In today’s e‑newsletter for physicians, you will find:

• Situation Update including COVID-19 Surveillance and Vaccine progress
• Vaccine Webinar with Dr. Joss Reimer
• Message to Physicians from Dr. Brent Roussin
• Vaccine developments, including the latest on AstraZeneca
• Registration has opened for Doctors Manitoba’s AGM (with a special keynote speaker)
• Meet our new website!
• Invitation to participate in a virtual care focus group (honorarium provided)
• MMSA and PARIM awareness campaign aimed at improving the culture in clinical learning environments

If you have questions or need help related to the pandemic or vaccine, contact us at covid19@​doctorsmanitoba.​ca

Situation Update

COVID-19 Surveillance Update

Since our last update last Friday:

• Daily cases steady: Another 719 new cases of COVID-19 have been identified, including 153 today. This brings the total case count in Manitoba to 35,688.
• Test positivity steady: The five-day test positivity rate is 5.3%, down from 5.5%. It is 5.1% in Winnipeg, unchanged from last Friday.
• Active cases up: There are 1,528 active COVID-19 cases province-wide, up from 1,180.
• Hospitalization steady: There are 137 people in hospital, up from 136. This includes 35 people in ICU.
• Six new deaths related to COVID-19 were identified, including one today. The total number of deaths is 955.

Since Friday, an additional 271 variant of concern cases have been identified. This includes the first confirmed case in Manitoba of the P1 variant first identified in Brazil. Overall there have been a total of 647 screened or sequenced variant of concern cases, and the breakdown by variant of concern includes:

• 88% B.1.1.7 variant (UK)
• 3% B.1.351 variant (South Africa)
• 0.2% (1 case) P1 variant (Brazil)
  
• 9% of cases have not yet been categorized

A dashboard has been launched by public health so Manitobans can learn more about the variants of concern. This dashboard reveals that most cases were likely acquired by close contact with a known case.

Vaccine Situation Update

• 308,576 doses have been administered, up from 259,847 on Friday.
• 22.3% of Manitoba adults have received their first vaccination, up from 15.7%
• Eligibility currently includes individuals age 59 and older, or 39 and older among First Nations people for government-run super sites and pop up clinics. Pop-up clinics have been planned for April in a number of rural communities.
• At medical clinics and pharmacies, eligibility includes people aged 55 to 64 with specific high-risk health conditions that put them at higher risk of severe outcomes from COVID-19, as well as all people aged 65 and older, with priority given to people who might be unable to attend a super site or pop-up clinic.
  

Doctors Manitoba continues to maintain two important vaccine resources:

• For physicians: Our Vaccine Resource Centre includes resources and information, including sample patient messaging, a billing guide, a vaccine hesitancy guide and more.
• For your patients: Our public vaccine hub, Man​i​to​baVac​cine​.ca, continues to offer your patients answers to common vaccine questions, including when individuals will become eligible.

Vaccine Webinar with Dr. Reimer

Join us on April 26 for a special Doctors Manitoba town hall about the COVID-19 vaccines with Dr. Joss Reimer, provincial Medical Lead with the Vaccine Implementation Task Force.

There has been no shortage of vaccine news coverage, including about the safety and effectiveness of vaccines, or about the provincial immunization rollout. Get an official update directly from Dr. Reimer, along with a Q&A dedicated to responding to physicians’ concerns and questions.

The town hall will include:

• An update about the vaccines approved in Canada, their effectiveness and safety
• Immunization roll-out plans in the face of new variants and a third wave
• Next priority population groups for immunization
• Physician role in the immunization campaign
• Q&A

Details
When: Monday, April 26 at 6:30PM
Register: Click here to register

You can submit questions in advance during the registration process. Live questions will also be accepted during the webinar.

Message to Physicians from Dr. Roussin

Dear Colleagues,

I know many of you are concerned about the third wave of COVID-19. You may be worried about the Variants of Concern (VOCs), the increased transmissibility of these variants and how they will affect the health of your patients and families. You may also be concerned about how the third wave will impact your clinical work over the next few months.

Our public health team has been actively monitoring the situation here in Manitoba as well as what is occurring in other provinces. I want to reassure you directly that we have been preparing for the third wave and we are prepared to act.

In fact, some of the measures already in place are helping to reduce the magnitude and impact of the third wave. This includes isolation requirements following travel, expanded case and contact isolation requirements, more aggressive contact tracing and continued efforts on the vaccine roll-out.

As we monitor the situation and consider further changes to public health measures and vaccine prioritization, there are a lot of things we consider. Protecting Manitobans through trying to reduce severe outcomes and containing the spread of the virus is, of course, top of the list. We also consider the capacity in our health system, both the beds available and the physicians and staff to care for patients. And we are very mindful of how public health restrictions can affect the health and well-being of Manitobans, including their emotional and mental health, their ability to seek care, testing or surgery for health issues, and their ability to continue their employment or their education.

I also want to take a moment to thank physicians. All physicians have been impacted by this pandemic. It has affected your work, your personal lives, and your families. I have been inspired by your ongoing commitment to your patients and your care for the well-being of all Manitobans. I also want to thank all of you who have received the vaccine and who continue to educate your patients and promote vaccination. Doctors Manitoba has passed on your views and concerns, which are important insights as we all navigate this pandemic together.

Next Thursday, I hope you’ll join me for my town hall exclusively with physicians, hosted by Doctors Manitoba. I’ll share a more complete update on the pandemic situation for physicians and take your questions as well.

Webinar Town Hall with Dr. Brent Roussin
When: Thursday, April 22, 6:30pm to 7:30pm
Register: Click here to register in advance

Sincerely,

Dr. Brent Roussin

Vaccine Developments

Health Canada has released its findings after an extensive, independent assessment of the blood clot risks associated with the AstraZeneca vaccine.
Their findings include:

• Blood clots following vaccination are very rare, but may be linked to the use of this vaccine among people with low levels of blood platelets.
  
