October 3 2021 COVID-19 report


Dear Colleagues: Welcome to our Sunday, October 3 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) RNAO celebrates the ruling on compensation for First Nation children and issues an action alert urging the federal government to stop fighting them in court; (2) RNAO commends the move to mandate vaccination for long-term care staff and asks for more; (3) the spring/summer issue of RNJ is here; (4) RNAO’s media report for September 2021; and (5) an invitation to join us this coming Tuesday – from anywhere in the world – for the launch of the Leading Change Toolkit which will revolutionize the way you lead change.

Action Alert – Stop fighting First Nation children in court: Concrete action on Truth & Reconciliation

On Sept. 29, 2021 the Federal Court dismissed an appeal by the federal government for a judicial review of landmark human rights tribunal decisions that ordered compensation and determined service eligibility for First Nation children and their families.

Join us! Demand that the prime minister stop the federal government’s long- standing court battle with First Nation children and compensate them for the effects of inadequate and discriminatory funding.

The Federal Court upheld the 2016 Canadian Human Rights Tribunal rulings that ordered Ottawa to pay $40,000 to each First Nation child (along with their parents or grandparents) to compensate for inadequate funding for health, educational and social services and for taking an overly narrow approach for eligibility for Jordan’s Principle.  Jordan's Principle ensures that no health, social or educational service for a First Nation child is denied or delayed because of jurisdictional squabbles between different levels of government. The tribunal found that Canada knew about the negative effects of their actions, including that inadequate funding drives First Nation children into state care. The federal government has 30 days to appeal the decision.

In the spirit of reconciliation, let’s ensure that First Nation children and their families are compensated for the harm caused by the inadequate and discriminatory funding of health, educational and social services to First Nation children.

Join us! Demand that the federal government stop fighting First Nation kids in court. Go here to sign the Action Alert.

RNAO commends move to mandate vaccination for long-term care staff and urges the same for all other health and education sectors

Toronto, Oct. 1, 2021. The Registered Nurses’ Association of Ontario (RNAO) commends and fully supports Minister of Long-Term Care (LTC) Rod Phillips’s announcement on mandatory vaccination for all in-home staff, support workers, students and volunteers in LTC, effective Nov. 15. As RNAO has publicly stated many times, this is a necessary action that will further protect LTC residents and staff from COVID-19 infection caused by unvaccinated health-care workers.

This move from Minister Phillips comes at a time when roughly half of Ontario’s 626 LTC homes (367) have staff immunization levels below 90 per cent. This is an unacceptable rate that places staff and residents at increased risk of being infected by the deadly COVID-19 virus and its highly transmissible Delta variant. RNAO expects this mandate will follow a formal process of proof of full vaccination with a narrow list of medical exemptions aligned with those in the vaccine certificate.

As a next crucial step in Ontario’s fight against COVID-19, RNAO continues to urge Premier Ford and other ministers to extend this mandate and immediately adopt the mandatory asks of nurses: mandatory vaccination for all health-care workers across all sectors, and mandatory vaccination for all teachers and education staff, unless medically exempt. 

“Nurses have said time and time again that the onus should not be on the patients to wonder whether they are at risk of COVID-19 infection when seeking care,” says RNAO CEO Dr. Doris Grinspun. “We applaud Minister Phillips for mandating vaccination to protect staff and vulnerable residents in LTC, and urge the premier and Ministers Christine Elliott, Raymond Cho, Stephen Lecce and Jill Dunlop to follow suit in announcing mandatory vaccination for all workers across all settings and sectors, meeting the same Nov. 15 deadline as LTC.”

“A consistent approach for all sectors and settings is imperative to our success in lowering the harm of the Delta variant, as staff move between settings and sectors,” says RNAO President Morgan Hoffarth. “It is not fair to leave it to the CEOs of hospitals, home care agencies or other health organizations to make individual decisions regarding mandating vaccination for their staff.” Hoffarth adds that “with each day that passes without mandatory vaccination for all health-care providers, patients’ health is being compromised.”

RNAO says the time is now to also mandate the same for all education staff in daycares, schools and post-secondary institutions. Formal proof of vaccination, not just an honour system, as has been observed at a number of universities across Ontario, is vital.

“With the temperature cooling down and movement to indoor settings increasing, mandatory vaccination of all staff must happen now to keep students safe and prevent closures – even temporary closures – of any education site,” says Grinspun.

