Voices and responses: Responding to issues and your messages
Every day in our daily report we profile an issue or respond to some those raised by you. Please continue writing!
- June 18 - This coming Monday, June 22, 6:45-8:00 pm, in our Together We Can Do It! Webinar (Part 12), we will celebrating National Indigenous People's Day. Our guest speakers will be Chief RoseAnne Archibald (Ontario Regional Chief), Mae Katt (Nurse Practitioner, Temagami First Nation) and Marilee Nowsegic (CEO, Canadian Indigenous Nurses Association). We encourage you to attend by Zoom and celebrate with us! The registration link is here.
- June 12 - COVID-19 webinar: Let’s talk about racism - Join us on Monday, June 15, at 6:45 pm - 8:00 pm Toronto time, for our COVID-19 webinar: Together We Can Do It! for a panel discussion on the topic, Let's Talk About Racism. We will have panelists addressing questions such as: How has COVID-19 exposed systemic racism? What actions can nurses and other health providers take to address systemic racism? We will have the opportunity for open discussion. Health providers from Ontario, Canada, and anywhere in the world are welcome to join. You can find information about the webinars here. Register now for this free webinar here.
- June 12 - Expanded EOC Situational Report - We were very pleased to see an expanded EOC situational report starting on June 8, with much more detail than previously provided regarding cases, active and resolved, deaths by sector, mode of acquisition, daily counts, effective reproduction number, testing, acute care, and active outbreaks.
As our readers are aware, we have been encouraging more data transparency for quite some time. A clear understanding of the epidemiology and where Ontario is situated with COVID-19 is essential to continue the opening of the economy. An expanded Situation Report is, despite the belated arrival, a good step in the right direction.
The new format is too long to include in full in our report, so in the MOH EOC Situation Report section below we are going to include a link to a posted version of the latest Situation Report.
- June 6 - Responding to racism against people of colour
We received the following note:
Hello, I am a long-time RNAO member, and am writing to you today to inquire about opportunities or programming around racial/cultural allyship and to support people of colour. I do so in the wake of increased violence and acts of racism; I am horrified by the treatment of Asian Canadians in our own country and the deaths of George Floyd and Ahmaud Arbery, as well as the current questions around the death of Regis Korchinski-Paquet.
While our provincial group of nurses are already overwhelmed by challenges presented by COVID-19, I am wondering if there are any current opportunities or potential for supporting our community members experiencing increased racism and threats to safety. We nurses are a strong voice, and I believe in our power for change. I look forward to hearing from you.
Allison M. Dalby, MN-NP (Paediatrics)
Response: Dear Allison, messages such as yours inspired us to draft the RNAO statement you read above. I am grateful that you agreed to participate as a resource person in our forthcoming webinar on Monday, June 15, 6:45 to 8:00 p.m. that will be focused on this topic. Everyone is invited and the details will be posted soon in our webinar page here.
June 6 - Mental health and addiction: We will continue to address this key topic in our next weekly webinar, Monday, June 8, 6:45 to 8:00 p.m. ET. We are thrilled to have three expert panelists: Kimberly Moran (CEO, Children's Mental Health Ontario), Camille Quenneville (CEO, Canadian Mental Health Association, Ontario), and Adrienne Spafford (CEO, Addictions and Mental Health Ontario). You can read their important article posted in my blog here. To register for the webinar, go here.
June 3 - Disability support program: “Thank you for the amazing initiative on homelessness. The government has determined that individuals require $2,000 a month to survive without a job, but an individual receiving Ontario Disability Support Program (ODSP) receives $1,100 per month. This vulnerable group might be included in your initiative.” Nicolette Parant, RN, RNAO member since 1984. ~~~Thanks for making us aware, Nicolette.
June 3 - Hand sanitizer in TTC stations: “I am a RN working in geriatrics. I am really confused why there aren't hand sanitizers in TTC stations here in Toronto, which has 50% plus of the cases. I reviewed WHO recommendations and it calls for hand sanitizers in prominent places as an optimal intervention. Thanks, Erin Murphy.” ~~~Thanks, Erin. We will take this issue on and let’s also encourage our readers to advocate for this initiative with city and TTC authorities.
