May 29 2021 COVID-19 report
Dear Colleagues: Welcome to our Saturday, May 29 report during this sixteenth 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. As always, feel free to share this report and links with anyone interested. Scroll down for information on an upcoming webinar.
COVID-19 VIANurse – Critical care nurses - As informed earlier, RNAO has activated VIANurse to augment nursing HR in critical care. If you are a critical care nurse and you are available, or if you are an employer needing critical care nurses, please go to the VIANurse page here. Employers: we still have hundreds of RNs with specialty in critical care available to work.
Actions & news to know
Reminder to answer our survey on nurses’ wellbeing: RNAO is working in partnership with researchers from the Rosemary Bryant AO Research Centre (RBRC) at the University of South Australia (UniSA) to deliver a Canada-wide survey of nurses on COVID-19 and wellbeing. We urge you to answer to this important survey! Please go here.
Take action on Bill 124 and sign the Action Alert. Add your voice to almost 4,000 others calling on Premier Ford to exempt health-care workers from Bill 124. We also join in the call to #RepealBill124.
Take action on global vaccine access: Sign an Action Alert calling on Prime Minister Trudeau to ensure global vaccine access.
Second doses: RNAO is glad that the government is heeding the call to accelerate the rollout of second doses. The government should engage, starting next week, in two parallel tracks for vaccinations. One is the continuation of the first dose for those 12 years and older – with priority given to hotspot zones. The second, full vaccination (second dose) should start for all persons 60+ – and not only 80+ as announced by the government. Ontario, starting next week, will have enough vaccines to move faster on both fronts. It is a matter of logistics and vaccinators, and with thousands of nurses in primary care and home care - plus 4,500 RN care coordinators available -- we can and must move faster. To help us push this agenda, add your voice here.
New CMOH: Good news today. Finally, after a year of asking for it, Ontario is replacing Dr. David Williams as Ontario’s Chief Medical Officer of Health. The new appointee, to be formally announced likely next week, is Dr. Kieran Moore currenty the medical officer of health for the KFL&A Public Health. Dr. Moore has been a stellar performer during the entire pandemic and will no doubt do a terrific job in this new post. Welcome and congrats Dr. Moore!
New cabinet secretary: The appointment of Michelle DiEmanuele as secretary of cabinet is terrific news. She will no doubt provide sound advice to the Premier, as well as lead much needed changes as head of Ontario Public Service (OPS). Congrats Michelle!
School reopening: Despite yesterday’s advice from the Science Table that schools can reopen safely on a regional basis, Many, including RNAO, say that’s wrong advice. There is a high price to pay if we get it wrong and the schools bring about a new wave of infection and a fourth lockdown in the summer. New variants, such as B.1.617, and other emerging variants, could potentially make vaccines less effective (see new variant from Vietnam). We should instead focus on fast-tracking full vaccination, maintaining public health measures and taking steps to end, once-and-for-all, the pandemic during the summer. In regards to schools, we should prepare a safe re-opening in September, with investments in ventilation, required renovations and full vaccination of all staff and children above 12. We should also invest in support for disadvantaged children, special education and mental health programs. In healthcare, investments in nursing health human resources for LTC and other sectors are essential. This is particularly true in hospitals and home care, so we can address the enormous backlog of procedures and surgeries.
We are all in shock at the news that the remains of 215 children were found buried at a former BC residential school. Every day we learn new things about the cultural and physical genocide of Indigenous Peoples throughout Canada’s long history. How many more atrocities will we learn about in the days to come? We join in the deep mourning of First Nation’s people, including the survivors among them.
In today’s report we share: (1) an invitation to RNAO’s Virtual AGM, June 24-26; (2) a resource with best new evidence about the COVID-19 response and (3) an article on how vaccination passports may help – but they have to be designed well.
RNAO’s Virtual AGM is just a few weeks away!
We are delighted to invite all RNAO members, other health professionals, and members of the public to our 96th Annual General Meeting (AGM) taking place on June 24 – 26, 2021. The theme for this year’s AGM is Protecting Ontarians and Leading Change: Nurses and RNAO during COVID-19. The AGM will highlight the incredible leadership played by RNs, NPs and students in nursing Ontarians during the pandemic, and the role of RNAO and its members advocating for healthy public policies to protect nurses and the public.
