May 10, 2020 COVID-19 report

Dear Colleagues:  Welcome to my Sunday, May 10, COVID-19 report – now in the fourth month of COVID-19 in Ontario. For the many resources RNAO offers on COVID-19, visit the COVID-19 Portal. In particular, VIANurse is your go-to page if you need to augment your nursing and personal support worker human resources. You can refer to earlier update reports here, including thematic pieces in my blog. Feel free to share this report or these links with anyone interested – they are public.

Two happy events bring light to our lives despite the challenging circumstances – let’s go ahead with the celebrations!

The first is today, Mother’s Day. As I tweeted, COVID-19 cannot steal from us the joyful and important moments in our lives. To the mothers, grandmothers, aunts and friends who nurture and help raise the next generation: THANK YOU for what you do day in and day out!

The second, happy event starting tomorrow, is Nursing Week. To each and all nurses, anywhere you work: Thank you for nursing with knowledge, compassion and courage. All of us at RNAO send your way a very special thank you for the extraordinary work you did, are doing and will continue to do throughout these unsettling COVID-19 times. Check RNAO’s Nursing Week portal with all the details about the many important events we have planned for you, and where you can register for each one of the activities. Join all from anywhere in the world, free-of-charge, through Zoom. We look forward to nurses and others participating.

A story of hope, ingenuity, support and genuine care for an LTC resident

We are grateful for this wonderful story shared by RNAO member Samantha MacNeill, RN, BScN. She writes a few days ago:

I am a nurse advisor redeployed to provide clinical support and guidance to Peel Region’s five Long-Term Care (LTC) facilities. Over the course of my few months working with the LTC teams I have heard stories of hope, ingenuity, support and genuine care for their residents.

None of these stories compare to the experience that was shared this morning. The administrator from Sheridan Villa, Marianne Klein, shared an experience of one of their beloved residents who was a retired RCMP officer and sadly passed away last night. Marianne, who is also an RN, shared that the resident was struggling yesterday and they knew that he was close to the end of his life. Mary Connell, our Dementia Care Advisor and also an RN, asked our volunteers to knit some red hearts so that one could be given to the resident and one to the resident’s son.

Due to the infection prevention and control measures that have to be observed for COVID-19, the resident would not be able to receive the honour guard and proper funeral that he deserved. Mary went to extraordinary efforts to arrange for a send-off for the resident to ensure his departure from his home was dignified and respectful. She contacted Peel Police, Mississauga Fire and Emergency Services and Peel Regional Paramedic Services and requested them to drive by the home, with lights and sirens on, as a form of an honour guard. She also had a Canadian flag delivered to the home, to drape the resident with.

In the middle of the night, last night, there were some issues with getting the resident ready for the funeral home. A call came into Marianne, who got out of bed, contacted her colleague Sara Kaur, RN and they both went into the Home to prepare the resident for the funeral home. Upon arrival at the Home, Marianne also contacted the Medical Director of the Home who is also the resident’s family doctor. He attended the Home in the middle of the night to support Marianne and Sara. The resident left the Home, through the front doors, with the red heart on the left side of his chest and draped with a Canadian flag.

The team’s main priority is to strive to provide the best possible care to all residents. They wanted to ensure the utmost respect and dignity for their resident.

This team deserves to be acknowledged for their dedication to their residents. We are hearing about so many experiences of lack of regard for LTC residents and staff that I felt compelled to share this amazing story of respect, teamwork and dedication. This is one memory that I will forever hold close to me as a true testament of the human spirit amidst a terrible crisis.

Thank you for your consideration of this request to recognize my colleagues by sharing this experience. I also have a video of the EMS parade, and staff holding a picture of the retired RCMP officer in his uniform if you would like me to share.

RNAO response: Thanks Samantha so very much for the beautiful and meaningful account of human caring of a resident at Sheridan Villa. Please send me the video of the parade, so we can share. Thanks hugely and please send my gratitude to Marianne Klein, Mary Connell, Sara Kaur, the Medical Director, EMS parade, retired RCMP Officer, and all others involved. Warmest regards and thanks again and again for sharing with us this superb and highest expression of outstanding care! Doris

 Your messages: Voices and responses

Each we receive numerous emails and phone calls. Each day we also welcome new readers to this daily report: Thank you deeply for the work you do always and especially during this public health crisis, and also for keeping us well informed. You can see previous reports at RNAO updates and resources on COVID-19 for members and other health professionals. Feel free to share these updates with other health professionals and other organizations both at home and abroad. RNAO media hits and releases on the pandemic can be found here. Daily Situational Reports from Ontario's MOH EOC can be found here. Many of the articles you see here are posted in my blog, where you can catch up with earlier issues. The COVID-19 Portal is here.

RNAO member Janet MacMillan, RN, writes: “I would like to inquire when, according to the government’s plan to reopen the economy, nurses in Independent Practice will be able to resume self-employment. What guidelines will be put in place for PPE requirements in a home based clinic where the nurse practices in very close proximity to the client? What will be the guidelines for admission of the client into a home based clinic? What will be the requirements for disinfection of the space? What will be the requirements to rid of waste? Although when we can re-open is unknown, I would like to source PPE and prepare; however, the stages set out by the government lack enough information.”

