October 10 2021 COVID-19 report


Dear Colleagues: Welcome to our Sunday, October 10 report during this twentieth 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 policy updates and action alerts, as well as RNAO’s upcoming webinars.

Today we share: (1) Our best wishes for Thanksgiving; (2) a renewed urgent call to sign the Action Alert to our prime minister to stop the federal government’s court battle with First Nations children; (3) a media release calling for mandatory vaccination for all health-care and education workers and for safe zones to protect patients, students and workers; (4) an article on the inherent racism of the anti-vaxx movement; and (5) RNAO launches new, evidence-based online implementation toolkit to lead change in partnership with Healthcare Excellence Canada.

Thanksgiving long weekend

RNAO pays tribute to the thousands of nurses and other health-care workers who are serving Ontarians over this Thanksgiving long weekend.

While many Canadians will celebrate with a Thanksgiving dinner, nurses and other health-care workers will continue to care for persons in hospitals, long-term care homes, their homes and on the streets of this province.

The fight against the COVID-19 pandemic, the opioid crisis, and other conditions continues. We are thankful that nurses – despite the unbearable human resources crisis – continue their work with an unwavering commitment to serve the public.

We ask that you show your gratitude to nurses and other health-care workers by doing your part in the fight against COVID-19. We urge you to participate in our #FullyVaccinated campaign, wear a mask in all indoor public places and maintain physical distancing.

We also ask that you please sign the #RepealBill124 Action Alert.

We wish everyone a healthy and safe #Thanksgiving!

A renewed call to sign the Action Alert: Prime minister, stop the court battle with First Nations children and their families!

The federal government must decide within weeks whether to appeal the decision of the Federal Court and continue battling First Nation children and their families in court. RNAO is calling on the prime minister to do the right thing: Do not appeal the ruling and stop battling First Nation families!

I am shocked that only 588 people responded to our call last week to sign the Action Alert calling on Prime Minister Trudeau to do the right thing. Let’s keep alive the spirit of the National Day for Truth and Reconciliation that we just observed on September 30. I plea to you to take a minute and sign the Action Alert now!

For background on this important struggle, read RNAO’s media release:

Following Canada’s inaugural National Day of Truth and Reconciliation on Sept. 30, RNAO urged Prime Minister Justin Trudeau to stop the federal government’s long-standing court battle with First Nations children and their families, and to compensate them for the effects of inadequate and discriminatory funding.

On Sept. 29, the Federal Court dismissed an appeal by the federal government for a judicial review of the rulings of the Canadian Human Rights Tribunal to compensate First Nations children and their families. RNAO deems this appeal and denial of compensation unacceptable. The rulings show that the federal government inadequately funded services for First Nations children and took an overly narrow approach to determining eligibility for Jordan’s Principle, which states no health, social or educational service for a First Nations child be denied or delayed due to disagreements between different levels of government.

“First Nations children and their families must be compensated for the harm caused by the misguided and discriminatory decision of the past,” says RNAO CEO Dr. Doris Grinspun. “This is a critically important concrete action to begin responding in a way that is congruent with the spirit of truth and reconciliation. It would be unthinkable to continue adding injustices to those inflicted in the past,” urges Grinspun.

RNAO has issued an Action Alert and is encouraging everyone to sign it to urge the federal government to stop fighting First Nations children in court and pay children and their families what they are rightfully owed.

“This Action Alert provides Canadians with the opportunity to demand that the prime minister lead the federal government to end this fight and respect the rulings of the Canadian Human Rights Tribunal,” says RNAO President Morgan Hoffarth. “First Nations children and their families deserve compensation for the harm caused by the federal government’s actions.”

Media release: Mandate vaccinations for all health-care and education workers and immediately establish safe zones to protect patients, students and workers

Toronto, Oct. 7, 2021. At a time when the federal government is mandating vaccinations for all of its public workers and municipalities, such as Toronto is doing the same, the Ontario government must move speedily to require all health-care and education workers across the province be fully vaccinated against COVID-19.

