October 23 2020 COVID-19 report

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Dear Colleagues: Welcome to our Friday,October 23 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 to share this report and links with anyone interested.

I am extremely humbled and honoured to share that I was the recipient this week of The American Academy of Nursing (AAN) COVID-19 Courage Award on Policy. These awards “honor the incredible contributions nurses, have made to save lives, advance health equity, and protect communities during the novel coronavirus (COVID-19) pandemic.”

Colleagues, I dedicate this award to you all. It represents an important recognition for the expertise, deep commitment, strenuous effort, compassionate drive, and courage being demonstrated by our RNAO team: staff, board, Assembly of Leaders and over 45,000 RNAO members, as well as BPSOs at home and abroad. I am privileged to work with you every day, as we pursue structural changes, policies, and funding to tackle the enormous health and social impacts brought about by this insidious virus, especially for vulnerable and marginalized populations. I also want to thank our partners outside of the RNAO family – nurses and non-nurses -- some of whom I met during this pandemic: You have been central to our advocacy and we will continue to lean on you.

Colleagues and friends, I thank you deeply for your beautiful text messages and emailscongratulating me. A special thanks to our Minister of Health Christine Elliott for her meaningful tweet. I ask you all to take this award as a sign of encouragement to continue the fight with evidence, compassion, courage, and determination. There will be an end to COVID-19, and when it happens, we will party ourselves away for having fought this virus together. We will also shed many tears of sorrow for the lives lost, and honourthose who are not with us by continuing to work for a health system that delivers better for ALL. 

 

Responding to the second wave of COVID-19: RNAO continues to speak out in the media

RNAO continues to speak out in the media about issues related to COVID-19 and our calls to the Ontario and federal governments for action regarding the alarming rise in the pandemic wave. This month, we focused primarily on two key issues: tightening restrictions in regional hotspots to slow the spread of the virus, and addressing the renewed and predictable crisis in long-term care (an issue we’ve been pushing for months – and years!). The RNAO COVID-19 press room has links to 42 media hits so far in the month of October.

On October 2, with 732 new COVID-19 cases that day, the Ontario government announced new measures, mandating province-wide masks in public indoor settings and targeted measures in Ottawa, Peel and Toronto, including restricted indoor capacity in restaurants, bars and nightclubs, as well as in gyms and event facilities. As I stated that day in an interview with CBC News, the actions announced were “too little, too late.” I added that, with all due respect to Premier Ford, RNAO and others had been asking for universal masking since at least June. RNAO also called for closing indoor activity in non-essential places. Despite our frustration with the slow action, RNAO recognizes that it took courage from Premier Ford to act three days ahead of Thanksgiving.

Indeed, Premier Ford listened on the need for more stringent measures on October 9, announcing important measures regarding closures of indoor places in the three hotspot regions. RNAO welcomed the new measures and added that the time it took for the Premier to act makes us question the quality of the advice he is receiving. The reality is that the situation today could have been better had we acted earlier, as RNAO and many others had advised.

RNAO has called for the province to develop thresholds for public health measures so the public can understand the seriousness of this virus and continue its efforts to contain it, in a revitalized way. We’ve pushed this message through traditional media and social media using the analogy of a stop light. Regions facing a red light need to return to a modified stage 2 or else case counts in the province will continue to climb, vulnerable populations will suffer more illness and death, and our health system will crumble.

The premier said today that additional hotspots in the province may have to move soon to a modified stage 2. To this, we respond: Premier, move immediately to save people from illness, save lives, as well as save the economy. The longer the virus spreads without restrictions, the more painful the required retrenchment becomes. Unfortunately, COVID-19 doesn’t take any breaks; it is a nasty and insidious virus.

The second targeted issue for RNAO this month has been our ongoing public fight – yes, I mean fight – to address the desperate needs of long-term care (LTC) nursing homes. The two key aspects here are 1) to keep Essential Family Care Partners in, even in the face of an outbreak; and 2) the immediate need to protect Ontario’s long-term care residents by hiring more staff. On the latter, minister of long-term care Dr. Merrilee Fullerton has had our report for months and we have yet to hear any feedback. We have raised these same requests in our meetings with her since she took this portfolio. We also sent her RNAO’s call for a Nursing Home Basic Care Guarantee in June, and we have continued to urge the premier and minister of long-term care to “hire, hire, hire.” Enough of reports, investigations, and inquiries – now numbering 37 in the past 21 years.

