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Registered Nurses' Association of Ontario      

Dear Colleagues:  Welcome to my Friday, May 01, COVID-19 report – now in the fourth month of COVID-19 in Ontario. For the many resources RNAO offers on COVID-19, visit the COVID-19 Portal. In particular, VIANurse is your go-to page if you need to augment your nursing and personal support worker human resources. You can refer to earlier update reports here, including thematic pieces in my blog. Feel free to share this report or these links with anyone interested – they are public.

Nursing Now – Webinar in English – now available for your view

Nursing Now is a three-year global campaign (2018-2020) that aims to improve health by raising the profile and status of nursing worldwide. Run in collaboration with the World Health Organization and the International Council of Nurses, Nursing Now calls on governments worldwide to place nurses at the heart of tackling 21st century health challenges and maximize their contribution to achieving universal health coverage. Nursing Now 2020 has honoured RNAO before by asking us to deliver webinars related to RNAO’s Best Practice Guidelines Program (BPG) and Best Practice Spotlight Organizations (BPSO). Last week we delivered a COVID-19 webinar – now available for your view.

Today is National Doctors’ Day and RNAO wants to THANK Ontario, Canada, and the world’s doctors for the vital contribution each and everyone makes to the public, and for being awesome team members! I shined the lights for them at 9:00pm and hope you did too. Please RT to show your gratitude.  

Vulnerable populations

RNAO’s speaking out for vulnerable populations continues today with one last and often forgotten group, one that is vital to our food chain and one that has been late in receiving policy attention in government plans: migrant agricultural workers. We are tremendously grateful to Dr. Susana Caxaj, RN, PhD, assistant professor at the University of Western Ontario, and Oleksandra Budna, communications and member relations lead, Alliance for Healthier Communities, for the following article.

Migrant agricultural workers are important members of our communities – they deserve respect and protection during the COVID-19 crisis

On Sunday evening, hundreds of workers at Greenhill Nursery were exposed to COVID-19. As of Wednesday, 47 individuals of the largely Jamaican, Guatemalan and Mexican workforce have tested positive. This outbreak is one of many seen in the agri-food sector and includes farms in BC, and meat plants in Alberta, Ontario and Quebec. Disheartening as these outbreaks are, they are not surprising given the poor working and living conditions that these essential workers often find themselves in. 

There are several reasons why those of us who work with migrant workers are concerned about the impacts that COVID-19 pandemic would have on these men and women. This group’s housing is often inadequate even outside of pandemic circumstances. Migrant farmworkers typically live in employer-provided housing on farms which are often crowded, lack proper ventilation, and are removed from basic health services and amenities.

We have also witnessed the many barriers that make it difficult for workers to get help when they are sick.  Many Alliance for Healthier Communities members, community-governed primary health care organizations offering health and social services, work in various regions of the province to address those barriers. However, not all migrant workers have access to a community health centre that can offer culturally safe primary care and mental health supports. Now, with COVID-19 a threat to us all, this workforce is one of the most at risk groups because some employers are not supporting workers to practice physical distancing effectively. And if they do get sick, in many regions, workers may have language barriers and even face discrimination in this climate of fear. 

Over the past month, advocates, community health providers and academic experts have asked authorities to enforce and oversee accommodation for migrant workers that will help prevent the spread of COVID-19. We also have urged government authorities to provide clear and rigorous workplace standards that promote physical distancing and other important infection control strategies. While guidance documents released by the Employment and Social Development Canada and Ontario Ministry of Health are steps in the right direction, a lot more needs to be done to ensure clear communications for both employers and workers, as well as more proactive inspections to keep workers healthy and safe.

As many of us have made clear before, so much responsibility – and really, power – to oversee the health and safety of this workforce has been left in the hands of employers. We know many employers want to do the right thing but we cannot expect them to contribute finances and implement public health measures without both oversight and support. The BC government has committed and begun to provide hotel accommodation to migrant agricultural workers upon arrival into the province until they complete their 14 days of quarantine. Ontario should do the same so that workers have a better chance of arriving on farm healthy. This promising first step must be followed with more commitment to keep workers healthy and safe once they arrive on the farm to work.

Because as shared by an anonymous farmworker at Greenhill, when outbreaks occur, there has been no system in place to prevent the spread. Since workers share kitchen spaces, kitchen utensils and washrooms, these men and women require and deserve clear and transparent housing standards that give them peace of mind. In their words, “This could have been avoided, this is a part of negligence.” 

Testing days upon arrival for all workers is another measure we’ve been calling for since they are coming from different households, and may be traveling in a variety of ways to get to Canada. As Ontario government develops the details of its COVID-19 action plan for marginalized groups living in group settings, it needs to ensure migrant agricultural workers are included to prevent future outbreaks.

When the workers become sick, they need to be able to trust that our healthcare system will protect their health and their livelihoods. They need to know that they will have access to relief funds, sick leave, and appropriate quarantining measures, and the legal status to refuse unsafe work.  Given the many barriers this group faces, they will need support, in their own language, and clear path to access it, without their employer’s involvement.  