The Registered Nurses’ Association of Ontario (RNAO) commended Rod Phillips, minister of long-term care (LTC), for his Oct. 1 announcement mandating all nursing home staff be fully vaccinated by Nov. 15. RNAO says that directive must extend uniformly to all health-care workers across the entire system. All Ontarians and workers deserve the same protection. The only exception should be for those who meet the province’s strict criteria for medical exemption.

To ensure a safe and successful academic year, RNAO is also urging that same requirement apply to all educational staff in child-care centres and schools.

“Quite frankly, it defies logic that the province is leaving the responsibility of making sure other health-care workers are vaccinated up to their employers (hospitals, home-care agencies, primary care clinics and other outpatient services), while making it mandatory only for those working in nursing homes. Every health-care worker who sees patients must be fully vaccinated. Period. And, we have been asking for this since June,” says RNAO’s CEO Dr. Doris Grinspun, adding health-care workers “have told RNAO they expect their colleagues to be fully protected against the virus and a government mandate will help achieve that.” 

Putting the onus on health-care employers sparked a series of protests outside hospitals last month by so-called anti-vaxxers intent on spreading misinformation and propaganda about vaccine mandates. RNAO says health workers need better protection. And that’s why it is re-issuing its August plea to Premier Doug Ford that the government immediately establish safe zones around all health-care and education workplaces to protect patients, students and workers.

“Health-care workers and educators deserve a safe work environment as we continue to navigate though this pandemic. It’s also essential that people who want to protest be able to do so, but far away from these institutions,” says RNAO President Morgan Hoffarth. “No one should be forced to run through the gauntlet to enter a health-care facility or school. It’s frightening, intimidating, and no patient , family member or staff should be subjected to the outrageous behaviour people have already witnessed.”

To press on its demands, RNAO has issued an Action Alert imploring Premier Ford to act. “We have been in a long, difficult and deadly battle with COVID-19 and its variants,” says Hoffarth. “We need to win and put an end to this fight with COVID-19,” she emphasizes, urging everyone to join RNAO in its call to extend mandatory vaccinations to all health-care and education workers and to establish safe zones around their places of work.

To sign the Action Alert, please go here.

The inherent racism of anti-vaxx movements

The majority of those not yet vaccinated are hesitant for a diversity of legitimate reasons, due to confusion created by disinformation, historical injustices, distrust of authority, lack of resources, and vulnerable situations. A small but influential minority of the unvaccinated are anti-vaxxers driven by ideology who produce and disseminate disinformation intended to obfuscate, confuse and create hesitation. They also lead the angry and dangerous mob actions against hospitals and schools that require the enactment of safe zones, as requested in RNAO’s media release (see above). In an earlier blog I included an article about how anti-vaxxers, conspiracy theorists, and the far-right came together over COVID. Here I expose the racist origins of ideologically driven anti-vaxxers.

The following is a July 15 article from Paula Larsson addressing the racist roots of the anti-vaxx movement. She is a doctoral student at the Centre for the History of Science, Medicine, and Technology, University of Oxford, UK. This article is republished from The Conversation under a Creative Commons license. Read the original article.

We are currently experiencing a worldwide vaccination effort that’s being impeded by rising pockets of anti-vaccination sentiment.

There has been a recent increase in anti-vaccination conspiracy theories, misinformation campaigns and protests in various countries.

And while many accuse anti-vaxxers of a selfish disdain for the health and safety of others, there is a underlying aspect of these movements that needs to be more widely recognized.

Vaccine resistance movements have always been led by white, middle-class voices and promoted by structures of racial inequality.

Racist language to discredit vaccination

The intrinsic racism of anti-vaccination movements began with their historical origin in the 19th century.

Inoculation originally referred to the older form of vaccination, where pus was taken from the pustule of someone with a mild form of smallpox and purposely scratched into the arm of a healthy person. This would ideally convey a mild form of the disease and thereby protect the recipient from more deadly forms.

This type of inoculation had its foundation in a number of non-western cultures before it was incorporated into western medical practice. Indeed, inoculation was practised in China for centuries before it made its way to Europe, as well as in the Middle East and North Africa.

Its use in North America was initiated by the knowledge of an enslaved man, Onesimus, who famously taught the procedure to puritan minister Cotton Mather during a smallpox outbreak in the early 18th century.

