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Hello RNAO members, This is RNAO’s daily communication for Friday, March 13 – our second month of the COVID-19 outbreak in Canada – now a pandemic. To see previous updates visit RNAO updates and resources on COVID-19 for members and other health professionals. Feel free to share any and all updates with other health professionals at home or abroad. MOH EOC Situational Report #48 here – containing the following links: 1) public sign in English here, 2) public sign in French here, 3) Screening Checklist here, 4) Memo CMOH here, 5) Enhanced Public Health Measures here, 6) Case Definition here. The number of confirmed cases in Canada reported by EOC today is 158 cases, and one death. This includes 20 new cases in Ontario, which brings our province to 79 cases (of which 5 are resolved cases). EOC reports that in Ontario, at this time, we have 580 persons under investigation with lab results pending. Health Canada reports a total of 176 cases + 3 probable ones, in the country. Media reports a total of: 197 (192 confirmed, five presumptive, and 11 cases resolved) in Canada. Ontario has 79 confirmed (5 cases resolved), British Columbia 64 confirmed, including one death (6 cases resolved), Alberta 29 confirmed, Quebec 17 confirmed, New Brunswick 1 confirmed, Manitoba 1 confirmed and 3 presumptive, Saskatchewan 2 presumptive, and Canadians quarantined at CFB Trenton: One confirmed. Public Health Ontario maintains an excellent resource site on materials on COVID-19. This is an essential resource for Ontario health providers; I encourage you to visit it. Public Health Ontario posted yesterday a technical brief Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19 (in English and French). Another essential resource is Health Canada's website on COVID-19. It provides the best information capturing all of Canada. It contains an outbreak update, Canada's response to the virus, travel advice, symptoms and treatment, and resources for health professionals. This is, again, a vital resource for those following the COVID-19 outbreak in Canada. The Public Health Agency of Canada has developed two new guidance documents for health system partners. The first, regarding community-based measures to mitigate the spread in Canada, and the second on informed decision-making related to mass gatherings. Situation Report 53 from WHO updates that worldwide there are 132,758 confirmed cases (7,499 new) and 4,955 deaths (342 new) in 123 countries (5 new). The vast majority of the cases are local transmission. There are 15,113 confirmed cases (2,651 new) in Italy, 10,075 cases in Iran (1,075 new) and 7,979 confirmed cases in South Korea (110 new). Other countries to note are Spain (with 2,965), France (with 2,860), Germany (with 2369), Switzerland (with 858), Japan (with 675), Netherlands (614), Sweden (620) and UK (594). You can also find up-to-date global numbers in Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE. These numbers appear in some cases to be more updated than those of WHO. For example, while WHO reports 1,264 confirmed cases in the United States, CSSE reports 2,174. In his daily media update, WHO Director-General acknowledged that even though COVID-19 has captured the world’s attention, there are still many other health issues people continue to face every single day. Babies are still being born. Essential surgery is continuing. People still need emergency care after road traffic crashes. People still need treatment for cancer, diabetes, HIV, malaria and many other diseases. And for all of these, we need health workers. In his words, “[t]oday I want to send a personal and sincere thank you to every health worker around the world – especially nurses and midwives, who we are celebrating this year through the International Year of the Nurse and the Midwife. You do a heroic job. We know that this crisis is putting a huge burden on you and your families. We know you are stretched to the limit. You have our admiration, our respect, and our commitment to doing everything we can to keep you safe and enable you to do your job.” RNAO’s ACTIONS: RNAO is unwavering in our commitment to support Ontarians, all health professionals and in particular nurses and nursing students, and our health system during the COVID-19 pandemic. An initiative we engaged yesterday, 12 March, was to invite Ontario nurses to volunteer for providing virtual clinical care or non-clinical services in their communities, when needed given the extraordinary demands created by the COVID-19 pandemic. The nurses will receive appropriate training and protocols so they can support quality care and outcomes. These nurses are being deployed to work in telehealth activities, and clinical leads are being provided as a resource for real time consultation and support. In less than one day over 1,700 RNs and NPs have responded to the call. We also welcome non-practicing class, or nurses who are no longer a member of CNO (e.g., retired, resigned) as we need all hands on-deck. Thanks to your response we are already connecting a good number of nurses with employers. Call to RNs & NPs: If you are interested in getting involved, please CLICK HERE to complete our survey. We would appreciate your response as soon as possible, given the rapidly evolving situation and urgent need to augment Telehealth Ontario, no later than Monday, March 16, 2020. Note for employers in Public Health Units: If you are experiencing a staff shortage to answer phone calls following protocols, please let us know. Write to dgrinspun@rnao.ca and Daniel Lau <dlau@rnao.ca> and we will connect you within hours with nurses in your locality. RNAO is also actively engaged in public education through mainstream media so we do all we can to delay community spread. We know that government officials are working very hard and we have offered our engagement in any and all that is required. To assist on this effort, RNAO is also engaging in public education through our website and though the media (please take a minute to watch and retweet). RNAO was very pleased to have been asked to review a confidential draft of the Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19. This is a Ministry of Health/ Public Health Ontario guidance document for the use of PPE for inpatient, outpatient and other settings. We did the review in consultation with public health, community and chief nurse executive colleagues – thanks to those of you who supported this work. We are very supportive and pleased with this important updated tool and are sharing the updated guidelines here with you in English and in French. Colleagues, we urge you to continue to educate yourself and others on how to diminish the risk of transmission. You can see the WHO recommendations for prevention here. Given the high likelihood that community spread is inevitable, here is and excellent guidance document for homes and residential communities, from the USA Center for Disease Control (CDC). At this time, RNAO is urging to replace face-to-face meetings with virtual meetings. Please continue to keep in touch and share questions and/or challenges of any kind, and especially shortages of PPE. Send these to me at dgrinspun@rnao.ca. You can also use 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. The WHO has provided an excellent link for you to share with members of the public here. RNAO has updated its information page for the public. Please share it widely. Together, we are and will continue to tackle COVID-19 with the best tools at hand: accurate information, calmness, determination and swift actions. Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, O.ONT
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