RNAO’s continuing media profile: The September 2021 report

Throughout September, RNAO focused most of its media presence on the following topics:  Ontario’s new vaccine certificate system, condemning anti-vax protests, the federal election and the crisis facing the nursing profession.

The vaccine certificate system (announced on Sept. 1) took effect on Sept. 22, which means people are now required to show proof of full vaccination to enter high-risk indoor settings (e.g., indoor dining, bars, gyms, cinemas and sports venues). I wrote a letter to the editor for the Toronto Star (Sept. 11) in response to a Toronto reverend who was concerned about individuals not having to show their vaccine certificate to enter places of worship. RNAO shares this concern and urges the government to add places of worship as well as personal care services and non-essential retail to the list to prevent additional cases that may come from gathering in these indoor spaces. I told QP Briefing on Sept. 14 that I was surprised the government wasn’t mandating vaccines for employees in settings where proof of vaccination is required: “I think that the more consistency we have on the use of [these certificates], the more people will comply and people will protect others.”

On Sept. 24, the province announced it would be increasing capacity limits in theatres and sports venues. On the same day, RNAO published a media release arguing the government’s announcement should have instead focused on mandatory vaccination for all health-care workers, as many long-term care (LTC) residents are still being infected and dying from COVID-19 due to unvaccinated staff. In a Sept. 29 letter to the editor I wrote for the Globe and Mail, I highlighted the absurdity that health-care workers must show proof of vaccination to enter a gym or restaurant, yet can go to work unvaccinated and potentially infect  their patients. If you haven’t already, please sign and share RNAO’s Action Alert on nurses’ three mandatory asks. The good news is that on October 1st, Minister of Long-Term Care (LTC) Rod Phillips announced mandatory vaccination for all in-home LTC staff, support workers, students, and volunteers by November 15, unless a staff member has a valid medical exemption. See RNAO’s media release above.   

With the Ontario government still not moving on mandatory vaccines for all health-care workers across all settings and sectors, some hospitals and health-care organizations are developing their own policies. Southlake Regional Health Centre gave its staff until Sept. 7 to provide proof of full vaccination or to undergo twice-weekly rapid testing on their own time in addition to attending an education session. Under this policy, employees who are not fully vaccinated by Oct. 30 could face termination with cause. I told NewmarketToday (Sept. 15) “this is a very difficult situation that health-care organizations have been put in by government not making vaccination mandatory. Patients need staff that is fully vaccinated so as not to add stress and to ensure safe care.” Meanwhile, Windsor Regional Hospital has suspended workers who were not vaccinated and has given them a deadline of Oct. 7 to get vaccinated or be terminated. I told CBC Windsor (Sept. 24) “to have any health-care professional, anywhere, in any health-care sector unvaccinated is a threat for patients.” In Kitchener-Waterloo and Wellington County, hospitals set a deadline of Oct. 12 for staff to be fully vaccinated or be placed on unpaid leave. “Health-care workers that are not fully vaccinated cannot be facing patients,” I told CTV News Kitchener on Sept. 27. RNAO fully supports hospitals and other health-care organizations that remove health-care workers who are not fully vaccinated from direct patient care.

A deeply worrisome development this month was the anti-vaccine protests held outside several hospitals, which led to the harassment of patients and health-care workers. This pandemic is providing “fringe groups of extreme ideologies a means of organizing,” I told CBC Windsor (Sept. 6).  On Sept. 7, RNAO issued a statement about these protests expressing “grave concern about the escalating violence and the inadequate action to avert these situations by local authorities and police services.”  We issued a joint statement with the Ontario Medical Association on Sept. 12 condemning these protests and calling for safe zones to be implemented around hospitals and other health settings, and since then, we’ve extended our call to include schools (see here and here). On City News (Sept. 12), I said “While many of these people are anti-vaxxers, there is a small percentage who are violent with white supremacist views.” With that in mind, we must protect health-care staff and patients. The group organizing these protests has leaders who are nurses. I told CBC Radio (Sept. 14) that this “is a disgrace to our profession.” Everyone has the right to peaceful protest; however, they should do so on the lawn at Queen’s Park and not put our already bruised health-care system in further jeopardy. On Sept. 25 I called in my blog to connect the dots and understand that far right extremism is a serious health threat.

