October 9 2020 COVID-19 report
Dear Colleagues: Welcome to our Friday, October 9 report – now in the eighth 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.
RNAO relieved that Premier Ford engages late, but essential, action to lessen spread of COVID-19
RNAO has been a central voice in Ontario alerting for the need to engage action against a galloping second wave of COVID-19. You can see some of our multiple interventions in social and mainstream media -- asking for government intervention from early September -- when we warned that, baring closures of inside non-essential places, we would see disastrous results. Our incessant actions intensified these past two weeks, as the alarming numbers showed we were heading in the wrong direction. A week ago we had another press release, desperate for action. You can see the full coverage in our tweeter accounts by following @RNAO and @dorisgrinspun, and in our daily media captured here. Today, the Ontario government took action. Please RT these important tweets here, here, here, here, and here-- acknowledging the announcement and asking next steps:
Here is RNAO’s press release today:
Nurses are relieved to hear Premier Ford is taking important steps to lessen the spread of COVID-19, especially in areas where cases counts are especially high, including Toronto, Peel and Ottawa. The government should act fast to add additional regions to these measures, based on the relevant indicators.
RNAO says Friday’s (Oct. 9) announcement that will come into effect Saturday (Oct. 10) includes closing for 28 days indoor dining in restaurants, bars, casinos, cinemas, and gyms, among other measures announced by the premier.
Grinspun says nurses wish these agonizing, but indispensable measures would have come earlier given that nurses had called for these weeks ago. Given the exponential spread of the epidemic, late action entails much larger loss of life, suffering and economic costs until we bring it under control. “We are glad the measures are taking effect ahead of the holiday weekend. It would have been devastating by next week, especially given the 939 cases reported today.”
Grinspun says there are lessons to be learned and they begin at the Premier’s command table. She says “the public has a right to know who sits at that table and who is giving advice because these measures should have been enacted weeks ago. The government was slow to act and thus made the situation much harder for everyone. Nurses are appalled that communications from health officials have blamed and shamed the public, ignoring socioeconomic conditions that make it very hard for vulnerable sectors of the public to distance and isolate.”
Morgan Hoffarth, RNAO president says these actions are especially important because no one is immune from this insidious virus and the second wave is happening just as flu season is kicking in. As pointed out by top epidemiologist Dr. David Fisman and others, if we act when we see hospitalizations up and ICUs filled – as is happening now – we are acting one month too late, given the lags involved. Similarly, if we wait for infections to start impacting on vulnerable age groups, as we are seeing now, we are, again, acting one month too late,” says Hoffarth.
Grinspun says nurses across the province also want to thank Ontarians for doing their part. “We appreciate what people are doing to keep them, their loved ones and others safe. We ask you to please keep doing what you are doing. Stay at home as much as possible, work from home if you can, wear a mask, wash your hands and maintain physical distancing if you have to go out. We understand businesses are hurting so if you can, please order curbside pick-up at cafes and restaurants this weekend.”
“We have the power to get ahead of this virus and change the direction of this pandemic. Let’s do it while we can. We are all in this together,” says Grinspun.
Patient-centred-care – the dream and the reality
RNAO has been advocating for person-centred care for years. Our Person-and-Family-Centre Care Best Practice Guideline (BPG) was first published in 2002 (it is now in its third edition), and thousands of organizations and health providers use this evidence-based tool to advance their own commitment to engage with the person – not only with their illness. This BPG is a mandatory one for the Ontario Health Teams (OHTs) that work with RNAO and Best Practice Spotlight Organizations (BPSO). RNAO’s work with Ontario Health Teams on person-and-family centred-care was at the centre of a BPSO OHT meeting two weeks ago. Please get a real glimpse of what person-and-family-centred care looks like from the field by reading the two contributions shared below from a caregiver and a health provider. The first one, by Mik Phipps, is a glimpse into person-centred-care at its best – and how small actions can have enormous meaning. The second, contributed by Helen Lascelle, shares an experience where patient-centred-care was a dream, not a reality.
Small steps lead to big surprises (a contribution of Mik Phipps)
Hi! My name is Mik and I’m delighted to share with you the story of a moment that truly exemplified why we, as health care practitioners, must listen to our clients or patients when they express their own desired path to service or treatment, especially when it may deviate from our usual approach.
