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Registered Nurses' Association of Ontario      

Dear Colleagues: Welcome to our Wednesday, June 3 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.

Colleagues, I can’t let go of the image of George Floyd gasping for air and pleading for his life – “I can’t breathe.” That image evokes the immense brutality, insanity and terror brought about by anti-Black racism and all forms of racism that have existed forever in the United States, Canada and elsewhere. I know that you, like me, are outraged with this cold and brutal murder. But we also know that this is only one incident, standing as a symbol of a long history of oppression, discrimination and injustice against Black people in the US. However, let’s not appease ourselves with the thought this only happens south of the border. Canada also has a long history of deep-rooted racism, exclusion and even genocide – against Blacks, racialized communities, not to speak about Indigenous peoples. We need to stand together and say, in one voice: No more!  #ICantBreathe  #BlackLivesMatter

                                               

 

RNAO’s 95th AGM goes virtual - June 11-13, 2020

We very much look forward to seeing you all very soon at our virtual Annual General Meeting taking place from June 11-13, 2020. We are excited to engage with you in this new format in light of the current COVID-19 pandemic and the physical distancing requirements across Ontario. Let’s continue to celebrate the Year of the Nurse and the formidable work of registered nurses, nurse practitioners and nursing students in such unprecedented times.

On June 11, Thursday’s Opening Ceremonies from 6:00pm to 7:00pm we will feature remarks from Christine Elliott, Deputy Premier and Minister of Health and other political party leaders and celebrate our LTC BPSOs designation ceremony for 2020. On June 12, Friday, from 4:00pm to 7:00pm, we’ll hear from Premier Doug Ford, and we will conduct our usual business including the Association’s auditor, provincial committees, followed by my yearly report that will undoubtedly showcase RNAO in action during these unprecedented times. As always, we will enjoy the consultation session on resolutions, media and member recognition awards, our president’s remarks and the passing of the gavel from President Angela Cooper Braithwaite to incoming President Morgan Hoffarth.

All this is followed by an important closing keynote panel on Saturday from 11:30am to 1:00pm titled: Celebrating the Year of the Nurse: Scaling Up Our Voices, featuring international nursing leaders Barbara Stilwell, Executive Director of Nursing Now Global and Mary K. Wakefield, former Administrator, Health Resources and Services Administration (HRSA) and Deputy Secretary, U.S. Department of Health and Human Services under President Obama. This session will focus on the history of nursing and set the foundation for the next generation of nurses. Submit your questions by June 5, 2020:  https://myrnao.ca/agmkeynotequestions

Looking forward to spending energetic and meaningful three days virtually together!

Visit the AGM portal for program and other details, to stay updated on AGM-related announcements and instructions, and to register: https://rnao.ca/agm-2020

Registration: Register online today. It’s free for all members and the public. All events will be broadcast live on RNAO.ca, YouTube and Facebook. 

One member, one vote: Make your voice heard – Voting is already open and closes on June 11 at noon (ET)

RNAO members play a central role in deciding governance issues that affect the current and future direction of RNAO. One member, one vote is how you can make your voice heard. Information on items that require a vote by all members is now available here: https://myrnao.ca/rnao_election 

This year, members are asked to cast their vote on three items:

  1. Amendments to RNAO’s bylaws to redefine region boundaries
  2. Approval of KPMG as RNAO’s auditors for fiscal year end, Oct. 31, 2020
  3. 2020 Candidates listed on the ticket of nominations for board of directors

 

Keeping our focus on vulnerable populations: People living with mental health and/or substance use face tremendous challenges that are often exacerbated by the pandemic. I urge all to share in the responsibility to mobilize so the right supports are in place to alleviate the pain, to protect and to save lives. The following is an article that a group of us co-authored, published in the Toronto Star on May 29. The initiative for this article came from a virtual RNAO Take your MPP to Work event with MPP and Ontario Green Party Leader Mike Schreiner to the Guelph Community Health Centre during Nursing Week (you can see the video here).