These non-western origins fuelled some anti-vaccination criticisms during the 19th century. Opponents to the practice declared it a “filthy, useless and dangerous rite” akin to using the “charms and incantations of an African savage.”

By the turn of the 20th century, racialized language began to appear in anti-vaccination dialogues which, on the surface, had little to do with race. These racial slurs served the purposes of anti-vaccinationists who sought to discredit the practice.

One of the most potent examples of this was in 1920, when vocal anti-vaccination writer Charles Higgins published a book against vaccination. Throughout this work he consistently referred to vaccination as a “savage rite” performed by “the Medicine Man” on helpless innocent children.

Medical freedom, white freedom

The racialized language utilized by these early anti-vaxxers was all the more potent when weaponized by white leaders of anti-vaccination leagues (or organizations).

Between 1860 and 1920, numerous anti-vaxx leagues were founded in Britain, the United States and Canada. One of their main arguments was that compulsory enforcement was a “tyrannical interference with the rightful liberties of the people,” an accusation often levelled at health officials attempting to increase vaccine uptake in the general public.

These people used their social standing to loudly condemn perceived limitations of their rights, while blindly ignoring the systemic absence of the same freedoms for racialized and low-income communities.

In North America, the freedom to choose vaccination was already defined by racial identity in many places. Throughout this period, Indigenous children in Canada were forced to attend residential schools, where vaccination was either implemented or ignored at the will of federal or school officials, with little regard for parental or individual choice.

On the West Coast, civic public health officials actively enforced compulsory vaccination on Asian communities based on racial profiling during disease outbreaks. In 1900, city health officials in San Francisco issued mandatory plague vaccination orders for all Chinese individuals after a few cases of plague were found in the city.

American writer Harriet A. Washington has vividly demonstrated how Black communities were frequently enrolled in medical research trials for testing new medical treatments and vaccines, often without their knowledge or consent.

Yet the medical oppression of non-white communities was ignored by anti-vaccination leaders, who instead used their platforms to retain the medical freedoms of dominant white communities.

Today: Anti-vaxx targeting of racialized people

In present times, the leaders of anti-vaccination movements are still predominantly white, with many receiving millions in revenue from their activities.

More concerning is that they have begun to deliberately target racialized communities with anti-vaccine disinformation and propaganda. Recognizing the societal factors that have eroded trust in medical institutions, anti-vaxxers are attempting to direct this distrust to benefit their own cause.

Through their actions, anti-vaxxers deliberately seek to increase the risk of infection in already vulnerable populations. We saw this in 2017 after an outbreak of measles in Minnesota among the Somali-American community in Minneapolis.

Anti-vaxxers staged two public meetings in the community, encouraging parents to avoid vaccination and pushed the false claim that the measles, mumps and rubella (MMR) vaccine is linked to rising rates of autism. The result was a drastic reduction in MMR vaccination uptake between 2004 and 2014 — dropping from 92 per cent to 42 per cent — and one of the largest measles outbreaks in the state in three decades.

Deliberate targeting has been amplified even further this year in the attempt to discredit COVID-19 vaccines. The prominent anti-vaccine organization Children’s Health Defense recently released a film aimed at fuelling distrust in vaccination among Black Americans.

Anti-vaccination leaders have also begun to co-opt narratives of persecution and suffering for their own purposes. Last month, a Washington state official wore a yellow Star of David to protest vaccine mandates, while prominent anti-vaccine voice, Naomi Wolf, was scheduled to headline a fundraiser for “liberation” from vaccine mandates on Juneteenth.

It’s not the white, middle- and upper-class anti-vaccination leaders who suffer most from a diminished herd immunity and increased prevalence of vaccine-preventable illnesses. Such individuals are generally protected by the same social and racial privileges that have historically enabled them to continuously gain a large following.

In the end, the individuals who bear the brunt of an increased burden of disease are those from historically vulnerable communities whose concerns continue to be co-opted and overshadowed by anti-vaccination activists.Image removed.

RNAO launches new, evidence-based online implementation toolkit in partnership with Healthcare Excellence Canada

Maintaining its commitment to advancing evidence -based care and health care, the Registered Nurses’ Association of Ontario (RNAO) has partnered with Healthcare Excellence Canada (HEC) to release its third edition of the Leading Change ToolkitTM.