These essential workers have been leaving their families to help put food on our tables for decades. They are important members of our communities. And they deserve our respect and protection. They deserve to live in a healthy and safe environment that gives them the best chance of avoiding exposure to COVID-19. 

RNAO’s ViaNurse Program               

RNAO’s VIANurse program, launched on March 13, has already registered 7,349 RNs for virtual and clinical care, 1,023 critical care RNs (who have experience and continued competency in the provision of critical care), and 287 NPs. RNAO is continuously responding to requests from health organizations. So far, we have served 282 organizations, of which 215 are nursing homes and retirement residences. RNAO has also offered the government to identify NPs and RNs who can help manage LTC organizations that are in crisis, and assist with urgent interventions where severe outbreaks are ongoing. For any nursing HHR needs go to RNAO’s VIANurse program

** Seeking RNs, NPs and nursing graduates ready to work in nursing homes in active outbreak

RNAO launched on Friday, April 24th a fourth survey for RNs, NPs and nursing graduates urging them to register for work in nursing homes that are on an active outbreak. The availability of these colleagues is already fastening even more the matching of nursing staff to homes in dire need. For example, between April 20th and May 1, we deployed RNs, NPs and/or PSWs to 108 organizations, including 102 nursing homes, with some of these organizations having been served multiple times. Today, on a matter of hours from request we responded to the staffing needs of 11 additional organizations. Also important to know is that VIANurse has no backlog requests, and we also respond after hours and on weekends – as we understand the urgency of each request. Please retweet the following urgent tweet to have many more RN, NP and new graduates enrolled.  

For those of you ready to work in a nursing home with an outbreak – we need you –please CLICK HERE and complete our survey ASAP. We need your response as soon as possible given the rapidly evolving situation, and the urgent need in nursing homes across the province. The government has now improved the compensation, recognizing your critical role – see Ontario’s press release here.

So far we have got 347 responses: 259 RNs and 37 NPs and 41 nursing students – ready to go to nursing homes in an active outbreak - plus, 10 RNs who can do non-clinical work. These colleagues are being deployed as we speak, including over the weekend. 

Your messages: Voices and responses

Each day we welcome new readers to this daily report: thank you deeply for the work you do always and especially during this public health crisis, and also for keeping us well informed. You can see previous reports at RNAO updates and resources on COVID-19 for members and other health professionals. Feel free to share these updates with other health professionals and other organizations both at home and abroad. RNAO media hits and releases on the pandemic can be found here. Daily Situational Reports from Ontario's MOH EOC can be found here. Many of the articles you see here are posted in my blog, where you can catch up with earlier issues. The COVID-19 Portal is here.

We are delighted to share with you RNAO’s portal on work related to First Nations Communities. Our deepest gratitude to Ontario Regional Chief RoseAnne Archibald, Carmen Jones (Director of Health) and their entire team for working with ours to develop the plan and related materials. A very special thanks to Sabrina Merali and Grace Suva, Program Managers at RNAO, who have led through this important work:

  • Webpage to support First Nations communities to address their needs during this pandemic to prevent and/or delay the spread of COVID-19.
  • COVID-19 action plan template (which is a working document) providing an overview of Chiefs of Ontario’s pandemic plan recommendations for First Nations communities in Ontario, developed in partnership with RNAO.
  • Blog article with Ontario Regional Chief RoseAnne Archibald, Carmen Jones (Director of Health) and their teams.

Together we can do it

Today was day #41 of RNAO’s #TogetherWeCanDoIt campaign, started on March 19. Here are my picks for today on noise that is becoming louder and louder in streets, workplaces and social media to #cheer4healthworkers – and it has gone even to India and Slovakia! Please remember to join-in this community building moment every evening at 7:30pm local time - until we defeat COVID-19! and post tweets from your communities, your children, workplaces and memory places - with your messages, cheers here, pots & pans, songs and other expressions of solidarity, reminders and more pots & pans -- Because: #TogetherWeCanDoIt.

MOH EOC Situational Report #97 here for Friday, May 1

Situation:  

Case count as of 8:00 a.m. May 1, 2020

Area

Case count

Change from yesterday

Deaths

Change from yesterday

Worldwide total

3,325,624

+89,911

234,495

+5,892

Europe

1,384,433

+26,787

135,503

+2,308

China

82,874

+12

4,633

0

Middle East

300,280

+7,939

10,028

+178

Asia & Oceania

152,307

+6,827

4,204

+155

Africa

40,009

+1,695

1,640

+45

Latin America and Caribbean

217,181

+14,280

11,432

+816

North America

1,148,540

+32,371

67,055

+2,390

United States

1,095,304

+30,732

63,871

+2,202

Canada

53,236

+1,639

3,184

+188

 

  • 421 new cases were reported today in Ontario, bringing the cumulative total to 16,608 (this includes 10,825 resolved cases and 1,121 deaths).
  • In Ontario, a total of 294,054 tests have been completed, with tests performed at Public Health Ontario Laboratories and non-Public Health Laboratories. There are currently 11,975 tests under investigation.
  • 1,017 patients are currently hospitalized with COVID-19; 225 are in ICU; and 175 are in ICU on a ventilator.