May 26 - Immunity passports: A physician colleague, Darren Larsen, writes in response to our discussion of apps: “Doris... once again an incredibly informative and thoughtful newsletter. I am flummoxed by the slowness of the response to contact tracing in Ontario. And feel that no one method is going to accomplish all... apps can definitively be useful, but they are best if backed up by quick and effective contact tracing done manually. Wondering ... what do you think about Immunity Passports?”
Thanks, Darren, and glad you like our newsletter. I fully share the frustration of Ontario’s overall slow response, including for testing, case and contact tracing. As it relates to the immunity passport, I am sure you have seen the article in The Lancet that reflects RNAO’s current thinking. I summarize it here for other readers so they can follow our dialogue. Immunity passports are “digital or physical documents that certify an individual has been infected and is purportedly immune to” COVID-19. Given the current state of science and serious social concerns, RNAO does not support this idea at this time. First, WHO informs there is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection. Second, “immunity passports would impose an artificial restriction on who can and cannot participate in social, civic, and economic activities and might create a perverse incentive for individuals to seek out infection, especially people who are unable to afford a period of workforce exclusion, compounding existing gender, race, ethnicity, and nationality inequities.”
May 24 - I have received several questions in recent days regarding our international reporting. Margarita Rose Noble McBurnie best articulates the view:
Why is RNAO no longer updating on the WHO situation report? I'm just wondering why the data being presented is now restricted to only Canadian sources? I thought it was beneficial to track the increase in cases and compare the fatality rate in other countries at the beginning of this pandemic. It was very interesting to compare articles in Germany when they had only a 0.2 fatality rate. I noticed now, during their second wave the fatality rate is much, much higher.
Is there a specific reason the data being shared now is only from Canadian sources? For example, the MOA situation report is being shared rather than the WHO situation report. The WHO situation reports provides the amount of new cases and new deaths per day in each country around the world, where as the MOA situation does not.
RNAO’s response: Dear Margarita, your feedback is appreciated. The table with numbers in each report (see below) is prepared by EOC based on data from WHO, providing a picture of cases in the each continent, the US and Canada. The direct link to WHO situation reports is here and you can also find it in each report at the very end, under Information Resources. More generally, we can appreciate your interest in international comparisons, and will try to include more of those in future issues (every time we have to make hard decisions about what to include in the report, as there are more important topics than we can practically handle). Today, in the article on app technology above, there is a discussion of Iceland and their experience with COVID-19 that I hope you find interesting. Best regards and keep safe, Doris
May 21 - Nurses in specialty care: Foot care services: As mentioned in this report, we have received a number of emails from nurses who provide foot care services in a variety of settings (home care, retirement homes, long-term care, community clinics, etc.) who are seeking information about the opening of services and how they will be able to resume their practice safely. Many of these nurses are in independent practice, while others work in community funded programs. To address the needs expressed by the nurses in this specialty area of practice, members of the IABPG and policy teams will be hosting a webinar on Thursday May 28th at 3:30 - 4:30 pm EDT. This webinar is open to any foot care nurses and others who would like to join us for dialogue and discussion. If you are interested and available to attend, please write to <email@example.com>.
May 19 - Nurses providing foot care services: Several colleagues who work in independent practice providing foot care to persons with diabetes have written with a variety of important questions. Please know that we will coordinate a webinar in the next few days to discuss your needs and provide you with the necessary support.
- May 10 - RNAO member Janet MacMillan, RN, writes: “I would like to inquire when, according to the government’s plan to reopen the economy, nurses in Independent Practice will be able to resume self-employment. What guidelines will be put in place for PPE requirements in a home based clinic where the nurse practices in very close proximity to the client? What will be the guidelines for admission of the client into a home based clinic? What will be the requirements for disinfection of the space? What will be the requirements to rid of waste? Although when we can re-open is unknown, I would like to source PPE and prepare; however, the stages set out by the government lack enough information.” RNAO response: Thanks for the question, Janet. We will inquire and be in contact with you. Doris
- May 7 - Insurance companies discriminate against health care providers - Insurance companies are screening for professional exposure to COVID-19. I applied earlier this year to The Cooperators Insurance for life insurance. They sent me a questionnaire asking whether I come in contact with COVID patients. Have I been tested or asked to stay home for quarantine? It is wrong and unfair to penalize front line healthcare practitioners and potentially have insurance companies raising premiums at our expense. Can the RNAO take a stand against this? Carol Chagnon, NP. RNAO’s response: Thanks, Carol. RNAO will review this matter with various insurance companies and will update you.
