COVID-19 Update — June 11, 2021
In today’s message you will find:
- Covid situation update
- A message from Dr. Joss Reimer
- Vaccine Update
- Reopening Plan
- Nursing situation news
- Upcoming events
- Fantastic physicians
Since our last update on Wednesday:
- Daily cases continue to come down: 469 new cases of COVID-19 have been identified, including 222 today. The total case count in Manitoba now stands at 53,872.
- Test positivity decreasing: the five-day test positivity rate is 10.6%, down from 11.5%. It is 11% in Winnipeg, down from 12.3%.
- Active cases down: There are 3,490 active COVID-19 cases province-wide, down from 3,786. Of these active cases, 2,164 are variants of concern.
- Hospitalizations remain high: There are 276 people in Manitoba hospitals due to COVID-19, down from 293. This includes 63 COVID-related patients in Manitoba ICUs, down from 67. There are also 30 Manitoba patients in out-of-province ICUs, unchanged from Wednesday.
- Eight new deaths were identified related to COVID-19, including two deaths reported today. The total number of deaths is now 1,089.
Dr. Jazz Atwal, Acting Deputy Chief Provincial Public Health Officer, provided an update today on COVID-19 projection modelling. While he said their COVID-19 surveillance and modelling supports the very cautious easing of restrictions that take effect tomorrow, he also urged people to limit their contacts and take precautions outdoors, including distancing or wearing masks when close.
The key findings from the new projection model include:
- Testing volumes are decreasing, which could suggest less virus is circulating due to restrictions.
- COVID daily case incidence has fallen into a “moderate” zone in their projection model, no longer in the severe or extreme zones and much lower than the “uncontrolled” scenario. The rolling seven-day average is now about 230 cases, having peaked at about 480 on May 22.
- New hospital admissions are starting to decrease, but they are still very high. ICU cases continues to be in an extreme
Dr. Atwal stressed that the ICU situation “is not sustainable.” He explained that “the strain on the health care system continues to be severe. While the numbers seem to have stabilized, the levels are still far too high.” The ratio between diagnosed cases and hospitalizations is continuing to improve as more people are vaccinated, though Dr. Atwal warned that the health system’s capacity could still be threatened by the affect of new variants of concern.
The projection model, which includes over 250 variables, has been updated to include vaccination and the impact of the Alpha variant. However it does not yet include the Gamma (P1) or Delta (B.1.617.2) variants.
The vaccine impact, Dr. Atwal explained, is evident in recent hospitalization statistics. From June 1 to June 6 there were 151 people admitted to hospital with COVID-19. 80% of these individuals were unvaccinated (73%) or had received their first dose less than 14 days ago (7%). Only 2.6% of hospitalizations were fully vaccinated, and none of these individuals needed ICU care.
Message from Dr. Joss Reimer
The following is a message to all physicians from Dr. Joss Reimer, Medical Lead for the provincial Vaccine Implementation Task Force:
I want to provide you with an update, personally, on the next steps for the vaccine rollout in Manitoba.
Over the last several months, the COVID-19 immunization rollout has been focused on speed, getting as many vaccine doses as possible administered. We had hoped doctors’ offices would play a larger role in the earlier rollout, but the changing recommendations for AstraZeneca and unpredictable supply disrupted our plans. I know this left many of you feeling frustrated too.
We are now at a stage where we will shift more vaccine doses away from the super sites and pop-up clinics, and into traditional immunization locations like doctors’ offices. As we move past getting first doses to the vaccine confident, we are encountering more individuals who are hesitant, not in a rush to get immunized, or haven’t been able to attend a larger super site clinic. We know that convenience and trust are absolutely essential to reaching these individuals, and physicians can play an essential role in reaching them.
Over the next few weeks, we will be increasing the supply of mRNA vaccines, both Pfizer and Moderna, to participating medical clinics with bi-weekly ordering. Your feedback, and the advice from Doctors Manitoba, has been instrumental in making this happen.
