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Dear Colleagues: Welcome to our Saturday, May 15 report during this fifteenth 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 upcoming webinars, events and updates. COVID-19 VIANurse – Critical care nurses - As informed earlier, RNAO has activated VIANurse to augment nursing HR in critical care. If you are a critical care nurse and you are available, or if you are an employer needing critical care nurses, please go to the VIANurse page here. Employers: we still have about 380 RNs with specialty in critical care available to work. In today’s report we share: (1) an end of Nursing Week media release calling on government to increase paid sick days and boost the minimum wage; (2) government announces second dose vaccination for high-risk healthcare workers in response to RNAO’s call; (3) government responds to RNAO’s call for increased enrollment in nursing education programs; and (4) an article introducing the complex issue of vaccine passports.
Nurses wrap up Nursing Week with a call to government to increase paid sick days and boost minimum wage Media release, May 14. As Nursing Week draws to a close (May 10 - 16), the Registered Nurses’ Association of Ontario (RNAO) is renewing its call for action to the Ontario government: Increase the number of paid sick days for workers who do not have access to this employee benefit and boost the province’s minimum wage. This demand addresses two of RNAO’s central concerns with the social determinants of health (SDOH). RNAO says the pandemic has widened the divide between people who are able to work from home and those who have no choice. Many workers take risks on a daily basis travelling to their jobs. Many work without sick time benefits – including part-time, casual and agency nurses. In this rich province and country, there remain vulnerable workers who earn minimum wage and work in precarious employment. They face deplorable conditions. They are part of communities that have suffered the brunt of the pandemic, with a larger proportion of essential workers who experience food insecurity, who live in crowded, multi-generational housing with limited ability to properly isolate, and less access to health services and to vaccines. “Providing only three paid sick days is utterly inadequate,” says RNAO President Morgan Hoffarth, adding that “We want Premier Ford to deliver on the recommendation he received from his own science table: ‘10 paid sick days on permanent basis.’ This will ensure Ontarians have the protection and peace of mind they deserve so they can stay home when they are sick and not fear they will lose their jobs.” RNAO CEO Dr. Doris Grinspun says the government must also take steps to increase the minimum wage, currently $14.25, which is, in effect, a poverty wage. Two years ago (on Jan. 1, 2019), the provincial minimum wage was set to increase to $15 per hour as promised by former Premier Kathleen Wynne, and then to be tied to inflation. However, Premier Ford cancelled the planned increase soon after his party was elected in June 2018 and froze it for two years, pushing families further into poverty. At the same time, his government cancelled the two sick days for persons in precarious employment, and eliminated the pay-equity that forced employers to pay part-time and casual staff at the same rate as full-time workers. “Reinstating the wage increase and taking steps for additional increases will bring Ontario closer towards a living wage and that’s essential because so many people are struggling,” adds Grinspun. The Ontario Living Wage Network estimated with 2019 data that a living wage in Ontario varied by region between over $16 to more than $22 per hour. Since 2019, the cost of living has increased considerably across the province, a situation worsened by the pandemic. “The primary goal of nurses is to keep people healthy. To help us do that, our province has to invest in healthy public policies. Our recommendations are just two examples of what the premier can do to advance the health and wellbeing of Ontarians, treat them more equitably and help build a society that leaves no one behind,” says Hoffarth, adding the COVID-19 pandemic has made it clear that health and the economy go hand in hand.
Ontario government announces second dose vaccination for high-risk healthcare workers in response to RNAO’s call As I reported in this blog last week, RNAO issued a media release on May 7 on the immediate need for nurses to be fully vaccinated against COVID-19. RNAO said the risks posed in hospital ICUs and other critical care units, emergency departments, operating rooms and other settings are too great and the lives of nurses needed to sustain a fragile health system battling COVID-19 must be fully protected. RNAO says the government must ensure all nurses – starting with those working with COVID-19 patients – are immediately vaccinated with both COVID-19 doses. I am pleased to share that our advocacy on behalf of nurses and other healthcare providers – especially those working on critical areas and in home care – brought results with the government’s announcement this week. The Ontario government responded on May 10 announcing that high-risk health care workers are being added to the list of those eligible to receive their second dose of the COVID-19 vaccine earlier. Eligibility for booking began this week. Many of our colleagues have shared that, indeed, they have been already booked, with some having received the second shot yesterday.