On Sept. 20, Canadians headed to the polls for the federal election, which resulted in Justin Trudeau remaining prime minister under a minority government. Ahead of election day, RNAO issued a media release urging members to review our policy platform to make an informed decision and to vote for health. In response to the election results, I highlighted in QP Briefing (Sept. 21) that the nursing shortage and vaccine mandates are key issues that this government must tackle: “It affects all of us. We are one country. And so, we cannot afford to have every jurisdiction doing what they please.” I discussed my views on the election results in the first episode of RNAO’s new podcast series Small Talk.

The serious human resource crisis in nursing that Ontario is facing has been in the making for two decades, and it should not come as a surprise to health system leaders. RNAO has been warning governments, the Ontario Hospital Association and others during these two decades: Ontario has the lowest RN-to-population ratio in the country and this situation has been exacerbated by the COVID-19 pandemic and by Bill 124, which puts a one per cent cap on wage increases for nurses. I told the Toronto Star (Sept. 26), “the only short-term solution is retention, retention and retention.” Without this, people can expect their surgeries to be delayed because there will not be enough RNs to care for them. There is no quick fix, but immediate changes are needed. We need to build careers for them here in Ontario. One way to transition out of burnout and rebuild our supply of nurses is by utilizing internationally-educated RNs. However, many of these nurses are experiencing extremely long wait times with the College of Nurses of Ontario to assess their skills and qualifications and become registered to work here. I told CBC News (Sept. 27) this long wait time “needs to be fixed because it’s a disservice to Ontarians…newcomers and the profession.”

As we move into the colder months and spend more time indoors, we expect the number of COVID-19 cases to rise. RNAO will continue its active presence in the media advocating for vaccine mandates and public health measures that will help keep us safe amid the fall and upcoming winter. Thank you to our many members who have also appeared in the media and are using their voices to speak out for nursing and health. Our media outreach this month resulted in 397 media hits. As always, you can view all our media coverage in our press room on the COVID-19 portal.

The spring/summer issue of RNJ is here

A Q&A with Former Associate Chief Justice Frank Marrocco, a recap of RNAO’s 96th Annual General Meeting, the impact of being an RNAO member by President Morgan Hoffarth, our CEO Dr. Doris Grinspun's reflections on the evolution of our profession during COVID-19, and a profile on Aaliyah Hoo Kim-Baker, an RN who’s bringing a voice to marginalized populations. These are only a few of the many captivating stories in the latest issue of RNJ – now available online exclusively for RNAO members to enjoy. The spring/summer issue also includes the popular In the End column, as well as a new BPG corner and policy update. 

Go to RNJ.RNAO.ca and sit back, relax and enjoy your reading. Afterwards, take a moment to share your feedback with the editorial team. On the bottom of the RNJ website, select “Feedback” to provide your thoughts on this issue and the platform, as well as suggestions for future issues.

Not a member of RNAO? RN? Not an RN? Anyone can be a member! RNAO has membership categories for everyone. Go here for information about joining RNAO.

Accelerating knowledge uptake and sustainability – learning from the Leading Change Toolkit™

RNAO, in collaboration with Healthcare Excellence Canada, are excited to launch the new online Leading Change Toolkit. The toolkit is designed for change agents and change teams whose goal is to create lasting improvement with the uptake and sustainability of knowledge, like best practice guidelines (BPG).

What makes the toolkit revolutionary is the integration of two complementary frameworks to guide and support a change process:

  • The novel Social Movement Action (SMA) Framework (Grinspun et al., 2020) – a dynamic approach to change that applies a grassroots, ‘bottom-up’ people-led action in response to an urgent shared concern or strongly desired change. The SMA Framework is structured according to preconditions, key characteristics and outcomes. The 10 key characteristics include collective identity, intrinsic motivation and mobilized individual and collective action as cornerstones of social movement action. The framework, based on a concept analysis, formalizes RNAO’s experience for the past 20 years as an association of social movement action to transform nursing, evidence-based practice, health system transformation and improved outcomes.
  • The Knowledge-to-Action (KTA) Framework (Graham et al., 2006) – a structured, systematic process model that includes seven action-cycle phases. The KTA Framework is featured in the second edition of the Toolkit: Implementation of Best Practice Guidelines and has been used successfully by Best Practice Spotlight Organizations®(BPSO®) to achieve excellence in care outcomes, knowledge translation and sustained practice change. It builds on RNAO’s first implementation toolkit issued in 2002.