- May 5 - I want to begin by asking each reader to take a moment of silence to mourn the loss of Sharon Roberts. Sharon is the third personal support worker and the fourth health care professional to give their lives to the care of others in Ontario. Like our three other colleagues, Sharon was a beautiful human being, an outstanding professional and will be missed by all. Please read about Sharon’s passing. May she rest in peace.
- May 5 - Pandemic pay - Several of the emails and calls we received at RNAO over the past few days relate to pandemic pay. Please know that I am seeking clarification regarding which sectors are in and which ones are out. For RNAO, all sectors are equally important. I am also seeking clarity regarding managers who also carry out clinical work such as those in nursing homes and in correctional facilities. Stay tuned as I will for certain keep you fully informed.
- May 5 - RNAO’s work being recognized - “Hello, Thank you for highlighting the vulnerable! This is what we nurses are here to do. I appreciate your work and feel a sense of calm and understanding and hope for the future with each email I read from you, as you look ahead and say what can be done to make this better. Keep RNAO checking in on our world’s accountability and effects. Keep bringing us nurse leaders to help raise people. I wanted to share the agricultural article and couldn’t find it on a couple of searches. I have a friend who isn’t a nurse but feels her community in Bradford is very judgemental against migrant workers and she feels unable to help her community see their worth. She sees the inequality and their needs. Her bank has extended hours and translators working to help them get their money to their families. They face a tough life. Thanks and keep shining!” Joni Eriksen, RN. Thanks, Joni, for the recognition. Here is the link to the blog article on migrant workers.
- April 30 - “A big shoutout to Diana Sebera. She says it all. Being retired, she talks with the wisdom of experience. The people of Ontario need to heed her remarks and stand up for their hard won Medicare, whose governing principles guide all front line workers in delivering equal and quality care to the infirmed. But it’s near impossible. Mr. Ford is right. The system got broken. Thank you RNAO for confronting him on that and staying the course.” Magee McGuire, another retired RN.
- April 30 - One member would like to encourage nurses to change into their uniform when they arrive to their workplace, and then change out of their uniform into clean clothes at the end of their shift – to be then taken home in a plastic bag. With no visitors and decreased transfers to and from hospital, staff are likely the main vectors for the virus entering facilities such as long term care. With PPE in place, it may be carried in and out on our shoes / uniforms / clothing. We must take every precaution and would recommend this to all staff in non-hospital locations. “Thank you for all of your hard work and initiatives during these uncertain times and always.” Karen North-Lewis, NP, proud RNAO member since 2000.
- April 28 - Abby Yuill, BScN RN, writes: “I have a concern regarding washroom access for community health nurses. I am a community health RN working full time in home care and have in the past relied on fast food restaurants to use as a public washroom. With the closure of bathrooms due to COVID-19, this has left many of us without access. Some homes we go to are not hygienic, as well as clients are anxious about letting nurses use their washrooms because we are “contaminated” which leads us to quite extreme discomfort during the shift, and/or wasted time to travel home to use our own washroom. Is it possible for fast food restaurants to allow access to public washrooms for nurses/healthcare providers?”
- April 28 - Wellness Together Canada: Resources for mental health and substance use support. We recognize the significant strain that COVID-19 has placed on individuals and families across the country. Many people are concerned about their physical and mental well being. Canadians are being challenged in a number of ways because of isolation, financial and employment uncertainty and disruptions to daily life. Wellness Together Canada provides tools and resources to help Canadians get back on track. These include modules for addressing low mood, worry, substance use, social isolation and relationship issues.
- April 25 - A special thanks to Catherine van Beek, a personal support worker who sent me the following note: "I wish to thank you for your comments showing your support of PSWs working full-time in one care setting or having their wages augmented. Many PSWs do what they do because of their clients. Ours is a difficult, unglamorous job that is undervalued with (mostly) abysmal pay, requiring us to work at several jobs. There is no governing body and most of the time no union to intervene on our behalf. I sincerely thank you for being a voice for us, the PSWs who are going into workplaces everyday despite the risks and challenges to provide care to our most vulnerable. Bless you, Catherine van Beek."
