Happy Weekend to All,  

The second cohort of Canadians and their family members, who arrived at CFB Trenton on Feb. 11 have three days of quarantine left. We are thinking of you and we know you too are counting the days to go home.   

Canadians from the Diamond Princess cruise ship, who arrived on Feb 21 from Japan, are in Cornwall and have 13 days left of their quarantine period. So far all is well and we wish them an easy as possible time, filled with encouragement and good wishes. 

Attached here is situational report #28 from the Ministry of Health’s Emergency Operations Centre (EOC), received this afternoon. The number of confirmed cases in Canada reported by EOC remains as nine, with three persons in Ontario and six in British Columbia. All three Ontario cases have now deemed resolved after two negative tests. In Ontario, at this time, there are 8 persons under investigation with lab results pending. No new materials were distributed today by EOC.

As new countries report the arrival of COVID-19 at their doorsteps (Lebanon and Israel today), and more cases are reported in countries outside of China, the threat of a pandemic is very real. Thus, your continuing safeguard of our supplies is as important as ever, so as to be able to count on these should the need arise. Please continue to remind colleagues that personal protective equipment (PPE) is 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 33 from the WHO updates that worldwide, there are 77,794 confirmed (599 new) cases of COVID-19 and 2359 deaths (112 new), largely in China. There are now 346 confirmed cases in South Korea (142 new); the majority of the cases were contracted in the country. Other countries to note are Japan (with 105 confirmed cases) and Singapore (with 86 confirmed cases). The total number of confirmed cases aboard the Diamond Princess cruise ship is 634. Two new countries (Lebanon and Israel) reported cases of COVID-19 in the past 24 hours.

The role of environmental contamination in the transmission of COVID-19 is not yet clear, and WHO is coordinating the investigation of these factors. On 18 February, a new research protocol entitled “Surface sampling of coronavirus disease (COVID-19): A practical “how to” protocol for health care and public health professionals” was published. This protocol was designed to determine viable virus presence and persistence on fomites in various locations where a COVID-19 patient is receiving care or isolated, and to understand how fomites may play a role in the transmission of the virus. For more information, see Situation Report 33.

RNAO policy corner: The WHO Director-General briefed an emergency ministerial meeting on COVID-19 organized by the Africa Centres for Disease Control and Prevention (see here). With every day that passes we are learning more about the virus. More than 80% of patients have mild disease and will recover, but the other 20% of patients have severe or critical disease, ranging from shortness of breath to septic shock and multi-organ failure. These patients require intensive care, using equipment such as respiratory support machines that are in short supply in less developed countries. In 2% of reported cases, the virus is fatal, and the risk of death increases the older a patient is, and with underlying health conditions. There are relatively few cases among children. More research is needed to understand these trends. The biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems, and thus the need to work hard to prepare countries in Africa for the potential arrival of the virus. For those of us in Canada, the long term lesson is the need to strengthen health systems everywhere, and not only in our country, as our health is interdependent with the health of everyone else around the world.

I encourage you to review the excellent online  courses  related  to  COVID-19  that have  been  added  to  the OpenWHO platform:

A general  introduction to emerging respiratory viruses, including novel coronaviruses

Critical Care of Severe Acute Respiratory Infections

Health and safety briefing for respiratory diseases - ePROTECT

Please, do continue to let us know if you or your teams experience challenges of any kind, and especially shortages of PPE. Send these emails directly to me at dgrinspun@rnao.ca. We also encourage you to 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.

Ontario’s 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.

This has been and will continue to be a stressful time for the public and for health professionals, especially in China and countries with growing numbers of persons with COVID-19. To our BPSOs abroad, know we are with you and we hope our updates support you.

To our health professionals at home, 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 here. This is prime time to get us and the public into healthy habits so these become the norm.  

Warmest regards!

Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, O.ONT
Chief Executive Officer, RNAO

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