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As we prepare to head tomorrow, Thursday (Feb 20), with 130 RNs, NPs and nursing student’s leaders of RNAO for the association's 20th annual political advocacy event, we want to make sure we don’t leave you without our daily update on COVID-19. Shining a light on the key health issues affecting their nursing practice and the health of Ontarians, RNAO members will hear remarks and exchange ideas with the Honourable Christine Elliott, minister of health, NDP health critic France Gelinas, John Fraser, interim leader of the Liberal Party and Mike Schreiner, leader of the Green Party. You can watch these political leaders and RNAO nursing leaders in action by watching the event via our live-stream coverage beginning at 12:45 p.m. (ET). All are welcome to join us here. Here is today’s update on COVID-19 outbreak. Canadians who arrived on Friday, Feb 7th on the two flights from Wuhan have 2 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 6 days left of their 14 day quarantine at CFB in Trenton. So far all continues well with everyone. It is important to stress that none have tested positive. As informed earlier, 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 departure date will be confirmed once final arrangements with the Government of Japan and Princess Cruises are in place. The flight is currently expected to depart Tokyo Haneda Airport tomorrow Thursday. According to a media report, 47 of about 250 Canadian passengers had been struck by the bug at last count. Those who remain in Japan will continue to receive full consular services from the Government of Canada. Attached here is situational report #25 from the Ministry of Health’s Emergency Operations Centre (EOC), received this afternoon. 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 (a patient in London, Ontario, who is resolved with two negative tests), are recovering at home in self-isolation. In Ontario, at this time, there are 17 persons under investigation with lab results pending. We thank you for continuing to safeguard 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 30 from the WHO updates that worldwide, there are 75,204 confirmed (1872 new) cases of COVID-19 and 2009 deaths (136 new), mainly in China. No new countries reported cases of COVID-19 in the past 24 hours. WHO is working with an international network of statisticians and mathematical modelers to estimate key epidemiologic parameters of COVID-19, such as the incubation period (the time between infection and symptom onset), case fatality ratio (CFR, the proportion of cases that die), and the serial interval (the time between symptom onset of a primary and secondary case). Preliminary estimates of median incubation period are 5-6 days (ranging from 0-14 days) and estimates for the serial interval range from 4.4 to 7.5 days. The confirmed case fatality ratio, or CFR, is the total number of deaths divided by the total number of confirmed cases at one point in time. Within China, the confirmed CFR, as reported by the Chinese Center for Disease Control and Prevention is 2.3%. This is based on 1023 deaths amongst 44,415 laboratory-confirmed cases as of 11 February. This CFR does not include the number of more mild infections that may be missed from current surveillance, which has largely focused on patients with pneumonia requiring hospitalization; nor does it account for the fact that recently confirmed cases may yet develop severe disease, and some may die. As the outbreak continues, the confirmed CFR may change. Outside of China, CFR estimates among confirmed cases reported is lower than reported from within China. However, it is too early to draw conclusions as to whether there are real differences in the CFR inside and outside of China. For more details, see Situation Report 30. Several online courses related to COVID-19 have been added to the OpenWHO platform:
Health care workers are on the front line of the response to the COVID-19 outbreak. WHO has developed guidance on the Rights, Roles and Responsibilities Of Health Workers, Including Key Considerations For Occupational Safety And Health. Based on the evidence currently available about COVID-19, WHO has developed guidance documents for managing public health events at points of entry and mass gatherings. These are posted on the WHO COVID-19 Points of Entry and Mass Gatherings website. 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 health professionals in Ontario, BC, and abroad, especially the over 13 million healthcare workers in China who are dedicating their expertise to their people! Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, O.ONT
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