We have an exciting program of events that will be livestreamed to rnao.ca, Facebook, and YouTube:
Thursday, June 24th
Opening Ceremonies | 6:00 p.m. – 7:30 p.m.
The opening ceremony is the official kick off our AGM. You’ll hear from Ontario’s top political leaders, government officials, and our international nursing colleagues. To top off the evening, we’ll be celebrating our newly designated provincial and international Best Practice Spotlight Organizations (BPSO).
Friday, June 25th
Annual General Meeting | 4:00 p.m. – 7:00 p.m.
The AGM is a time for members and the board of directors to gather to discuss the required business of the association. During the AGM, you’ll hear from President Morgan Hoffarth and CEO Dr. Doris Grinspun on the year’s achievements and successes for nursing and the health system. The results of the governance items up for vote will be announced; including the election of the President-Elect and Regional Representatives, bylaw amendments, and the appointment of auditor. Another key feature of this event is the consultation session with Consultation Representatives from RNAO’s chapters/regions without chapters and interest groups who will have the opportunity to vote on the proposed resolutions brought forward by members.
Voting prior to AGM is restricted to RNAO voting members. Become a member today for $50 to join in on the vote! RNs, NPs, and our Friends of RNAO can now join for $50 for a limited time and receive professional liability protection (for RNs and NPs), access our award-winning RNJ, discounts on home and auto insurance, and so much more. Join our voice today at join.rnao.ca or call 1-800-268-7199.
Saturday, June 26th
Promoting 2SLGBTQI+ Health Equity Best Practice Guideline: Launch & Media Conference
10:45 – 11:15 a.m.
RNAO is excited to release its newest best practice guideline (BPG), Promoting 2SLGBTQI+ Health Equity at this year’s Annual General Meeting (AGM). The virtual release will celebrate the rigorous and collaborative efforts by RNAO and a diverse expert panel – consisting of persons with lived experience, nurses and other health providers, researchers, educators, policy makers and administrators – to publish a much-needed resource with evidence-based recommendations on ways to promote inclusivity and enhance the safety of 2SLGBTQI+ people across health, school and academic settings. The virtual release will be hosted by RNAO President Morgan Hoffarth and will include the co-chairs of the BPG, Sheena Howard, RN psychotherapist and founder of Love-Led Leadership and Dr. Elizabeth Saewyc RN, professor and director of the School of Nursing at the University of British Columbia. Dr. Paul-André Gauthier, RN and provincial president of RNAO’s Rainbow Nurses’ Interest Group, will also take part. Speakers will discuss the important need for this BPG, its purpose and scope, share key best practice recommendations, and answer questions from members of the media.
Closing Keynote: Protecting Ontarians and leading change: The COVID-19 pandemic as viewed through the eyes and experiences of Ontario’s RNs, NPs, and nursing students.
12:00 p.m. – 1:30 p.m.
Concluding the exciting activities is our closing keynote presentation. Moderated by CEO Dr. Doris Grinspun, this presentation will include a panel of RNAO leaders from various sectors sharing their experiences working on the frontlines of COVID-19.
We look forward to you joining us to celebrate the past year’s achievements.
Register now and we’ll see you there!
If you’re not an RNAO member, don’t forget you can join now for only $50!
For a recap on last year's virtual AGM, please visit our AGM portal.
Twice-monthly email updates to highlight best new evidence about the COVID-19 response
As decision-makers across Canada continue to seek out the best-available, synthesized research evidence to inform their pandemic-response efforts, helping them efficiently focus on only the highest quality and most up-to-date evidence syntheses is important. To help address this need, the COVID-19 Evidence Network to support Decision-making (COVID-END) in Canada has recently launched a twice-monthly email update, which includes spotlights on the best available new evidence from across Canada and around the globe, as well as a horizon scan of emerging issues. Individuals interested in automatically receiving these email updates twice a month can sign up to receive them.
The Canadian COVID-19 evidence spotlight draws on the work of the 40+ evidence-synthesis teams contributing to COVID-END in Canada, and profiles newly prepared syntheses and newly updated living syntheses updated in response to requests from Canadian decision-makers. The spotlight organizes the syntheses according to the public-health measures, clinical-management options, health-system arrangements, and economic and social responses they address. The syntheses prepared and updated with the support of COVID-END in Canada can be found here.
