Happy Sunday Members,  

The second cohort of Canadians and their family members, who arrived at CFB Trenton on Feb. 11, have two days of quarantine left. The excitement of going home is within arm’s reach and we can feel it and celebrate with you!   

Canadians from the Diamond Princess cruise ship, who arrived on Feb. 21 from Japan, are in Cornwall and have 12 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. 

To date, there are no COVID-19 positive cases among the repatriated Canadians from Wuhan currently under quarantine at CFB Trenton or NAV Centre.

Attached here is situational report #29 from the Ministry of Health’s Emergency Operations Centre (EOC), received this afternoon. The number of confirmed cases in Canada reported by EOC remains at 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 3 persons under investigation with lab results pending. I also received later in the evening a press release informing of a new presumptive case -- see here.  

Situation Report 34 from the WHO updates that worldwide, there are 78,811 confirmed (1017 new) cases of COVID-19 and 2462 deaths (103 new). One third of the new cases are outside China. There are now 602 confirmed cases in South Korea (256 new); the majority of the cases were contracted in the country. Other countries to note are Japan (with 132 confirmed cases), Singapore (with 89) and Italy (with 76). The total number of confirmed cases aboard the Diamond Princess cruise ship is 634. No new countries reported cases of COVID-19 in the past 24 hours.

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.

With almost 78,000 cases of Covid-19 now confirmed across the globe, experts say the situation will soon reach a critical threshold. The world is fast approaching a tipping point in the spread of the coronavirus, according to experts, who warn that the disease is outpacing efforts to contain it, after major outbreaks forced Italy and Iran to introduce stringent internal travel restrictions and South Korea’s president placed the country on red alert. Some of the countries most affected by the virus are scrambling to halt its progress two days after the director general of the World Health Organization (WHO), said the international community needed to act quickly before the narrowing “window of opportunity” closed completely.

From RNAO’s perspective, although we hope not to face the situation, this means we need to accelerate the preparation for a possible COVID-19 pandemic. The heroic efforts to stop or limit the spread of the virus in China, South Korea and elsewhere have bought time and have slowed down the spread, providing more opportunity for preparations at every level, including assisting countries with weak health systems, as mentioned above. In Canada, this preparation should happen at every level – federal, provincial and city governments and agencies, as well as each health care institution. RNAO hopes that at this time, every agency and institution has a task force specifically addressing these preparations. EOC has been fantastic in providing guidance, protocols and resources, while, at the same time, providing a flow of reliable, evidence-based information, maintaining calm, and avoiding negative expressions such as panic, stigma and discrimination.

As we envision the possibility of a pandemic, the continuing safeguard of our supplies is more important than ever, so we have these when and if needed. 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

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

We are here for you and your teams if you have questions and/or 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 an evolving public health emergency and we must keep on top of it. 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.

For our nursing and other health professional colleagues in the frontlines of the outbreak, in China, South Korea, Italy, Iran, Singapore and others, we are with you sending energy and positive thoughts. To our BPSOs abroad, know we are with you and we hope our updates support you – feel free to share these with other health professionals.

Warmest regards!

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

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