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Happy Family Day to all our health professionals; indeed, we are a big and awesome family! Canadians who arrived on Friday, Feb 7th on the two flights from Wuhan have 4 days left out of their 14 days of quarantine at Canadian Forces Base (CFB) Trenton. Those who arrived Feb 11th on the third flight from Wuhan, have 8 days left of their 14 day quarantine at CFB in Trenton. So far all continues well with everyone. The Federal Government announced on Saturday that it has chartered a plane to repatriate Canadians on board the Diamond Princess cruise ship docked in Yokohama, Japan, given the extraordinary circumstances faced by passengers and to lighten the burden on the Japanese healthcare system. The aircraft will bring passengers from Japan to CFB Trenton, after which they will be assessed and transported to the NAV Canada Training Institute in Cornwall, Ontario, to undergo a further 14-day period of quarantine. Before boarding in Japan, passengers will be screened for symptoms. Those who exhibit symptoms of COVID-19 will not be permitted to board and will instead be transferred to the Japanese health system to receive appropriate care. The flight is planned to depart from Japan with the evacuees tomorrow Tuesday, and arrive in Canada on Wednesday. Those who remain in Japan will continue to receive full consular services from the Government of Canada. No situational report was received today from the Ministry of Health’s Emergency Operations Centre (EOC). The number of confirmed cases reported this morning in the federal government’s website is eight, with three persons in Ontario and five in British Columbia. All except one in London, Ontario, who is resolved (two negative tests), are recovering at home in self-isolation. In Ontario, at this time, there is no person under investigation. RNAO wants to stress the need not to let your guard down, and continue to protect yourself and educate others to regular respiratory protection practices - see WHO guidelines here. The silver lining of COVID-19 is that hopefully, with these measures, we can also reduce flu and common cold transmissions. Thanks you for safeguarding our supplies as we must make sure we have them should we need them. Please continue to remind colleagues that personal protective equipment (PPE) are to be used only when there is a need, as per the EOC guidelines. Health care providers facing immediate supply needs regarding PPE can email the ministry at EOCLogistics.MOH@ontario.ca. A reminder to all to be up-to-date on EOC information: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/2019_guidance.aspx. Situation Report 28 from the WHO updates that worldwide, there are 71 429 confirmed (2162 new) cases of COVID-19 and 1775 deaths (106 new), mainly in China. No new countries reported cases of COVID-19 in the past 24 hours. From today, WHO has changed the way it informs of confirmed cases, including both laboratory-confirmed as previously reported, and those reported as clinically diagnosed (currently only applicable to Hubei province, China). The change in reporting is now shown in the figures. This accounts for the apparent large increase in cases compared to yesterday's situation report. RNAO policy corner: As we shared yesterday, initial efforts to understand the behavior of the COVID-19 virus by researchers in Singapore suggest it is different from Severe Acute Respiratory Syndrome (SARS) and has more similarities with H1N1. Like influenza, COVID-19 is infectious when symptoms are mild, the researchers found. Because of this transmission mechanism, COVID-19, like influenza, can spread quite quickly, as people with mild symptoms may let their guard down. The other difference between COVID-19 and SARS is the severity, since the fatality rate in China for COVID-19 is lower than SARS. Outside of Hubei province in China, it is even lower, so mortality rates are lower than SARS. The fatality rate of SARS globally during the 2002-2003 outbreak was 9.56 per cent, as compared to a 2.14 per cent fatality rate for COVID-19 so far. The SARS outbreak led to 774 deaths out of 8,098 cases, according to WHO figures, while COVID-19 has so far killed at least 1,380 people out of about 64,400 cases (using the Hubei case definition). A study by the WHO based on 17,000 patients found that 82 per cent had mild symptoms, 15 per cent severe symptoms and 3 per cent had critical symptoms. The key message from this is not to let our guard down and insist on respiratory hygiene for persons with symptoms of a cold, flu and the like; and to follow EOC guidelines for testing when a travel history to China or other affected regions exits. We are here to hear from you and your teams should you be experiencing any challenges – please send your emails directly to me at dgrinspun@rnao.ca. You can also access the health provider hotline and website regarding questions about the outbreak, protocols, preparedness, and more. The toll free number is 1-866-212-2272, and the health provider website, updated regularly with useful resources, can be accessed here. An important reminder that the health provider website and the toll free number are for you – as a health professional – and not for members of the general public. The ministry’s public website on the COVID-19 exists to inform the general public – encourage your family and friends to access this public website. We also have information for the public on our website at www.rnao.ca which we update daily. The WHO has provided an excellent link for you to share with members of the public here. THANKS to all our health professionals in Ontario – especially the ones working at CFB Trenton and to those being deployed to the NAV Canada Training Institute in Cornwall, to those working in the cruise ships, and the over 13 million healthcare workers in China who are dedicating their expertise and compassion to the people in China – we send all our energies and admiration to you! Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, O.ONT
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