- April 23 - This evening we received a message from Cheryl Knott, NP-PHC. She says: "Thank goodness for RNAO weeding through the politics and keeping me grounded! [You are] My daily source of information. For instance, discussions about swabbing atypical presentation (in the NP group) took us ahead of the curve in regard to vigilant swabbing. I have never been so proud to be affiliated with RNAO knowing that they are walking side by side with the Minister of Health to make decisions - in an ever evolving situation." Cheryl is referring to the weekly virtual meetings of NPs with me and RNAO’s LTC team where valuable information and experiences are exchanged. For more on RNAO’s support for long-term care, see here.
- April 22 - Thank you to Mwali Muray for alerting alert me that I made a mistake in my last update when paying tribute to the deceased personal support worker. Christine Mandegarian, who was on her 50s, was a personal support worker for 31 years, and not as I wrote. She worked at Sienna Altamont Care Community in Scarborough, and she died last Wednesday, less than 24 hours after testing positive for the virus. Her union says this “tragic death is a difficult reminder of the very real dangers health-care workers face in the selfless delivery of care for Ontario families, as well as the support and protection that they need immediately.” The union confirmed that a second staff member from the same facility is in serious condition after testing positive for COVID-19. They also report that proper personal protective equipment was not used, and infection controls were not put in place at that nursing home.
- April 20 - I am sharing an inspiring message from one of RNAO’s board members who lives in Thunder Bay: "Dear Doris - I wanted to share how proud I am of my nursing colleagues at Thunder Bay Regional Health Sciences Centre (RNAO Region 12), including Registered Nurses, Nurse Practitioners, Registered Practical Nurses, and nursing students. I would like to recognize, in particular, the efforts of all bedside Registered Nurses and their unit managers (Terri Gurney and Wayne Taylor) in the Cardiac Catheterization Department and 2C In-Patient Cardiology. Well done! So very proud to be a Registered Nurse at Thunder Bay Regional Health Sciences Centre and to work with such intelligent Registered Nurses in cardiology!" Signed: Dr. Michael Scarcello, DNP, CNS, RN
- April 20 - One of the reasons I like to write this blog is that it serves to inform, collaborate and share. As you can see we have moved away from only RNAO’s analysis and RNAO’s “asks” to invited pieces and profiling important work that serve to build collective solutions and a #togetherwecandoit approach. We have had important pieces by Dr. David Fisman on testing, surveillance and case definition and Minister of Health Patricia Gomez from Balearic Islands on primary care and homecare as approaches for tackling COVID-19. We received tips for effective use of masks from Dr. Jeff Powis, an infection prevention and control specialist. We profiled Shirley Sharkey on the challenges of homecare during COVID-19, Dr. Aaron Orkin on surveillance and the work of Inner City Health Associates (ICHA) with persons experiencing homelessness (also here), and the lessons from Médecins Sans Frontières from their work overseas. We look forward to continue to profile key work and expand the collaborative network that RNAO believes is at the core of substantive progress on COVID-19 (and anything else). Please send us your ideas for new items and significant questions.
- April 15 - Need for accommodation away from home. We have been contacted by a number of health care providers asking about temporary accommodation for those working on the front lines. In our research to enlist hotels that will provide free or discounted accommodation we became aware of a program available to hospital staff that need temporary accommodation. The Ontario government has issued guidelines to hospitals for temporary accommodation for patients and for staff (see here). If you need temporary accommodation close to your hospital or for self-isolation we encourage you to contact your manager or human resources department to inquire. You should not be out of pocket to access this program.