Government responds to RNAO’s call for increased enrollment in nursing education programs Results of a January 2020 RNAO survey showed that an alarming number of young RNs are planning on leaving the profession post-pandemic. In addition, an even higher proportion of late career nurses indicated their intention of retiring in the next few months. This anticipated scenario threatens to worsen the already high RN vacancy rates across the health care system brought about by illness or pandemic burnout, with dire consequences for Ontarians’ access to quality care. In its Vision for Tomorrow report, the RNAO Nurse Practitioner Task Force’s first recommendation is to increase the supply of NPs across all sectors and settings. Nurse practitioners in Ontario enable improved access to primary care, acute care and long-term care. NPs provide comprehensive care for vulnerable and underserviced populations, and lead to improved health and health care cost outcomes across all sectors, as well as increased access to care, particularly in rural and remote areas. In its March 24 response to the provincial budget RNAO reminded all, once again, that Ontario has the lowest RN per population in Canada. It insisted on the need to hire thousands of additional RNs and NPs, measures to retain nurses currently working in the system and redoubling our efforts to recruit future nurses. In particular, RNAO called on the government to increase the number of seats in RN nursing education programs by 10 per cent this year and further increases of 10 per cent in subsequent years. In an April 28 joint letter to the Ontario government, RNAO and the Council of Ontario Universities (COU) universities asked to immediately increase the intake into baccalaureate nursing programs (BScN) as well as NP programs in the province, starting with the Fall 2021 semester. The Ontario government announced on May 14 that it is investing $35 million to increase enrollment in nursing education programs in publicly-assisted colleges and universities across the province. The new spaces will be available for Fall 2021 and Winter 2022 cohorts and will introduce approximately 1,130 new practical nurses and 870 registered nurses into the health care system. The government also announced the expansion of clinical education placements for nursing students and personal support worker students in the long-term care sector. The government’s announcement partially addresses RNAO’s call to increase university seats in BScN. While RNAO is pleased with the announcement, it is insufficient to respond to the demands on RN and NP care during and post pandemic. RNAO will further comment on this need in the days to come.
Vaccine passports may be on the way – but are they a reason for hope or a cause for concern?As the vaccination rollout advances, the discussion on vaccine passports intensifies. This is a complex issue with no easy answers, and RNAO intends to address it in the months to come from a perspective of equity and health for all. The following is an introductory article by Yara M. Asi, Post-Doctoral Scholar, Health Management and Informatics, University of Central Florida, originally published March 12. This article is republished from The Conversation under a Creative Commons license. Read the original article. After a year of canceled concerts, closed-door sporting events and restricted air travel, vaccine passports are being touted as a way to quicken the route back to normalcy. The premise is straightforward: A digital or paper document will indicate whether individuals have received a COVID-19 vaccination or, in some cases, recently tested negative for the coronavirus. This could allow them to travel more freely within their communities, enter other countries or engage in leisure activities that have largely been closed off during the pandemic. Vaccine passports seem like a desirable alternative to continuing lockdowns until herd immunity – estimated to occur at about a 70%-85% vaccination rate – is achieved. As a global health management researcher, I can certainly see the benefits of vaccine passports. But I’m also aware of the pitfalls. While vaccine passports may open the world to many, they may lead to discrimination – especially against the poor. Return to the skies Undoubtedly there is a desire to get back to normality as quickly as possible. For the tourism industry, which is estimating more than US$1 trillion in losses due to COVID-19, a reopening of travel would be much-needed relief. Even for those able to travel during the pandemic, arrival in most countries has required significant restrictions, often including a hotel quarantine of up to 14 days. Vaccination passports could allow families separated by local lockdowns, or state or country border restrictions, to meet in person. Pushing the case for a digital passport, an executive from Air New Zealand told The Guardian, “Reassuring customers that travel is, in fact, safe is one of our priorities. By using the app, customers can have confidence that everyone onboard meets the same government health requirements they do.” And it isn’t just travel. Passports could also open the door to everyday pursuits that seemed normal before the pandemic. In Israel, the country with the fastest vaccination rate, citizens with a vaccination “green pass” will be allowed entry to gyms, hotels, concerts and indoor dining at restaurants. And some employers are considering requiring proof of vaccination to return to work. Getting a green pass In short, the concept of vaccine passports is no longer theoretical, as it was early in the pandemic, when the World Health Organization recommended against their use. It has even been suggested that the lure of a vaccine passport could result in more people stepping forward to get vaccinated. Israel instituted its green pass program on Feb. 21, both to reopen the economy and to encourage