November 13 2020 COVID-19 report

Dear Colleagues: Welcome to our Friday, November 13 report– now in the ninth month of COVID-19 in Ontario.Visit the COVID-19 Portal for the many resources RNAO offers on COVID-19.Find earlier update reports here, including thematic pieces in Doris’ COVID-19 Blog. RNAO media hits and releases on the pandemic can be found here. Daily Situational Reports from Ontario's MOH EOC can be found here.As always, feel free for to share this report and links with anyone interested.

 

As we come to an end of Nurse Practitioner Week we salute our NP colleagues! With over 1,700 NP members of RNAO, and the incredible progress we have achieved together, the time to celebrate is this week – and everyday! A big THANK you from Minister Elliott! We at RNAO THANK YOU DEEPLY for your incredible contributions to Ontario’s health system and we look forward to seeing many of you at the NP Knowledge Exchange Annual Symposium on Monday,November 23, 9 am to 4 pm(details in the webinar section below). Ontario and Canada, let’s emulate: At Mount Sinai Hospital in New York they have 45 NPs in just one of their units!

 

 

RNAO’s media conference to address the crisis in long-term care resonates widely

We were thrilled to host a media conference today Friday, alongside Sinai Health System geriatrician and powerful advocate Dr. Nathan Stall. This virtual event was crucial in our ongoing efforts to raise red flags and push for action that we hope will stop an evolving disaster in long-term care (LTC) homes similar to the one we saw during the first wave of COVID-19.

In no uncertain terms, we are calling on government to ACT NOW on four key asks:

• a complete lock-down in red zones, except for essential service and schools, for 28 days,
• immediate funding and directives to hire RNs, NPs, RPNs and PSWs in all nursing homes across the province,
• a call to keep essential care partners in all LTC homes, and
• the urgent need to de-crowd nursing homes with residents in multi-occupancy rooms (>2)

Dr. Stall stated today that he sees our current situation in LTC as “our provincial shame.” We at RNAO agree wholeheartedly. I, too, feel ashamed as a health professional, on behalf of all my nursing colleagues who have put their knowledge, hearts and souls into efforts to beat this terrible virus. We have not succeeded in moving the needle where it should be during this second wave, and those suffering the most are the vulnerable residents in LTC homes, their loved ones and staff.

We had 132 people joining our media conference today, including journalists from 15 media outlets,government officials, families of loved ones in nursing homes, frontline nurses and personal support workers, researchers and epidemiologistswatching the trends and warning of what’s to come. Dr. Stall and his team are collecting statistics daily in an effort to keep the numbers under a microscope. His analysis shows that RNAO is correct in its repeated warnings that we are headed for disaster, if the government does not act immediately.

We saw the devastating impact of COVID-19 on LTC residents during the first wave. We watched the death curve go up between the end of March and May. And we are once again watching the curve trend upward. Between Sept. 1 and Nov. 11 we have gone from zero deaths in LTC to more than 200 residents taken by the virus. Many of these could have been prevented with adequate staffing and de-crowding of nursing homes. There’s absolutely no excuse for this to happen.

As Dr. Stall so pertinently pointed out today, we can’t just focus on stats in the hospital sector to evaluate how we’re doing in our response to this second wave of COVID-19. We must talk about LTC. There are currently almost 700 active resident cases in LTC. 435 staff are currently infected.

Most concerning, since the second wave began this fall, 2,100 residents and 1,500 staff have tested positive for COVID-19. Already in this second wave,68% of COVID-related deaths are residents in nursing homes. Ninety-four nursing homes are in outbreak right now. Given the escalating numbers, we can expect a lot more tragedy and preventable loss of life in LTC, unless government takes immediate action. More must be donenow, Dr. Stall and I urged.

Although we have seen some improvements in access to PPE, testing, and the important inclusion of essential care partners since the first wave, we have seen no action whatsoever on staffing. We have heard promises of four worked hours of care, but these are empty promises because there have been no directives to hire more staff in this sector, or more importantly, to channel the required funding for this to happen. One reporter at today’s media conference (Chelsea Nash of Rabble.ca) asked how the announcement to hire resident support aides (RSA) (made in early November) will help during this emergency. I was direct and honest in my answer: we will not support Band-Aid solutions to this problem. A person trained for a few days, with all due respect, can never provide what a PSW, RPN, RN and NP can provide. I would rather have an essential care partner take on that role than someone who has been displaced from the hospitality sector and receives almost no training in working with older persons. Of course displaced workers – all of them!–need support, but not in this form where they will endanger residents, themselves and potentially their own families. Essential care partners know much more about what their loved ones need than someone who will only receive a few days of training to care for our most vulnerable.

The lack of political will and courage is a major barrier we must address at this crucial stage of the pandemic. But another equally troubling barrier is the bias and discrimination we are seeing towards vulnerable populations, such as LTC residents, people experiencing homelessness and Indigenous communities. We talked today about structural ageism and the complacency we are seeing with the ongoing loss of life due to COVID-19. It seems that many people have become numb to the tragic numbers, as if it’s just numbers we’re talking about – not the lives of people leaving behind traumatized loved ones and staff.

