Dear Colleagues: Welcome to our Saturday, April 3 report during this fourteenth 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. Daily Situational Reports from Ontario's MOH EOC can be found here. As always, feel free to share this report and links with anyone interested. Scroll down for information on several webinars.
RNAO says government’s “shutdown” announcement doesn’t go far enough to confront third wave of COVID-19
Ontario’s health system is on the precipice of collapse and nothing short of a complete lockdown and stay-at-home order are needed to combat a fast and furious third wave of COVID-19 says the Registered Nurses’ Association of Ontario (RNAO).
On Thursday (April 1), Premier Doug Ford announced what he is calling a province-wide 28-day “shutdown”. Under the plan, indoor dining and outdoor patio dining will no longer be permitted, with restaurants only able to offer take-out and delivery. Personal care services such as hair salons and barber shops will not be allowed to operate. However, under the government’s plan, many non-essential businesses will remain open with 25 per cent capacity, along with indoor religious services operating at 15 per cent capacity.
RNAO says the announcement does not go far enough to confront the biggest health crisis facing Ontarians and the province, since the outset of this pandemic. “This third wave is unlike any situation we have faced before. It is being driven by variants of the virus that spread much faster and cause more severe illness,” says RNAO CEO Dr. Doris Grinspun, pointing to the number of ill people occupying hospital intensive care unit (ICU) beds. “As of today (April 1), there were 2,557 new cases and 430 patients sick due to COVID-19 in ICUs, the highest number since the beginning of the pandemic, according to Critical Care Services Ontario.”
RNAO reiterates that vaccines alone are insufficient to contain the virus’s spread. “What is needed is bold action by Ontario’s premier and his team, and this is why we are disappointed with today’s announcement. The people who are ending up in hospital are in their forties and fifties – many from vulnerable communities – and they are very sick. These people have lives to lead, families to feed and love, yet they may not make it or will face a prolonged recovery after they leave the ICU. This virus, as we have repeatedly said, needs to be fought on two fronts: With ongoing tough public health measures to contain its spread and with a much more effective vaccine rollout than what we have seen so far in Ontario,” says Grinspun.
“We are very discouraged that the government is not listening to the voices of experts calling for a stay-at-home order. The province’s science table laid out its latest modelling projections on just how dire and dangerous the scenario is that is unfolding right before our eyes. It will get much worse without stricter measures to control the spread of the virus,” insists Grinspun.
Also, missing from today’s announcement is the plea of many – including RNAO – for paid sick days. “Many essential workers do not have access to this crucial employee benefit. The government of Ontario has an obligation to workers. It is obvious that workplace outbreaks account in large part for the increase in case counts and yet, there is still no provision for what should be a central public health measure in the fight against this virus – sick paid days,” urges Grinspun.
Premier Ford's failure to confront the virus in a decisive way also has implications for people who are awaiting diagnostic tests and surgeries for illnesses such as cancer, heart disease and other serious conditions that require hospital care. “We have to remember that outside of COVID-19, people still get sick with other diseases and need care. Having to cancel diagnostic tests and/or surgical procedures to make room for those sick with the virus has serious implications for people’s health and the system itself,” says RNAO President Morgan Hoffarth.
RNAO says the government also needs to consider the health of health providers who have been caring for patients non-stop over the past 14 months. “Nurses are running on empty and almost at the breaking point and this is another important reason why we have to do everything in our power to contain a pandemic that is out of control in our communities,” says Hoffarth, adding exhausted nurses, physicians and other health providers poses its own risk. This is why RNAO released yesterday the results of a survey on the work and wellbeing of nurses, ringing the alarm bell on the looming crisis facing the nursing workforce in Ontario – a crisis, which will deepen given today’s deficient announcement.