Adapting harm reduction during a pandemic

By Mike Schreiner, Doris Grinspun, Raechelle Devereaux and Adrianna Tetley

Toronto Star, Friday, May 29, 2020

Earlier this month, we met online for Nurses Week to talk about Ontario’s overdose crisis, which is worsening under the weight of COVID-19.

Overdose deaths are on the rise, with Toronto reporting 25 deaths in April, the highest number in over a year, and the pandemic has deepened existing inequities.

People dependent on substance use are more likely to have underlying conditions that put them at greater risk if they contract COVID-19. They might also be sleeping in a crowded shelter or relying on under-resourced food banks.

On top of it all, given COVID-19, when they visit an overdose prevention site, the experience is radically different than it was a few months ago.

For example, COVID-19 has imposed new barriers such as long waiting lines outside, additional screening processes, and outreach workers who have swapped their street clothes for face shields.

These measures, while necessary, are counter to a harm reduction approach that is based on a low barrier to entry — a safe space where there is no judgment and where workers build trust by meeting people where they are in life and empowering them on their recovery journey.

The risk of spreading the virus has also meant that many wraparound services like meal programs and peer support groups have had to be paused.

This all amounts to a deterrent to some people accessing harm reduction services that have kept them alive.

To make matters even worse, we’re hearing stories of more people falling victim to toxic fentanyl because their usual supplies are not available.

While isolation is saving lives from COVID-19, it can claim lives for people living with a substance use disorder.

That’s why nurses with the Guelph Community Health Centre are visiting motels and apartment buildings to check in with people, distribute naloxone kits, and offer harm reduction training.

That’s why they are distributing phones as a lifeline for people who have become even more isolated than before.

Indeed, workers are rapidly adopting new outreach strategies in the name of health equity, and we must back up their efforts with better harm reduction policies.

One common sense change is to follow British Columbia’s example and expand access to safer drug supplies under Ontario’s Drug Benefit program.

This would allow clinicians to prescribe untainted alternatives to the deadly fentanyl acquired on the street, building on pilot projects and unfunded programs already taking place.

This discussion was happening before the pandemic, and now we have even more reason to make this intervention available to people who are alone and suffering.

As we mobilize all the health care resources we can to combat COVID-19, we cannot take our eyes off the overdose crisis.

The improved health and fiscal savings, which have been demonstrated through wraparound safer drug supply programs, cannot be ignored.

Like so much else, we need to adapt to save lives.

Mike Schreiner, Leader, Green Party of Ontario; Doris Grinspun, CEO, Registered Nurses’ Association of Ontario; Raechelle Devereaux, Executive Director, Guelph Community Health Centre; Adrianna Tetley, CEO, Alliance for Healthier Communities.

Your messages: Voices and responses

Each day we receive numerous messages. 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.

Disability support program: “Thank you for the amazing initiative on homelessness. The government has determined that individuals require $2,000 a month to survive without a job, but an individual receiving Ontario Disability Support Program (ODSP) receives $1,100 per month. This vulnerable group might be included in your initiative.” Nicolette Parant, RN, RNAO member since 1984. ~~~Thanks for making us aware, Nicolette.

Hand sanitizer in TTC stations:  “I am a RN working in geriatrics. I am really confused why there aren't hand sanitizers in TTC stations here in Toronto, which has 50% plus of the cases. I reviewed WHO recommendations and it calls for hand sanitizers in prominent places as an optimal intervention. Thanks, Erin Murphy.” ~~~Thanks, Erin. We will take this issue on and let’s also encourage our readers to advocate for this initiative with city and TTC authorities.  

Together we can do it

Today is day #76 of RNAO’s #TogetherWeCanDoIt campaign… However, we too held yesterday Blackout Tuesday in solidarity with those who stand up in support of racial equality, and all those who search for it. We are resuming today, Wednesday, at 7:30 pm. Please post your pics and videos – or send to Susan McNeill smcneill@rnao.ca.