In my role as an Outreach Case Manager with the Ottawa branch of the Canadian Mental Health Association, I often get to experience firsthand the value of a person- and family-centred care approach. While working with folks experiencing homelessness and a mental illness, I’ve had the privilege of witnessing the strengths and resources a person draws from their community.
Outside a local shelter, I met with a client of CMHA Ottawa who requested assistance with changing their medication dosage to reduce unpleasant side effects. I was eager to be supportive and immediately started to outline my own plan. This included a call to their clinic, scheduling an appointment, arranging for accompaniment, etc. This plan would likely unfold over a few days or even weeks if missed appointments had to be rescheduled.
That’s when the person suddenly spoke up and said: “No, thanks! Let’s go to my church instead!”
That stopped me in my tracks.
Luckily, we use a strengths-based approach and my role allows for the flexibility and spontaneity to accompany people in their community as determined by what they value as important. I was excited to support this person in taking the lead. So, of course, I said a very enthusiastic “YES!”, then we headed towards the church (even though I had my own biased impression about the plan and was skeptical anything would come of it).
I couldn’t have been more wrong.
When we arrived, I found a church filled with people that all seemed to know each other. A volunteer community worker welcomed us and within minutes they were on the phone with a direct line to the person’s prescriber; they completed a consultation on the phone and arranged for delivery of the adjusted prescription to the shelter where the person was staying.
I was so impressed to see this person leverage his established network to navigate access to health care! Just as I was thinking of ways to celebrate this unexpected success, we learned a community meal was being served. The person I was accompanying said grace (a prayer before a meal) in English and Inuktitut for all those gathered around the tables and we shared a meal.
As we ate, I realized how close we came to missing this opportunity. By focusing on a person’s experience and relationships rather than only on formal ways of navigating health care systems we expand possibilities, allow more space for culturally significant experiences, and enjoy benefits that can go way beyond any expected outcome.
When patient-centred care is a dream (a contribution of Helen Lascelle)
I would like to share a personal experience of the health system being self-centered instead of patient-oriented. Roger needed a carpal tunnel surgery, which is typically a one-day surgery. However, Roger is 83 years old with multiple conditions: he is diabetic, only 27 % of his heart works, had a stroke that left him with cognitive loss, and is on warfarin and aspirin. The medication has to be stopped and restarted after surgery, and that is a big risk. The last time the warfarin was stopped he lost his legs’ strength and fell to the ground. He had to spend the night in the emergency. Do you think that this is a one-day surgery for him?
I asked if he can be hospitalized overnight after the surgery to make sure everything is coming fine. Or – could he have a nurse for the first night at home? The answer was a double negative. I am a 77 year old caregiver and surely, I would need help for the first few days. It will cost more if he is re-hospitalized because of a bad recovery.
I asked for help from Community Services. There is no residence that offers respite time for surgery recovery with French services in Ottawa. They can offer more respite time during the day… a care worker to whom I would have to explain everything? Or I can pay around $150 per day in a private residence with the risk of the Covid-19 virus. In any case, it would be up to me to coordinate everything.
It would be so nice if all the coordination of a patient’s needs would be taken in charge and adapted to his different needs. As a patient, I would like him to feel safe and in good hands – that his special needs are being addressed. As a caregiver, I would like to feel accompanied. We both would like to hear: You are not alone; we are there for you!
This is my dream!
Update on RNAO webinars and events
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Let’s Talk about Anti-Black Racism and Discrimination in Nursing
Our monthly webinar series is designed 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.
The upcoming webinar will be on Monday, October 19, 6:45-8:15 pm – stay tuned for details here. Information about past webinars, including presentation slides, can be found here.
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Landscape and Emerging Issues with E- Cigarettes: Webinar Series
Webinar 1 of a 3 part series - Wednesday, October 14, 12:00 - 13:00 pm
Vaping Landscape and Overview 101
This webinar is in partnership with the Registered Nurses’ Association of Ontario (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:
- Dr. Robert Schwartz, PhD, University of Toronto, Dalla Lana School of Public Health, Centre for Addiction and Mental Health, Ontario Tobacco Research Unit
- Mathew McGuigan, RN, BScN, Chatham Kent Public Health
Register here.
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Nursing and Compassionate Care in the Age of Artificial Intelligence Virtual Symposium
The symposium will happen on Wednesday, 21 October, 1:00-4:30 pm.
A new era in health care and in nursing has begun. COVID-19 has accelerated the adoption of virtual care delivery models in Canada. According to a recent Ipsos poll, in the next 10 years, Canadians envision a health-care system with health technologies powered by artificial intelligence (AI) — such as predictive analytics and robotics.
