Dear RNAO members,
Today is Sunday, what used to be a day of relaxation and fun for many that were not working – especially as spring begins. Instead, COVID-19 has turned our lives upside down, and today was another long day for you in the front-lines of care, for managers, for executives making critical decisions, for government officials, civil servants, us at RNAO and countless other – all doing intense work to fight the COVID-19 beast!
Here is your RNAO daily communication – for Sunday, March 22 – our third month of the COVID-19 outbreak in Canada – a global pandemic of major proportions. To see previous updates visit RNAO updates and resources on COVID-19 for members and other health professionals. Feel free to share these updates with other health professionals at home or abroad.
PPEs: A key area of concern is the availability of PPEs for the protection of nurses, physicians, other health workers and patients. Given the extensive community spread of COVID-19, and the evidence that persons, including health workers, became contagious before symptoms appear, one cannot assume that asymptomatic health workers are not spreading the virus. Thus, RNAO is recommending to health officials that all health workers, at this point, should be using surgical masks while at work. Given the limited stocks of masks, this should start in our view in nursing homes and other setting where patient populations are most vulnerable, and, as stocks of surgical masks increase, all health workers in all settings should be using them.
Availability of PPEs is becoming more acute each day. Many emails and phone calls I received today related to PPE issues, and in particular, dwindling stocks. One hospital administrator shared that the institution is using today 10 times the normal daily usage in non-COVID-19 times -- and we have not even entered the critical stage of the pandemic -- when the hospitals will be flooded with patients and will consume vast amounts of PPE per day. RNAO is urging government – in the strongest possible terms – to move aggressively to secure a supply chain for these products. International procurement is not a likely option at this time, as every country in the world is desperate to procure. Thus, government needs to obtain required health care supplies by immediately taking control of the domestic supply chain. Place a prohibition on the commercial sale either by internet or in stores, of a list of healthcare supplies. All privately-held stocks of defined list of supplies (i.e., drugstore chains) should immediately be handed to government through legal order. Simulation labs, dentist offices, and all other education and health organizations that have a stock of PPE should be re-purposed immediately by government. Most importantly, the federal and provincial governments should be moving at breakneck speed to mobilize technical know-how and production capacity in the private sector to procure the key items required. There is absolutely no time to lose and we should be hearing from both levels of government how they are implementing this. It is an evidence-based statement to say: Lives are on the line. At the end of this nightmare, it will be shocking to see the correlation between the availability of the required PPEs and equipment, such as ventilators, and the death rate. Bluntly put, the number of deaths will be correlated to the availability of PPE and critical equipment such as ventilators. We issued today a joint press release of RNAO and OMA, please read and RT.
Today was the fourth day of the #TogetherWeCanDoIt campaign and the noise was even lauder to #cheer4healthworkers. My neighbours and I participated from our own porches, thus keeping social distance and yet feeling a deep sense of togetherness. Please take a few minutes every day at 7:30pm local time, continuing every evening until we defeat COVIC-19! Join in whichever way you can – our collective energy can cheer the millions of health providers, social service and other essential front-line workers in Ontario, Canada, and around the world tackling #COVID-19. At 7:30 pm local time, each evening, step out onto your porch, balcony or open a window and make some noise in honour of the heroes working on our behalf. You can bang some pots and pans, you can sing a song, you can applaud, ring your bike’s bell, and yes – you can honk.
WHO and Global Citizen launched #TogetherAtHome, a virtual, no-contact concert series to promote physical distancing and action for global health. Chris Martin, lead singer of Coldplay, kicked it off earlier this week with a performance from his home. More Solidarity Sessions are planned to promote health, show support for people who are staying at home to protect themselves and others from COVID-19, and encourage donations to the COVID-19 Solidarity Response Fund.
As COVID-19 cases continue to increase, many countries are requesting individuals to stay at home in self-quarantine. WHO EURO has released a guide on how to stay physically active during self-quarantine. Information can be found here.
MOH EOC Situational Report #57 here for Sunday, March 22 – EOC reports that the number of confirmed cases in Canada today is 1,318 cases, and 19 deaths including five persons in Ontario. EOC reports 36 new cases that bring our province to a total of 412 cases (of which 8 are resolved cases and 5 deaths). EOC reports that in Ontario, at this time, we have 8,360 persons under investigation with lab results pending. Ministry reminds organizations in the health system that:
Coronavirus COVID-19 Global Cases by Johns Hopkins -- CSSE reports a total of 425 cases in Ontario and 1,470 total cases in Canada as of March 22, at 11:50pm.
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. Make sure to check the Public Health Ontario technical brief on the Updated IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID-19 (in English and French).
Health Canada's website 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 61 from WHO updates that worldwide there are 292,142 confirmed cases (26,069 new) and 12,784 deaths (1,600 new). There are 53,578 confirmed cases (6,557 new) in Italy, 20,610 confirmed cases (966 new) in Iran, and 24,926 confirmed cases in Spain (4,946 new). Other countries to note are Germany (with 21,463) and France (with 14,296). China has 81,498 cases (with only 82 new), and 8,897 confirmed cases in South Korea (98 new), both countries clearly managing, so far, to “flatten the curve”. The number of confirmed cases worldwide has reached almost 300,000. It took over three months to reach the first 100,000 confirmed cases, only 12 days to reach the next 100 000, and just 3 days for the third one.
You can also find up-to-date global numbers in Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE. These numbers appear to be more updated than those of WHO. For example, while WHO indicates there are 15,219 cases in the United States, CSSE reports 33,760.
As of today, 4,560 RNs and NPs responded to the RNAO survey with availability to provide virtual clinical care or non-clinical services. We have already deployed 59 to Ottawa Public Health and a good number to other places. RNAO is in the process of working with various other areas of need and will connect with you depending on the locations required. We also understand that Telehealth will necessitate additional staff. We know that you are ready and eager to help and thank you hugely for it!
Note to employers in Public Health Units and other call centres: If you are experiencing a staff shortage to answer phone calls following protocols or contact tracing - please let us know. Write to Daniel Lau email@example.com and we will connect you within hours with RNs and NPs in your locality.
Note to employers in Long Term Care Homes: Starting this Monday, RNAO has responded to AdvantAge’s call to supports its 400 LTC homes by facilitating the hiring of nursing students. RNAO’s 5,000-strong nursing student members who completed year one of the BScN program can work as Personal Support Workers (PSWs) to increase the homes’ capacity to meet HR needs. If you are a Nursing Home that needs help, contact Daniel Lau firstname.lastname@example.org and he will connect with nursing students in their 2nd, 3rd and 4th year, that live in the vicinity. For the nursing students, this is an opportunity to put into action their knowledge and skills, gain valuable experience as well as an income, as these will be paid positions. This is another just-in-time service RNAO and AdvantAge provide to the people of Ontario and their members, a win-win-win for all parties.
URGENT STEPS FOR GOVERNMENT TO TAKE: RNAO’s VOICE
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 email@example.com. We are responding daily and are continuously solving your challenges. WE ARE HERE FOR YOU! 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.
Let’s thank our colleagues in the front lines in Ontario, Canada and in other countries – especially Italy and Spain – now hit the hardest. We are here with you in solidarity. These are stressful and exhausting times; the only silver lining is coming together and working as one people – for the good of all!
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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