- April 15 - Don’t spread COVID-19. With permission, I share this message from Barbara Loomis as we must heighten awareness: “I keep hearing of the lack of PPE in LTC. No amount of PPE will replace good old common sense. Apparently we now have a restriction on staff only working for one facility (a restriction way too long in coming), but I have not heard of a restriction that forces those workers to change their clothing when leaving a facility – including changing shoes from outside shoes to shoes only worn in the facility. Common sense should tell you that uniforms/scrubs worn in the facility should not leave the facility except in a closed bag to be taken home and washed. This washed clothing should be taken back to the facility in a closed bag and put on when you arrive for your shift. This applies to shoes also. I almost had heart failure when a health worker was interviewed leaving the place of employment wearing the same clothing worn for the past eight hours in a facility that had a COVID outbreak. What is to stop that employee from stopping to pick up a loaf of bread on the way home and thus contaminating all those around? I know this is a widespread practice across all sectors, and it must be stopped.”April 10 - conquercovid19.ca is a grassroots incubator that is facilitating access to priority products that are in short supply but essential for the healthcare community during the COVID-19 pandemic. Collecting masks/respirators, tablets, diapers/formula for women’s shelters, etc. Seeking volunteers. For details, go here.
- April 10 - A new website was created to inform public health with real-time insights on the COVID-19 pandemic. You contribute your health status daily – it takes two minutes – and help track the virus. I very strongly encourage you to participate. Go here.
- April 10 - Several articles have raised the critical situation in LTC and universal PPE for all sectors. Please, take action and retweet: here, here, here and here.
- April 10 -This week I joined a panel in TVO’s The Agenda with Steve Paikin: “Health-care workers now comprise one in 10 known Ontario COVID-19 cases. Do they feel as protected as possible while executing their work? How can Canada ensure the safety of those fighting this disease on the frontlines? The Agenda discusses the immediate and future need to protect health-care workers with Dr. Sohail Gandhi, president of the Ontario Medical Association; and Doris Grinspun, CEO of the Registered Nurses' Association of Ontario.” You can watch here.
- April 8 - A reader shares she is concerned with the public using nitrile gloves to 'protect' themselves: cashiers, grocery clerks, the people serving drive-through, and people shopping. They have a false sense of security and don't understand cross-contamination. Posts on social media, mainly in a joke format, show people touching everything while wearing gloves. We need education. RNAO: Everything touched wearing the same gloves becomes contaminated.
- April 8 - A member of the public writes: “I am watching an ICU nurse from NYC talk on television about watching people dying alone and the feeling of despair. This woman looks terrible and her body language is heartbreaking. We are going to have a whole generation of our finest and brightest suffer from PTSD from this traumatic experience and some will leave the professions as a result of this. As part of our “recovery” this province needs to officially recognize this issue NOW and move quickly, once the emergency is over, to assist health providers. We cannot allow them (health professionals) to be the walking casualties of this war.” RNAO: Yes, we saw this during SARS and COVID-19 is exponentially larger.
- April 8 - “I am a new graduate nurse who is unable to write the NCLEX and complete my CNO registration due to the delays in NCLEX exam administration. The exam has been pushed from its March original date to June. I am unable to apply for a temporary licence as I do not have a job offer and many others are in the same position. Can we advocate to get NCLEX testing reopened sooner? We feel defeated and powerless. We want to help and we want to work but are unable to.” RNAO: Yes, we are tackling this and other issues related to students.
- April 8 - “With an exemption made for border crossings to make way for the arrival of migrant agricultural workers into Canada, and hundreds of workers already working on farms throughout the country, organizations that work with this population are very concerned about the spread of transmission and potential loss of life among this cohort. Housing, working conditions, access to health care, and employer-mediation to access services, benefits and compensation are among many of the factors that make this group uniquely vulnerable. They typically live in overcrowded bunkhouses, with dozens sharing access to one washroom, isolated from amenities and services. Many of these workers are also arriving in Canada with no knowledge of the virus. They are moving in large groups (because they depend on their employer to access groceries, etc.), and they have not been made aware of the severity of COVID-19. There are several organizations that have developed important recommendations and guidelines, but we need to make sure that public health authorities act on these steps and take this group into account as they implement comprehensive social distancing measures and treatments. Temporary migrant agricultural workers are being allowed entry into the country because they are deemed essential workers and crucial to our food system, I hope that you can support me in keeping them safe!” RNAO: Please see here Guidance for Employers of Temporary Foreign Workers Regarding COVID-19.
