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Dear Colleagues: Welcome to our Sunday, August 1 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. I am absolutely exhausted with this relentless pandemic. You are too. But, as much as we don’t like it, we must confront the fourth wave. Daily case numbers in Ontario are increasing (218 today) with a reproduction value that remains above 1. The fourth wave of the pandemic driven by the highly transmissible Delta variant is here. RNAO has been listening to the experts and warning about this for weeks. The fourth wave will be the wave of the unvaccinated and the vulnerable. RNAO launched the #FullyVaccinated campaign and is advocating for #MandatoryVaccination for healthcare workers and education staff (except for medical exemptions), as well as a safe school reopening plan. Today’s tweeter thread by Ryan Imgrund shows the powerful effects of the vaccine on preventing infection, hospitalization and death from the virus. For the RNAO campaigns please see the Media Report below. The safe school plan is essential as Ontario’s 4,800+ elementary and secondary schools will house this fall the greatest number of unvaccinated persons in congregate settings in the province. Children under 12 are not eligible to vaccinate and only 45.4% of students between ages 12 and 17 are fully vaccinated. Although much better than the rest of Canada at 37.3%, it still means that each second student in this cohort is not fully vaccinated. Thus, we must diminish the risks for children this fall and winter and by extension the risk for their families and communities. On top of COVID-19, the flu season arrives soon and the respiratory syncytial virus (RSV) is a real threat already present in the USA. In addition to vaccination, RNAO continues to insist on ventilation, smaller class sizes and universal indoor masking for children over two. Masks are essential, and the great majority of children mask without any problem. Abandoning this vital public health measure contravenes science and common sense. It amounts to an ideological decision that can kill many lives. We are greatly concerned about premature decisions to ditch masks in some provinces. That option should not even be considered at this time in Ontario. Next, we bring you RNAO’s media report for July.
RNAO’s continuing media profile: The July 2021 report In July, RNAO launched its #FullyVaccinated campaign to encourage Ontarians to get both doses of the COVID-19 vaccine. RNAO also spoke out about vaccine hesitancy, #MandatoryVaccination for healthcare and education workers, a safe reopening plan for schools as well as nurse understaffing. On July 9, the province announced the move into step three of reopening on July 16 – nearly a week earlier than planned. The measures allow indoor dining with no limits on the number of patrons at a table but with physical distancing in place. Essential and non-essential retail can have more customers in their shops with capacity limited by the ability to maintain physical distancing. I told QP Briefing on July 9 that I wasn’t concerned about the earlier move to step three but rather the lack of restriction on indoor capacity given what we know about aerosol transmission and the risks of the Delta variant. I added that we must keep focused on speeding up vaccination and maintaining indoor masking. RNAO has been laser-focused on enhancing vaccine access and uptake. On July 7 I told QP Briefing that vaccine outreach requires a tailored approach to the needs of the community. Operation Remote Immunity is a pandemic success story, a model of Indigenous-led policy implemented in partnership with government that has helped achieve strong vaccination rates. "We really need to work community by community to find out why they're hesitant," I observed. Enlisting community leaders, including influencers on social media, is crucial. I expressed support for providing incentives if that achieves that an additional 20% of Ontarians get their shot. I reiterated that homecare nurses are eager and ready to administer vaccines in Ontarian’s homes as that will boost vaccination rates among homebound persons. We urge everyone to join our #FullyVaccinated social media campaign, launched on July 15. Tag RNAO on Twitter (@RNAO) and Instagram (@registerednurses) in photos of you and your loved ones when receiving your vaccine. Give your reasons for being #FullyVaccinated. Check out the tweets shared with RNAO so far. Every eligible individual should get both doses of the vaccine. We will also continue to insist on #MandatoryVaccination for all healthcare workers and school staff (allowing for medical exemptions). As I told KitchenerToday on July 16, “We have a due diligence as health professionals to keep our patients safe.” RNAO called on Premier Ford to ensure healthcare workers are vaccinated. On July 20 we sent him an open letter urging him to take immediate action. The letter was shared on Reddit and was flooded with support from people in Ontario and beyond. On July 19, I spoke with Arlene Bynon on SiriusXM167 about RNAO’s call for #MandatoryVaccination for healthcare workers and said that “It is unfair to put patients through the stress of not knowing if their healthcare worker is vaccinated or not.” It is also unfair for vaccinated healthcare workers to be put at risk by their unvaccinated colleagues. The pandemic is far from over and the severity and impact of the fourth wave led by the Delta variant depends on vaccination rates – and