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

• Situation Update including COVID-19 and Vaccine Updates
  
• New Vaccine Eligibility in Hot-Spot Communities
• Take-aways from Dr. Roussin’s Town Hall 
  
• Upcoming Town Hall with Dr. Joss Reimer
  
• Our CEO gets vaccinated
  
• Overhead Cost Comfort
  
• A busy week for Manitoba’s Medical Learners
  

Situation Update

COVID-19 Surveillance Update

Since our last update on Wednesday:

• Daily cases stay higher: Another 437 new cases of COVID-19 have been identified, including 181 today. This brings the total case count in Manitoba to 37,069.
• Test positivity up: The five-day test positivity rate is 6.5%, up from 6.3%. It is 6.8% in Winnipeg, up from 6.6%.
• Active cases down: There are 1,739 active COVID-19 cases province-wide, down from our last report of 1,833.
• Hospitalization up: There are 144 people in hospital, up from 137. This includes 35 people in ICU.
• Three new deaths related to COVID-19 were identified, including two today. The total number of deaths is 964.

The total number of cases involving variants of concern has grown to 1,201, up 397 from Wednesday. The B.1.1.7 variant continues to be the dominant variant of concern.

Canada has banned passenger flights from India and Pakistan for 30 days, as cases surge in the region. 

Vaccine Situation Update

• Vaccine eligibility has remained unchanged, with those age 50+ (or 30+ for First Nations) eligible at provincial vaccine clinics. It remains at age 40+ in medical clinics and pharmacies offering AstraZeneca. Targeted community eligibility was unveiled (see below).
• 29.9% of Manitoba adults (or 23.1% of all Manitobans) have received at least one dose, up from 27.4%

AstraZeneca recommendations have again been updated by the National Advisory Committee on Immunization (NACI). AstraZeneca is now recommended by NACI for individuals age 30 and up, ​“without contraindications, if the individual does not wish to wait for an mRNA vaccine and the benefits outweigh the risk.” You can view a summary of their updated recommendations here.

Please note that the NACI recommendation has not yet been adopted in Manitoba, where eligibility remains age 40 and up for this particular vaccine.

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.

Hot Spot Communities Eligible

Today, Dr. Joss Reimer unveiled the initial list of communities deemed to be COVID-19 ​“hot spots” due to increased risk for infection, serious illness or death from COVID-19.
The communities include most of downtown and part of the north end. Specifically, the neighbourhoods of:

• Inkster East
• Downtown East
• Point Douglas South.

All adults (age 18+) living in these communities are now eligible. Individuals who work in these communities are eligible if their job involves public-facing roles or essential work.

This includes individuals working:

• In schools or child care centres
• In food processing facilities or food inspector
• As a 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

These communities were identified using a number of criteria, including COVID-19 case rates, population density, percentage of racialized populations, income levels, suitable housing. 

We have posted the communities at Man​i​to​baVac​cine​.ca, along with an address lookup. 

Takeaways from Dr. Roussin Town Hall

Last night, Doctors Manitoba held an exclusive town hall for our members with Dr. Brent Roussin, Chief Provincial Public Health Officer. While hundreds of physicians participated, we know some were not able to make it. Below you will find key takeaways from his presentation and the Q&A.
Key Takeaways

1. The third wave is here and variants of concern now dominate. Variants of concern now account for about two thirds of cases in Winnipeg. B.1.1.7, first identified in the UK, is by far the dominant variant of concern, accounting for nearly all of the identified cases. These variants are more transmissible and lead to more severe illness and death. The vaccines used in Manitoba appear to be effective against the B.1.1.7. The other variants of concern are very minimal in Manitoba, with 20 cases of B.1.351 (originally identified in South Africa) and P.1 (originally identified in Brazil). 
   
2. Younger people account for most new cases: The fastest growing age cohorts are young adults (20−39 years) and children (0−19 years).
   
3. How concerned should we be about the third wave? Short answer, concerned. The increase in cases and test positivity is similar to where the province was last fall at the beginning of the second wave, but this time there are variants of concern circulating. The doubling time for the epidemic in Winnipeg is 16 days, but for the more transmissible variants of concern, the doubling time is about half of this which illustrates their increased risk to public health. 
4. How is spread occurring? Most of the spread public health can identify is happening because of close contacts. A lot of this is happening outside of the current public health orders, which means spread is happening because some people aren’t following the restrictions already in place. Sleepovers, multiple households gathering, house parties, and larger social gatherings were cited as common themes. Dr. Roussin pointed out that risk identification can be challenging and that some individuals don’t see an increased risk in hosting a sleepover with classmates their child spends the day with at school. 
   
