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

• Situation Update including COVID-19 Surveillance and Vaccine progress
• New Vaccine Eligibility Approach and Access, including targeting doses to high-risk communities and workers
• Vaccine in Doctors’ Offices and AZ update
• Travel to Ontario
• Tomorrow — Town Hall for Physicians with Dr. Brent Roussin

Situation Update

COVID-19 Surveillance Update

Since our last update on Monday:

• Daily cases up: Another 365 new cases of COVID-19 have been identified, including 164 today. This brings the total case count in Manitoba to 36,632.
• Test positivity up: The five-day test positivity rate is 6.3%, up from 5.7%. It is 6.6% in Winnipeg, up from 5.7%.
• Active cases up: There are 1,833 active COVID-19 cases province-wide, up from our last report of 1,685.
• Hospitalization steady: There are 137 people in hospital, up from 132. This includes 34 people in ICU.
• Two new deaths related to COVID-19 were identified, including one today. The total number of deaths is 961.

The total number cases involving variants of concern has grown to 804, up 157 from last Friday. The B.1.1.7 variant, originally identified in the UK, accounts for 88% of these cases, while 2.5% are B.1.351 variant, first identified in South Africa. There are two cases of the P.1 variant identified in Brazil, and 10% of cases are still being confirmed. 

On Monday, Dr. Brent Roussin did report that two thirds of Winnipeg cases are variants of concern.

Vaccine Situation Update

• Vaccine eligibility was expanded to age 50+ (or 30+ for First Nations) in provincial vaccine clinics. It remains at age 40+ in medical clinics and pharmacies offering AstraZeneca. 
• 364,389 doses have been administered, up from 341,962 on Monday.
• 27.4% of Manitoba adults (or 21% of all Manitobans) have received their first vaccination, up from 25.3%

With news that Pfizer is increasing shipments to Canada, Manitoba now expects all adults to be eligible by June 9. 

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.

New Vaccine Eligibility Approach and Access

While prioritized access based on high-risk medical conditions was removed on Monday, Dr. Joss Reimer unveiled a new approach to prioritizing vaccine eligibility today.

As of today, front-line police officers and firefighters are now eligible for the vaccine.

Starting on Friday, Manitoba will make all adults (age 18+) eligible in high risk communities. Eligibility will include those living in these specified communities, as well as people working in specific public-facing occupations. This is similar to an approach already used in Ontario, and recommended by the National Advisory Committee on Immunization. 

The specific communities will be unveiled on Friday, but today Dr. Reimer shared the criteria being used by public health to identify these communities. An analysis of risk is based on factors known to increase the risk of infection, or of severe illness or death from COVID-19:

• COVID-19 case rates
• Population density
• Percentage of racialized populations
• Income levels
• Suitable housing

Individuals who work in the yet-to-be-specified communities could also be eligible if their job involves public-facing roles or essential work. This includes individuals working:

• In schools or child care centres
• Food processing facilities or food inspector
• Public health inspector or workplace safety and health officer
• At a grocery store, convenience store or retail gas location
• Anywhere that provides food, such as restaurants, food banks or soup kitchens

The province also announced it was opening vaccine clinics for urban Indigenous and homeless people in Winnipeg, Brandon, Portage la Prairie and Thompson. Most of the immunization clinics are expected to open the week of April 26, with the Portage la Prairie and Thompson locations expected to open the week of May 3. 

Eligible people can make appointments through the provincial call centre, with support from the community partners when needed. The clinics will be located at:

• Ma-Mow-We-Tak Friendship Centre in Thompson , 4 Nelson Rd., Thompson;
• Brandon Friendship Centre, 205 College Ave., Brandon;
• Prairie Fusion Arts and Entertainment Centre, led by the Portage la Prairie Community Revitalization Corporation, 11 Second St. NE, Portage la Prairie;
• Aboriginal Health and Wellness Centre, 180 Higgins Ave., Winnipeg; and
• Ma Mawi Wi Chi Itata Centre – Win Gardner Place, 363 MacGregor Ave., Winnipeg. 

You can learn more about the provincial vaccine approach at an upcoming town hall webinar with Dr. Joss Reimer on Monday.

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

Meanwhile, the Manitoba Federation of Labour issued an urgent call for the provincial government to introduce paid sick days to help slow the spread in workplaces of COVID-19. Their analysis found over 1,200 cases of COVID-19 in workplaces based on WCB claims. The group also called for paid time off from work to get immunized. Medical groups in Ontario had pushed the provincial government there to make a similar policy change. 

Vaccine in Doctors’ Offices & AstraZeneca Update

There are hundreds of doctors who have signed up to offer the vaccine in their clinic, and we know doctors’ offices are the preferred vaccine location for 88% of Manitobans. 

As part of our advocacy to get more vaccine doses to medical clinics, we worked with participating clinics to identify how the vaccine distribution could be improved. 

A new ​“pull” ordering system would enable these doctors’ offices to:

• Receive a predictable and reliable supply of vaccine,
• Administer vaccine doses quickly after receiving them, and
• Target doses to individuals most at risk first.

We’ve submitted a detailed overview to the provincial Vaccine Implementation Task Force outlining how distribution to clinics could work better, and how they can play a larger and more effective role in extending the provincial immunization rollout to more Manitobans. This includes three recommendations:

1. Shift to a more routine, ​“pull” vaccine ordering system, ensuring it is reliable and that doses are allocated equitably.
2. Allocate more vaccine doses to doctors’ offices now, including mRNA vaccines
3. Use doctors’ offices to offer ​“pop-up” vaccine locations in rural areas and in Winnipeg, including to target individuals at increased risk due to geography, occupation or other risk factors. 

You can view the full submission to the provincial government here. Thank you to the dozens of clinics who contributed to this work. 

AstraZeneca Supply and Second Dose Update

We understand all AstraZeneca vaccine doses have been delivered to participating medical clinics and pharmacies. There are no details of when the next shipment of AstraZeneca will arrive. We have heard a small shipment of the Johnson & Johnson vaccine may arrive in May, but no details are available yet. Officials are also waiting for Novavax to be approved, a more stable vaccine option that could be used in physician offices. 

Provincial officials also responded to questions about second doses of AstraZeneca. At this point, they are expecting shipments of AstraZeneca that will enable second doses to be offered within the four month window. They are also working on contingency plans, including whether the second dose could be an mRNA vaccine, a Johnson & Johnson or Novavax vaccine if available, or whether delaying beyond four months is a safe option to wait for more AstraZeneca doses. 

Travel Restriction in Ontario

The Ontario government has banned all non-essential travel into the province, including those who have cottages in the Lake of the Woods area. Access will be limited to essential travel only, including essential workers and anyone travelling for medical care, transportation of goods and exercising Indigenous treaty rights. Travel to secondary properties, such as cabins or cottages, is not considered essential. People without a valid reason for entering Ontario will be turned back, with provincial police actively monitoring at the border.

Shared Health has updated its Non-Essential Travel for Health-Care Workers FAQs document.

Tomorrow — Dr. Roussin Town Hall

Please join us tomorrow for a town hall webinar with Dr. Brent Roussin, hosted by our President, Dr. Cory Baillie. 

Dr. Roussin will share a complete update on the pandemic situation for physicians and take questions as well. You can ask questions during the webinar or you can submit questions in advance during your registration.This timely update will include:

• Current epidemiology
• What we know about the variants of concern in Manitoba
• Public health measures
• What the future may bring
• Q&A

Webinar Town Hall with Dr. Brent Roussin

When: Thursday, April 22, 6:30pm to 7:30pm
Register: Click here to register

To view previous updates click here.