The global COVID-19 evidence spotlight draws on all of the evidence syntheses being prepared by teams internationally, and profiles only the ‘best’ evidence syntheses for every major COVID-19 decision. The designation of best is based on recency of the search for evidence, quality of the synthesis, and availability of a GRADE evidence profile that speaks to the certainty of evidence contained in the synthesis. This designation reduces the ‘noise-to-signal’ ratio from more than 6,200 syntheses to 420 ‘best’ evidence syntheses. These best evidence syntheses are available through the COVID-END inventory of best evidence syntheses.
The Canadian horizon scan identifies emergent issues (or previously missed long-term and recurring issues and/or elaborations on these issues) related to COVID-19 in Canada for which evidence syntheses are or will be needed. For over a year COVID-END has been convening a global horizon-scanning panel. Now COVID-END in Canada is regularly convening a Canadian panel comprised of citizens, providers, policymakers and researchers from across Canada. The panel’s deliberations are informed by a pre-circulated briefing note and captured in a panel summary.
You can sign up for the twice-monthly email updates here.
Vaccination passport apps could help society reopen – first they have to be secure, private and trusted
Vaccine passports may become unavoidable as we gradually move out of the pandemic. RNAO supports the use of one if it is designed in the proper way, given the serious concerns about equity, safety and privacy. We started the conversation before and now continue with an article published March 23 by Laurin Weissinger, a lecturer in cybersecurity at Tufts University. This article is republished from The Conversation under a Creative Commons license. Read the original article.
You might soon have an additional app on your phone: a digital vaccination passport that allows people who have been vaccinated against COVID-19 to travel, enter business establishments and attend events. Not having the app could deny people access.
The theory goes that vaccination passport apps can help society reopen despite still-high infection risks, including from more infectious and deadly strains of the coronavirus, because they allow protected people to resume normal activities while keeping people vulnerable to infection out of high-risk environments.
Vaccination passports, however, can have unintended, negative consequences. And beyond ethical issues, building vaccination passport apps is far from straightforward. As a cybersecurity researcher, I see several challenges, including how best to ensure security and privacy, and to get people to trust the verification systems.
Fuzzy on the details
Like nationality, vaccine status is not visible to others. Passports and government IDs have long been used to prove identity, citizenship and birth dates, and the World Health Organization’s carte jaune, or yellow card, has served this role to prove vaccinations for international travel. These rely on governments as trusted third parties.
A lot is still up in the air when it comes to vaccination passport apps. This month, the EU announced its vaccination passport plans. Judging from initial documentation, the system is meant to be decentralized, relying on health authorities to issue certificates that store only necessary information. Notably, it allows for paper and app-based certificates.
In either case, verification would be based on digital signatures, and all health data would remain with the issuing authority or member state. However, while the concept document is promising, what gets rolled out and whether anyone breaks the rules by storing or tracking data remain to be seen.
The CommonPass app being built by an international nonprofit organization appears to be the most developed vaccination passport app. It currently documents test results. However, while its makers claim that records will be stored only locally on users’ devices, the app is closed source, and the only documentation is a superficial FAQ.
Israel has rolled out its “green pass” app, which verifies that a person has been vaccinated or has recovered from COVID-19, but the system has raised privacy and security concerns. Several other countries have also launched vaccination passport apps for internal use, including China and Saudi Arabia.
How an ideal app works
App designers are faced with a difficult task: They need to create a system that is secure, privacy preserving, easy to use, compatible with as many devices as possible, highly scalable and able to operate across borders. The system will have to track institutions providing the vaccination records and the chains of trust – the digital handshakes that prove each part of the system is what it claims to be – linking those records to the app.
It’s preferable for users and the organizations that have to verify records to deal with fewer apps, which means that each app would have many users. Security vulnerabilities in these key applications would thus have widespread impact. The large number of users also increases the incentive for attackers who would benefit from abusing a trusted, health-related, government-backed app.
Therefore, it’s important for vaccine passport apps to maximize privacy by collecting and retaining only needed data, similar to what the EU is proposing. This would include identity, type of vaccine and date of vaccination. Not only does this reduce internal misuse of data, but it also reduces risk in case of breaches.
