Dear Colleagues: Welcome to our Tuesday, May 26 report – now in the fifth month of COVID-19 in Ontario. Visit the COVID-19 Portal for the many resources RNAO offers on COVID-19. 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.

Today I am appreciative to Tim Richter, President & CEO, Canadian Alliance to End Homelessness, for engaging us all in what promises to be a very effective campaign to end homelessness, once and for all. Tim’s message is so simple and so powerful: Yes, we want to go back to normal, but not a normal where more than a quarter of a million Canadians are homeless. Not a normal where we look the other way as vulnerable people suffer injustice and discrimination. Not a normal where so many people do not have shelter and basic needs. Not a normal where “recovery” means some people recover and others remain homeless, excluded and unhealthy. We need a recovery for all! I urge each of you to read and take action.

Ending homelessness: Will you join us to build a COVID-19 recovery for all?

As healthcare professionals, you’ve seen firsthand the devastating impact that the co-occurring and cumulative crises of homelessness, the opioid crises and now a pandemic can have on people who are homeless. COVID-19 is layering on yet another assault, one with widespread and damaging consequences. Meanwhile, governments across Canada are starting to re-open the economy and people are talking about getting back to normal.

There can be no getting back to normal. Normal was more than 235,000 Canadians per year homeless and at life-threatening risk for no other reason than they were poor and without a home.

That’s why the Canadian Alliance to End Homelessness is launching Recovery for All. This campaign calls on our federal government to make the right investments in a post-COVID recovery, stimulate the economy and help those who need it most. If done right, this recovery effort can not only restore the country’s financial health, it can end homeless in Canada, once and for all. 

I want to be clear about two things: First, homelessness policy choices were made more than 30 years ago. And second, as we recover from COVID-19, we need to ensure that the government invests not only in industry, but in people. And most importantly, we must make sure people experiencing homelessness are not excluded yet again. A recovery for all. 

We are at a unique moment in time when big change is possible, and we can finally begin to reverse the policy choices that first put people on Canadian streets and kept them there, generation after generation.  

Thank you for your work on the frontlines, keeping people safe and putting yourselves at risk every day to care for those in need. In addition to this incalculable service, we need something else:  your powerful voice. Now more than ever, we need your voice to push for permanent support for the most vulnerable people in the country – a push for housing for people who are homeless.  We need the healthcare community’s collective call for housing, a home not only for protection against the pandemic, but for health.

Will you join us?

CALL TO ACTION

Today, Tuesday, May 26, take action:

• Sign up for the campaign at www.recoveryforall.ca.
• Send out a personal and organizational email to your contacts (Board, staff, supporters, volunteers, donors, friends and relatives) to encourage them to sign up while also sharing our campaign website and video.
• Share the campaign website on social media through your personal and organization pages (making sure to add a comment as to why you are supporting the campaign).

Homelessness as we see it today has not always been with us. It is a solvable problem. We know what it takes to end homelessness. It is captured in the Recovery for All campaign’s six-point plan including:

1. A federal commitment (with timelines and targets) to the prevention and elimination of homelessness, with expanded federal investment in community-based homelessness responses.
2. A national guaranteed minimum income to ensure those in greatest need have minimum financial resources to help them meet their basic needs and prevent homelessness when times are tough.
3. Construction of 300,000 new permanently affordable and supportive housing units and enhanced support for low-income Canadians to address Canada’s housing and homelessness crisis.
4. Meaningful implementation of the right to housing to surface and resolve inequities and systemic/structural breakdowns that contribute to homelessness and housing need.
5. Implementation of measures to curtail the impacts of financialization of rental housing markets by limiting the ability of large capital to purchase ‘distressed’ rental housing assets.
6. Implementation of an Urban and Rural Indigenous Housing and Homelessness Strategy that is developed and implemented by urban, rural and Northern Indigenous peoples and housing and service providers.

For more information on our six-point plan, please visit recoveryforall.ca.

The choices we make today will shape Canada’s future for a long time. Half of the hard work is knowing what to do – and that work is complete.  Let’s now make choices that will build a better Canada for all. 

Thank you for all that you do and have done to keep our homeless neighbours safe and healthy. To that end, please add your voice and join us.

RNAO’s response: Thanks again to Tim Richter. RNAO adds its voice to the campaign and will spread the message far and wide: There is no recovery, if some are left behind. The time to end homelessness is now. This is why we urge every one of our readers to go to recoveryforall.ca and take action!

Your messages: Voices and responses

Each day we receive numerous messages and phone calls. Each day we also 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 here. 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.

Foot care webinar

As mentioned a few days ago when answering to your questions, to address the needs expressed by nurses who work in foot care, members of the IABPG and policy teams will be hosting a webinar on Thursday May 28th at 3:30 - 4:30 pm EDT. We already have more than 200 registrants, and there is space for more! This webinar is open to any foot care nurses and others who would like to join us for dialogue and discussion. If you are interested and available to attend, please register here: https://us02web.zoom.us/meeting/register/tZUpcOuqqjMrGNB1b4JWVuUZUB3jeoZVTDqM

If other groups of RNAO members have special needs and would like support, simply write to me at dgrinspun@rnao.ca and copy pgbatten@RNAO.ca

Immunity passports

A physician colleague, Darren Larsen, writes in response to our discussion of apps: “Doris... once again an incredibly informative and thoughtful newsletter. I am flummoxed by the slowness of the response to contact tracing in Ontario. And feel that no one method is going to accomplish all... apps can definitively be useful, but they are best if backed up by quick and effective contact tracing done manually. Wondering ... what do you think about Immunity Passports?”

