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Registered Nurses' Association of Ontario      

Good evening members,

We are now entering the second month of the COVID-19 outbreak in Canada; this a sobering thought, as the virus continues to spread in terms of contracted cases, persons who have died, and countries entering the fight. As we plan for an extended period of focused, concerted and calm action on COVID-19, we also want to update you on how our communications will proceed. The Ministry of Health’s Emergency Operations Centre (EOC) Reports will be shared with you each day of the week, and also the Situation Reports posted daily by WHO. In addition, you will receive on Monday, Wednesday and Friday, longer updates such as the one today, likely including an RNAO policy corner and more detail. We would like to, once again, reiterate our appreciation to all those who are benefitting from our reports, and particularly those who write to us to thank us or provide suggestions for improvement. This is a good opportunity to indicate that we welcome that health organizations, anywhere, use our messages, adapt them and distribute them.

Today’s update: The second cohort of Canadians and their family members, who arrived at CFB Trenton on Feb. 11, are being released tomorrow after 14 days of quarantine. 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 11 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 #30 from the Ministry of Health’s Emergency Operations Centre (EOC), received this afternoon. The number of confirmed cases in Canada reported by EOC is 11, with four persons in Ontario and seven in British Columbia. Three Ontario cases have now been resolved after two negative tests, and the fourth case is in self-isolation after a brief stay at North York General Hospital. In Ontario, at this time, there are 9 persons under investigation with lab results pending.  

Situation Report 35 from the WHO updates that worldwide, there are 79,331 confirmed (715 new) cases of COVID-19 and 2618 deaths (156 new). Forty percent of the new cases are outside China. There are now 763 confirmed cases in South Korea (161 new); the majority of the cases were contracted in the country. Other countries to note are Japan (with 144 confirmed cases), Italy (with 124), Singapore (with 89) and Iran (with 43). The total number of confirmed cases aboard the Diamond Princess cruise ship is 695. One new country, Kuwait, reported cases of COVID-19 in the past 24 hours.

RNAO policy corner

Since the emergence of COVID-19 we have seen instances of public stigmatization among specific populations, and the rise of harmful stereotypes. Stigmatization could potentially contribute to more severe health problems, ongoing transmission, and difficulties controlling infectious diseases during an epidemic. The WHO Situation Report 35 provides an excellent guideline that we reproduce in the next few paragraphs. (For more information, visit EPI-WIN.com and download Social Stigma associated with COVID-19 – A guide to preventing and addressing social stigma.)

Stigma occurs when people negatively associate an infectious disease, such as COVID-19, with a specific population. In the case of COVID-19, there are an increasing number of reports of public stigmatization against people from areas affected by the epidemic. Unfortunately, this means that people are being labelled, stereotyped, separated, and/or experience loss of status and discrimination because of a potential negative affiliation with the disease.

 

Given that COVID-19 is a new disease, it is understandable that its emergence and spread cause confusion, anxiety and fear among the general public. These factors can give rise to harmful stereotypes. Stigma can drive people to hide the illness to avoid discrimination, prevent people from seeking health care immediately, and discourage them from adopting healthy behaviours. Such barriers could potentially contribute to more severe health problems, ongoing transmission, and difficulties controlling infectious diseases during an infectious disease outbreak.

 

Do your part: Governments, citizens, media, key influencers and communities have an important role to play in preventing and stopping stigma. We all need to be intentional and thoughtful when communicating on social media and other communication platforms, showing supportive behaviors around COVID-19.

 

Here are some examples and tips on possible actions to counter stigmatizing attitudes:

Spreading the facts: Stigma can be heightened by insufficient knowledge about how the new coronavirus disease (COVID-19) is transmitted and treated, and how to prevent infection.

Engaging social influencers such as religious leaders on prompting reflection about people who are stigmatized and how to support them, or respected celebrities to amplify messages that reduce stigma.

Amplify the voices, stories and images of local people who have experienced COVID-19 and have recovered or who have supported a loved one through recovery to emphasize that most people do recover from COVID-19.

Make sure you portray different ethnic groups. Materials should show diverse communities that are being affected, and show communities working together to prevent the spread of COVID-19.

Balanced reporting. Media reporting should be balanced and contextualized, disseminating evidence-based information and helping combat rumour and misinformation that could lead to stigmatisation.

Link up. There are a number of initiatives to address stigma and stereotyping. It is key to link up to these activities to create a movement and a positive environment that shows care and empathy for all.

On a separate topic, and as reported yesterday, with close to 80,000 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. 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.

All our best regards and keep up the fantastic work!

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

 

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