When it comes to delivering vaccines, RNAO is again imploring the government to utilize the more than 20,000 home care and primary care nurses who can help speed up the vaccine rollout. RNAO sent a letter to Premier Ford and Health Minister Christine Elliott on Feb. 10 about the importance of this. “This is urgent. For example, 7,500 home care nurses and their agencies are eager and ready to vaccinate homebound persons – yet very few have been given supplies of the vaccine and the go-ahead to roll these out,” says Hoffarth, adding “home care and primary care nurses can also support the urgent need to vaccinate essential workers in precarious work conditions like warehouses, schools and shelters.”
Hoffarth says the health of the province’s children also has to be top of mind and that is why doing everything possible to keep schools open and safe must trump the need for businesses to remain open. “If we can get past these next few weeks, with public health measures and dramatically slow down the spread of the variants, we will be able to return to some semblance of normalcy that Ontarians are yearning for. We are getting further and further away from that goal and this puts schools and children at higher and higher risk,” says Hoffarth, adding vaccinating teachers, children and their families in compromised communities must also be seriously considered.
RNAO’s continuing media profile: The March report
I am pleased to share our media profile for March 2021, prepared in partnership with RNAO’s communication department. The most prominent issue has been, by far, the quickly escalating third wave of Covid-19 in Ontario, driven mainly by the loosening of public health measures in the face of a faster spreading B7.1.1 variant of COVID-19. However, before getting into that, here are other issues we faced in the media.
This month – on March 11 – we marked one year since the World Health Organization declared COVID-19 a pandemic. On that day, 35 organizations responded to RNAO’s invitation and called on Ontarians to mark the anniversary by lighting a candle in memory of those we’ve lost this past year and to shine a light on for a brighter tomorrow. I told CTV News on March 11 that the first word that comes to mind to describe this past year for nurses is “exhausting,” the second is “inspiring” the third is “fearful” plus “hopeful.” On that same day, I also told Global News: “It’s time to look ahead [to vaccination]… there is light at the end of this long, long, long tunnel.” We experienced many tragedies this past year, and it is important for every person anywhere to take a moment to feel together in our pain and to reflect and look ahead with hope.
We remain laser-focused on the funding and staffing crisis in long-term care (LTC), and continue to call on the provincial and federal governments to implement long-needed standards for the sector. Ontario’s Ministry of LTC recently announced its Staffing Supply Accelerator Group to tackle the issue of staffing. I am glad to be a member of this group. I said to CP24 on March 18 that I’m looking to “remedy the decades of disaster we’ve had in LTC that came under a magnifying glass during COVID-19.” I will advocate for the staffing mix outlined in RNAO’s Nursing Home Basic Guarantee to ensure residents receive four worked hours of care by RNs, RPN, and PSWs. We also need one NP on each nursing home to help address the increasingly complex needs of residents, and one IPAC nurse on each home to bolster the sector’s surveillance and practices.
The provincial government recently announced its plan to spend $933M to create more beds in LTC and to upgrade facilities. “It’s great that we are strengthening LTC. We need to equally strengthen home care so people actually have a choice to stay home and then you will likely need less space in LTC,” I told the Canadian Press on March 18.
On March 24, the provincial budget was announced. RNAO issued a media release expressing our disappointment for the lack of investments desperately need to help nurses fighting COVID-19 and to sustain the nursing workforce after the pandemic. The budget does nothing to tell my nursing colleagues help is on its way and it fails to deliver more hands-on care by RNs, NPs, RPNs and PSWs for Ontarians. As I told Global News on March 26, you cannot open 500 new ICU beds (as planned in new COVID field hospitals) and other types of beds in hospitals without RNs. Nurses have been poorly supported by the government during this pandemic and this budget doesn’t encourage them to stay in the profession.