The Leading Change Toolkit is a free online implementation resource that provides change agents – persons developing knowledge and skills to make a positive difference – and change teams with up-to-date evidence, tools and strategies to lead change across health sectors and settings. Change teams may include interprofessional practitioners, persons/patients and their families, administrators, students, educators, as well as other staff or volunteers in organizations and across integrated teams.

This dynamic, freely accessible resource replaces RNAO’s 2012 toolkit and features two complementary frameworks to support the uptake and sustainability of evidence:

  • Social Movement Action (SMA) framework (Grinspun et al., 2020) – a new framework that integrates social movement action to create lasting change for improvement
  • Knowledge-to-Action (KTA) framework (Graham et al., 2006) – a dynamic systematic and structured process model

RNAO and HEC will launch the toolkit during a national webinar on Tuesday, Oct. 5. All health-care professionals and educators interested in facilitating and promoting sustainable change are encouraged to attend. The webinar will introduce the toolkit and its features, as well as provide an overview of how to use it to mobilize change.

“The Leading Change Toolkit is a groundbreaking online resource that will revolutionize how health-care professionals and teams implement best practices within their organization,” says Dr. Doris Grinspun, RNAO CEO and co-chair of the toolkit’s expert panel. Adding that “the two complementary frameworks set change agents and teams up for success, which will improve quality of care and health outcomes for all.”

“As a living resource, the toolkit will be updated regularly to embrace innovations in the field of implementation science aimed at facilitating social movements of knowledge to action, ensuring evidence-among health teams in different sectors reaches every staff and every patient on every encounter,” says Dr. Janet Squires, expert panel co-chair of the Leading Change Toolkit.

“Shaping a future where everyone in Canada has safe and high-quality health care is in our collective interest,” says Dr. Jennifer Zelmer, president and CEO of HEC. “Through resources like this toolkit, people who share this commitment to change will be better equipped to drive the rapid adoption of quality and safety innovations across the country.”

For more information on the Leading Change Toolkit, please visit RNAO’s website.


Continuing the Conversation: An Open Forum for Nurses

Oct 13, 2021, 2:30pm - 4:00pm

RNAO is aware nurses across Ontario – especially those working on the frontlines of COVID-19 – are experiencing tremendous levels of physical and emotional stress and burnout. We know this can affect your mental health and wellbeing at this challenging time and that you may have less time to devote to your own self care.

During these forums, RNAO facilitates open discussions and holds breakout sessions for participants to discuss themes identified in the previous forums, such as dealing with multiple losses, taking care of yourself, burnout and more.

All RNs, NPs, RPNs and nursing students – in all roles and sectors – are invited to participate. You may wish to share how things are going for you or you can simply join and listen in.

Visit our COVID-19 Portal for additional resources and information on psychosocial support.

Next session:

Oct. 13, 2021, 2:30 - 4 p.m. ET

Topic: Nursing student transitions into the workplace part 2: International perspectives

COVID-19 has disrupted nursing education worldwide, and new graduates are entering the workforce at a critical time in history for health care. During this webinar, we will hear how the pandemic is affecting nursing students, new graduates and faculty from Brazil, Qatar, Jamaica and Chile.

This conversation builds on the dynamic discussion we hosted in August with an Ontario panel. It will help participants identify similarities, differences and potential strategies to ensure the next generation of nurses thrive in the profession.

Discussion questions include the following:

  • What has it been like being a nursing student during this time? What are your hopes, needs and concerns?
  • What is required to support students in their final year as they transition into the workforce so they have an exciting and long career in nursing?

Register now.

Watch and read about earlier webinars here.

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

October 18, 2021, 2:30pm - 4:00pm

This webinar, originally scheduled for September 20, has been re-scheduled due to the federal election for October 18, 2:30-4:30 pm.

This is a webinar series designed for members of the public interested in receiving updates on RNAO’s Black Nurses Task Force and to engage them in meaningful conversations that will inform the work of the Task Force. The Black Nurses Task Force has a mandate to tackle anti-Black racism and discrimination within the nursing profession.