 

MOH EOC Situational Report #129 here for Tuesday, June 2

Situation:

Case count as of 8:00 a.m. June 2, 2020

Area

Case count

Change from yesterday

Deaths

Change from yesterday

Worldwide total

6,396,269

+105,520

377,972

+3,638

Europe

2,043,926

+13,341

174,890

+960

China

83,022

+05

4,634

0

Middle East

603,258

+12,115

14,531

+172

Asia & Oceania

505,827

+18,477

12,504

+352

Africa

155,282

+5,864

4,372

+126

Latin America and Caribbean

1,053,556

+32,845

52,788

+1,268

North America

1,951,398

+22,873

114,253

+760

United States

1,859,693

+22,115

106,927

+729

Canada

91,705

+758

7,326

+31

 

  • 446 new cases were reported in Ontario today, bringing the cumulative case count to 28,709 (this includes 22,484 resolved cases and 2,293 deaths).
  • In Ontario, a total of 747,964 tests have been completed, with tests performed at Public Health Ontario Laboratories and non-Public Health Laboratories. There are currently 10,622 tests under investigation.
  • 801 patients are currently hospitalized with COVID-19; 125 are in ICU; and 87 are in ICU on a ventilator.

EOC report #126 for May 30 informs of the following actions taken:

  • The Ontario government made amendments to the Retirement Homes Act, 2010 regulation, enabling the Retirement Homes Regulatory Authority (RHRA) to better support seniors living in retirement homes during the COVID-19 outbreak.
    • The regulation change increases the emergency payment the RHRA can pay to eligible retirement home residents from $2,000 to $3,500. In the event of an emergency, such as an outbreak, this funding can be used to support residents to cover costs for transportation, alternative accommodation or temporary care.
    • The regulation change also requires retirement homes to report infectious disease outbreaks to the RHRA during COVID-19 and beyond.     
  • In addition, the government has issued an emergency order eliminating barriers to eligible frontline workers receiving pandemic pay. It will allow employers with unionized workforces to provide pandemic pay to eligible employees without the need to negotiate separate terms or conditions with their bargaining agents.
  • Assessment centre locations can now be found on the ministry website. 

EOC report #128 for June 1 informs of the following actions taken:

  • Guidance for Congregate Living for Vulnerable Populations has been posted on the ministry’s website.
  • A new guidance document has been developed to support summer day camps that will operate during the months of July and August 2020. The document (here) in English and French will be posted on the Ministry’s website in the coming days.
  • The Ontario government announced that it has enacted a new regulatory amendment that will put non-unionized employees on Infectious Disease Emergency Leave during the COVID-19 outbreak any time their hours of work are temporarily reduced by their employer due to COVID-19. This will ensure businesses aren't forced to terminate employees after their ESA temporary layoff periods have expired.
  • Dr. David Williams, Chief Medical Officer of Health, and Dr. Barbara Yaffe, Associate Chief Medical Officer of Health, will now hold bi-weekly media briefings to provide an update on the province's ongoing response to COVID-19.
  • The Command Table met on May 22, May 25 and May 29; summaries of the discussions are here and here and here. 

EOC report #129 for June 2 informs of the following actions taken:

  • The Ontario government continues investing in local manufacturers in order to keep frontline workers and communities safe during the COVID-19 outbreak. More innovative businesses are receiving financial support today through the Ontario Together Fund to re-tool their processes and increase their capacity to make personal protective equipment (PPE).

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:

29 May - Update on pandemic pay; pandemic pay in consumption and treatment sitesgo here.

28 May - RNAO Calls for Immediate Action in Response to the Canadian Armed Forces’ LTC reportgo here.

26 May - Update on VIANursego here.

26 May - Ending homelessness: Will you join us to build a COVID-19 recovery for all?go here.

24 May - Technology as a solution: Opportunities and pitfalls of COVID contact-tracing appsgo 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 systemgo here.

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

14 May - Nursing Week updatego here.

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

14 May - Disappointment for not being included in pandemic paygo here.

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

13 May - End racism and prejudicego here.

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

11 May - Nurses share their successes and challenges during National Nursing Weekgo here.

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

7 May    - Counting the missing deaths: Tracking the toll of the coronavirus outbreakgo here.

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

5 May    - Addressing differential access to virtual care due to technology inequitiesgo 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 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. 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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