November 20 2020 COVID-19 report

Dear Colleagues: Welcome to our Friday,November 20 report– now in the tenth 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.

 

 

RNAO says government’s measures too late and insufficient to break the transmission – but we must enact them fully within a COVID-Zero strategy

RNAO issued today a press release in response to the lockdown measures in Toronto and Peel regions announced by the government.Please RT our tweet. This is the text:

RNAO thanks the government for listening to the voices of nurses and imposing a 28-day partial lockdown for Toronto and Peel region. However, much more was asked of government at the association’s media conference Nov. 13. 

COVID-19 is running rampant in several communities and decisive government action was essential as the virus continues to spread unabated in the community and the effectiveness of more targeted measures has fizzled. It is unfortunate that the measures announced today are once again incomplete. RNAO continues to call for an aggressive and all-encompassing lockdown, followed by an effective and concerted strategy to snuff out the virus – a “COVID-Zero” strategy. The longer we wait, the more painful these cycles will be.

For too long the government has argued there is a conflict between taking care of the economy and taking care of the health of people. The situation we face right now proves how wrong that belief is. The harsh truth is that we will not have a healthy economy until we eliminate this virus. Half-measures to reduce transmission only buy time until we are forced to enact stricter measures, and the stop-and-go approach is putting working people and small businesses in an impossible situation.

We must change the approach. The current measures should be framed within a clear, scientifically-based strategy to suppress the virus and return to some semblance of normal. That can only be achieved with very low rates of transmission, as close as possible to zero – commonly referred to as a “COVID-Zero” strategy. There must be a longer term strategy so that this lockdown is not simply a rehearsal for the next one.

Learning from jurisdictions that have successfully done so, a COVID-Zero strategy entails a short period of stringent lockdown, with travel bans, very limited contact between persons, staying home for those who can (except for essential purposes), accompanied by comprehensive testing – including rapid testing – of key segments of the population and isolation of those who test positive. The intent is to break the reproduction cycle of the virus. Once the lockdown achieves its goal of drastically reducing community transmission, we can proactively use testing to control cases and outbreaks.

Going through the pain of a lockdown without having the tools, funding, political will and appropriate measures in place to ensure this is the final lockdown – and not just a premonition for the next one – is a worst-case scenario. It also means that this lockdown is likely to be longer than if a more aggressive one had been implemented. 

RNAO says today’s announcement, which will limit shopping in retail businesses to curbside pick-up, limit dining in restaurants to takeout, and close gyms, hair salons and other personal care services does not go far enough to suppress the virus and stop it in its tracks. For example, the measures do not go far enough for places of worship and do not affect people who live in York Region and other red zones, including Hamilton, Halton, Durham and Waterloo. There were no measures in the announcement to prevent persons bringing the virus from one region to another. There were insufficient measures to diminish non-essential movement and socializing. There were no restrictions to ensure big box stores that remain open reduce their spreading impact, such as closing non-essential sections of the store.

RNAO is gravely concerned about the impact of the lockdown on small businesses, their employees, and their families. The federal and provincial governments must implement urgent measures to ensure these businesses can survive this second lockdown. We are also extremely concerned about the mental health impacts of the lockdown, and worry about the lack of proper resources to assist and support those who need mental health services during this terribly difficult period.

RNAO knows the burden of COVID-19 illness and death will fall once again on vulnerable, racialized and marginalized neighbourhoods and populations that do not have adequate resources to protect themselves during a lockdown. There must be immediate measures to protect vulnerable people in congregate settings, high-rises, and racialized communities. Governments at all levels must also protect persons experiencing homelessness, addictions and disability.

Although as nurses we believe that schools should remain open, we remain gravely concerned that not enough resources have been provided to ensure proper physical distancing in all schools, proper ventilation, and adequate support for educators who are working under extremely stress-producing realities. Masking is still not universally required in all school boards and for all children ages three and up, as recommended months ago by many, including RNAO.

The virus is once again surging and claiming the lives of residents in long-term care (LTC) homes at a much higher rate than in the population at large. Since Sept. 14, 323 seniors in LTC homes have died. RNAO has been clear about the urgency of a LTC nursing home basic care guarantee to keep residents and staff safe. Responsibility for the death toll in long-term care falls squarely on decision-makers who have known for years – and have seen consistently for the past eight months – the ensuing tragedy caused by their inaction. We have also insisted that essential care partners must be allowed to be with their loved ones – in all nursing homes – and we have made government aware that not all homes comply.

Nurses are working together with other health-care providers under enormously stressful and exhausting conditions to keep people healthy. Nurses call on the public to do their part. There is nothing more demoralizing than to see people who show disregard, ignorance and harmful behaviours at a time when many of us, and many other essential workers, are risking their lives to provide care and services. We must all act together: staying home if we can, minimizing interactions with others, washing our hands, practising physical distancing, avoiding crowded places, wearing a mask, avoiding social events beyond our household, isolating if we come into contact with a suspected case, and eliminating all but the most essential travel. Applauding us and calling us heroes is nice, your actions helps us care for others.

Nurses call on our government to immediately take a COVID-Zero approach to COVID-19; and we call on the public to fully engage in protecting themselves and others. This is the only way to reduce the threat that looms as winter approaches and the resulting tragedy of losing loved ones. Heeding this advice means we will all one day be able to resume our normal lives and do the things we used to take for granted.

 

This Monday -- November 23th – Join us for the NP Knowledge Exchange Annual Symposium

Over 200 registered already! You can still register for this virtual symposium.

An exciting program awaits NPs, members of RNAO, who will be participating at no cost in the upcoming NP Knowledge Exchange Virtual Symposium on Monday,November 23, 9 am to 4 pm. The theme of the seventh-annual symposium organized by RNAO is “Moving from Strength to Greater Strength: NPs in Ontario, Canada, and around the Globe.”

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. If you are not yet a member of RNAO and would like to join the symposium, become a member of RNAO here.

See the agenda and other info and 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 #299 for 20 November: 

 

Case count as of November 20, 2020 / Nombre de cas le 20 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*	56 984 076	+ 616 187	1 360 872	+ 10 166
Canada*	315 751	+ 4 642	11 265	+  79
Ontario**	100 790	+ 1 418	3 451	+  8

Update:

 

• Ontario Extends COVID-19 Orders. The Ontario government, in consultation with the Chief Medical Officer of Health, has extended all orders currently in force under the Reopening Ontario (A Flexible Response to COVID-19) Act, 2020 (ROA) until December 21, 2020.
• Ontario Taking Further Action to Stop the Spread of COVID-19 . In consultation with the Chief Medical Officer of Health, local medical officers of health, and other health experts, the province is moving certain public health unit regions to new levels in the Keeping Ontario Safe and Open Framework, which includes moving Toronto and Peel into Lockdown. These necessary measures are being taken to limit community transmission of COVID-19 in order to keep schools open, safeguard health system capacity, and protect the province's most vulnerable populations.
• A number of COVID-19 testing-related guidance documents have been posted to the Ministry’s website including:

• Considerations for Employer Antigen Screening Pilot
• Considerations for Privately-Initiated Testing
• Case & Contact Management Guidance Appendix 9: Management of Individuals with Point-of-Care Results
• Updated Provincial Testing Guidance
• Updated Case Definition
• Updated Quick Reference Public Health Guidance on Testing and Clearance

 

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:

13 Nov - Mobilizing collective action for long-term care reform in Canada – go here.

13 Nov - RNAO’s media conference to address the crisis in long-term care– go here.

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.