On March 31, RNAO published a media release about our work and wellbeing survey results. The primary finding of the survey -- which checked the pulse of RNs, NPs and nursing students -- is that the stress and strain of the last year has taken a toll on the mental health and wellbeing of nurses. A significant number are considering leaving the profession after the pandemic ends. I shared that same day on CBC’s Ontario Morning that the biggest issues for nurses were the length of the pandemic, lack of supports and being overworked. “The results are that many will leave the profession immediately after the pandemic...The only way we can see out of it is to immediately put in retention strategies.” Our survey showed that 13% of nurses aged 26 to 35 are considering leaving. I told the Toronto Star on March 31 that “losing so many nurses at an early stage in their career would have a profound and lasting effect on how our health system functions.”
RNAO continued to speak out on the vaccine rollout and how to make it faster and effective. On March 5 I told Global News Radio that rather than keep focusing on the supply – which will grow hugely starting in late March – let’s worry about the logistics. We should be ready with the nurses, pharmacists, doctors and other providers in the community to put needles on the arms. One of the targets should be vulnerable populations that face barriers accessing the public sites. For homebound persons, RNAO has been urging and writing letters to the Premier and Minister Elliott asking to enroll homecare nurses to bring the shots to homebound person’s homes. Homecare nurses do tens of thousands of visits every day, and each visit could vaccinate a vulnerable individual and their essential care partner. The nurses are eager to help and the agencies for which they work have the logistical know how – all they need is the supply of vaccines. Primary care providers – community health centres, family health clinics, solo doctors, and nurse practitioner-led clinics – should play a central role as well. They have the expertise and the setup to engage in vaccination of their clients.
The COVID-19 pandemic curve has been worrisome for weeks and in recent days has taken a terrifying turn for the worse. The third wave is being driven by variants that are far more transmissible and dangerous and are also affecting younger ages. We have seen an exponential increase in cases, increased hospitalizations, greater illness, all of which are threatening people’s lives. It’s also threatening hospital ICUs and the health system itself. Tragically, this is no surprise. RNAO was already warning about “the worrisome impact of the new variants and the potential larger spread of these” on February 8. On February 10 RNAO sent a letter to Premier Doug Ford and Minister of Health Christine Elliott on the vaccine rollout and on preempting a third wave. We wrote that “There is the distinct risk of an explosive rise in the number of cases and hospitalizations. The public is not prepared for the worrisome characteristics of some of these variants, which appear to challenge our assumptions about transmissibility (such as two‐metre distancing, 15 minutes of exposure, and use of regular cloth masks).” On February 20 we cautioned that “many Ontarians will unnecessarily die or suffer severe and prolonged illness because of a preventable third wave of COVID-19. And they will continue to see illness and death due to non-COVID reasons because they cannot get timely access to an overwhelmed health-care service.” In these communications RNAO urged the government to strengthen restrictions across the province. Instead, the government and the Ontario medical officer of health proceeded to relax measures and open-up regions. In RNAO’s view this has been failure by design.
We continued to raise these concerns, with ever increasing alarm, over the ensuing days and weeks. I told CTV News on March 17 that the variants are taking over and we’re in a race to do two things: “mitigate the spread of variants and vaccinating super-fast to prevent people from dying.” The province needs to mandate vaccines be administered 24-hours-a-day, seven-days-a-week to slow the spread of COVID-19. In late March the province announced plans to allow personal care services to reopen in grey-lockdown zones on April 12. I told the Canadian Press on March 26 that I understand the government wants to help small businesses but there’s a way to do so without reopening and threatening lives. “Give [small businesses] the funding so they can bridge for the next two or three months because that’s all we have left. If we don’t do that, it will be a disaster because we will be mourning more and more people who will die.” On March 28 on CBC News, I said: “ICUs are pretty full. The variants of concern are spreading at an increasing rate. What nurses are asking [for] is [to] contain the virus, do not relax the public health measures.”
Finally, on April 1, Premier Ford decided to engage belated and less-than-satisfactory measures. He announced a province-wide ‘shutdown’ that would see indoor and outdoor dining as well as personal care services (hair salons and barber shops) closed for 28 days. However, during this period, non-essential retail stores would still be allowed to operate at 25% capacity. RNAO released a media release on the same day saying that this doesn’t go far enough. The premier is once again not attending to the science and doing nothing to help workers stay home if they fall ill.
