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Dear Colleagues: Welcome to our Sunday, July 25 report during this eighteenth 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 policy updates for all to act on & must join events.
URGENT: Last call to answer the survey on nurses’ wellbeing -- for ALL RNs, NPs, RPNs, LPNs and nursing students anywhere in Canada. Dear colleague, Time is running out and we must hear from you by end of this week, Saturday. Be part of this international COVID-19 nursing workforce survey and help us gain a better understanding of the effects of the COVID-19 pandemic on Canada’s nursing workforce and how it compares to other countries in the world. What’s the same? What’s unique? What’s the path forward? Your experience during COVID-19 is important. The survey results will compare what happened in various jurisdictions in Canada with other regions around the world. We know that nurses have experienced the pandemic in different ways. We urge you to add your voice to over 2,500 who have already responded. We need to hear from you: RNs, NPs, RPNs, LPNs and nursing students anywhere in Canada. PLEASE fill out the survey today. With warmest regards, Doris Please go here to answer. This is the last call. The deadline to fill out the survey is July 31.
In today’s report we share: (1) RNAO’s concerns regarding a safe school reopening in September and the need to vaccinate students and all school staff; (2) an Action Alert regarding #MandatoryVaccination for all healthcare workers; and (3) an update on RNAO’s #FullyVaccinated campaign.
Are we preparing for a safe school reopening? – RNAO asks once again I am greatly concerned that once again the Ontario government is slow in acting to prepare schools for a safe and timely reopening in September. The Ontario Science Table (ST) put out a report on July 19 with their advice on school reopening, which has raised controversy. The ST called for permanent measures that support the ongoing operation of schools, irrespective of the state of the COVID-19 pandemic, including vaccination of all eligible individuals, exclusion of sick students and staff, hand hygiene, adequate ventilation, and environmental cleaning. RNAO agrees with these measures, but we are gravely concerned about the lack of political transparency on the government’s plans to implement the ST recommendations. RNAO has raised many of these issues for over a year now (see here and here and here and here and here), and after a year and a half into the pandemic, and powerful vaccines on-hand, the path should be clear. One of the controversial recommendations issued by the ST – not supported by RNAO – is its position on masking, physical distancing and cohorting, which the ST refers to as “temporary measures” to be implemented at the health unit level according to the conditions present. The conditions present refer to the COVID-19 disease burden that in their view must be taken into consideration, such as student age, grade, and vaccination status. Social media posts suggested the ST report called for an end to masks and physical distancing at schools. When reading the report it becomes clear that is a misrepresentation, and the ST position is more nuanced than that. Nonetheless, RNAO strongly disagrees with any discussion of ditching the masks or any nuanced approach at this time. RNAO insists that masking should be seen as an essential and necessary component of the public health measures taken everywhere across the province in September. Dr. Kieran Moore, Ontario’s top doctor, has recognized that there may not be high enough levels of immunity across the province by September for kids to return to school unmasked. “It may be that we have a very cautious start in September and then monitor the situation because I don’t know that we’ll achieve that high community immunity that we need in September,” he said. Indeed, Dr. Nisha Thampi, one of the authors to the ST report, emphasized that the report does not recommend ditching masks in September – rather, the low-risk part of the framework is forward-looking to a time when rates and disease burden are very low and community immunity is very high. RNAO says let’s not confuse parents, students, and teachers: Let’s be clear that masks and physical distancing are not in question for reopening of schools in September. We will have time to discuss relaxed conditions further in the future, likely next spring. Now is not the time to confuse the discussion and provide fodder for anti-maskers with a discussion of hypothetical conditions of very low risk for COVID. We will not be in such a situation in September. Masks for all children over 2 in kindergarten and schools this September! A physician and mother, Dr. Jillian Horton calls in the Globe and Mail to continue with school mask mandates and physical distancing: A premature abandonment of these measures would also be an abandonment of every child with an underlying health issue, or whose siblings or parents have high-risk conditions. You want to cause a kid a lifetime of psychological harm? Set them up to be the vector for an infection that disables or kills their parent. After all, this isn’t only about whether COVID-19 can seriously sicken young kids – which it can. It’s about the ways in which kids exist in a vast, adult ecosystem. They are resilient, and they are also vulnerable. What valid reason could we have to abandon the simplest, evidence-based interventions that can help protect them from the Delta variant until they can be vaccinated, presumably by later this year? RNAO is gravely concerned also about another failing