- April 8 - “An estimated additional 180 - 195 deaths per day occurring at home in New York City due to COVID-19 are not being counted in the official figures. ‘Early on in this crisis we were able to swab people who died at home, and thus got a coronavirus reading. But those days are long gone. We simply don't have the testing capacity for the large numbers dying at home. Now only those few who had a test confirmation *before* dying are marked as victims of coronavirus on their death certificate. This almost certainly means we are undercounting the total number of victims of this pandemic,’ said Mark Levine, Chair of New York City Council health committee.” Are we planning to count all the COVID-19 deaths in Ontario? RNAO: You are right on. This is a question I ask daily from Dr. David Williams. In the view of RNAO Ontario is vastly undercounting COVID-19 related deaths – especially in nursing homes, homes, shelter, and even in ICU. What we count today is persons that had been tested as COVID-19 positive and who die. We are also urging to massively scale up testing, and are hopeful it will happen.
- April 8 - “We should protect health care workers’ families by providing shelter for hospital workers so they do not need to go back to their homes. Since the government failed to protect us at the workplace, at least stop further spread to our families. This is a costly proposition, however, ICU beds are even more costly. This would significantly decrease health care providers stress as we are worried about bringing the illness home; it could reduce stress on us and our loved ones and increase staff morale. It would also be an incentive for more nursing staff to come back to critical care practice.” RNAO: Stay tune, we are working on it.
- April 6 - Physical distancing also at the hospital: A member writes: “I see groups of staff in PPE posting pictures on Facebook with their arms around each other and big grins! They are motivated by a positive intention to boost team morale and solidarity, but the message they send does a disservice.”
- April 6 - Cloth caps: We also heard that: “Staff are wearing cloth scrub caps and/or headbands, often with a button on each side over the ears to hold the elastic ear loops off the backs of their ears. I’m concerned about impact on fit if the masks are worn this way, and also concerned that some may not realize that caps and headbands must be washed after every shift, just like scrubs.”
- April 6 - Not enough swabs: A reader reacts to our calls to escalate testing: “The province doesn’t have enough swabs, that’s why there is case definition for swabbing now opened to healthcare workers and nursing home residents. They are anticipating getting more swabs at which point more people will be swabbed. Right now the priority with the swabs we have is to test the most critical people.”
- April 6 - Keeping cell phones clean: A reader writes “Can cell phones spread COVID-19 within our clinical spaces? Most patient/staff alike access their phones at work, on breaks, or when waiting to be seen by medical staff. Everyone should be asked to wipe their phones down (or leave them in cars) when they enter the hospital, then put it in a plastic bag, and leave it there within all clinical areas.” Good advice. For more info, read here.
- April 6 - Making a will: “I'm an RN on the front line. Both my wife and I are nurses, and we have two teens. I don’t have a will and am afraid of leaving my kids without a will. The likelihood that one of us gets sick is very high. Is there a lawyer or software that is actually free to create our own will? Obviously time is of the essence.” Although this is not my area of expertise. I found this article useful.
- April 6 - Public using medical masks: “When I see the general public wearing medical masks I want to cry! Two thirds of the customers at the grocery store were wearing surgical masks and not one of them was a homemade mask. Those wearing a homemade mask in public are protecting everyone from COVID-19 and respecting frontline workers who deserve to have all of the medical/surgical masks available.”
- April 6 - Telehealth: A reader writes: “I can’t believe that telehealth has not gotten their act together, I waited yesterday 15 hours and gave up.” RNAO shares on this disappointment. RNAO has repeatedly been calling for Telehealth to hire more nurses (which RNAO can deploy instantly) and start providing timely service. Minister Elliott was asked about people experiencing COVID-19 symptoms and having to wait two or three days before receiving a call back from a Telehealth nurse. The health minister said this was "not acceptable." She responded: "We really want to get that down to within 24 hours, so that’s something that we’re continuing to work on," Elliott said, encouraging people to call their family doctors for a "more timely way to deal with it." Minister, even 24 hours wait for Telehealth is unacceptable. We have the nurses – please hire them.
- April 6 - Thank you: “I just want to take this opportunity to thank everyone! I want to thank all of our frontline workers (RNs, RPNs, PSWs, DOCs, ADOCs etc.). I also want to thank all other essential workers too that are not healthcare related (we are a huge team of people; not just healthcare workers who are fighting hard in this pandemic). Finally, I want to thank all of you at the RNAO – I read your email postings every day; thank you so much.” To you and the many others who thank us daily: We are honoured to be here for you!