RNAO remains committed to speaking out about this and other emerging issues in the media and using evidence to guide the discussion. Furthermore, RNAO is committed to stand on behalf of nurses, health professionals and the public who now are facing a catastrophic health situation.
RNAO’s media outreach for the month of March results in 152 hits. Rest assured, we will continue to advocate for a Just Recovery for All, and for keeping public health restrictions in place until case counts come down. For more information, please visit our Press Room in our COVID-19 Portal.
POLICY UPDATES FOR ALL TO ACT ON & MUST JOIN EVENTS – OPEN TO ALL
Webinar: Let’s Talk about Anti-Black Racism and Discrimination in Nursing
Apr 19, 2021, 6:30pm - 8:00pm
This is a monthly webinar series designed for nurses interested in receiving updates on RNAO’s Black Nurses Task Force and to engage them in meaningful conversations that will inform the work of the Task Force. The Black Nurses Task Force has a mandate to tackle anti-Black racism and discrimination within the nursing profession. Read more here.
Connecting Culture, Land and Wellness to Indigenous Youth Webinar
Apr 20, 2021, 4:00pm - 6:00pm
This webinar is in partnership with the Registered Nurses’ Association of Ontario (RNAO), Nishnawbe Aski Nation (NAN), Chiefs of Ontario (COO), the Centre for Addiction and Mental Health (CAMH) Shkaabe Makwa, the Canadian Indigenous Nurses Association (CINA) and Ontario First Nation Young Peoples Council (OFNYPC).
The overall purpose of this webinar is to increase health care providers' awareness of the importance of Indigenous language, community, culture and the wise practices and teachings of Elders to support well being amongst Indigenous youth. The objectives of this webinar are to facilitate knowledge exchange between Indigenous youth and health-care providers in regard to:
Presenter: Joseph Pitawanakwat (biography)
Moderated by: Quinn Meawasige, Indigenous Youth and Rachel Radyk, RPN, RN Student.
Target audience: Registered nurses, nurse practitioners, registered practical nurses and nursing students across care settings, primary care providers, public health and health promotion professionals, allied health-care providers and policy makers.
Note: Webinar will focus on nurses and health-care providers supporting First Nations communities and organizations; however all are welcome to attend.
NP Virtual Institute on April 21 with LTC Commissioner Frank Marrocco and other notable speakers
April 21, 2021, 9 am - 4:30 p. (ET)
Nurse practitioners from all sectors and settings across the province are welcome to RNAO’s Second-Annual Nurse Practitioner Institute – Nurse practitioners shaping the health system of the future.
The one-day virtual event provides NPs with an opportunity to network, engage and explore topics related to policy, clinical practice, quality improvement and patient safety, leadership and research. Top speakers this year include Matt Anderson, President & CEO, Ontario Health; Frank Marrocco, Associate Chief Justice and LTC Chief Commissioner; Dr. Jennifer Zelmer, President & CEO Canadian Foundation for Healthcare Improvement; and Greg Tofner, President & CEO from the Ontario Association of Medical Radiation Sciences delivering a clinical session of CT Scans & MRIs, and much more!
Participants will also discuss and debate key lessons and learnings from COVID-19 relevant to their practice and health system performance as well as build leadership and advocacy skills to drive meaningful policy and practice changes.
The NP Institute will close with an update about RNAO’s NP Task Force report Vision for Tomorrow, including the advisory role task force members will take on to ensure progress is made on each of the eight recommendations.