measure: ventilation. It has taken a long time to recognize that COVID-19 is transmitted primarily through aerosol – a point that Dr. David Fisman has systematically emphasized for a long time. The implications of COVID-19 being transmitted through aerosol are profound but slow in coming as they relate to public health measures and government policy. The ST informs that COVID-19 is primarily transmitted by aerosols and respiratory droplets during close unprotected contact, and it is recognized that aerosols play a role in longer range transmission, especially in poorly ventilated indoor areas. The ST report contains a detailed discussion on how to achieve and maintain adequate air quality through ventilation and filtration in schools. As Dr. Horton says, “On the aerosol front, we aren’t listening closely enough to engineers, the experts who can help us understand the scope and nuance of the ventilation challenges in new and aging schools – a complex, heterogenous problem. What percentage of those schools have windows that are fused shut? What’s a realistic timeline for making even simple modifications? What about an adjunct CO2 monitoring strategy? Where is a commitment to put free-standing HEPA filters into every classroom?” RNAO’s concern is not on identifying what should be done, which the experts in various fields have clearly delineated. Our concern is the lack of political will and sense of urgency to implement investments in school infrastructure that are necessary and costly, take time, and have traditionally not been seen as a priority. We are used to flashy buildings for financial institutions such as banks while schools remain in decrepit buildings. So many of our children study in physical environments that are crowded, poorly ventilated and not up to standards. Does it remind us of the state of long-term care homes, another RNAO issue of concern? Exactly, it does, in both cases – the poor status of long-term care homes and of schools – it reflects a shameful abdication of political and public policy responsibility. Here is a reality check: Schools (in grades 7 and below) will house the largest population of unvaccinated people in congregate places starting in September. We should take the concerns expressed for over a year by RNAO, teachers, parents, and scientists seriously. Now epidemiologists warn of a fourth wave of COVID-19 driven by the dangerous Delta variant that will target the unvaccinated. Even if most children will have mild or no symptoms from COVID-19, they do and will transmit the illness to others who are more at risk. Unvaccinated school staff are particularly at risk, and thus the need for mandatory vaccination of school staff. This is similar to the call for mandatory vaccination of health care workers that RNAO has issued (with only medical exceptions). How many unvaccinated people will be in schools in September is focal. ‘Time is of the essence now,’ Dr. Kieran Moore told reporters on Tuesday, July 20. Children younger than 12 cannot vaccinate, but children 12 and older, as well as school staff and parents, can do so. Unfortunately, time is running out. With 28 days between two doses of vaccines -- plus two weeks to build immunity following the second dose -- 6 weeks are minimally required from first dose to full vaccination. This week is the deadline for first dose for those who have not received any. And the need is great. Only about 35% of the 12–17-year-old cohort and about 46% of the 18-29 year-old cohort are fully vaccinated at this time. According to the Ontario government, widespread vaccination is a key aspect of Ontario’s plan to resume in-class learning in the fall but that plan has not yet been made public. To reiterate, RNAO is calling for mandatory vaccination of school staff. Let’s hope Premier Doug Ford and Minister of Education Stephen Lecce make an announcement this Monday. A year ago, on August 7, 2020, I wrote in this blog an article with the title “School reopening: Ontario government can still do the right thing on class sizes.” Today – 18 months into the pandemic and with clear science under our belt – we are still asking whether the government is doing the investments and providing policy directives to make our schools safe. Crucial investments are required in smaller class sizes, hiring teachers, improved ventilation and air quality, rapid testing and vaccination. Has the funding from the Federal government flowed from the province to the school boards and have the COVID-19 closures been utilized to do the building renovations and engineering work? Was this funding sufficient to meet the proper standards? We require full disclosure and full accountability from the government and school boards on these crucial matters. The government remains largely silent and provides few specifics. Parents, teachers and nurses should not be forced to keep asking. Governments exist to lead during good times and especially during difficult ones. That today is July 25 – less than 7 weeks from start of classes – and Minister Stephen Lecce has not yet made public his plan for reopening in September says it all. It appears we are continuing the approach of doing too little, too late that has been the trademark of the Ford government in addressing the pandemic. Let’s hope that tomorrow Monday, July 26, government officials – Premier Ford and Minister Lecce – will make their views and directives known. Doing otherwise will place at risk children, their families and teachers – and by extension, our communities. The fourth wave will be made worse than if we took seriously school preparation. Please see tweet and RT urgently.