young people to get vaccinated. Other countries are monitoring the success of Israel’s program. The U.K. has shown interest in the idea of vaccine passports, and the 27 member states of the European Union are considering some form of vaccine-certification system to allow easier cross-border travel in the EU. In the U.S., President Joe Biden has directed government agencies to “assess the feasibility” of some form of digital vaccine certificate, analogous to the concept of a vaccine passport. Pandemic inequities This potential opening up of the world after months of restrictions is welcomed. But the concern is that the benefits will not be distributed equitably, and as a result some groups will be disadvantaged. After all, a pandemic once considered a “great equalizer” soon turned out to be anything but. As with most health crises, racial minorities made up a higher proportion of those affected in the U.S. – as seen in their higher rates of hospitalizations and deaths. Disparities along income and racial lines have persisted in vaccination campaigns. In the United States, for example, Black Americans have received the vaccine at half the rate of white Americans, and the disparity is even larger for Hispanic Americans. Globally, rich countries have ordered almost all of the currently available vaccines, meaning that the average citizen in a high-income country is much more likely to receive a vaccine than a health care worker or high-risk citizen in lower-income countries. It is also likely that demographic groups with higher levels of trust in authorities and medical institutions are the most willing to be vaccinated, and this may adversely affect marginalized communities. A recent study found that Black Americans – who have legitimate reasons to distrust the medical establishment – were the least likely of any racial group in the U.S. to say they’d get vaccinated against the coronavirus. As such, vaccination passports could perpetuate existing inequities within countries if those who are vaccinated can enjoy the freedom to move about their community while others remain in lockdown. A world divided? Given the global imbalance of vaccine availability, it is not difficult to imagine a situation where the citizens of rich countries may regain their rights to travel to environments where local populations are still in some form of lockdown. This potential to further divide the global rich from the global poor is a significant concern. Once economies start to “open” and those with vaccine passports are able to go about their business as usual, the urgency to deal with COVID-19 in marginalized communities may dissipate. Further, vaccination passports may give populations an inaccurate level of risk perception. It is still unclear how long immunity will last. It is also unclear the extent to which virus transmission is limited once one is vaccinated. Public health authorities still suggest that vaccinated individuals wear masks and maintain distancing in public for now, especially if interacting with unvaccinated people. These recommendations have led to concerns that vaccinated tourists, diners and shoppers may act in ways that might risk the unvaccinated service and hospitality employees with whom they are interacting. There are also privacy concerns with vaccine passports, which are primarily being proposed in a digital format. In the U.K., the proposed vaccine certification would come in the form of an app, which could be scanned to gain entry to restaurants and venues. It has sparked concerns that digital passports may infringe on the rights to privacy, freedom of movement and peaceful assembly. Countries that rank low in global freedom indices, such as Bahrain, Brunei and China, are also using apps, often with troubling implications. In China, the app was found to be linked to law enforcement, and as people checked into locations across the city, their locations were tracked by the software. Despite the upsides of vaccines passports, these concerns remain. The World Health Organization has called on nations to make sure that, if implemented, vaccine passports are not responsible for “increasing health inequities or increasing the digital divide.” The danger is that thus far, at every stage the pandemic has exposed society’s inequities. Vaccine passports may perpetuate these inequities as well.
POLICY UPDATES FOR ALL TO ACT ON & MUST JOIN EVENTS – OPEN TO ALL
Vaccination clinic for Black, African and Caribbean (BAC) communities We reported earlier on grassroots efforts to address vaccine engagement in marginalized and excluded communities. We are delighted to share that there will be a pop-up clinic from May 15 to June 11 for BAC residents from Brampton and Malton who live in the following postal codes: L6P, L6R, L6S, L6T, L6V, L6X, L7A, L6Y, L6W, L6Z, L4T. For details, please check here.
RNAO ends first busy week of Take Your MPP To Work LIVE RNAO’s Take Your MPP To Work (TYMTW) LIVE provides members with the opportunity to meet virtually with their local MPP. The schedule of the first week, which ended yesterday, can be found here. Launching during Nursing Week, this event gave an opportunity to share your experience with your MPP so they can better understand the depth of nursing practice challenges while caring for patients and communities throughout the COVID-19 pandemic. Since it began in 2000, TYMTW has grown to become an important political engagement event for RNAO members and MPPs alike. Premiers, cabinet ministers, opposition leaders and numerous MPPs, have gone to work with registered nurses and nurse practitioners in public health units, community health centres, family health teams, nurse practitioner-led clinics, hospitals, long-term care homes, and post-secondary institutions, among others. Next week we will provide a summary of the many substantive and powerful events held during Nursing Week.