5. Tougher restrictions could be coming, but… While Dr. Roussin noted additional restrictions could be next, some pointed out tougher restrictions alone may not be the best tool if people aren’t following the rules. Public health is working to increase public messaging to further raise awareness. Enforcement of existing orders is being increased. More aggressive case and contact tracing and isolation rules are in place. There is lots of unused testing capacity. The vaccine rollout is helping. And, like any medical decision, there are benefits and risks that come from implementing tougher restrictions that many health care providers are concerned out. 
6. Is a return to remote learning coming? Likely not at a provincial level. A localized approach to specific schools or areas may be used, but at this point a broad closure of in-person learning is not expected. Most of the transmission in school-age kids is happening outside of school, and keeping kids in school is a priority when considering their well-being more broadly. 
   
7. Vaccines are working. Among those with high rates of immunization, such as PCH residents and among older adults, COVID-19 cases are way down. 
   
8. Vaccine passports could happen. There are significant legal, ethical and policy issues with introducing so-called vaccine passports, to allow individuals to attend large events or other public activities. Such a policy, Dr. Roussin noted, would let Manitobans do more, sooner. Public health cannot introduce a measure like this on its own, however. Proof of immunity will be offered at some point to support travel, as other countries are starting to require this for international travellers. As for right now, changes are being introduced gradually and cautiously. Most fully vaccinated individuals don’t need to isolate if they are a close contact. Fully immunized PCH staff can now work in multiple facilities. 
   
9. Clarity on masks outdoors. Masks are only encouraged outdoors only when individuals can’t be socially distanced from others. Transmission outdoors is much lower than indoors.

Dr. Roussin thanked physicians for their hard work and dedication over the past challenging year. Where possible, physicians are encouraged to reinforce the importance of following public health restrictions and the fundamentals of social distancing and mask wearing.
Vaccine questions submitted for the Dr. Roussin town hall will be used in Monday’s town hall with Dr. Joss Reimer (see below and register!)

Join Us for a Vaccine Town Hall with Dr. Reimer

Join us this Monday, April 26 for a town hall about the COVID-19 vaccines with provincial Medical Lead with the Vaccine Implementation Task Force, Dr. Joss Reimer.
Learn more about the rollout, the safety and effectiveness of vaccines, and get an official update directly from Dr. Reimer. A Q&A session for physicians’ concerns and questions will follow. You can submit questions in advance during the registration process. Live questions will also be accepted during the webinar.

Webinar Town Hall with Dr. Joss Reimer
When: Monday, April 26 at 6:30PM
Register: Click here to register

Why I got my shot from my doctor

With expanding eligibility, our CEO Theresa Oswald became eligible earlier this week. In fact, she went from not being eligible to having options: book downtown for a Pfizer shot, or call her doctor and consider the AstraZeneca shot.

Read Theresa’s story about how she decided, why she hesitated, and how her doctor had the exact advice and reassurance she needed. Believe us, this is a story you don’t want to miss!

Overhead Cost Comfort

Many doctors have fixed overhead costs, like utilities and rent. The pandemic has made a lot of physicians realize how unexpected disruptions to their practice can leave them at risk, as these fixed overhead costs can keep piling up.

We’ve seen an increase in calls from members inquiring about our non-profit overhead cost insurance, many surprised at how low the premiums are for this coverage. In the event of an accident, sickness or injury, this insurance benefit will help to cover your overhead costs when you’re not able to work.

For members who were injured or became sick, and have faced a disruption in their work, this coverage has offered comfort and financial assistance. It’s saved their clinic from closing permanently and protected their family. 

You can learn more about our Office Overhead Expense Insurance on our new website, or by contacting Mark Venton, Insurance Coordinator at 204−985−5846 or mventon@doctorsmanitoba to learn more. 

A Big Week for Manitoba’s Medical Learners

It’s been a busy week for medical students in Manitoba!

Match Day

On Tuesday Manitoba’s graduating medical learners received their CaRMS Match results. Congratulations to all those who matched to their chosen program! While match day is an exciting culmination of medical learners’ years of dedication and hard work, it can be a difficult day for those who did not match or those who may not have been matched to their program or school of choice. If you, or another medical graduate you know, are struggling with the results of the first iteration, reach out to the Physician and Family Support Program 1 – 844-4DOCSMB (436−2762). This program is available to all medical students. Guid​anceRe​sources​.com Company ID: DOCSMB 

Additionally, as part of the CFMS Safe Spaces initiative, the CMA is hosting a free confidential peer support session for unmatched students on April 28, 2021 at 7p.m. EST. Participants can join other unmatched fourth-year medical students from across the country in a confidential, moderated peer support session. Learners can participate anonymously or choose to identify themselves. CFMS has also created an exhaustive list of supports for graduates which can be found here.

Civility Saves Lives 

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 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.
Sign the Civility Saves Lives Pledge today!

MMSA Combating Vaccine Hesitancy

With assistance from Doctors Manitoba, MMSA members Anmol Mann and Philip Kawalec have spearheaded a sticker campaign to combat vaccine hesitancy. Vaccine positive stickers were designed and printed and are being distributed to participating clinics to hand out to patients who have received their vaccine. We would love to photos from participating clinics and be sure to tag us in your social media posts. Physicians who would like to participate by distributing stickers in their clinics can contact Braden Kalichuk at bkalichuk@​doctorsmanitoba.​ca.