EOC report #96 for April 30 informs of the following actions taken:

  • The Ontario government released safety guidelines today to provide direction to those working in manufacturing, food manufacturing and processing, restaurant and food service, and the agricultural sector. The Ontario government is ensuring employers have the safety guidelines they need to protect workers, customers, and the general public from COVID-19 as it prepares for a gradual reopening of the provincial economy.
  • The Command Table met on April 27 and 29, 2020. Summaries of the discussions will be available shortly on the Ministry’s website in French and in English.

EOC report #97 for May 1 informs of the following actions taken:

  • The Ontario government announced today that it is allowing certain businesses and workplaces to reopen on Monday, May 4 at 12:01 a.m. as long as they comply with strict public health measures and operate safely during the COVID-19 outbreak. Those permitted to start up include seasonal businesses and some essential construction projects.
  • The Government of Ontario issued new temporary emergency orders under the Emergency Management and Civil Protection Act to support the immediate needs of the province's hospitals and health care workers. Further details on these orders can be found here.
  • The Assistive Devices Program has resumed accepting new applications for funding for devices and supplies. Here and here are the memos sent to stakeholders on April 29, 2020.
  • A new guidance document has been created for Labour, Delivery and Newborn Care. It is available on the ministry’s website.
  • Guidance for Community-Based Mental Health and Addiction Service Providers in Residential Settings has been uploaded to the ministry’s website.

Staying in touch          

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. We are responding daily and are continuously solving your challenges. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!

Thank you deeply colleagues in the front lines; in administrative roles; in all labour, professionals and sector associations, and in governments in Ontario, in Canada and around the world. 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 must redouble our efforts to tackle COVID-19 with the best tools at hand: full, accurate and transparent information, calmness, determination and swift actions. 

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

 

RECENT RNAO POLICY CORNER ITEMS:

30 April - COVID-19 pandemic in provincial institutions and correctional centres – go here.

28 April - Supporting First Nation Communities during COVID-19 – go here.

27 April - Responses to COVID-19 for persons experiencing homelessness in Toronto: An updatego here.

25 April - Lessons learned through a COVID-19 nursing home outbreakgo here.

25 April - Letter from a retired RN to Premier Ford: The problems with LTC were evident long before COVIDgo here.

23 April - Working with seniors in long-term care requires specialized knowledgego here.

22 April - Shaking the stigma: We need a proactive COVID-19 response for mental health and addictiongo here.

21 April - We Require Expanded and Accessible COVID-19 Data in Ontario go here.

20 April - Can Loss of Smell and Taste Help Screen for COVID-19? – go here.

18 April - COVID, Trump and the World Health Organization go here.

16 April - A Home Based Model To Confront COVID-19 – The Case Of The Balearic Islandsgo here.

15 April - COVID-19 and the Challenges in Homecare – go here.

14 April - Reprocessing Of N95 – An Update – go here.

14 April - A New COVID-19 Facility For Persons Experiencing Homelessness In Toronto – go here

13 April - Practical Tips for Safe Use of Masks – go here.

10 April - Ontario’s Tragedy in Long Term Care Homes and Retirement Homes – go here.

10 April - RNAO Action – Supporting Long-Term Care – go here.

10 April - Update For Nursing Students – NCLEX Exam – go here.

9 April - Celebrating Passover, Good Friday, Holy Saturday, Easter Sunday and the start of Ramadan during a pandemic – go here.

9 April - Guidance on use of N95 mask – go here.

7 April - Sentinel surveillance and on-site testing in the homeless service sector – go here.

7 April - Reprocessing of n95 – safe? – go here.

5 April - We must change the way we do testing and case definition – go here.

5 April - Ringing the alarm bells on critical care beds – go here.

4 April - COVID-19, stay at home and domestic violence – go here.

We have posted earlier ones in my blog here. Please go and take a look.

RNAO’S policy recommendations for addressing the COVID-19 crisis: We presented 17 recommendations for government, last revised on April 2. Some of these, such as #15, continue to be of grave concern to RNAO. Read them here.

 

Information Resources

Public Health Ontario maintains an excellent resource site on materials on COVID-19. This is an essential resource for Ontario health providers. 

Ontario’s health provider website is updated regularly with useful resources here.

Ontario’s public website on the COVID-19 is there 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.

Please promote the use of Ontario’s COVID-19 self-assessment tool: It also has a guide where to seek care, if necessary. Its use will provide the province with real-time data on the number and geography of users who are told to seek care, self-isolate or to monitor for symptoms. Data will inform Ontario's ongoing response to keep individuals and families safe.

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.

The World Health Organization plays a central role in addressing the COVID-19 pandemic. See here and here.

You can find up-to-date global numbers in Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.

 

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Registered Nurses’ Association of Ontario (RNAO)
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