other public health measures – such as quarantine, contact tracing, isolation, ventilation and indoor universal masking (all aspects Alberta has tragically decided to abandon). RNAO has insisted that vaccines should be brought to the workplace and provide workers with an additional two paid sick days for vaccination. Epidemiologists and other experts are supporting these critical asks. So are thousands of nurses and members of the public through Twitter and other social media. Please, sign our Action Alert to let the Ontario government know mandatory COVID-19 vaccination for healthcare workers is needed now. Every signature helps (already 2,374)! On July 28, RNAO sent a second urgent open letter to the premier about safe reopening of schools in the fall. We call on government to improve ventilation, maintain universal masking indoors, reduce class sizes and mandate vaccination for teachers. We also want the 625 public health nursing positions assigned to schools during the pandemic to be funded on permanent basis, as well as the 50 community wellness nurses already working with First Nations communities. Please join over 1,700 signatories to our Action Alert and kindly share our tweet. We continue to see the pandemic’s effect on nurses, with many feeling burnt out and considering leaving the profession. Our Work and Wellbeing Survey Results report, published in March 2021, found that the nursing workforce could see a 15.6% loss within the next year – a much higher loss than the typical rate of roughly 4.8%. “It would be devastating for our healthcare system. We are not prepared to lose 15 per cent of our RNs across the province,” said our President Morgan Hoffarth in a CBC News interview on July 24. The stress and workload that has been put on nurses and other healthcare workers is not sustainable. “We’re feeling pretty overloaded, pretty overburdened,” said RNAO member Denise Jeffrey in the same article. Intensive care units (ICU) in Ontario are being hit again. This time, they are feeling the effects of an understaffing crisis with many nurses leaving the specialization. In a July 25 CTV News interview, RNAO member and ICU RN Birgit Umaigba said, “There are not enough ICU nurses in Ontario and (many) existing, experienced nurses are taking time off or people are just quitting because of the stress of the pandemic and very, very poor working conditions.” On July 29 I told the Globe and Mail that “the province is facing a crisis as burnt-out nurses leave their jobs, and warned ramping up operating rooms would be impossible without addressing the profession’s issues – including scrapping the government’s 1-per-cent cap on all wage increases.” We don’t want to “burn the last group of nurses left,” I added. “These people have been working 17 months non-stop ... Nurses don’t grow on trees.” Hospitals are trying to cope with some opting to use team-based nursing models on a permanent basis. Southlake Regional Health Centre plans to implement this model, which consists of partnering critical care nurses with non-critical care staff to treat patients. 96% of the hospital’s respiratory therapists and RNs in Southlake’s intensive care, cardiovascular and cardiac units signed a letter stating this team-based model puts patients at risk. Team nursing was first implemented in the 70s and quickly abandoned as it proved to be unsafe for patients. Now, fifty years later, it will have even more disastrous outcomes with an increasingly complex population and shortened length of stay in hospitals. On July 23, I told the Toronto Star that this model “will end the nursing profession and put patient care in dire situations.” That same day I told CTV News that “Ontario went into the pandemic with the lowest RN-to-population ratio (in the country). When you layer it (with the toll of the pandemic), it’s toxic.” RNAO continues to call on the premier to repeal Bill 124 – legislation that limits wage increases. Make your voice heard by signing our Action Alert. This month, our media coverage resulted in 305 hits. RNAO will continue to speak out with our members through the media and through our advocacy with the government and all political parties. Be sure to follow us on Twitter, Facebook and Instagram. Visit our Press Room to see the full list of our COVID-19 media coverage.
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 the 5,162 others calling on Premier Ford to exempt health-care workers from Bill 124. We join the call to #RepealBill124. This is urgent given the deterioration of nursing human resources as colleagues leave the profession or move to the United States. President Biden is eager to welcome our awesome RNs. 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. RNAO’s #FullyVaccinated social media campaign and calls for #MandatoryVaccination for health-care workers – For social media, graphics, updates and other information go to our COVID-19 vaccine information and resources page here.
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 #483 for July 30:
Update: The COVID-19 Vaccination Recommendations for Special Populations guidance has been updated and is available on the Ministry’s website.
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: 25 July - Action Alert: Mandate COVID-19 vaccination for all health-care workers, premier! – go here. 25 July - Are we preparing for a safe school reopening? – RNAO asks once again – go here. 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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