A matter of trust
Who could be trusted to build and maintain this app? Some people worry about government and private-sector surveillance. Indeed, there is reason for concern: Vaccine passport apps might become required or quasi required, link identity to personal health information, and, depending on implementation, could be used to establish detailed personal profiles, including movement patterns.
Private companies exist to make money and would thus have incentive to monetize passport apps, usually through data mining or sale. Government-backed apps might raise concerns about surveillance and citizens’ rights.
Therefore, to build trust, it’s important to clarify concepts and designs beforehand, documenting what data will be collected and processed, and how. As practiced by the German contact-tracing app, any passport application’s back end and front end need to be fully open source and penetration-tested by security experts to build public trust.
There are many challenges, but the technology to build a trusted, secure and privacy-respecting vaccination passport app is available. Technology, however, is just part of the picture. It’s also important to consider a vaccine passport system in the context of COVID-19 and society as a whole.
Governments will need to consider in more depth the consequences of requiring a vaccination passport app to access restaurants or gyms in places where vaccine doses are not easily and cheaply available to everyone, which is most of the world.
Passport apps create inequality between vaccinated and unvaccinated individuals. Those selected by governments to be vaccinated first would enjoy considerable privileges. In the U.S., these have tended to be disproportionately older, wealthier and white. Younger people and communities of color – both groups have been hit particularly hard by the effects of the pandemic – are more likely to be left out. Thus, these apps might increase social tensions.
The perceived safety gains may also have various unintended consequences. For example, premature opening could increase transmission from vaccinated but infected individuals or through increased patronage requiring more unvaccinated staff on site.
Last but not least, requiring passporting apps may encourage the unvaccinated to misrepresent their status, whether to make ends meet, to hold on to a job, or simply to avoid being left out, further increasing infection risks.
Therefore, in places like the U.S., where all willing individuals will soon be vaccinated, it would make sense to wait to roll out vaccine passports until everyone has had the chance to be vaccinated. Second, there need to be clear, open and public discussions about what these apps are supposed to provide and how they should work.
A more analog approach that does not need a smartphone or app to work would be more accessible, cheaper and more privacy preserving. The EU’s approach, as it currently stands, allows the use of paper records, verifiable by QR code. A similar system is also being developed by an MIT nonprofit. These semi-digital approaches could be hacked, but so can apps.
POLICY UPDATES FOR ALL TO ACT ON & MUST JOIN EVENTS – OPEN TO ALL
Webinar: COVID-19 Webinar Series
June 14, 2021, 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.
- 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!
June 14, 2021, 2 - 4 p.m. ET
July 12, 2021, 2 - 4 p.m. ET
You can watch our May 10 webinar. Here is the description of that webinar:
Kick off National Nursing Week with us; we will be dedicating our COVID-19 webinar to your stories.
Nurses, other health providers and members of the public are welcome to join our webinar to pay tribute to the roles nurses have played during the pandemic. This webinar is focused on good news. You can share examples, words or stories of the nurses’ leadership: Their knowledge, compassion, bravery, dedication, collaboration and creativity as they have given it their all for patients this past year. Together, we will create a virtual wall of appreciation where you can share stories, upload images, take photos and share GIFs. The wall can be shared within your networks and on social media. Let's take time to collectively honour nursing and reenergize ourselves and our colleagues. We are an awesome mosaic of human richness!
Watch and read about earlier webinars here.
MOH EOC Situational Report
We are posting each day the Daily Situational Reports from Ontario's MOH EOC at RNAO’s website. That way, you can access the Ministry’s guidance at any time.
For a more detailed Ontario epidemiological summary from Public Health Ontario, you can always go here.
Here is a segment from the last Situation Report #439 for May 28:
Case count as of May 28, 2021 / Nombre de cas le 28 mai 2021
Area / Région
Area / Région
Change from yesterday / Changement par rapport à hier
Deaths / Décès
Change from yesterday / Changement par rapport à hier
1 371 073
+ 2 967
+ 1 273
- Ontario Accelerates Rollout of Second Shots Targeting a Two-Dose Summer. Ontario has reached a key milestone in its fight against COVID-19, having achieved its target to administer first doses to 65 per cent of Ontarians aged 18 and over ahead of schedule. Ontario is also preparing to roll out the eligibility for accelerated second dose appointments starting with individuals aged 80 and over, beginning on May 31, 2021. If there is sufficient vaccine supply, it is anticipated that the majority of Ontario residents who choose to receive the vaccine will be able to be fully vaccinated by the end of summer.
