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Registered Nurses' Association of Ontario      

Dear Colleagues: Welcome to our Saturday, February 6 report during this twelfth month of COVID-19 in Ontario. You can find earlier update reports here, including thematic pieces in Doris’ COVID-19 Blog. And, for the many resources RNAO offers on COVID-19, please visit the COVID-19 Portal where you will also find RNAO media hits and releases on the pandemic here. As always, feel free to share this report and links with anyone interested. Daily Situational Reports from Ontario's MOH EOC can be found here.

Webinar on vaccine hesitancy and effective vaccine communication – Monday, Feb. 8, 2021, 2:00 to 4:00 pm ET (open to all; details below).

 

RNAO’s continuing media profile: The January report

We’ve begun a new year with even more determination to address the challenges brought forward by the relentless COVID-19 virus. RNAO continues its central role in the media, speaking about key issues and continuing our advocacy efforts to mobilize change and help bring an end to this pandemic. This is a summary of our January interventions.

Just over one year ago, on January 25, 2020, the first COVID-19 case in Canada was reported. It has been a hard year for all Canadians, but especially for residents in long term care, their loved ones, and their nursing and support care staff. They have had no relief from suffering and hardship for a full year! Also, heart-wrenching have been the experiences and death for persons in ICU, away from their loved ones. We salute the heroic work of RNs, NPs, physicians, RTs and others who in these settings have tried so hard to save lives and sustain humanity under the most difficult circumstances. Indeed, health professionals in all sectors have and continue to give it their all – and remain dedicated to providing care despite the unimaginable challenges.

On January 1, the Toronto Star published New Year’s wishes from prominent Canadians. My statement read: “Please bring more laughter and less pain, more hugs and less distance, and a COVID-19 free fall! Healing for the grieving and help for the impoverished. Let’s redouble our efforts to build a stronger health system for all, a green and just recovery devoid of discrimination, racism, violence and inequality. Together we must do it!”

Stress and burnout can affect nurses during normal times, but they become magnified and unbearable as the months wear on during this pandemic. RNAO member and chair of the Staff Nurses Interest Group (SNIG), Lhamo Dolkar, spoke with CBC on January 12 about her experience. “It’s a vicious cycle that’s ongoing and is affecting patient safety and our safety,” she said about the burnout nurses are experiencing. In another article on January 29, I said that “politicians have no understanding of the unwavering commitment of nurses and other health-care professionals or the price that is being paid for that commitment.” It is crucial for the Ontario government to increase mental health supports for frontline staff during COVID-19 and then afterward. The news of the tragic and sudden death of Toronto RN Stefanie Van Nguyen was absolutely devastating. On CHCH News, January 25, I said: “It makes you think, who else is feeling dark inside?” If you are struggling with your mental health, please reach out for help. You are not alone. Read RNAO’s statement on Stefanie’s passing here. On Wednesday, February 3, RNAO hosted an open forum for RNs, NPs, RPNs and nursing students to allow nurses to talk openly about burnout and mental health while working through COVID-19. The participants, 130 of them, shared candidly and generously. The open forum is a biweekly event. The next one will be held on February 17, 2:30 – 4 p.m. ET (see details below).

As Ontario continues its COVID-19 vaccine rollout, a central issue for RNAO has been to ensure that vaccines are going to those who need them first: long-term care (LTC) home residents and their essential family care partners. It was incredibly disheartening that the first phase of the vaccination plan did not include all of them. “It’s another tragedy,” I told the Toronto Star on  January 4. “The reality is all the excuses used for not vaccinating all LTC homes residents first are just that, excuses.” In another interview with the Canadian Press on January 25 I explained how the government should have focused on residents in LTC when it first began giving out the vaccine. I told Dahlia Kurtz on 580 CFRA on January 15 that any vaccines currently in the province should be administered 24-hours-a-day, seven-days-a-week to help save lives in LTC. The good news is that public pressure brought about the government’s decision to announce a faster timeline to vaccinate residents in LTC homes.