RNAO and AMS Healthcare are hosting a virtual pan-Canadian symposium to bring together nurses and other stakeholders to critically reflect and discuss this important topic.
Join us at our virtual symposium to learn more about the emerging future and its potential impact on the nursing profession and the delivery of compassionate care.
Target audience: nurses in all roles and sectors, other health professionals, educators, health service administrators, researchers, policy makers, media and technology experts.
Program-at-a-glance: click here Digital flyer: click here
Background documents are available here.
The event is free, but registration is required. REGISTER NOW
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Health System Transformation & COVID-19 Webinars - On Monday, November 5, 6:45-8:00 pm we will be holding the next monthly webinar for health providers. Details will be posted and registration is available by going here.
Information on past webinars, including videos and presentation slides, can be found here.
#Togetherwecandoit
Today is day #204 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 #Maskathon to help spread the message and the actions of masks-for-all!
Government took swift action, and we too must push the brake pedal. With the number of new cases in Ontario growing exponentially -- 732 Friday a week ago to 937 today -- we are now in the thick of the second wave. Now that government took action to halt the spread – we MUST ALL demand swift actions from ourselves. Let’s remember to do: 1) If you can, work from home; 2) Use a mask anytime you are out and cover well your mouth, nose and chin (I still see many people with the mask beneath their nose or hanging in their neck); 3) Use sanitizer or wash your hands before you put your mask and upon taking it off, and don’t touch your face while outside your home; 4) Keep your bubble to those in your household or a couple of friends who commit to your same bubble; 5) Remind your friends, family members, colleagues, neighbors and just about anyone you know to protect themselves and others.
I shared last week and it is worth repeating that: we are in for another difficult period and we are all tired! This is why you should try to get 6-8 hours of sleep (I am trying... L). On the positive side, RNAO is here for you – always!!!!!!! Tell us about the important work you do. When you are not working, think of reading a good book, cooking a yummy meal while listening to music you love, joining our webinars, joining our facebook groups, join our virtual chapter meetings, do some good exercise (not at the gym), take walks, and join the #togetherwecandoit campaign! On this last point, check our awesome director of communications Marion Zych. Building resilience through this challenging time is essential! If you have other tips, please send those to pgbatten@rnao and we will feature those next Friday in our Blog.
Visit our website for #Maskathon message alongside RNAO’s Maskathon Portal where you can borrow graphics for your own social media play! And, join us on the #Maskathon challenge by wearing your mask correctly, as together we educate and encourage everyone – to wear a mask including children!
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 #258 for 9 October:
|
Case count as of 10:00 am October 9, 2020 / Nombre de cas à 10h00 le 9 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 / |
36 834 296 |
+ 363 569 |
1 068 099 |
+ 6 322 |
|
Canada* |
175 559 |
+ 2 436 |
9 557 |
+ 16 |
|
Ontario** |
57 681 |
+ 939 |
2 997 |
+ 5 |
Update
- Ontario Taking Immediate Action to Reduce Rates of Transmission in Toronto, Ottawa and Peel Region. To protect the health and wellbeing of all Ontarians, the government is acting on the recommendations of the Chief Medical Officer of Health and the Public Health Measures Table to put in place additional targeted public health measures in the Ottawa, Peel and Toronto by moving them into modified Stage 2 restrictions for a period of at least 28 days in response to higher than average rates of transmission.
- Ontario Implementing Additional Public Health Measures in Toronto, Ottawa and Peel Region. In consultation with the Chief Medical Officer of Health, the Public Health Measures Table, and local medical officers of health and other health experts, the Ontario government is introducing additional targeted public health measures in the Ottawa, Peel, and Toronto public health unit regions. These modified Stage 2 restrictions will be for a minimum of 28 days and reviewed on an ongoing basis.
- Increased COVID-19 Precautions for Congregate Care Settings. The Ontario Government is setting out increased precautions for congregate care settings in areas where there is a high rate of community spread of COVID-19 to ensure the province's most vulnerable and those who care for them are safe. Those settings include homes serving adults with developmental disabilities, shelters for survivors of gender-based violence and human trafficking, children's residential settings, youth justice facilities and Indigenous Healing and Wellness Strategy residential programs that support Indigenous individuals and families both on- and off-reserve.