Upcoming webinar

Oct. 18, 2021, 2:30-4:00 pm

Topic: The Lived Experiences of Black Nurses Using Mental Health Services in Ontario


Dania Versailles, RN, MScN, CPMHN (C), Director of Clinical Services of Outreach, Canadian Mental Health Association – Ottawa

Register now.

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 detailed Ontario epidemiological summary from Public Health Ontario, you can go here.

According to the latest Situation Report #530 for October 8, the case count was as follows: 590,677 total, +573 change from yesterday; 9,786 deaths, +10 change from yesterday.

No updates for today.

Staying in touch          

Keeping in touch remains important as we face the pandemic and other challenges in Ontario, in Canada and elsewhere – in particular, in Africa and Latin America – two of the continents most affected by COVID-19 and its variants – delta and lambda. Feeling that we are part of a community and that we have each other’s backs helps us get through these challenges, becoming better people in the process. We are eager to hear 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 my executive assistant, Peta-Gay (PG) Batten at pgbatten@rnao.ca. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!

Thank you for being there for your community – everywhere and in all roles! Together, in solidarity, we are strong and resilient. In Canada we see hope at the end of this long pandemic tunnel. Please keep encouraging your colleagues, their loved ones and your communities to be fully vaccinated. We must not forget, however, about our privilege. Canada has purchased more vaccines than what it needs, while 9 out 10 countries have almost nothing. Like in other challenges we face, such as racism, Islamophobia, and other forms of discrimination, we are not safe until everyone is safe. Vaccines for all – literally for all, across the world – must guide policy in the upcoming 12 months. Let’s learn from the 17-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 all along to come together and work as one people for the good of all. Let’s join efforts to demand political leaders bring about !SafeZones to protect patients, students, and workers; and #Vaccines4All to protect humanity.

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


3 Oct - RNAO’s continuing media profile: The September 2021 report – go here.

3 Oct - RNAO commends move to mandate vaccination for long-term care staff; urges for more – go here.

3 Oct - Action Alert – Stop fighting First Nation children in court: Concrete action on Truth & Reconciliation – go here.

25 Sept - Accelerating knowledge uptake and sustainability – learning from the Leading Change Toolkit – go here.

25 Sept - Connecting the dots – far right extremism as a serious health threat – go here.

25 Sept - How anti-vaxxers, conspiracy theorists, and the far-right came together over COVID – go here.

25 Sept - The anti-vax movement is being radicalized by far-right political extremism – go here.

19 Sept - Nurses urge Canadians to vote – go here.

19 Sept - Keeping schools open and safe – learning from Spain’s exceptional experience – go here.

11 Sept - Vote in the federal election! Nurses vote for a healthy recovery for all Canadians – go here.

11 Sept - Federal election: Which party has the best climate plan? Here’s where they stand – go here.

11 Sept - Where the parties stand on gun control in the 2021 federal election – go here.

4 Sept - RNAO condemns protests outside health organizations – go here.

4 Sept - RNAO’s continuing media profile: The August 2021 report – go here.

4 Sept - RNAO welcomes important steps to implement vaccine certificates – go here.

28 Aug - Mandatory vaccination in process; vaccine certificates coming to Ontario – go here.

28 Aug – MSF on boosting global vaccine supply – go here.

21 Aug - Nurses call on voters to vote for a healthy recovery for all – go here.

21 Aug – RNAO calls for a stronger vaccine mandate and action on vaccine certificates – go here.

21 Aug - WHO condemns rush by wealthy nations to give Covid vaccine booster – go here.

21 Aug - Calling on Canada to back WHO Moratorium on Booster Shots and Donate Vaccines – go here.

15 Aug - Why is Delta such a worry? – go here.

15 Aug - This is what we know about the Delta variant and kids – go here.

15 Aug - RNAO welcomes mandated vaccination for health care workers – go here.

8 Aug - COVID-19 vaccine boosters: is a third dose really needed? – go here.

8 Aug - RNAO calls to implement vaccine passports to help reopen Canada – go here.

8 Aug – School reopening plan: additional measures needed to stave off worst effects of fourth wave – go here.

1 Aug - RNAO’s continuing media profile: The July 2021 report – go here.

1 Aug - Preparing for the fourth wave – go here.

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