• The side effect is treatable.
  
• The potential risk of these events is very rare, and the benefits of the vaccine in protecting against COVID-19 outweigh its potential risks
  

Dr. Supriya Sharma, Health Canada’s Chief Medical Advisor, reinforced that the vaccine is viewed as safe and effective:
​“Get whatever vaccine is available to you. It’s that simple. The longer you wait to get vaccinated, the longer you’re not protected. We know the risks of getting these side effects from the vaccine are very rare.“

Health Canada’s review concluded the risk is about 1 in 250,000. Comparatively, the risk of getting a regular blood clot are 1 in 5 for people hospitalized with COVID-19. Women on birth control have a 1 in 1,600 chance of developing a blood clot.

The label has been updated and patients should be advised about the very rare risk, what symptoms to watch for, and when to seek medical treatment. More information can be found from Health Canada.

Health Canada will not place any age restrictions on the use of the AstraZeneca vaccine. The current recommendations for AstraZeneca are being reviewed by the National Advisory Committee on Immunization, and should be available within a week. At this time, the 55 and over criteria in Manitoba remain in place.

The review findings follow the identification of the first and only case in Canada of the blood clot side effect, called VIPIT. A woman in Quebec is recovering at home.

Scrutiny of AstraZeneca causing hesitancy
The intense media coverage about AstraZeneca has had an impact on patients’ views about the vaccine. Only 41% of Canadians say they would be comfortable receiving the AstraZeneca vaccine according to a recent poll, though another 15% would likely accept it despite their discomfort. Nearly a quarter (23%) said they would say no to this type of vaccine.

This reinforces the importance of the physician role in immunizing patients. Physicians have been able to reassure patients about the AstraZeneca vaccine, to help them understand the level of risk and compare it to the benefit that the vaccine offers.

Because doctors have built that trust with patients, they are often able to address patients’ concerns and many proceed with AstraZeneca.

It also reinforces why it is so important for physicians to also be able to offer mRNA vaccines in their clinics. This is happening elsewhere, and Manitoba could reach more Manitobans with the vaccines if more doses were offered through doctor’s offices. Doctors Manitoba continues to advocate for the province to leverage its existing ​“immunization infrastructure,” using doctor’s offices as a familiar and trusted source for vaccines.

Johnson & Johnson vaccine linked to blood clots?
The United States has paused the use of the J&J vaccine to investigate very rare blood clots. There have been six cases of blood clots among the nearly seven million Americans who have received the vaccine. All six cases involved women under the age of 50.

Both the J&J and AstraZeneca vaccines use adenovirus viral vector technology, and now both have reports of similar, exceptionally rare, blood clot side effects. Over half a million Canadians have received the AstraZeneca vaccine so far.

Register Now: AGM

You can now register for the Doctors Manitoba AGM!

The Annual General Meeting will be held on Thursday, May 6 at 6PM. We have a special headline speaker planned on a topic that couldn’t be more important. We hope you’ll join us. Our AGM will start this year with a presentation about physician health and wellness, featuring Dr. Tait Shanafelt from WellMD at Stanford University. We are very lucky to be joined by this global thought-leader and researcher in the field of physician well-being and its implications for quality of care, and one who recognizes the importance of organizational and system-level strategies to improve wellness. You can learn more about our keynote speaker and the AGM online. We will update this page with traditional AGM materials, including the agenda and other documents.

New Website Responds to Members’ Advice

Doctors Manitoba has launched a new website! It’s at the same old address, Doc​tors​Man​i​to​ba​.ca, but with a new look and easier way to find the information you need.

The site was created in response to feedback from members, who wanted a new modern site with easier to find resources and information. For example, our COVID-19 resource centre and our Insurance options are now much easier to navigate. A modern website helps to reinforce the credibility of your Association and the profession.

If you have suggestions on how to improve our site, let us know.

What’s Next? We are now turning our attention to developing a members-only area. Once this is ready in a few months, you will receive a unique, secure login. This will allow you to:

• Access non-public documents, like the uninsured services guide, that are not currently online
  
• Provide feedback on current issues and policy changes in a new discussion forum
• Bookmark key resources on the site and subscribe to updates on topics important to you
  
• Apply for insurance
  
• Apply for benefits and rebates, and check your status with the Physician Retention Program
  
• View invoices, receipts and tax information
  
• And more.

Join Virtual Care Study

Researchers studying Virtual Visits and Management of Primary Care in a Pandemic Environment, are seeking the input of primary care providers on the use of virtual care in Manitoba. Share your experiences by participating in one focus group session (honorarium provided).

For additional information and/​or to participate, please contact Alanna.​Baldwin@​umanitoba.​ca.

Improving Culture in Clinical Environments

The Manitoba Medical Students’ Association (MMSA) and the Professional Association of Residents and Interns of Manitoba (PARIM) have partnered with Rady Faculty of Health Sciences faculty/​staff and Doctors Manitoba to launch an awareness campaign aimed at improving the culture in their clinical learning environments. Positive and respectful clinical learning environments impact patient care. The Civility Saves Lives Manitoba team is made up of medical students from
all four years of training, residents and faculty from various backgrounds, and staff from the Rady Faculty of Health Sciences.

The campaign will launch this month with a workshop organized in partnership with Sanokondu facilitated by Dr. Sara Hosseini on April 21^st from 5:15 – 17:15p.m. To register click here or contact civilitysaveslives@​gmail.​com. Additional events and educational sessions will be planned throughout the year.

To view previous updates click here.