And when it comes to vaccinating others around the province, RNAO has urged the provincial government to keep nurses in mind. Thousands of nurses in public health, primary care and home care already play a central role in vaccination programs, including giving flu shots and other immunizations. And they can be an effective force in inoculating millions of Ontarians. They, along with physicians and pharmacists, should be deployed if we are serious about scaling up a rapid vaccine plan. I told the Toronto Star on January 16 that there’s no need to reinvent the wheel when it comes to a rollout. We already have existing and established networks in place and nurses as well as physicians and pharmacists are ready and eager to lend their expertise.

January also saw the Ontario government announce that it would be adding more ICU beds. However, this won’t help if there aren’t more nurses to take care of patients in those beds. “That’s what happened in Italy in the first wave. At the end of the day, it was not the beds. It was that they did not have enough RNs that specialize in ICU” that constrained their ability to expand, I told the Globe and Mail on February 1.

On January 12, we called on the premier to implement measures to suffocate COVID-19. These included a full province-wide lockdown, not reopening schools while the virus is running rampant, especially in hot zones, increasing supports for vulnerable populations, including 10 paid sick days, a full moratorium on evictions and vaccinating residents in LTC homes 24-hour-a-day, seven-days-a week. We had an op-ed published in the Hamilton Spectator on December 27 about eviction moratoriums and how preventing evictions is not just about economic relief but protecting the health of tenants. RNAO welcomed the news of the Ontario government’s stay-at-home order and again urged the premier on January 12 to “increase supports for vulnerable populations because some people simply can’t afford to abide by a stay-at-home order.” When it comes to paid sick days, I told Toronto.com on January 14, “they absolutely need to move forward with paid sick days for essential workers who, through no fault of their own, are spreading the virus.” Join us in calling for paid sick days, along with other vital public health measures, such as a moratorium on evictions and accommodation for those awaiting test results for COVID-19. You can help make a difference by signing our Action Alert.

Looking back to late December, you’ll remember that Ontario’s finance minister resigned after he travelled to the Caribbean in the midst of the lockdown. In January, we learned of two hospital CEOs who also travelled. “We have been working tirelessly day-in and day-out. To have leaders that are travelling internationally or abroad for pleasure is not something I think people will respond favourably to,” RNAO president Morgan Hoffarth said in a CBC online story on January 5. I was interviewed by CBC London Morning on January 11 about another hospital CEO, who ignored public health guidelines when he travelled over the holidays and on numerous occasions throughout the pandemic. Not only did he ignore guidelines, but he abandoned his staff in the middle of a pandemic.

It was also shocking to learn that a London NICU nurse travelled to Washington to speak at an event spreading anti-mask disinformation. In an interview with CBC on January 12, I explained how “damaging” this is “because what people need is factual information.” In an interview with Global News on January 19, I called it a betrayal of public trust. “For a nurse to use that public trust and betray the same public we are trying to protect and serve every single minute, it’s just outrageous.”

Toward the end of January, we witnessed vicious attacks against scientists whose science is not palatable to some government positions. I joined other colleagues in a Queen’s Park Briefing article on January 27 arguing these attacks pose a distraction from what really matters right now — tackling the COVID-19 pandemic. I was quoted as saying “it is tragic, that at the time when we should be completely focused on suffocat(ing) this… virus ... that we find the time to attack scientists and people who have given every ounce of their ... time every day to try to help with this pandemic.”

As the months of this pandemic wear on, you can count on RNAO to continue to forcefully advocate with government, all opposition parties, and on the media on behalf of Ontarians, nurses and other health providers. In January, we had 285 media hits related to COVID-19. To keep up with our COVID-19 media coverage, visit our COVID-19 Press Room.

 

POLICY UPDATES FOR ALL TO ACT ON & MUST JOIN EVENTS OPEN TO ALL

 

Use community care providers to ramp up vaccinations!