Today, the independent commission into long-term care released several early recommendations in a letter to minister Fullerton. There is a tone of urgency to their letter: they say there is no need for further study; what is required is timely implementation. Their recommendations include hiring more staff in full-time positions, including “an appropriate staff mix to meet the increasing acuity and complex care needs of residents,” for a total of four hours of direct care for each resident. This, again, is exactly what we have called for in our Nursing Home Basic Care Guarantee. We met twice with the commissioners and urged them to speak with the premier about increasing funding to long-term care homes. We are very glad to see the commissioners are heeding our advice which by now is expert consensus. In a Globe and Mail article today I am quoted saying the commission is clearly issuing a call for permanent solutions to the staffing crisis. “This is not Band-Aid approaches anymore,” I said. “We are already three months late.” The ball is now in the hands of premier Ford and minister Fullerton; they must deliver now. The time for “carefully reviewing” recommendations is over.    

On Sept. 23, prime minister Justin Trudeau promised national standards for Canada’s long-term care home in the Speech from the Throne. A month earlier, on August 27, RNAO had written to the prime minister asking exactly for that. Our message has been: We’ve already lost too much time and too many lives in long-term care, so we need national standards now. I said in an interview with CityNews,  “We wouldn’t support money without strings attached. We want standards,” and we will continue to push this issue until they are developed and implemented.

As we are all painfully aware, the issues in LTC extend beyond Ontario. For this, we have decided that our next Health System Transformation & COVID-19 Webinarwill focus on LTC. It will take place on Monday, November 9, 6:45-8:00 pmand it will be a Cross Country Meeting with a call to Collective Action for Long-Term Care Reform in Canada.See details in the webinars section below.

RNAO has put out several media releases on important issues recently and the two that garnered the most media coverage were related to our call and then our response to public health measures to deal with the rising infection rates. RNAO continues to be dedicated to making sure the voice of our members and the needs of the public we serve are heard by media.

Update on RNAO webinars and events

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Webinar on: Ask the Expert - Cannabis Edibles, Extracts and Topicals

RNAO hosted this webinar onOctober 22in partnership with the Cannabis Knowledge Exchange Hub at CAMH. You can watch the recorded webinar here.

The purpose was to:

  • understand the prevalence of different modes of consumption for cannabis
  • understand the risks and benefits for different modes of consumption for cannabis
  • review changes in cannabis use patterns during the COVID-19 pandemic

Presenter: Dr. Robert Gabrys, PhD, Canadian Centre on Substance Use and Addiction

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Upcoming webinars:

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

Our monthly webinar series isdesigned for RNs, NPs and RPNs interested in receiving updates on RNAO’s Black Nurses Task Force and to engage 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.Media is welcome. Please RT a powerful piece by bxavier@thestar.ca(Twitter: @breanna_xcarter)in the Toronto Star

The upcoming webinar will be on Monday, October 26, 6:45-8:15 pm:

Topic: Systemic Racial Discrimination and Microaggressions in the Workplace: From Recognition to Action. Everyone is welcome, please RT 

Objectives:

  • Explore manifestations of systemic racial discrimination and microaggressions experienced by Black nurses in the workplace.
  • Discuss how complaints of anti-Black racism and discrimination are raised and addressed in the workplaces of Black nurses across the health system.
  • Generate awareness about the mental and physical health impacts of anti-Black racism and discrimination and identify trauma-informed supports for Black nurses in the workplace.
  • Describe types of and effectiveness of training and orientation programs around cultural competence/safety, diversity, and anti-oppression from the perspective of Black nurses.
  • Share and discuss approaches for responding to and coping with systemic racial discrimination and microaggressions in the workplace—experienced personally or witnessed.

Presenters:

  • LaRon Nelson, PhD, RN, FNP, FNAP, FAAN
    Independent Foundation Professor and Associate Professor of Nursing and Associate Dean of Global Affairs & Planetary Health at Yale University, Scientist with MAP Centre for Urban Health Solutions in the Li Ka Shing Knowledge Institute at St. Michael’s Hospital
  • Jackie Williamson, RN, BScN, MEd, PhD
    Professor, Durham College
    Staff Nurse, Centre for Addiction and Mental Health (CAMH)
  • Crystal Garvey, RN BScN MScN PhD (student)
    Professor Collaborative BScN Program, Durham College/ Ontario Tech University

Detailshereand register here.

Information about past webinars, including presentation slides, can also be found here.

