COVID-19 Update – November 2

Situation Update

Since our last update on Friday, there have been 901 new cases of COVID-19 identified, including 241 new cases today. The total number of cases identified so far in Manitoba now sits at 5,374.

The five-day test positivity rate in Manitoba is 9%, up from 8.6% on Friday. In Winnipeg, the test positive rate is 9.8%, up from 9.7% on Friday. 

There are currently 3,455 active cases, up from 2,737 on Friday. This includes 124 people in hospital up from 104 on Friday, with 18 in ICU. Over 75% of active cases (2,603) are in Winnipeg, but cases are increasing in all health regions.

Fifteen more COVID-related deaths have occurred since Friday, including six yesterday and five today.

You can learn more about the current situation in today‚Äôs public health bulletin.

Code Red restrictions begin today in Winnipeg, with other regions now all at orange on the pandemic response system. You can learn more about what Code Red means, including limitations on health services, in our earlier post

Additional Restrictions

Starting today in Winnipeg, public health is urging everyone in the household of an individual with symptoms to self-isolate. Anyone who is symptomatic should continue to get tested and isolate, but what is new is the requirement for everyone else in their household to isolate too. The symptomatic individual should stay in their own room and, if possible, use their own bathroom and not use common areas to limit their contact with others in the household. Exemptions are in place for asymptomatic household members if they are a health-care worker or first responder.

Dr. Roussin acknowledged this will lead to increased absenteeism, but stressed it should be short term if we can slow the spread of COVID-19.

Premier Brian Pallister has floated the idea of a curfew to help slow the spread, and is inviting feedback on this proposal, though it is not clear how this feedback is being invited. We will tweet this information out when it is available from the government. 

Physicians Issue Red Alert

Today, Doctors Manitoba issued a red alert on behalf of all physicians urging Manitobans to act now to stop the spread. Without these actions, physicians are reporting that hospital resources could be overwhelmed within days.

The red alert message has been covered widely in newspaper, radio and TV. Doctors Manitoba will be investing thousands for online advertising in the days ahead to help this message reach as many Manitobans as possible.

You can see our full media release and call to action for Manitobans here. A big thank you to our President, Dr. Cory Baillie, and ICU physician Dr. Kendiss Olafson for your comments, describing how dire the situation and what Manitobans can do to help. 

Our Red Alert call to action supports the advice of Dr. Brent Roussin. The code red restrictions are the minimum, but as Dr. Roussin has explained Manitobans should be going further to limit their contact with others. These steps include:

  • Staying home whenever possible to limit contact with those outside of your household. If you can work from home, please do.
  • Designate one individual in your household to run only essential errands, such as grocery shopping.
  • Wear a mask at all times when outside of your home.
  • Wash your hands frequently and stay six feet away from people outside of your household.
  • Stay home if you are sick, even with mild symptoms, and get tested.

This red alert call to action by Doctors Manitoba builds on our earlier advocacy efforts with government and through the media. More importantly, it builds on the efforts of dozens of physicians who have issued open letters with advice to slow the spread of COVID-19. We want to recognize those selfless physicians’ work.

Please continue to raise your concerns and ideas with Doctors Manitoba by emailing covid19@doctorsmanitoba.ca. You can also read our post from Friday providing advice to physicians considering taking their concerns public. We are here to help.   

ICU capacity will now be reported provincially by Shared Health, rather than only Winnipeg. Today, of the 80 critical care beds within province, 94% were occupied and only 5 were available across Manitoba. 

You can help! Get the word out to your patients and your personal contacts. We will be posting tips with image files and text for posts here

Hospital Contingency Plans still MIA

As we worry about hospital capacity being overwhelmed within days, now is the time to learn more about the contingency plans developed by Shared Health to accommodate a surge in hospital admissions. Unfortunately, despite our daily requests, these plans are still not available to physicians. 

We have recommended an urgent virtual meeting or town hall with physicians and we have offered to host it, to allow Shared Health to share their plans with physicians and seek their feedback. They are considering this request. In the mean time, the closest we have come to hearing the plan was a verbal overview provided by Shared Health pandemic lead, Lanette Siragusa. You can find a summary in the Winnipeg Sun

As Sir Dr. Don Berwick from the Institute for Healthcare Improvement says about patient safety plans, some is not a number and soon is not a time. Plans need to be specific. Physicians need to know how many beds are planned and when they can be opened. Some beds is not a number, and soon is not a time. 

We will keep you posted and we hope we will be able to offer a joint virtual town hall with Shared Health in the days head.

Virtual Care Update

As all regions are elevated to level orange or red on the pandemic response system, Shared Health has issued new advice to physicians working in community offices or outpatient clinics, urging you to shift your visits to virtual care, with the target of two thirds of your visits being offered virtually through phone or video. 

We have stressed that a major barrier to achieving this target is the lack of extended virtual visit tariffs. Whether it is an extended visit with an elderly patient or a complete exam with patients with more complex needs, extended virtual visits will help these at-risk populations stay home and stay on top of their medical needs. 

Our advocacy for these additional tariffs has been unrelenting, and shall continue until they are approved by Manitoba Health. 

Until then, it is still worth reviewing the Shared Health guidance as it offers principles to conserve PPE and screen patients during code orange and code red restrictions. 

And if you haven’t already, take our 2-minute survey about your patient visit volumes, and what would help keep you connected to your patients with these added restrictions.