Ontario’s vaccination roll-out has stumbled out of the gate. Please take a moment to set things right. Join us in urging Premier Doug Ford to start Phase 2 of the roll-out by putting vaccinations into the hands of the thousands of nurses, physicians and pharmacists working in community care across this province. By making use of existing community care providers and their existing infrastructure, the vaccination roll-out can be accelerated across Ontario.

There is no need to reinvent the wheel. Every year, thousands of nurses, physicians and pharmacists provide routine vaccinations through public health and established networks including primary care, pharmacies and home care. These community-based infrastructures and their health-care professionals, using tried and true distribution systems for vaccination, must be put to work to deliver what is urgently needed – COVID-19 vaccinations.

Let’s leave hospitals to do what hospitals are meant to do – provide acute care. And let’s allow public health and community care do what they do best – prevent illness and protect health in the community.

It’s been a long, long year. We need to get this vaccination roll-out right. Call on the premier to put community providers – nurses, physicians and pharmacists - to work vaccinating their communities.

Sign our Action Alert and make your voice heard!

See also two important letters related to this matter here and here.

 

Webinar on vaccine hesitancy and effective vaccine communication

Monday, Feb. 8, 2021, 2:00 to 4:00 pm ET (Open to all nurses and other health professionals)

The COVID-19 vaccine will change the course of this pandemic. As millions of people are getting immunized, how can we as health-care workers become champions for this vaccine, and feel empowered to communicate about it with our patients, colleagues, family and friends?

Join Dr. Cora Constantinescu, pediatric infectious disease specialist, for a session on COVID-19 vaccine hesitancy and effective communication.

At the end of the session, the participants will be able to:

  • appreciate the extent of vaccine hesitancy around the COVID-19 vaccine and some of the reasons for this phenomenon,
  • understand how Canada measures up globally and at home; and
  • apply a communication framework to hold a vaccine hesitancy conversation around COVID-19 vaccine.

Register here.

 

Past webinar on vaccines rollout

RNAO holds its Health System Transformation and COVID-19 Webinar webinar series every month to support health providers from Ontario, Canada and anywhere around the world. They are free and open to any health provider. For information on the series and on earlier webinars, go here.

The January 11 webinar was on COVID-19 vaccine distribution: Progress to date with Dr. Dirk Huyer, Chief Coroner, member, Lead Clinical Guidance and Surveillance Work-Stream, COVID-19 Vaccine Distribution Task Force. About 850 health providers participated online. You can watch the webinar here and see the slides here. Dr. Huyer’s written summary and RNAO’s perspective on vaccines can be found here.

 

Continuing the conversation – an open virtual forum for nurses and a survey to share how they are feeling during COVID-19

Webinar: Wednesday, Feb. 17, 2:30-4:00 pm ET

RNAO is aware nurses across this province – especially those working on the frontlines of COVID-19 – are experiencing tremendous levels of physical and emotional stress and burnout. We know this can affect your mental health and well-being at this challenging time and that you may have less time to devote to your own self-care. 

In an effort to understand the impact of COVID-19 on your work and well-being and the best ways we can continue to support you and Ontario’s nursing community, RNAO has created a short survey and initiated an open forum webinar series.

Survey: If you are an RN, NP or nursing student in Ontario, please complete this 15-minute survey. Your participation will allow RNAO to better understand how this pandemic has changed your work, your attitude to work and your future in nursing, and inform our policy and advocacy now and into the future. It will also allow us to capture trends and themes across health-care sectors and settings that may inform our "Continuing the Conversation" open forum series for nurses to share how they are feeling and coping during COVID-19.

Webinar: On Wednesday, Feb. 3, RNAO hosted the first open forum with 130 participants and heard firsthand how nurses are feeling during COVID-19. Feedback on the first forum was very positive; participants felt supported, more connected and heard about new resources and strategies for coping. We are continuing the conversation on Wednesday, Feb. 17 from 2:30-4 p.m. (ET) and invite you to join us, please register here.