Action Alert: Mandate COVID-19 vaccination for all health-care workers, premier! RNAO has led the way in advocating for mandatory COVID-19 vaccination for health-care workers in Ontario. There is strong and growing evidence about the effectiveness of the COVID-19 vaccines in preventing serious illness and hospitalization, as well as in reducing transmission of the virus. Join us! Call on the premier to make COVID-19 vaccination mandatory for all health-care workers in Ontario. Sign the Action Alert here. Health-care workers are at increased risk of contracting COVID-19 and transmitting it. New variants, such as the delta and lambda, pose an increased risk for those who are unvaccinated, and these variants are more dangerous and transmissible. We believe that provincial and territorial governments across Canada should institute mandatory COVID-19 vaccination for health-care workers in all public and private settings. Rules for vaccination should not be left to individual employers. Now is the time for Ontario to show leadership in this critical issue. Mandatory vaccination will result in all health-care workers being vaccinated, which will help prevent a fourth wave of COVID-19. Ontarians requiring health services must not be burdened with the fear of contracting COVID-19 from health-care providers. Let the premier know that the COVID-19 vaccination should be made mandatory for all health-care workers in Ontario. Go here to sign the Action Alert, urgently. Please RT urgently this tweet.
RNAO’s #FullyVaccinated social media campaign and calls for #MandatoryVaccination for health-care workers continues RNAO will continue to call for the Ontario government to mandate COVID-19 vaccination for all health-care workers until action is taken. Letter to Ontario government: On July 20, 2021, RNAO sent an open letter to Ontario’s premier regarding the importance of mandatory vaccination for all health-care workers. We drew on the research of experts to identify the issues and challenges, and to pave the way forward. Read the letter here. Watch a video on RNAO’s letter to the premier: Here. Media release: To read our official media release on #MandatoryVaccination, please click here. Twitter: RT our tweet on #MandatoryVaccination as well as a tweet I sent. RT tweets from reporters Laura Stone and David Hains, and Ontario Medical Association. #FullyVaccinated campaign: RNAO has launched a new #FullyVaccinated social media campaign to encourage everyone to receive both doses of the COVID-19 vaccine. How to participate: Tag @RNAO in your photos on Twitter or @registerednurses on Instagram of you and your loved ones before, during or after receiving your COVID-19 vaccine. Include the hashtag #FullyVaccinated along with your reason for receiving the vaccine. Participants have a chance to be featured in RNAO’s fully vaccinated hall of fame on social media. For social media graphics, updates and other information go to our COVID-19 vaccine information and resources page here.
POLICY UPDATES FOR ALL TO ACT ON & MUST JOIN EVENTS – OPEN TO ALL
RNAO Action Alerts Take action on Bill 124 and sign the Action Alert. Add your voice to 5,000 others calling on Premier Ford to exempt health-care workers from Bill 124. We also join in the call to #RepealBill124. This is more important than ever as we see a fast deterioration of nursing human resources with colleagues leaving the profession or moving to the United States. Take action on global vaccine access: Sign an Action Alert calling on Prime Minister Trudeau to ensure global vaccine access. Let’s also make sure we urge Prime Minister Trudeau to match President Biden’s commitments to Covax.
Call on elected leaders to step up and end the opioid crisis: Sign an Action Alert calling on politicians at all orders of government to work together to save lives and bring this crisis to an end. Enshrine a nursing home basic care guarantee in legislation, premier, set the path forward! Sign an Action Alert! Call on the premier to enshrine in legislation RNAO’s Nursing Home Basic Care Guarantee.
Continuing the Conversation: An Open Forum for Nurses Aug 18, 2021, 2:30pm - 4:00pm Topic: Nursing student transitions into the workplace: Experiences and supports COVID-19 has disrupted nursing education. Hands-on clinical placements have been replaced by simulation, in-class learning has gone virtual and students are completing their education at a time when all energy is focused on the global pandemic. Thousands of Ontario nursing students will be entering the nursing workforce at a critical time in history for health care: one where structural inequities and system failures have been brought to the spotlight, and where nurses, exhausted from relentless waves of the pandemic, are facing burnout and considering leaving the profession in larger numbers than usual. However, the pandemic has also raised the centrality of our profession and reinforced that without nurses the health-care system will collapse. RNAO is issuing a call to ensure the next generation of nurses thrive in the profession. During this heart-to-heart nursing forum, you will hear from nursing students, new grads and educators who will discuss the following questions:
Visit our COVID-19 Portal for additional resources and information on psychosocial support. Information about prior webinars can be found here.
