COVID-19 Updates

This page contains updates on the COVID-19 pandemic for Doctors Manitoba members. Below you will find messages to members on a variety of issues. You can also access official resources from provincial, national and international sources on our resource page.

May 29

Situation Update

Manitoba identified two new cases yesterday and zero today, bringing the total identified to date to 294. There are only 14 active cases today, with none in hospital or ICU. Yesterday, an additional 1,115 tests were performed bringing the running total to 42,306 so far. The full public health bulletin is available for more information.

Some testing clinics have changed their hours of operation. See the hours of operation on Shared Health’s website. Some locations may also change in the future.

The WRHA has reported historically low ER wait times, with a median of 38 minutes in April. This has been attributed to a significant decrease in visits to ERs, and provincial officials reminded Manitobans to seek care if and when they need it. This mirrors public messaging from Doctors Manitoba urging Manitobans not to put their health on hold.

Phase Two of Manitoba’s reopening plan begins on Monday, June 1 with a range of businesses and services permitted to resume operations provided appropriate public health precautions are in place. Dr. Roussin reported in today’s briefing that decisions about any further easing of restrictions will be made in a few weeks, allowing for two incubation periods.

Meanwhile, approval ratings on Canada’s premiers was released this week by the Angus Reid Institute. The research group noted most premiers have seen a boost in approval ratings due, at least in part, to how they have handled COVID-19. in Manitoba, the premier’s approval rating increased 4% since January.

Cautionary Tale from New Brunswick

Just last week, New Brunswick was down to zero active cases in the province and was moving forward with reopening more services and lifting more restrictions. However, earlier this week, an outbreak was identified and traced back to a doctor who had traveled to Quebec and brought COVID-19 back with him. The physician then resumed practice at the Campbellton Regional Hospital, seeing patients, and now eight cases are connected, including the physician’s child. Two of the cases are in ICU. Plans to reopen more businesses have been put on hold as a result of the outbreak and more cases are anticipated. The physician has now been suspended and the RCMP is reportedly investigating whether charges are warranted against the physician.

Physicians in Manitoba should take note of this cautionary tale for two reasons:

  1. It’s a reminder of how easily the COVID-19 situation can change and why continued precautions are so important. Manitoba has a very favourable case count with more businesses slated to reopen next week, but a single individual can change this situation quickly. The two cases reported in Manitoba yesterday, for example, were travel-related.
  2. No physicians wants to find themselves in this situation. Manitoba has travel restrictions in place with guidance for health care workers requiring 14 days of isolation with few exceptions. Additional information is available from Shared Health’s occupational health resource page.

PPE Assistance

Doctors Manitoba continues to offer assistance to physicians requiring PPE. We still have some non-medical grade PPE available to physicians in need including cloth masks and gowns. We have been able to source some medical-grade PPE that we can begin offering early next week on a cost recovery basis. You can request help from Doctors Manitoba, using our new PPE Assistance Request form. We will capture your PPE needs to help gauge demand and you can place an order for PPE. Currently, for medical-grade PPE we have procedure masks and gloves available.

Physicians are encouraged to try their normal supplier first and then try ordering through Shared Health Logistics. You can view the ordering information on our PPE resource page.

How has your ordering experience been with Shared Health? Please email us at ppeconcerns@doctorsmanitoba.ca. We would like to hear if you’ve tried ordering, and whether or not your order was delivered.

Pre-Surgery Self-Isolation Requirement

As surgeries resume in Manitoba, more patients and physicians are becoming aware of Shared Health’s guidance requiring patients to self-isolate for 14 days prior to their procedure and receive a COVID-19 test as a precaution. We understand this requirement has been in effect since late March, but has not had a major impact in practice until recently as very few scheduled surgeries were proceeding due to pandemic restrictions in the health system.

A memo was issued earlier this month clarifying the definition of “reliably isolated patients” for further guidance. Shared Health has also produced patient information on the requirement that you can use with your patients.

If you are concerned about your patient’s ability to self-isolate, please encourage your patient to discuss these challenges with their surgeon or contact the surgeon to discuss your patient’s circumstances and urgency.

Sick Note Requests

As more services reopen, we have heard reports that more patients are calling for sick notes. Several physicians have raised concerns that some of these requests are arising from employees who are fearful of catching COVID-19 at work or bringing it home to their families. In many cases, patients have incomplete or unclear information from their employers about the precautions being taken.

For example, there is considerable confusion among teachers about what their return to the classroom will look like, as schools begin reopening to individual and small group meetings next week. We are writing to school system leaders recommending that they provide clear and detailed descriptions of work environments to teachers and other staff to enable physicians to use their best judgment when addressing their patients’ concerns.

Physicians should consider the following when faced with COVID-related sick note requests:

  • For patients reporting possible COVID-19 symptoms, the answer is simple. On March 12, after advocacy by Doctors Manitoba, the Province of Manitoba issued a recommendation that employers should encourage employees to stay home when ill “without facing barriers such as the requirement for sick notes.” This recommendation remains in effect. We encourage you to provide this response to employers requesting notes for ill employees and we have a draft template for such a letter on our website.
  • For other concerns from patients about returning to work, ensure they have a good understanding of COVID-19, its risks, and clear and complete information from their employers about precautions.
  • If your patient reports a new condition – including anxiety or other mental health condition exacerbated by a return to the workplace – it is entirely reasonable to require an in-person or virtual visit before you can draw any conclusions.
  • If your employee is requesting an accommodation at, or absence from, the workplace because they believe they are at increased risk, you may choose to provide a note. However, unless you are aware of your patient’s working conditions, it may be very difficult to draw a conclusion that a return to the workplace is not appropriate. You can reference the Shared Health guidance on sick notes for health care workers for some information, but you should know that different employers may require different information to understand the cause of the limitation or restriction to help assess if additional precautions or changes are needed.
  • It can also be difficult to respond to patients requesting sick notes because of other issues, such as child care or transportation challenges, or because of family members’ health concerns. These are all valid concerns, but can be problematic to use as medical rationale for sick notes.

Please review our sick note guidance page for more information.

New from CMA

The CMA has submitted a proposal to the federal minister of finance outlining the financial challenges physicians across Canada are facing and proposing a series of recommendations to help address them. These proposals include expanding eligibility for federal economic relief programs to capture more physician practice situations along with new tax measures to support front line health care workers.

The CMA Foundation announced a financial contribution of $250,000 to Jack.org to develop on-line mental health education for Canada’s youth, who are facing increased isolation and uncertainty due to the COVID-19 pandemic.

What’s happening in Canada and Around the World?

Nearly 7,000 people in Canada have died from COVID-19 as our country passes 90,000 cases. From a global perspective, Canada has now surpassed China on reported cases. The US has now recorded over 100,000 COVID-19 deaths, with over 1.7 million cases in total. Brazil and Russia have had major increases in positive cases and now have the second and third highest case counts, respectively. There have been over 5.8 million cases reported confirmed worldwide, with over 360,000 deaths. You can see more on the Johns Hopkins University coronavirus tracker.

You may also be interested in this analysis that compares national COVID-19 recovery rates and resumption of economic activity. In countries like Vietnam and New Zealand, there are high recovery rates from COVID-19 that are allowing increased economic activity and more individual mobility.

Meanwhile in Brazil, for example, there are risks as recovery rates remain low but mobility is increasing, which could cause cases to surge. Canada is identified as having a moderate recovery rate but lower mobility, suggesting a more cautious approach of not reopening services until cases stabilize and patients recover.

 

Do you have a suggestion for our COVID-19 updates? Is there something Doctors Manitoba can help with? Email us anytime at covid19@doctorsmanitoba.ca

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