RNAO response: Thanks for the question, Janet. We will inquire and be in contact with you.  Doris

Together we can do it

Today is day #50 of RNAO’s #TogetherWeCanDoIt campaign and it seems I myself lost track of the days… RNAO began this campaign on March 19 to cheer up health care workers and others in essential services. The campaign also allows us to suffocate the anguish we all feel over lost lives. Readers tell me they really like my pics, so here are the ones for last evening for noise that is becoming louder and louder in streets, workplaces and social media to #cheer4healthworkers! Please remember to join-in this community building moment every evening at 7:30pm local time - until we defeat COVID-19! And we need you to always post tweets from your communities, your children, workplaces art and memory places - with your messages, cheers here, pots & pans, songs and other expressions of solidarity, reminders and call for help - Because: #TogetherWeCanDoIt.

MOH EOC Situational Report #105 here for Saturday, May 9

Situation:    

Case count as of 8:00 a.m. May 9, 2020
Area	Case count	Change from yesterday	Deaths	Change from yesterday
Worldwide total	4,034,681	+99,128	276,693	+5,525
Europe	1,596,698	+30,547	150,915	+2,196
China	82,887	+01	4,633	0
Middle East	356,898	+8,315	11,213	+80
Asia & Oceania	209,876	+8,134	5,855	+175
Africa	59,530	+3,948	2,171	+86
Latin America and Caribbean	340,187	+17,379	18,720	+1,152
North America	1,388,605	+30,804	83,186	+1,836
United States	1,322,171	+29,292	78,617	+1,675
Canada	66,434	+1,512	4,569	+161

 

• 346 new cases were reported today in Ontario, bringing the cumulative total to 19,944 (this includes 14,383 resolved cases and 1,599 deaths).
• In Ontario, a total of 416,376 tests have been completed, with tests performed at Public Health Ontario Laboratories and non-Public Health Laboratories. There are currently 15,307 tests under investigation.
• 1,016 patients are currently hospitalized with COVID-19; 203 are in ICU; and 158 are in ICU on a ventilator. 

EOC report #105 for May 9 informs of the following actions taken:

• The Ontario government announced today that it is opening provincial parks and conservation reserves for limited day-use access. The first areas will open on Monday May 11, 2020, with the remaining areas opening on Friday May 15, 2020. At this time, recreational activities will be limited to walking, hiking, biking and birdwatching. Day visitors will also be able to access all parks and conservation reserves for free until the end of the month. 
• The Ontario government has approved an emergency order that would enable available school board employees to be voluntarily redeployed to congregate care settings during the COVID-19 pandemic, including hospitals, long-term care homes, retirement homes, and women's shelters. Many of these congregate care settings are in need of staff such as custodial and maintenance workers.
• A new Guidance document for Mental Health and Addictions Service Providers in the Community is here.

EOC report #104 for May 8 informs of the following actions taken:

• Updated guidance for Home and Community Care has been posted on the ministry’s website.
• The Guidance for Emergency Childcare Centers was updated and is here.

EOC report #103 for May 7 informs of the following actions taken:

• Guidance for Hospice Care has now been posted on the ministry’s website.
• The Ontario government has developed a comprehensive framework to help hospitals assess their readiness and begin planning for the gradual resumption of scheduled surgeries and procedures, while maintaining capacity to respond to COVID-19. Timelines will vary from hospital to hospital and be conditional on approval by regional oversight tables involved with planning and coordinating Ontario's response to COVID-19.
• The Screening Tool for long-term care settings has been updated and is posted on the ministry’s website.
• The Command Table met yesterday; a summary of the discussion is here.

RNAO’s ViaNurse Program             

RNAO’s VIANurse program, launched on March 13, has already registered 7,389 RNs for virtual and clinical care, 1,026 critical care RNs (who have experience and continued competency in the provision of critical care), and 287 NPs. RNAO is continuously responding to requests from health organizations. So far, we have served 300 organizations, of which 229 are nursing homes and retirement residences. RNAO has also offered the government to identify NPs and RNs who can help manage LTC organizations that are in crisis, and assist with urgent interventions where severe outbreaks are ongoing. For any nursing HHR needs go to RNAO’s VIANurse program

** Seeking RNs, NPs and nursing graduates ready to work in nursing homes in active outbreak

RNAO launched on Friday, April 24th a fourth survey for RNs, NPs and nursing graduates urging them to register for work in nursing homes that are on an active outbreak. The availability of these colleagues is already fastening even more the matching of nursing staff to homes in dire need. For example, between April 20th and May 8, we deployed RNs, NPs and/or PSWs to 126 organizations, including 116 nursing homes, with some of these organizations having been served multiple times. On May 8, on a matter of hours from request we responded to the staffing needs of 7 additional organizations. Also important to know is that VIANurse has no backlog requests, and we also respond after hours and on weekends – as we understand the urgency of each request. Please retweet the following urgent tweet to have many more RN, NP and new graduates enrolled.  