The Leading Change Toolkit is for you – it is available at no cost for everyone as a free download. It includes robust evidence, strategies, pragmatic and valid tools, worksheets and other resources to support your change initiative from start to sustainment. 

We invite you to join us on October 5th, 2021 from 12:00 – 1:30 p.m. ET for a virtual international webinar and launch of the Leading Change Toolkit. Register at The Leading Change Toolkit: National Webinar and Launch Registration (myrnao.ca).

The presentation will include members of the expert panel, including co-chairs Dr. Doris Grinspun and Dr. Janet Squires. Grinspun is CEO of RNAO and the founder of RNAO’s Best Practice Guidelines Program, including its BPSO social movement of knowledge mobilization. Squires is full professor, School of Nursing, University of Ottawa, Research Chair in Health Evidence Implementation, and senior scientist for the Ottawa Hospital Research Institute. 

You will also hear from members of the toolkit’s development team led by Katherine Wallace, Senior Manager, Implementation Science. And, you will hear Dr. Jennifer Zelmer, President and CEO, Healthcare Excellence Canada, as the Executive Co-Sponsor. The master of ceremony will be Susan McNeil, Associate Director, Guideline Implementation and Knowledge Transfer at RNAO’s International Affairs and Best Practice Guidelines (IABPG) Centre supported by Oliwia Klej, Project Coordinator, Implementation Science, IABPG.


RNAO Action Alerts

Sign the Action Alert calling on premier Ford to Implement the 3 Mandatory Asks of Nurses: 1) #MandatoryVaccination for health-care workers (unless medical exemption); 2)  #MandatoryVaccination for teachers and educational staff (unless medical exemption); and 3)   #MandatoryVaccinePassports for everyone (unless medical exemption). In addition, we are asking for indoor masking for children two years old and up.

Take action on Bill 124 and sign the Action Alert. Add your voice to the 5,302 others calling on Premier Ford to exempt health-care workers from Bill 124. We join the call to #RepealBill124. This is urgent given the deterioration of nursing human resources as colleagues leave the profession or move to the United States. President Biden is eager to welcome our awesome RNs.

Take action on global vaccine access: Sign an Action Alert calling on Prime Minister Trudeau to ensure global vaccine access. Let’s also make sure we urge Prime Minister Trudeau to match President Biden’s commitments to Covax.

Call on elected leaders to step up and end the opioid crisis: Sign an Action Alert calling on politicians at all orders of government to work together to save lives and bring this crisis to an end.

Enshrine a nursing home basic care guarantee in legislation, premier, set the path forward! Sign an Action Alert! Call on the premier to enshrine in legislation RNAO’s Nursing Home Basic Care Guarantee.

Webinar: COVID-19 Webinar Series

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

We are now well into our 20th month of the global COVID-19 pandemic. During this webinar we will pause to reflect on the most valuable lessons learned and ask you to share your insights.

On Monday, October 4, 2:00 - 4:00 p.m., join RNAO CEO, Dr. Doris Grinspun, nurses and other health-care colleagues to take stock of what the pandemic has meant for us individually and collectively.

Come to the webinar prepared to answer the following: What is the most valuable lesson learned from the COVID-19 pandemic for you, for nursing, and for health?

Please note: We will be recording this session and taking notes in case the discussion will be used to inform a future publication about the pandemic.

Register now.

Watch the September 13 webinar:

Topic: COVID-19 amidst back to school and a federal election

School is back in session, vaccine mandates and passports are being rolled out, and the federal election is upon us. What does this mean for Ontario nurses, families, teachers, community members and those deciding how to vote on Sept. 20?

Join us for a discussion with RNAO CEO Dr. Doris Grinspun who will share updates, latest news and pressing issues related to COVID-19. Learn how to use RNAO’s non partisan federal election policy platform to inform your election decisions, and hear about current calls to action that support a Just Recovery for All.

Watch the webinar here. See the slides here.

Watch and read about earlier webinars here.

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 #525 for October 1, the case count was as follows: 586,817 total, +668 change from yesterday; 9,743 deaths, +11 change from yesterday. (Three of the deaths occurred more than one month ago and were updated based on data cleaning).

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


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.