- April 5 - Window visits in nursing homes: This is an inspiring practice to enable loved ones to visit through a window – however, please keep the window surfaces clean. If visitor A, asymptomatic, touches the glass and visitor B comes to visit his mum and touches the glass, then spreading happens. Also not a good practice is to pass items through the window, such as chocolates, thus defeating the point of isolation.
- April 5 - People not keeping physical distance and Medical Officers of Health remain silent: A few individuals wrote to us, asking: Where is the physical distancing? Stores continue to let crowds in without physical distancing. At a bank line up no one was self-distancing. Young people still don’t get it – at the pet store helping consumers without self-distancing. Thankfully, there are new Plexiglas barriers at Shoppers checkouts. Is the situation better in British Columbia because they educate better the public? RNAO urges all our Medical Officers of Health to speak strongly and frequently about staying at home and physical distancing.
- April 5 - A must read: I encourage all to read a magnificent piece by Toronto Star reporter Moira Welsh on the inspiring work of nurses and personal support workers with residents in a nursing home. Please share also your comments. I did, thanking Moira for her detailed and accurate account of the awesome work of front-line nurses and PSWs, as well as the solid evidence-based leadership at the Henley Place long-term-care home (in London, Ontario). I also added that their impeccable and inspiring work is aided by the home having the necessary PPE to protect residents and staff. This is why they can focus on what's most important: caring for residents in a dignified and safe way.
- April 3 - Violation of the measures for physical distancing, or other actions that create risk, are a concern we all share. Colleagues have written to report they’ve seen health workers, still wearing their scrubs and masks, doing grocery shopping or in other public spaces; that’s a serious risk to others. Others have heard colleagues sharing their plans to meet with extended families for Easter. I urge all of us to avoid these types of lapses in judgment and abide by physical distancing rules.
- April 1 - Many concerns address PPE shortages in different sectors. There are still hospitals not allowing front line workers to use PPE, while other hospitals have moved to supply two surgical masks per day. There are community health organizations – home care and primary care – suffering from dire shortages, and some have lost hope and tried to obtain their own PPE. RNAO’s urgent recommendation is that all front line health care workers facing patients – in all sectors and settings – must wear a surgical mask. Kudos to Pembroke Regional Hospital – a staff shared her pride that they are directing staff to mask for every encounter with a patient.
- April 1 - There is a horrific crisis unfolding in nursing homes, and a direct link between lack of proper protection and mounting infection clusters reported by the media in at least 41 nursing homes and 77 by our account. RNAO has been sounding the alarm bell for well over a month. We will not stop saying it: The time is NOW, to ensure all nursing homes are provided with sufficient quantities of surgical masks and other essential PPE, so that all staff wear one at all times – to prevent outbreaks and NOT after an outbreak has happened. We must #flattenthecurve of nursing home outbreaks!
- April 1 - Fourth year BScN nursing students are expressing concern, as they are eager to graduate and begin working as RNs to protect and care for patients during this difficult time. They share with RNAO that they face barriers to complete their studies and registration with the CNO, as well as in their application for temporary licenses. Many want to be in clinical placement to help with this crisis and are not allowed in. We are speaking with government and hope to have answers for you soon.
- April 1 - Should the public wear a surgical mask in public spaces, as many do in south east Asian countries? Given the shortages of regulated PPE for health care workers, the public should not be purchasing those. There is a live discussion on whether to wear home-made and other unregulated types of masks. The general advice has been to keep two meters physical distancing and thus it is optional to wear a mask. However, if you have to shop groceries, take public transit, work as an essential worker, or other activities where you cannot keep physical distancing, a cloth-made mask is recommended. The CDC in the US has issued such a recommendation.
- April 1 - We reported earlier about Michael Garron Hospital launching #MGH1000masks campaign. The hospital is challenging makers in the community to fabricate 1,000 masks a week, which will be worn by all approved visitors who enter the hospital, all discharged patients as they reintegrate into the community, and the broader east Toronto community to prevent the transmission of COVID-19.