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Landscape and Emerging Issues with E- Cigarettes: Webinar Series

Webinar 2 of a 3 part series - Tuesday, October 27, 12:00 - 13:00 pm

Preventing E-Cigarette Use Amongst Youth

This 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:

  • Cindy Baker-Barill, RN BNSC, Simcoe Muskoka District Health Unit
  • Claire Alexander, RN BScN, Simcoe Muskoka District Health Unit
  • Adam Armitage, RN BScN, Simcoe Muskoka District Health Unit               

Register here.

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Health System Transformation & COVID-19 Webinars - On Monday, November 9, 6:45-8:00 pm we will be holding the next monthly webinar, entitledCross Country Meeting: Collective Action for Long-Term Care Reform in Canada.

COVID-19 has swept through long-term care (LTC) homes, taking the lives of over 5,000 residents and devastating thousands of family members and loved ones. Health care providers in LTC are exhausted, distressed and fearful of what is to come. 

Prime Minister Justin Trudeau has committed to national standards for LTC. Canadians across the country recognize the need for transformation; we want the very best care for our parents, grandparents and seniors.

RNAO's voice is over 45,000 members strong and thousands have shown their support for reform by signing our action alerts. We must build the momentum to affect change by mobilizing these voices and joining with others who care.

On Nov. 9 we will be hosting a virtual town-hall style meeting focused on ensuring national standards become a reality. The purpose is to mobilize collective action.

Who is invited? Anyone across Canada who cares about true reform in LTC: Residents, families, nurses, PSWs, reporters, students, interprofessional colleagues, concerned Canadian citizens, allied organizations.Let’s talk action and let’s drive it! 

Sign up here for free.

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

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NP Knowledge Exchange Virtual Symposium

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” this November at our seventh-annual NP Knowledge Exchange Virtual Symposium.

On Nov. 23, you 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, understand 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 minister of health and many more. Co-chairs for the day are NPIG Chair Sally Baerg and RNAO CEO Dr. Doris Grinspun.

This event is open to all NPs in Ontario who are RNAO members.

See the agenda online. 

Register online today to secure your spot. 

#Togetherwecandoit

Today is day #219 of RNAO’s#TogetherWeCanDoIt campaign. RNAO began this campaign on March 19 to cheer up health care workers and others in essential services. A central pillar of our campaign is #Maskathonto help spread the message and the actions of masks-for-all!

In the thick of the second wave and with new areas moving into modified Stage 2 in Ontario, in other parts of Canada, and the world (the latter with some in full lockdowns), it is clear that we MUST avoid travelling from one community to others. If we don’t, things will get much worse and for longer.

We call on everyone – again and again – to1)work from home, if you can; 2) Use a mask anytime you are out and cover well your mouth, nose and chin; 3) Use sanitizer or wash your hands every time before you put your maskon and upon taking it off, and don’t touch your face while outside your home; 4) Keep your bubble to those in your household; 5) Remind your friends, family members, colleagues, neighbors and just about anyone you know to protect themselves and others. And, please do exercise to keep healthy and connect virtually – LOTS -- so no one feels lonely.

Keep joining our webinars, facebook groups, and tell us how else we can support you! We are always here for you! Keep sending tips to pgbatten@rnao and we will feature those in our Blog. 

Our #Maskathon is still very active and needed. We love your pics! Keep sending these and encourage others to visit the RNAO’s Maskathon Portal where they can borrow graphics for their own social media play! We need your help in educating everyone on how to wear a maskcorrectly. On this later point, see what RNAO’s Nursing Students did, it’s educational, FUN and great for you to RT!

BTW, follow NSO on tweeter and if you are a nursing student – BScN or bridging program: Join for FREE! And, for those who are already RNs or NPs: check this out there is RNAO fever and it is a good fever to have as we have now surpassed 45,000 members!

Post your pics using #Maskathon because#TogetherWeCanDoIt.

 

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 #272 for 23October: 

 

Case count as of 11:00 am October 23, 2020 / Nombre de cas à 11h00 le 23 octobre 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

42 169 183

+ 574 879

1 144 928

+ 7 046

Canada*

209 974

+ 3 614

9 871

+  42

Ontario**

68 353

+  826

3 080

+  9

No updates for today.

 

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 continue to be tough times for many colleagues – especially those working in the front lines in countries around the world hit hard by evil COVID-19!

Remember, 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:

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. Please go and 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.