These awesome speakers and much more are at NO cost for RNAO’s 1,800+ NPs. Register online today. If you are an NP and not yet a member of RNAO, you can join for a short time for ONLY $100 with PLP and all taxes included! And, then join the NP Institute for free! Join here
Work and well-being survey
RNAO’s work and wellbeing survey asked RNs, NPs and nursing students in Ontario how they’ve been impacted by COVID-19 and the best way RNAO can continue to support Ontario’s nursing community. The survey closed on Feb. 22, and the more than 2,100 responses have been analyzed. We reported on the preliminary results in an earlier blog post. RNAO released its final report on the results of the survey at a media conference on March 31, 2021. Read here.
At the COVID-19 Webinar Series on March 8, 2021, RNAO's CEO Dr. Doris Grinspun, Director of Nursing and Health Policy Matthew Kellway, and Senior Economist Kim Jarvi provided an overview of how the pandemic has changed nurses’ work, their attitudes toward work and their future in nursing. They also discussed how the survey results will inform RNAO’s upcoming policy work and advocacy efforts. Watch the webinar here.
Downloadable file: Mental Health and Well Being: Resources for Psychosocial Support during the COVID-19 Pandemic
Action alert: An urgent call for more nurse practitioners (NP)
Increased utilization of nurse practitioners (NP) in Ontario’s health system will advance access to care. We have received substantial support for our urgent call for the government to deliver immediately on long-standing promises of:
In February, RNAO released its NP Task Force Vision for Tomorrow report. RNAO’s Vision for Tomorrow is a big and bold plan to increase health equity and access to health care in Ontario’s post-pandemic health system.
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 #395 for April 2 (no report on April 3):
No updates today.
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 email@example.com and copy my executive assistant, Peta-Gay (PG) Batten email: firstname.lastname@example.org. 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 health professionals – must keep focused. There is hope at the end of this long tunnel. Vaccines are being delivered in large quantities and now we need to fasten the rollout! Hugely important is to continue 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 stands 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
RECENT BLOG ITEMS:
27 Mar - Provincial budget fails to deliver urgent nursing investments to care for Ontarians – go here
27 Mar - Government's reopening plan threatens the health of Ontarians – go here
20 Mar - Preliminary results of RNAO‘s Work and Wellbeing Survey – go here
13 Mar - Getting it right – go here
– go here
6 Mar - RNAO’s continuing media profile: The February report – go here
– go here
6 Mar - Webinar: Understanding wellness in Indigenous wisdom traditions for caregivers – go here
27 Feb - RNAO celebrates Black History Month 2021 – go here
27 Feb - RNAO’s 21st annual Queen’s Park Day goes virtual – go here
27 Feb - RNAO’s NP Task Force releases groundbreaking report – Vision for Tomorrow – go here
20 Feb - Are you struggling with substance use and/or mental illness? – go here
20 Feb - RNAO hears about COVID-19: A heart-to-heart dialogue for nurses – go here
20 Feb - With new variants growing, concerns mount about the premature lifting of restrictions – go here
18 Feb - Anti-Black racism and discrimination in nursing: The power of mentorship in nursing education – go here
13 Feb - RNAO’s letter to the premier on the vaccine rollout and the current context – go here
6 Feb - Use community care providers to ramp up vaccinations! – go here
6 Feb - RNAO’s continuing media profile: The January report – go here
30 Jan - The PrOTCT plan for nurses: Counseling vaccine hesitant patients & colleagues – go here
– go here
23 Jan - Mitigating the spread in Toronto shelter settings – go here
23 Jan - Home care nurses are #ReadyToVaccinate – go here
23 Jan - Hurtful comments about law enforcement – go here
15 Jan - The escalating catastrophe of the COVID-19 second wave in Ontario – go here
15 Jan - Progress in vaccine distribution: Updates, issues and concerns – go here
8 Jan - RNAO raises its voice in the media: Media coverage in December 2020 – go here
– go here
8 Jan - RNCareers: Help during the holidays and help for next phases of this pandemic – go here
We have posted earlier ones in my blog here. I invite you to look.
Public Health Ontario maintains an excellent resource site on COVID-19 materials.
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.
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.
You can find up-to-date global numbers in Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.
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