For those of you ready to work in a nursing home with an outbreak – we need you –please CLICK HERE and complete our survey ASAP. We need your response as soon as possible given the rapidly evolving situation, and the urgent need in nursing homes across the province. The government has now improved the compensation, recognizing your critical role – see Ontario’s press release here.

So far we have got 378 responses: 278 RNs and 39 NPs and 50 nursing students – ready to go to nursing homes in an active outbreak - plus, 11 RNs who can do non-clinical work. These colleagues are being deployed as we speak, including over the weekend. 

Staying in touch        

Please continue to keep in touch and share questions and/or challenges of any kind, and especially shortages of PPE. Send these to me at dgrinspun@rnao.ca. We are responding daily and are continuously solving your challenges. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!

Thank you deeply colleagues in the front lines; in administrative roles; in all labour, professionals and sector associations, and in governments in Ontario, in Canada and around the world. We are here with you in solidarity. These are stressful and exhausting times; the only silver lining is coming together and working as one people – for the good of all!

Together, we must redouble our efforts to tackle COVID-19 with the best tools at hand: full, accurate and transparent information, calmness, determination and swift actions. 

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

 

RECENT RNAO POLICY CORNER ITEMS:

7 May    - Counting the missing deaths: Tracking the toll of the coronavirus outbreak – go here.

5 May    - Life on the front lines of the pandemic: Profile of RNAO member NP Daria Gefrerer – go here.

5 May    - Addressing differential access to virtual care due to technology inequities – go here.

3 May    - Being person-and-family-centred during COVID-19 – go here.

1 May    - Migrant agricultural workers and the COVID-19 crisis – go here.

30 April - COVID-19 pandemic in provincial institutions and correctional centres – go here.

28 April - Supporting First Nation Communities during COVID-19 – go here.

27 April - Responses to COVID-19 for persons experiencing homelessness in Toronto: An update – go here.

25 April - Lessons learned through a COVID-19 nursing home outbreak – go here.

25 April - Letter from a retired RN to Premier Ford: The problems with LTC were evident long before COVID – go here.

23 April - Working with seniors in long-term care requires specialized knowledge – go here.

22 April - Shaking the stigma: We need a proactive COVID-19 response for mental health and addiction – go here.

21 April - We Require Expanded and Accessible COVID-19 Data in Ontario – go here.

20 April - Can Loss of Smell and Taste Help Screen for COVID-19? – go here.

18 April - COVID, Trump and the World Health Organization – go here.

16 April - A Home Based Model To Confront COVID-19 – The Case Of The Balearic Islands – go here.

15 April - COVID-19 and the Challenges in Homecare – go here.

14 April - Reprocessing Of N95 – An Update – go here.

14 April - A New COVID-19 Facility For Persons Experiencing Homelessness In Toronto – go here. 

13 April - Practical Tips for Safe Use of Masks – go here.

10 April - Ontario’s Tragedy in Long Term Care Homes and Retirement Homes – go here.

10 April - RNAO Action – Supporting Long-Term Care – go here.

10 April - Update For Nursing Students – NCLEX Exam – go here.

9 April - Celebrating Passover, Good Friday, Holy Saturday, Easter Sunday and the start of Ramadan during a pandemic – go here.

9 April - Guidance on use of N95 mask – go here.

7 April - Sentinel surveillance and on-site testing in the homeless service sector – go here.

7 April - Reprocessing of n95 – safe? – go here.

5 April - We must change the way we do testing and case definition – go here.

5 April - Ringing the alarm bells on critical care beds – go here.

4 April - COVID-19, stay at home and domestic violence – go here.

We have posted earlier ones in my blog here. Please go and take a look.

RNAO’S policy recommendations for addressing the COVID-19 crisis: We presented 17 recommendations for government, last revised on April 2. Some of these, such as #15, continue to be of grave concern to RNAO. Read them here.

 

Information Resources

Public Health Ontario maintains an excellent resource site on materials on COVID-19. This is an essential resource for Ontario health providers. 

Ontario’s health provider website is updated regularly with useful resources here.

Ontario’s public website on the COVID-19 is there to inform the general public – encourage your family and friends to access this public website. The WHO has provided an excellent link for you to share with members of the public here.

Please promote the use of Ontario’s COVID-19 self-assessment tool: It also has a guide where to seek care, if necessary. Its use will provide the province with real-time data on the number and geography of users who are told to seek care, self-isolate or to monitor for symptoms. Data will inform Ontario's ongoing response to keep individuals and families safe.

Health Canada's website provides the best information capturing all of Canada. It contains an outbreak update, Canada's response to the virus, travel advice, symptoms and treatment, and resources for health professionals.

The World Health Organization plays a central role in addressing the COVID-19 pandemic. See here and here.

You can find up-to-date global numbers in Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.