Today, we thanked the media and urged them to keep this issue front-and-centre. I also took the opportunity to thank the media for continuing to approach RNAO for comment and perspective. Each and every media outlet must keep talking about the implications of doing too little, too late while people die and the healthcare system becomes overwhelmed. They must continue to remind us these are not just numbers – they are human beings, our cherished parents, grandparents, and friends. We must all raise our voices both in our personal and professional roles. Our collective efforts will force the change we need for the most vulnerable among us.

Please take some time to watch the media conference online here. You will find the press coverage of our media conference in the RNAO COVID-19 press room (the items will be posted on Monday). We also urge you to watch RNAO’s Nov. 9 Cross Country Meeting: Mobilizing Collective Action for Long-Term Care Reform in Canada. We will continue this important conversation at our next COVID-19 webinar on Nov. 14 (see details next).

 

Continuing the conversation: Mobilizing collective action for long-term care reform in Canada

RNAO organized a pathbreaking cross country meetingto engage collective action for long-term care reform in Canada. This special Health System Transformation & COVID-19 Webinar happened on Monday, November 9. You can watch the seminar here.

We will continue the conversation on Monday, December 14, 6:45 to 8:00 pm. You can register here.

The November 9 webinar was moderated by The Globe and Mail columnist André Picard, the author of Neglected No More: The Urgent Need to Improve the Lives of Canada's Elders in the Wake of a Pandemic and panelists included:

• Nathan Stall, staff geriatrician at Sinai Health System;
• Doris Grinspun, RNAO CEO;
• Shirlee Sharkey, president and CEO of SE Health;
• Miranda Ferrier, national president of the Canadian Support Workers Association;
• Linda Silas, president of the Canadian Federation of Nurses Unions and president of the Ontario Personal Support Workers Association; and
• Laura Tamblyn Watts, president and CEO of CanAge. 

Everyone is invited to attend including anyone across Canada who cares about seniors and wants to join forces to inspire our provincial, territorial and the federal governments to establish national standards for LTC and to take additional action to support people staying in their homes longer. 

See the press release here. Find info here about the upcoming December 14 webinar and register here.

Information on past webinars, including videos and presentation slides, can be found here.

 

 

Other upcoming webinars and events for November – Open to all

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Let’s Talk about Anti-Black Racism and Discrimination in Nursing

The next webinar in the series will be onMonday, November 16, 6:45-8:15 pm. The topic will be Becoming an Ally of the Black Nursing Community. 

Objectives:

• generate awareness among participants about what it means to be an ally working against anti-Black racism;
• identify essential responsibilities and behaviours for effective allyship;
• explore strategies to support Black nurses and challenge systemic racial discrimination and microaggressions in the workplace; and
• share and discuss resources that are available for those wanting to advance in their allyship journey.

Presenters:

• Frances Delsol, Executive Director of the Black Business and Professional Association
• Allison Hector-Alexander, Director of the Office of Equity, Diversity and Inclusion at Durham College
• Tina Garnett, Human Rights and Inclusion Specialist at Hamilton Health Sciences
• Dr. Sally Thorne, Professor at UBC School of Nursing

Details available here and you can register here.

Our monthly webinar series is open to RNs, NPs and RPNs interested in receiving updates on RNAO’s Black Nurses Task Force and to engage in meaningful conversations that are already influencing the work of the Task Force. 

The presentations and details for this and earlier webinars can also be found here.

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Landscape and Emerging Issues with E- Cigarettes: Webinar Series

Webinar 3 of a 3 part series - Tuesday, November 17, 12:00 - 13:00 pm

Preventing E-Cigarette Use Amongst Youth

This three-part webinar is in partnership with the RNAO, Community Health Nurses’ Initiatives group (CHNIG) and Community Health Nurses of Canada (CHNC).

Objectives:

• understand the prevalence of vaping in Ontario and across Canada
• understand the mechanism of vaping (primary focus: nicotine)
• articulate health impacts of vaping
• discuss how nurses and other health-care providers can provide clients with prevention, protection and cessation support

Guest speakers:

• Rosemary Lamont, RN, York Region Public Health, Community and Health Services           
• Dr. Andrew Pipe, CM, MD, LLD(Hon), DSc(Hon), FRCPSC(Hon), University of Ottawa Heart Institute

Register here.

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NP Knowledge Exchange Annual Symposium (this year virtual)

NPs who are members of RNAO are invited at no cost to our NP Knowledge Exchange Virtual Symposium on Monday,November 23, 9 am to 4 pm.

Explore the theme “Moving from Strength to Greater Strength: NPs in Ontario, Canada, and around the Globe” at our seventh-annual NP Knowledge Exchange Symposium.

We will have a chance to network, collaborate and learn more about the NP Task Force and its compelling history, progress and promise to drive successful health transformation. In addition, we will discuss how the clinical, policy and governance roles of NPs during COVID-19 impacted the system and can be leveraged in the vision for tomorrow. 

