Lack of N95 masks, Bill 124 choking Nurses as Omicron advances; Acute care beds in Peel at 100% capacity

In a virtual press conference Tuesday, the Registered Nurses' Association of Ontario said if the nursing shortage fuelled by Bill 124 is not contained, the healthcare system in Ontario will not be able to control the spread of Omicron.

With the Region of Peel reporting that acute care beds in its three hospitals were at 100 percent capacity as of December 13, the healthcare system is facing another bleak winter.

The latest data, released by the Region yesterday, had some good news. Intensive care capacity was at 74 percent and ventilated-bed capacity was at 42 percent.

These figures can be compared to where Peel was one year ago. As of December 14, 2020, acute care bed capacity was at 94 percent, intensive care beds were 89 percent filled and beds with ventilators were at 66 percent capacity.

This suggests that while more patients overall are currently seeking treatment at hospitals (possibly for a range of illnesses), there are fewer severe cases that require ICU and ventilator treatment, but this could change rapidly.

 As of data released December 17, Peel had 21 confirmed cases of the Omicron variant, and the latest information shows acute care hospital beds in the region are at 100 percent capacity.

(Peel Public Health)

While Ontario recorded 1,429 new infections on Tuesday, the province added another 3,124 new infections Friday, with five people losing their lives to COVID. Peel Region had 21 confirmed Omicron cases according to data released yesterday (December 17) but the actual number of current infections is likely higher.

Nurses have been sounding the alarm, as more and more of them are either leaving the profession or are no longer able to perform to expected standards due to burnout following almost two years of the pandemic. Peel has been especially hard hit, and nurses here have recently said the profession is in turmoil.

The two largest organizations representing them have pointed a finger of blame at Premier Doug Ford and his PC government for enacting and refusing to rescind Bill 124, passed prior to the pandemic to curtail public sector salaries, including those for nurses, by capping annual increases at 1 percent during a “moderation” period.

The legislation, nurses say, is driving more and more of them out of the profession. With a fifth wave now looming, the timing could not be worse.

With a lone hospital in Brampton, Civic, the situation could get grim for Peel residents, after disturbing reports throughout the pandemic of local patients who could not get adequate care, sometimes resulting in the loss of life.

“This Bill is a slap in the face after 22 months that we are confronted with a devastating pandemic, where we [nurses] have needed to cancel vacations, cancel days-off, have lived in constant fear during the pandemic waves before vaccination, and now yet again in front of a holiday that likely most of them will need to cancel and we will need to to see them again and again and again at work,” said Dr. Doris Grinspun, RNAO’s CEO.

“The Premier is deepening this nursing crisis significantly by ignoring the plea of nurses.”

In a media release following Tuesday’s press conference, RNAO said the Ford government must take swift action to confront the province’s nursing crisis, to make sure there are enough frontline professionals available to deal with the coming fifth wave of the COVID-19 pandemic and the backlog of procedures and surgeries.

The RNAO says the public health measures announced Friday and earlier this week (a reduction to 10 for indoor social gatherings, the curtailing of travel, caps on restaurant capacity, cutting large event gatherings by 50 percent and severe restrictions in long-term care settings) are essential first steps but not enough to contain the out-of-control spread of the Omicron variant or to prevent a collapse of the healthcare system.

“Capacity limits provided today are too generous given the millions of Ontarians over the age of 18 still in line to get booster shots, and the demand for boosters outstrips our capacity to deliver them quickly,” said Grinspun.

One encouraging piece of information out of Friday’s Peel data was the continued protection of vaccines.

As more new cases are reported among younger residents, the figures suggest inoculation has had a significant impact. Between September 1 and December 9, of 1,204 cases reported among those aged 4 to 13, only two percent were among those with two doses of the vaccine; and of the 236 cases during the same period among 14 to 17-year-olds only 20 percent involved those with two doses.

But one piece of data not going in the right direction is the reproduction rate in Peel, meaning the number of secondary infections caused by each new case. Between December 8 and 14 Peel’s reproduction rate was 1.4, compared to a reproduction rate of 1.0 between December 9 and 15, 2020.

This shows that, collectively, all strains and variants of the novel coronavirus are spreading much more rapidly now than they were a year ago, when we were in the middle of one of the two worst waves yet.

The big unknown is how serious the coming wave will be. With widespread vaccine protection, and the early scientific view based on initial evidence that Omicron might not be as dangerous as Delta (even though it spreads much faster) it’s possible that the actual impact could be less severe.

But public health officials have been adamant in their position that we cannot “hope” for a better outcome because of vaccine protection and the possibility Omicron causes less severe disease. We have to prepare for the worst they say.

Grinspun says the best way to ensure there are enough nurses to fight the explosive growth in new infections is to immediately repeal Bill 124.

“Nurses care deeply about their patients and they keep going to work facing insurmountable challenges. Their patient assignments have increased dramatically. Most still do not have the N95 masks needed to keep them and their colleagues safe given that COVID-19 is airborne, and they feel increasingly ignored by a government that does not care about their health and wellbeing,” says Morgan Hoffarth, RNAO’s President, referring to Bill 124.

“This is a virus that knows no bounds. We all have an obligation to look out for ourselves and for one another,” Hoffarth says.

The RNAO says the one percent salary increase limit under Bill 124 actually results in a reduction in pay when inflation is taken into account. 

