapid.
RNAO sends letter to Ontario political parties on anti-Black racism
RNAO sent on March 25 the following letter to the leaders of the Ontario political parties: Premier Doug Ford; Leader of the Official Opposition and Ontario NDP leader Andrew Horwath; Ontario Liberal Party leader Steven Del Duca; and Green Party leader Mike Schreiner.
Dear leader,
In response to the widespread systemic racism that exists within the nursing profession – and inspired by the activism and the courage of the Black Lives Matter movement – RNAO formed a Black Nurses Task Force (BNTF) in June 2020. It was formed to move beyond solidarity and interrupt complicity to promote transformational change. The mandate of the BNTF is to reduce anti-Black racism and discrimination within the nursing profession – its organizations, regulatory body, associations and the broader health system – targeted towards and experienced by Black nurses.
The BNTF propelled change from the day it began its work. The members, activism and activities of the BNTF have become a social force for change within and outside our profession. From the open recruitment process calling for expressions of interest, to the co-chairs’ thoughtful selection of 15 panelists with lived experience of anti-Black racism in various domains of practice, the task force is a tapestry of Black nursing excellence.
On Feb. 8, 2022, the task force released a ground-breaking report Acknowledging, Addressing and Tackling Anti-Black Racism and Discrimination Within the Nursing Profession. The report highlights the work of the BNTF across four pillars – education and awareness building, research, advocacy, partnership with allies and stakeholders. It outlines 19 specific recommendations and accompanying actions to dismantle anti-Black racism in nursing workplaces and academic settings. The report’s recommendations include:
- the need for urgent advocacy to address racism against Black nurses
- education and awareness building at individual, organizational and policy levels
- greater mentorship and support for Black nurses
- partnership with allies and stakeholders leading anti-Black racism initiatives
- equitable and fair human resources processes
The members of the task force – all Black nursing colleagues – have contributed to the content and the need for change. Certainly, it is not a new cause for them. They have lived in their skin and fought discrimination for all of their lives, and now they are creating a social movement that includes everyone. They are opening doors for people to become allies. The purpose is to challenge the injustices of the past, building for them – and by extension – a fair and better future for everyone.
RNAO is urging you to become an ally of Black nurses by incorporating the report’s recommendations into the Green party’s election platform. Ontarians look to you for leadership and guidance on such an important social and health-care issue, and at no time is the public more attentive to you than during an election campaign. RNAO’s executive and the co-chairs of our BNTF are eager to meet with you to discuss the BNTF report and explain our research and recommendations.
Racism is entrenched in the history of nursing and our health-care system, and continues to have a devastating impact on the lived experiences of both racialized nurses and patients. We look to you to be an ally to bring change.
With warmest regards,
Dr. Doris Grinspun, RN, MSN, PhD, LLD(hon), Dr(hc), FAAN, FCAN, O.ONT
Chief Executive Officer
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.
To learn more, join the social media campaign and stay updated on the issue, please read the media release and visit the official #IENaction webpage in RNAO’s COVID-19 portal.
A Person- and Family-Centred Care Virtual Community of Practice: Assessing Current Practices
Mar 29, 2022, 2:00pm - 3:00pm
The RNAO Long-Term Care Best Practices Program is offering a community of practice (CoP) exclusive to Ontario long-term care (LTC) homes to implement the Person-and Family-Centred Care (PFCC) best practice guideline (BPG) practice recommendations through a collaborative peer supported process.
For further details and registration, please go here.
Wisdom in Wound Care Webinar Series: Wound Dressings
Mar 30, 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.
For further details and registration, please go here.
Best Practice Champions Virtual Workshop - Session 2
Mar 31, 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, please go here.
RNAO-LAP webcast: Documentation in nursing practice
Mar 31, 2022, 5:30pm - 7:00pm
Documentation is an important part of your nursing practice. Join lawyer Rebecca Jones and Legal Assistance Program Administrator, Mara Haase, as they discuss legal issues related to documentation in nursing practice.
For further details and registration, please go here.
COVID-19 Webinar Series
Apr 11, 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:
April 11, 2022, 2- 4 p.m. ET
Details coming soon.
Additional date: May 9, 2022, 2 - 4 p.m. ET
Archived webinars can be seen here.
Best Practice Champions Virtual Workshop Session 1
Apr 19, 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.
For further details and registration, please 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
For more details, please visit the official event page. This event is free for RNAO members. If you are not a member, you can join here now.
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 #644 for March 25, the case count was as follows: 1,148,336 total, +2,761 change from yesterday; 12,388 deaths, +22 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
RECENT BLOG ITEMS:
11 Mar - RNAO commemorates the #NationalDayOfObservance – go here.
11 Mar - Persisting with masks after vaccination has major economic, health benefits, Lancet study says – go here.
11 Mar - Ontario’s decision to drop mask mandate puts politics ahead of science, risking gains made – go here.
11 Mar - CMAT gets ready to head to Poland and Ukraine – how you can help their urgent appeal – go here.
25 Feb - Solutions exist for Canada’s alt-right radicalization – go here.
25 Feb - Black and Indigenous protesters are treated differently than the ‘convoy’ because of Canada’s ongoing racism – go here.
25 Feb - RNAO releases its 2022 provincial election platform; calls on party leaders to prioritize Ontarians’ health – go here.
16 Feb - A better post-pandemic future means not giving in to COVID-19 now – go here.
16 Feb - Restoring community dialogue and resilience: The next COVID-19 emergency – go here.
16 Feb - Key public health measures needed to address catastrophic surgical backlog – go here.
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.