 

Register for February 25, virtual Queen’s Park Day – open only to RNAO members

Registration is open for Queen's Park Day on Thursday, February 25, 3:30 to 7:30 pm. The virtual event will feature remarks by Premier Doug Ford, Minister of Health Christine Elliott, Minister of Long-Term Care Merrilee Fullerton, Official opposition and NDP leader Andrea Horwath, Liberal Party leader Steven Del Duca, and Green Party leader Mike Schreiner.

The agenda will also feature the release of Vision for Tomorrow: The Nurse Practitioner Task Force Report. You can register for the event here.

 

MOH EOC Situational Report

We are posting each day the Daily Situational Reports from Ontario's MOH EOC at RNAO’s website. That way, you can access the Ministry’s guidance at any time.

For a more detailed Ontario epidemiological summary from Public Health Ontario, you can always go here.

Here is a segment from the Situation Report #361 for February 5 (no report on February 6):

Case count as of February 5, 2021 / Nombre de cas le 5 fevrier 2021

Area / Région

Case count / Nombre de cas

Change from yesterday / Changement par rapport à hier

Deaths / Décès

Change from yesterday / Changement par rapport à hier

Canada*

793 734

+ 4 083

20 513

+  158

Ontario**

275 330

+ 1 670

6 438

+  45

Weekly Frequently Asked Questions – Friday February 5th Edition

Please see below for the answers to some frequently asked questions from the past week.

What should I do if I got my first dose of vaccine and am showing symptoms of COVID 19? Should I get the second dose per the prescribed interval?

Mild side effects are common for all vaccines and typically resolve in a few days. It is important to receive both doses as protection offered by the first dose is lower than the efficacy achieved after the second dose.

The Ministry has provided a number of guidance documents describing common side effects following vaccination including an After Care sheet and Guidance for Health Care Workers.

What do I tell my patients about why they need two doses of the COVID-19 vaccine?

It is important to receive both doses as protection offered by the first dose is lower than what is achieved after the second dose. The Pfizer-BioNTech and Moderna vaccines are expected to be 94-95% effective after two doses.

After receiving your two doses it is still important to follow all public health guidelines including maintaining a physical distance of two metres from people outside of your household, wearing a mask, practicing proper hand hygiene and limiting non-essential travel. These measures will help keep you, your loved ones and your community safe.

Is there an update on the timing of vaccine rollout?  When will I get vaccinated, what should I tell my patients?

Due to fluctuations in supply of vaccine, it is difficult to specify exactly when individuals will be able to receive a COVID-19 vaccine. The government has rolled out a three-phase distribution plan to ensure Ontario is prepared to receive, store and administer COVID-19 vaccines as soon as they are available. It focuses first on vulnerable populations that are at greatest risk of COVID-19 and those who care for them, including Health Care Workers. More information on phases of vaccination rollout and the prioritization of Health Care Workers is available on the Ministry’s website.

Will guidance documents be updated to reflect the emergence of new variants of COVID-19?

The province recently announced a six-point plan to help stop the spread of COVID-19 variants. The Ministry of Health is working to incorporate information on variants of concern into new and existing COVID-19 guidance.

 

Staying in touch          

Keeping in touch is now more important than ever. Feeling that you are part of a community and that we have your back will help you get through this challenging time. We are also eager to hear from you how we can best support you. Send to us your questions, comments, and challenges. Feel free to also recommend ideas for future webinars. Send these to me at dgrinspun@rnao.ca and copy my executive assistant, Peta-Gay (PG) Batten email: pgbatten@rnao.ca. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!