Speakers include Dr. Barbara Stilwell, executive director of Nursing Now; Helen Angus, Ontario’s deputy ministers of health and many more fantastic speakers. Co-chairs for the day are NPIG Chair Sally Baerg and RNAO CEO Dr. Doris Grinspun.

This event is open at no cost to all NPs in Ontario who are RNAO members.

See the agendaand other infoand documents online. 

Register online today to secure your spot. 

 

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 latest Situation Report #293 for 13 November: 

 

Case count as of November 13, 2020 / Nombre de cas le 13 novembre 2020
Area / Région	Case count / Nombre de cas	Change from yesterday / Changement par rapport à hier	Deaths / Décès	Change from yesterday / Changement par rapport à hier
Worldwide total / Total Mondial*	52 774 574	+ 602 850	1 293 099	+ 7 986
Canada*	282 577	+ 5 516	10 768	+  83
Ontario**	91 180	+ 1 396	3 312	+  19

Update:

 

Ontario Updating COVID-19 Response Framework to Help Stop the Spread of COVID-19. In consultation with the Chief Medical Officer of Health and the Public Health Measures Table, the Ontario government is taking immediate action to respond to the rapid increase in COVID-19 cases and is updating the Keeping Ontario Safe and Open Framework, by lowering the thresholds for each level in the framework. These necessary updates will help limit the spread of COVID-19 while keeping schools open, maintaining health system capacity, protecting the province's most vulnerable, and avoiding broader lockdowns.

 

Staying in touch       

Please continue to keep in touch and share questions, comments and challenges. Send these to me at dgrinspun@rnao.ca and copy my executive assistant, Peta-Gay (PG) Batten <pgbatten@rnao.ca>.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 will continue to be tough times for a while for 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!

As we have said before, 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, O.ONT
Chief Executive Officer, RNAO

 

RECENT BLOG ITEMS:

6 Nov - Fall 2020 provincial budget once again leaves vulnerable populations to fend for themselves – go here.

6 Nov - Elections in the US: A path to healing and respect for science – go here.

30 Oct - 2S-LGBTQ+ Seniors: Our Existence is Our Resistance! – go here.

23 Oct - Responding to the second wave of COVID-19: RNAO continues to speak out – go here.

16 Oct - RNAO advocates for national long-term care standards in Canada – go here.

16 Oct - Reta’s Story  (a contribution of Judy Smith, Reta’s daughter-in-law) – go here.

9 Oct - RNAO relieved that Premier Ford engages late, but essential, action – go here.

9 Oct - Patient-centred-care – the dream and the reality – go here.

2 Oct - RNAO urges stricter measures to combat rapidly rising number of COVID-19 infections – go here.

25 Sept - Nurses say throne speech advances A Just Recovery for All – go here.

18 Sept - Is Your Hospital Using Blood Wisely? – go here.

18 Sept - RNAO calls to Delay Action on CNO Council Decision to Expand RPN Scope – go here.

11 Sept - International Overdose Awareness Day: Statement from RNAO – go here.

11 Sept - RNAO joins global movement: A Just Recovery for All – go here.

28 August - RNAO letter to Prime Minister Justin Trudeau regarding Speech from the Throne – go here.

21 August - Black August and an update on RNAO’s Anti-Black Nursing Task Force – go here.

21 August - Winter Surge Planning: How one Ontario Health Team is Preparing – go here.

14 August - Insights from Cuba: Primary care as the focus of COVID-19 prevention – go here.

7 August - School reopening: Ontario government can still do the right thing on class sizes – go here.

31 July - Preparing for the second wave of COVID-19: Discussion – go here.

31 July - Important announcement regarding the VIANurse program – go here.

31 July - Government must immediately mandate hiring to avert second tragedy in LTC – go here.

24 July - Preparing for the second wave of COVID-19: What is the plan? – go here.

17 July - RNAO launches new social media campaign #Maskathon – go here.

17 July - RNAO calls on government to reunite families in LTC homes in Ontario – go here.

10 July - Nurses’ mental health, leave of absence and return to work experiences – go here.

10 July - RNAO continues to pursue family reunification in LTC – go here.

10 July - Support Zimbabwean nurses arrested and fired for protesting deteriorating pay and working conditions during pandemic – go here.

3 July -   RNAO launches task force to tackle anti-Black racism within the nursing profession – go here.

3 July -   Rather than praise, let’s protect our nurses – go here.

3 July -   Nurses celebrated diversity during Pride month – go here.

26 June - Nursing Home Basic Care Guarantee – go here.

26 June - Masks for all – the policy imperative in Canada – go here.

18 June - Annual General Meeting – an exhilarating week! – go here.

12 June - Petition on masks for Canada – go here.

12 June - LTC: RNAO releases list of 35 reports and recommendations dating back 20 years – go here.

6 June   - Statement – RNAO stands together with our Black sisters and brothers – go here.

3 June   - Adapting harm reduction during a pandemic – go here.

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

 

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 HopkinsCSSE.