Webinar: COVID-19 Webinar Series September 13, 2021, 2:00pm - 4:00pm When: Every second Monday of the month (except for August) RNAO's CEO Dr. Doris Grinspun will be hosting COVID-19 webinars for health providers. Topics include:
Health providers from Ontario, Canada, and anywhere in the world are welcome to join at no cost. We are here with you in solidarity. Together, we will continue to tackle COVID-19 with the best tools at hand, including accurate information, calmness, determination and swift actions! Upcoming webinar: September 13, 2021, 2 - 4 p.m. ET Details and registration link coming soon. Watch and read about earlier webinars 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 last Situation Report #478 for July 23:
Update: The COVID-19 Guidance on Long-Term Care Homes and Retirement Homes for Public Health Units has been updated and is effective immediately. This guidance is available on the Ministry Website in English and French.
Staying in touch Keeping in touch remains important as we face the pandemic and other challenges in Ontario, in Canada and elsewhere – in particular, in Africa and Latin America – two of the continents most affected by COVID-19 and its variants – delta and lambda. Feeling that we are part of a community and that we have each other’s backs helps us get through these challenges, becoming better people in the process. We are eager to hear how we, at RNAO, can best support you. Send us your questions, comments, and challenges. Recommend ideas for articles and webinars. Write to me at dgrinspun@rnao.ca and copy my executive assistant, Peta-Gay (PG) Batten at pgbatten@rnao.ca. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU! Thank you for being there for your community – everywhere and in all roles! Together, in solidarity, we are strong and resilient. In Canada we see hope at the end of this long pandemic tunnel. Please keep encouraging your colleagues, their loved ones and your communities to be fully vaccinated. We must not forget, however, about our privilege. Canada has purchased more vaccines than what it needs, while 9 out 10 countries have almost nothing. Like in other challenges we face, such as racism, Islamophobia, and other forms of discrimination, we are not safe until everyone is safe. Vaccines for all – literally for all, across the world – must guide policy in the upcoming 12 months. Let’s learn from the 17-month pandemic and take real action to build a better world. To everyone – THANK YOU! Please take care of yourself and know that RNAO always stands by you! Here’s one constant throughout the pandemic. The silver lining of COVID-19 has been to come together and work as one people for the good of all. Let’s join efforts to demand political leaders bring about #Vaccines4All! Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, FCAN, O.ONT
RECENT BLOG ITEMS: 17 July - Mandatory vaccination for healthcare workers – Exploring issues, challenges and supports – go here. 17 July - #FullyVaccinated campaign and mandatory vaccination for health-care workers – go here. 10 July - A Detailed Study of Patients with Long-Haul COVID – go here. 10 July - Prolonged brain dysfunction in COVID-19 survivors – go here. 3 July - RNAO’s continuing media profile: The June report – go here. 3 July - RNAO celebrates virtual 96th Annual General Meeting – go here. 26 June - Global herd immunity out of reach because of inequitable vaccine distribution – go here. 26 June - Canada is virtue signalling while waffling on global access to COVID-19 vaccines – go here. 20 June - Building your Twitter presence: Here are tips from RNAO – go here. 20 June - Let’s flatten the infodemic curve – go here. 12 June - RNAO statement on the terrorist attack in London, Ontario – go here. 12 June - Reducing the time interval for second dose after first AstraZeneca dose – go here. 12 June - AstraZeneca second dose: Should I get the same vaccine or Mrna? – go here. 5 June - RNAO’s continuing media profile: The May report – go here. 5 June - RNAO supports Premier Ford's announcement on schools as risk is too high – go here. 29 May - Vaccination passport apps could help society reopen – go here. 29 May - Email updates highlight best new evidence about COVID-19 – go here. 23 May – NPs speak about LTC during the COVID-19 Pandemic – go here. 23 May – Three surveys on the impact of COVID-19 on Canadian nurses – go here. 23 May – Exemption of nurses and other health-care workers from Bill 124 – go here. 23 May – RNAO’s statement on the government’s phased-in re-opening plan – go here. 23 May – Remembering Charlotte Noesgaard (1948-2021) – go here. 15 May - Nursing Now Ontario Awards Ceremony – go here. 15 May - Vaccine passports – reason for hope or cause for concern? – go here. 15 May - Government responds to RNAO’s call for increased enrollment in nursing education – go here. 15 May - Second dose vaccination for high-risk healthcare workers in response to RNAO’s call – go here. 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. We have posted earlier ones in my blog here. I invite you to look.
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