- The Management of Cases and Contacts in Ontario guidance has been updated and is available on the Ministry’s website.
- Retirement home alert status (high alert and alert) will be posted on the Retirement Homes Regulatory Authority website, along with the up-to-date visiting policy. The policy is available here and here.
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 deeply to each and all of you 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, during stressful and exhausting times, the only silver lining is -- coming together and working as one people – for the good of all!
As case numbers are now consistently increasing in Canada – in particular in Quebec and Ontario – we must redouble our efforts to tackle COVID-19 with the best tools at hand: full, accurate and transparent information, public health swift actions, and individual accountability.
Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, O.ONT
Chief Executive Officer, RNAO
PAST BLOG ITEMS:
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.
29 May - Foot care nurses – go here.
29 May - Update on pandemic pay; pandemic pay in consumption and treatment sites – go here.
28 May - RNAO Calls for Immediate Action in Response to the Canadian Armed Forces’ LTC report – go here.
26 May - Update on VIANurse – go here.
26 May - Ending homelessness: Will you join us to build a COVID-19 recovery for all? – go here.
24 May - Technology as a solution: Opportunities and pitfalls of COVID contact-tracing apps – go here.
21 May - Debunking PPE myths with Dr. Jeff Powis: Which masks should health care workers wear during COVID-19? – go here.
20 May - RNAO response to announcement of an independent commission into Ontario's long-term care system – go here.
19 May - With the pandemic curve flattening, VIANurse program will focus its effort on outbreaks – go here.
14 May - Nursing Week update – go here.
14 May - Pandemic puts health system to the test: Nurses have answers for shortfalls – go here.
14 May - Disappointment for not being included in pandemic pay – go here.
13 May - RNAO saddened by the loss RN Brian Beattie to COVID-19 – go here.
13 May - End racism and prejudice – go here.
12 May – Enhancing Community Care for Ontarians (ECCO 3.0) – go here
11 May - Nurses share their successes and challenges during National Nursing Week – go here.
10 May - A story of hope, ingenuity, support and genuine care for an LTC resident – go here.
7 May - Counting the missing deaths: Tracking the toll of the coronavirus outbreak – go here.
5 May - Life on the front lines of the pandemic: Profile of RNAO member NP Daria Gefrerer – go here.
5 May - Addressing differential access to virtual care due to technology inequities – go here.
3 May - Being person-and-family-centred during COVID-19 – go here.
1 May - Migrant agricultural workers and the COVID-19 crisis – go here.
30 April - COVID-19 pandemic in provincial institutions and correctional centres – go here.
28 April - Supporting First Nation Communities during COVID-19 – go here.
27 April - Responses to COVID-19 for persons experiencing homelessness in Toronto: An update – go here.
25 April - Lessons learned through a COVID-19 nursing home outbreak – go here.
25 April - Letter from a retired RN to Premier Ford: The problems with LTC were evident long before COVID – go here.
23 April - Working with seniors in long-term care requires specialized knowledge – go here.
22 April - Shaking the stigma: We need a proactive COVID-19 response for mental health and addiction – go here.
21 April - We Require Expanded and Accessible COVID-19 Data in Ontario – go here.
20 April - Can Loss of Smell and Taste Help Screen for COVID-19? – go here.
18 April - COVID, Trump and the World Health Organization – go here.
16 April - A Home Based Model To Confront COVID-19 – The Case Of The Balearic Islands – go here.
15 April - COVID-19 and the Challenges in Homecare – go here.
14 April - Reprocessing Of N95 – An Update – go here.
14 April - A New COVID-19 Facility For Persons Experiencing Homelessness In Toronto – go here.
13 April - Practical Tips for Safe Use of Masks – go here.
10 April - Ontario’s Tragedy in Long Term Care Homes and Retirement Homes – go here.
10 April - RNAO Action – Supporting Long-Term Care – go here.
10 April - Update For Nursing Students – NCLEX Exam – go here.
9 April - Celebrating Passover, Good Friday, Holy Saturday, Easter Sunday and the start of Ramadan during a pandemic – go here.
9 April - Guidance on use of N95 mask – go here.
7 April - Sentinel surveillance and on-site testing in the homeless service sector – go here.
7 April - Reprocessing of n95 – safe? – go here.
5 April - We must change the way we do testing and case definition – go here.
5 April - Ringing the alarm bells on critical care beds – go here.
4 April - COVID-19, stay at home and domestic violence – 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 Hopkins CSSE.