Thanks, Darren, and glad you like our newsletter. I fully share the frustration of Ontario’s overall slow response, including for testing, case and contact tracing. As it relates to the immunity passport, I am sure you have seen the article in The Lancet that reflects RNAO’s current thinking. I summarize it here for other readers so they can follow our dialogue. Immunity passports are “digital or physical documents that certify an individual has been infected and is purportedly immune to” COVID-19. Given the current state of science and serious social concerns, RNAO does not support this idea at this time. First, WHO informs there is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection. Second, “immunity passports would impose an artificial restriction on who can and cannot participate in social, civic, and economic activities and might create a perverse incentive for individuals to seek out infection, especially people who are unable to afford a period of workforce exclusion, compounding existing gender, race, ethnicity, and nationality inequities.”   

Together we can do it

Update on VIANurse

RNAO launched the COVID-19 VIANurse program on March 12, 2020, and has provided staffing services free of charge to the entire province during an unprecedented time of need.

As we informed on May 19, RNAO’s VIANurse program is now providing staffing assistance only to health facilities with active COVID-19 outbreaks. Health organizations – in all sectors – not facing a COVID-19 outbreak, but looking to fulfill their ongoing staffing needs in nursing and other health professions, are asked to advertise as always in RNAO’s job board, RNCareers.ca

During this period, VIANurse registered 7,448 RNs for virtual and clinical care, 1,031 critical care RNs (who have experience and continued competency in the provision of critical care), and 289 NPs. In addition, 394 colleagues responded to our call for work at nursing homes experiencing an outbreak: 289 RNs and 40 NPs and 54 nursing students – ready to go to nursing homes in an active outbreak - plus, 11 RNs who can do non-clinical work in outbreaks places.

VIANurse served the staffing needs of more than 313 organizations in different sectors, including 238 long-term care homes, 29 hospitals, 11 public health units, 7 indigenous health facilities, 3 hospices, 3 correctional centres and other sectors. And, many organizations have accessed VIANurse multiple times.

The latest partnership is with Toronto Public Health, and was graciously acknowledged by their leaders:

I am pleased to share news of this partnership and I sincerely thank the RNAO for their generous support of our COVID-19 response. We've had a very positive response to our job call thus far from RNAO’s VIANurses who are enthusiastic about this important opportunity. My team and I look forward to welcoming these colleagues to work with us on our COVID-19 response.

- Dr. Eileen de Villa, Medical Officer of Health

MOH EOC Situational Report #121 here for Saturday, May 25

Situation:

• 404 new cases were reported in Ontario today, bringing the cumulative case count to 25,904 (this includes 19,698 resolved cases and 2,102 deaths).
• In Ontario, a total of 619,539 tests have been completed, with tests performed at Public Health Ontario Laboratories and non-Public Health Laboratories. There are currently 3,883 tests under investigation.
• 859 patients are currently hospitalized with COVID-19; 148 are in ICU; and 114 are in ICU on a ventilator

EOC report #121 for May 25 informs of the following actions taken:

• The COVID-19 Reference Document for Symptoms has been updated to include some additional language around how multisystem inflammatory vasculitis may present in children. This document is here.
• An updated version of Directive #3 has been uploaded to the ministry’s website.
• An updated version of the Primary Care Guidance has been uploaded to the ministry’s website.  

EOC report #120 for May 24 informs of the following actions taken:

• Additional direction was issued today (here and here) on testing for COVID-19. Effective immediately testing is available for the following populations:
  • Symptomatic testing:
    • All people with at least one symptom of COVID-19, even for mild symptoms.  Please see the “Guidance for All Populations” of the Testing Guidance Update for details about the symptoms.
  • Asymptomatic, risk-based testing:
    • People who are concerned that they have been exposed to COVID-19.  This includes people who are contacts of or may have been exposed to a confirmed or suspected case.
    • People who are at risk of exposure to COVID-19 through their employment, including essential workers (e.g., health care workers, grocery store employees, food processing plants).

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:

24 May - Technology as a solution: Opportunities and pitfalls of COVID contact-tracing apps – go here.

21 May - Debunking PPE myths with Dr. Jeff Powis: Which masks should health care workers wear during COVID-19? – go here.

20 May - RNAO response to announcement of an independent commission into Ontario's long-term care system – go here.

19 May - With the pandemic curve flattening, VIANurse program will focus its effort on outbreaks – go here.

14 May - Nursing Week update – go here.

14 May - Pandemic puts health system to the test: Nurses have answers for shortfalls – go here.

14 May - Disappointment for not being included in pandemic pay – go here.

13 May - RNAO saddened by the loss RN Brian Beattie to COVID-19 – go here.

13 May - End racism and prejudice – go here.

12 May – Enhancing Community Care for Ontarians (ECCO 3.0) – go here

11 May - Nurses share their successes and challenges during National Nursing Week – go here.

10 May - A story of hope, ingenuity, support and genuine care for an LTC resident – go here.

7 May    - Counting the missing deaths: Tracking the toll of the coronavirus outbreak – go here.

5 May    - Life on the front lines of the pandemic: Profile of RNAO member NP Daria Gefrerer – go here.

5 May    - Addressing differential access to virtual care due to technology inequities – go here.

3 May    - Being person-and-family-centred during COVID-19 – go here.

1 May    - Migrant agricultural workers and the COVID-19 crisis – go here.

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 update – go here.

25 April - Lessons learned through a COVID-19 nursing home outbreak – go here.

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

23 April - Working with seniors in long-term care requires specialized knowledge – go here.

22 April - Shaking the stigma: We need a proactive COVID-19 response for mental health and addiction – go 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 Islands – go 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.

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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