Thank you all for being there for our communities – everywhere and in all roles! Together, in solidarity, we are stronger and more resilient. These continue to be tough times and we have to reach out to one another in solidarity! Our government, the public and indeed all of us as health professionals – must also keep focused. While the vaccine is hugely important, the immediate target is fighting the spread of the virus to preserve lives. To everyone and most especially our colleagues working in the front lines here at home and in countries around the world hit hard by evil COVID-19 – THANK YOU, and please take care of yourselves and know that RNAO always stand by you!

As we have said before, the silver lining of COVID-19:  Coming together and working as one people – for the good of all!

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

 

RECENT BLOG ITEMS:

30 Jan - The PrOTCT plan for nurses: Counseling vaccine hesitant patients & colleaguesgo here.

30 Jan - Please sign action alert urging Premier Ford to suffocate COVID-19, NOW!go here.

23 Jan - Mitigating the spread in Toronto shelter settingsgo here.

23 Jan - Home care nurses are #ReadyToVaccinatego here.

23 Jan - Hurtful comments about law enforcementgo here.

15 Jan - The escalating catastrophe of the COVID-19 second wave in Ontariogo here.

15 Jan - Progress in vaccine distribution: Updates, issues and concernsgo here.

8 Jan - RNAO raises its voice in the media: Media coverage in December 2020go here.

8 Jan - A practicum experience at RNAOgo here.

8 Jan - RNCareers: Help during the holidays and help for next phases of this pandemicgo here.

29 Dec - Public health nurses in schoolsgo here.

29 Dec - Government failing Ontarians as virus runs rampant and endangers livesgo here.

29 Dec - We need your help in addressing urgent staffing needs in health facilitiesgo here.

29 Dec - Best wishes for the holidaygo here.

18 Dec - Providing compassionate nursing care in an age of artificial intelligencego here.

18 Dec - RNAO continues to express grave concern regarding the second wavego here.

18 Dec - Long-term care staffing plan lacks urgency and legislated actiongo here.

11 Dec - RNAO gravely concerned about the second pandemic wavego here.

11 Dec - Health organizations plead for Ontarians to celebrate holiday season safelygo here.

4 Dec - Continuing the conversation: Mobilizing collective action for LTC reformgo here.

4 Dec - Nurses urge dedicated funding for infection prevention and control in LTCgo here.

27 Nov - RNAO, once again, plays major role in the media during Novembergo here.

27 Nov - COVID-19 in long-term care: A nurse’s witness statementgo here.

20 Nov - Government’s measures too late and insufficient; calling for a COVID-Zero strategygo here.

13 Nov - Mobilizing collective action for long-term care reform in Canadago here.

13 Nov - RNAO’s media conference to address the crisis in long-term care go here.

6 Nov - Fall 2020 provincial budget once again leaves vulnerable populations to fend for themselvesgo here.

6 Nov - Elections in the US: A path to healing and respect for sciencego here.

30 Oct - 2S-LGBTQ+ Seniors: Our Existence is Our Resistance!go here.

23 Oct - Responding to the second wave of COVID-19: RNAO continues to speak outgo here.

16 Oct - RNAO advocates for national long-term care standards in Canadago here.

16 Oct - Reta’s Story  (a contribution of Judy Smith, Reta’s daughter-in-law)go here.

9 Oct - RNAO relieved that Premier Ford engages late, but essential, actiongo here.

9 Oct - Patient-centred-care – the dream and the realitygo here.

2 Oct - RNAO urges stricter measures to combat rapidly rising number of COVID-19 infectionsgo here.

25 Sept - Nurses say throne speech advances A Just Recovery for Allgo here.

18 Sept - Is Your Hospital Using Blood Wisely?go here.

18 Sept - RNAO calls to Delay Action on CNO Council Decision to Expand RPN Scopego here.

11 Sept - International Overdose Awareness Day: Statement from RNAOgo here.

11 Sept - RNAO joins global movement: A Just Recovery for Allgo here.

We have posted earlier ones in my blog here. I invite you to 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.

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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