Mark your calendar: 96th Annual General Meeting (AGM) Jun 24 – Jun 26, 2021 RNAO’s 96th AGM will be held virtually between June 24, 2:00 pm and June 26, 1:30 pm. Details on how to join the live streamed events will be posted in early June. Mark your calendar for the signature events:
View the schedule of events and register now! For updated information visit the AGM page here. For a recap on last year's virtual AGM, please visit our AGM portal.
Webinar: Let’s Talk about Anti-Black Racism and Discrimination in Nursing May 17, 2021, 2:30 - 4 p.m. ET Topic: An intergenerational conversation: Addressing anti-Black racism Objectives:
Presenters:
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. Register for the May 17 webinar here.
Watch the May 10 “COVID-19 Webinar Series” – Play tribute to the roles nurses have played during the pandemic We kicked off National Nursing Week on May 10 by dedicating our COVID-19 webinar to your stories. Nurses, other health providers and members of the public are welcome to join our webinar to pay tribute to the roles nurses have played during the pandemic. This webinar focused on good news. You can share examples, words or stories of the nurses’ leadership: Their knowledge, compassion, bravery, dedication, collaboration and creativity as they have given it their all for patients this past year. Together, we will create a virtual wall of appreciation where you can share stories, upload images, take photos and share GIFs. The wall can be shared within your networks and on social media. Let's take time to collectively honour nursing and reenergize ourselves and our colleagues. We are an awesome mosaic of human richness! You can watch the webinar here.Upcoming webinar:June 14, 2021, 2 - 4 p.m. ET Additional date: July 12, 2021, 2 - 4 p.m. ET Watch and read about earlier archived webinars here.
Profile of the awardees – Nursing Now Ontario Awards Ceremony The Nursing Now Ontario Awards celebrated on May 12 the contribution of nurses who improve the health outcomes of Ontarians and who contribute to nursing practice. Awards are presented to one winner in three categories: registered practical nurse (RPN), registered nurse (RN) and nurse practitioner (NP). The awards ceremony took place during Nursing Week 2021. After receiving 213 nominations, the Ontario Nurses’ Association (ONA), RNAO and the Registered Practical Nurses Association of Ontario (WeRPN) recognized the award recipients during a special ceremony on May 12, 2021 at 2 p.m. (ET). The award recipients were:
You can see a profile of the awardees 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 #430 for May 14 (no report on May 15):
Update: Retirement Homes Policy to Implement Directive #3 has been updated and is available on the Ministry’s website. COVID-19 Vaccine Storage and Handling Guidance has been updated and is here. A memo (here) was shared from Dr. Williams today to provide some additional context and rationale to the pause in first doses of AstraZeneca (AZ)/COVISHIELD (CS). The Questions and Answers document here is to support providers in talking to patients about this change.
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 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 and everyday more true: 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: 8 May - Nurses must be fully vaccinated immediately, RNAO demands – go here. 8 May - A bill to support individuals with assistive devices for mental health – go here. 8 May - Action alert: Ensure global vaccine access, prime minister! – go here. 1 May - RNAO statement on the passing of RN Lorraine Gouveia – go here. 1 May - RNAO’s continuing media profile: The April report – go here. 1 May – RNAO response to Long-Term Care COVID-19 Commission report – go here. 24 April - RNAO launches new policy webpages – go here. 24 April – RNAO responds to federal fiscal budget – go here. 17 April - Vaccine engagement as a tool to address marginalization and exclusion – go here. 17 April - Here's how the COVID-19 pandemic could play out in 2021 and beyond – go here. 17 April - Reacting to the latest Ontario government public health measures – go here. 10 April - RNAO and NAN sign Relationship Accord to improve health across NAN Territory – go here. 10 April - RNAO media release on public health measures and vaccination rollout – go here. 10 April - 3 ways to vaccinate the world and make sure everyone benefits, rich and poor – go here. 3 April - Government’s “shutdown” announcement doesn’t go far enough – go here. 3 April - RNAO’s continuing media profile: The March report – go here. 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. 13 Mar - RNAO leads dozens of organizations in candlelight vigil – go here. 6 Mar - RNAO’s continuing media profile: The February report – go here. 6 Mar - Communication during a Pandemic: How we can endure the pandemic together – go here. 6 Mar - Webinar: Understanding wellness in Indigenous wisdom traditions for caregivers – go here. We have posted earlier ones in my blog here. I invite you to look.
Information Resources 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. 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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