- Administration of Pfizer-BioNTech COVID-19 Vaccine has been updated and is available on the Ministry’s website. The document has been updated since it was shared by email earlier this week to reflect the new NACI statement and vaccine storage guidelines.
Staying in touch
Keeping in touch is now more important than ever. Feeling that you are part of a community and that we have your back will help you get through this challenging time. We are also eager to hear from you how we can best support you. Send to us your questions, comments, and challenges. Feel free to also recommend ideas for future webinars. Send these to me at firstname.lastname@example.org and copy my executive assistant, Peta-Gay (PG) Batten email: email@example.com. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!
Thank you all for being there for our communities – everywhere and in all roles! Together, in solidarity, we are stronger and more resilient. These continue to be tough times and we have to reach out to one another in solidarity! Our government, the public and indeed all health professionals – must keep focused. There is hope at the end of this long tunnel. Vaccines are being delivered in large quantities and now we need to fasten the rollout! Hugely important is to continue fighting the spread of the virus to preserve lives. To everyone and most especially our colleagues working in the front lines here at home and in countries around the world hit hard by evil COVID-19 – THANK YOU, and please take care of yourselves and know that RNAO always stands by you!
As we have said before and everyday more true: The silver lining of COVID-19: Coming together and working as one people – for the good of all!
Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, FCAN, O.ONT
Chief Executive Officer, RNAO
RECENT BLOG ITEMS:
23 May – NPs speak about LTC during the COVID-19 Pandemic – go here.
23 May – Three surveys on the impact of COVID-19 on Canadian nurses – go here.
23 May – Exemption of nurses and other health-care workers from Bill 124 – go here.
23 May – RNAO’s statement on the government’s phased-in re-opening plan – go here.
23 May – Remembering Charlotte Noesgaard (1948-2021) – go here.
15 May - Nursing Now Ontario Awards Ceremony – go here.
15 May - Vaccine passports – reason for hope or cause for concern? – go here.
15 May - Government responds to RNAO’s call for increased enrollment in nursing education – go here.
15 May - Second dose vaccination for high-risk healthcare workers in response to RNAO’s call – go here.
8 May - Nurses must be fully vaccinated immediately, RNAO demands – go here.
8 May - A bill to support individuals with assistive devices for mental health – go here.
8 May - Action alert: Ensure global vaccine access, prime minister! – go here.
1 May - RNAO statement on the passing of RN Lorraine Gouveia – go here.
1 May - RNAO’s continuing media profile: The April report – go here.
1 May – RNAO response to Long-Term Care COVID-19 Commission report – go here.
24 April - RNAO launches new policy webpages – go here.
24 April – RNAO responds to federal fiscal budget – go here.
17 April - Vaccine engagement as a tool to address marginalization and exclusion – go here.
17 April - Here's how the COVID-19 pandemic could play out in 2021 and beyond – go here.
17 April - Reacting to the latest Ontario government public health measures – go here.
10 April - RNAO and NAN sign Relationship Accord to improve health across NAN Territory – go here.
10 April - RNAO media release on public health measures and vaccination rollout – go here.
10 April - 3 ways to vaccinate the world and make sure everyone benefits, rich and poor – go here.
3 April - Government’s “shutdown” announcement doesn’t go far enough – go here.
3 April - RNAO’s continuing media profile: The March report – go here.
27 Mar - Provincial budget fails to deliver urgent nursing investments to care for Ontarians – go here.
27 Mar - Government's reopening plan threatens the health of Ontarians – go here.
20 Mar - Preliminary results of RNAO‘s Work and Wellbeing Survey – go here.
13 Mar - Getting it right – go here.
13 Mar - RNAO leads dozens of organizations in candlelight vigil – go here.
6 Mar - RNAO’s continuing media profile: The February report – go here.
6 Mar - Communication during a Pandemic: How we can endure the pandemic together – go here.
6 Mar - Webinar: Understanding wellness in Indigenous wisdom traditions for caregivers – go here.
We have posted earlier ones in my blog here. I invite you to look.
Public Health Ontario maintains an excellent resource site on COVID-19 materials.
Ontario’s health provider website is updated regularly with useful resources.
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.
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.
You can find up-to-date global numbers in Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.