“Bill 124 is having a detrimental effect on the profession, like nothing I have seen before. We are losing nurses of all categories and we are hemorrhaging RNs. Ontario had a shortfall of 22,000 RNs before this pandemic began. And, when you factor in the length of the pandemic and the exhaustion and burnout our colleagues have been experiencing, we desperately need a government that recognizes nurses’ efforts and brings hope by moving to immediately #RepealBill124,” Grinspun said.

The RNAO rallied a month ago on Nov. 14 against the wage cap, as The Pointer earlier reported.

“Today [Dec. 14] marks the end of the countdown. We are at day zero and nurses are stunned they have been met with complete silence from the premier. This is being perceived as a blatant lack of respect for nurses, who have been under tremendous pressure and who have sacrificed and risked their lives and the lives of their loved ones for the past 22 months,” Grinspun said, echoing nurses in the field.

While the RNAO has received support from 48 MPPs so far, 60 PC MPPs have yet to take any action.

During Tuesday’s media conference, the RNAO revealed that all of Ontario’s NDP, Liberal and Green party MPPs have signed a letter pledging to vote in favour if Premier Ford brings forward legislation to repeal the bill.

In a recent move to thank the MPPs that have pledged to support its campaign and to urge other MPPs to get onboard, the RNAO is asking the public to drop off special #RepealBill124 stylized holiday cards at their MPP local constituency offices.

Grinspun hopes the Premier realizes the public is standing with the nurses when his caucus members get flooded with these holiday cards, just as a new pandemic wave looms.

The RNAO shared social media posts on its campaign page, urging the public to share these by tagging their local MPPs.

(RNAO)

The public can join the RNAO’s campaign online by emailing their local MPP these holiday cards and tagging them on social media.

The RNAO chief executive says repealing Bill 124 will not fully solve all the issues causing the current nursing crisis, “but it is the life-saving jacket that will say to nurses, please know that we are listening to you.”

With acute care beds in Peel’s hospitals at 100 percent capacity there is absolutely no room for loss of nursing care, which is perhaps the most critical need to keep each bed operational.

Losing bed capacity because of staffing, could be the final blow to a healthcare system once again at its breaking point.

Grinspun says the Premier speaks with her often but has ignored any conversation around Bill 124.

“I have heard zero from the Premier, no answer to my calls, no answer to my text message and no answer to our letter.”

Grinspun says while the government is scrambling with the fifth wave of a pandemic, Premier Ford does not understand the seriousness of the nursing crisis.

“We know that emergency departments in some hospitals already have closed during the weekend, and we believe ICUs will be full.”

Grinspun says Premier Ford is playing with the lives of Ontarians, and if no RNs are manning the ICUs here in Ontario, then “we'll be in the same situation as Manitoba”, which this week had to ask Ottawa for emergency help as some ICUs there can no longer meet their capacity due to a shortage of nurses.

Leah Waxman, right, a full-time emergency department nurse, is a co-founder of NurseWithASign416.

(Courtesy NursewithaSign416/Twitter)

Leah Waxman says nurses are fed up with the support they are not receiving, and the heavy patient loads and short staffing are adding to their dire reality.

She says nurses fear coming out and talking in the open.

“One night we just wanted to let the public know what we are going through without necessarily getting lash back from our employer,” she said.

“Nurses have a lot to say but they want to remain anonymous but still share their stories,” Waxman said.

Grinspun says she can’t recall any other government that muzzled people, intimidating them against speaking up.

“Nurses want to speak anonymously because they fear repercussions, presidents and CEOs of hospitals are calling me because they're afraid of speaking up - the provincial government is taking the safety valve off the system,” Grinspun said.

Claudette Holloway of the RNAO said many nurses had left Ontario to work in other provinces, while some are leaving the profession altogether.

Holloway says Bill 124 is a sucker punch to nursing.

“Nurses have been at the epicentre of this pandemic for 22 months, they will continue to be at the center of the fight but the Ford government must show the respect that nurses deserve, and the most pressing way to do so is with repealing Bill 124,” she said.

The likelihood of a fifth wave might push some over the edge.

“Many people in our province say, ‘Well, I go to the hospital and I don't really notice a difference.’ That’s because the nurses are working overtime but they cannot continue to do this. So you may not have noticed, but that nurse may not have had any lunch, that nurse may not have had any days off, that nurse may be working way past her time,” Holloway said.

“We are doing whatever we can.”

With Omicron threatening the healthcare system, Sara Singh, MPP for Brampton Centre and NDP Deputy Leader, urged Ford to take action before things might get out of hand.

“No one wants their loved ones to get sick, no one wants another shutdown, and no one wants hospitals to be overwhelmed. But we need to act now to prevent those things — experts have made it clear we are quickly running out of time,” Singh said in an ‘Omicron Action Package’ press release.

“He is sleepwalking us right into an Omicron wave,” she added.

“Day after day, Ford refuses to take actions that could help.”

She urged the Ontario government to launch an urgent recruitment and retention blitz for nurses. 

Singh says hospitals and vaccination centres are badly short of frontline health care workers, and the ones that remain are burnt out and exhausted.

“We cannot do Ontario’s best to care for patients and complete vaccinations and booster shots if Doug Ford sticks with his bad plan to cap nurse wages, and just wave goodbye as thousands of nurses leave.”

The Pointer reached out to Ontario’s Ministry of Health on its plan to stem the loss of nurses and to address high levels of burnout which may impact the healthcare system in the rising fifth wave but did not receive a response ahead of publication.

The Premier's Office also did not respond.

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