Thank you to all physicians. Whether you have worked at a super site, offered vaccine in your clinic, or offered patients advice about vaccination, your help has been crucial to get us this far. But there is still a lot of work to do.
We are now at a critical point.
We need to reach more Manitobans with a first dose of the vaccine to protect the population and lift public health restrictions. Your help is essential. It won’t be easy, and some of us may feel discouraged at times by the level of hesitancy we may encounter. Your health expertise is greatly valued by your patients. What might surprise you though is that research has shown that it is physicians’ empathy and not medical expertise that is often the most important driver of vaccine uptake amongst those who are hesitant. Your ongoing relationships with your patients and how you demonstrate over time your mutual goals of their health and well-being cannot be over-valued.
Please know every patient conversation you have helps, and a no today is not a no tomorrow.Sincerely,
Dr. Joss Reimer
We have several vaccine updates for you today.
Second dose eligibility expanded today to include individuals who received their first dose on or before May 6, 2021. We maintain up-to-date eligibility at ManitobaVaccine.ca.
Additionally, all Indigenous people in Manitoba and individuals with specific health conditions are also eligible to book their second dose, as long as they meet the minimum time interval between doses.
Update on mRNA Vaccine in Doctors’ Offices
With news that more Moderna vaccine will arrive in Canada this month, the province may be getting ready to share more vaccine with medical clinics. We are following up, and we hope this means weekly vaccine allocations to clinics will increase.
As clinics get more vaccine, they will be expected to keep their status up-to-date on vaccine finder maps. To ensure you are correctly labeled on both the government and ManitobaVaccine.ca vaccine finder maps, please send an update whenever you have doses, or run out of supply by doing the two following steps:
- Email Doctors Manitoba at firstname.lastname@example.org with your clinic name, location, status change and vaccine product(s) offered (AZ or mRNA)
- Complete the online form to update the government map. You can find the government’s online form here.
Clinics are urged to use their doses within 7 days of delivery, as directed by the government. Your success with using doses quickly will help all clinics get more vaccine supply in the future. If you need help promoting vaccine doses that must be used quickly, please contact us at email@example.com and we can help to publicize the availability. Some clinics have considered half day vaccine clinics to quickly use up doses.
Clinics are reminded to use the correct tariffs for vaccine injections, noting that each vaccine product has a different tariff:
- AstraZeneca: Tariff code 8256 for each dose
- Moderna: Tariff 8252 for each dose
- Pfizer BioNTech: Tariff 8251 for each dose
You can view our guide on vaccine billing here. Tariffs are used not only for remuneration, but also to update individuals’ vaccine records and provincial tracking.
Vaccine Rollout Progress
The one millionth dose of COVID-19 vaccine was administered in Manitoba today. About 68.5% of Manitobans age 12 and up have received their first dose. About 15% have received their second dose.
The Leila super site in Winnipeg (770 Leila Ave) will be allowing walk-in appointments next week for first-dose immunizations. Walk-in hours include:
- June 15 from 9 am to 3:45 pm
- June 16 from 1 pm to 7:45 pm
- June 17 from 9 am to 3:45 pm
Yesterday, the province released its plan to lift restrictions over the next several months, based primarily on achieving vaccination targets. Other indicators, such as COVID surveillance and hospital capacity, are also factored in, but the specific triggers were not part of the plan published publicly.
The plan ties reopening milestones to holidays over the summer, which could be an effective way to blunt the impact holiday gatherings can cause.
The plan includes the following milestones and restriction changes:
|Date||Vaccine Milestone||Possible Restriction Changes|
|Canada Day (Jul 1)||70% of those age 12+ with first dose and 25% of those age 12+ with second dose||Businesses, services and facilities can open at 25% capacity|
|August long weekend (Aug 2)||75% of those age 12+ with first dose and 50% of those age 12+ with second dose||Businesses, services and facilities can open at 50% capacity|
|Labour Day (Sep 6)||80% of those age 12+ with first dose and 75% of those age 12+ with second dose||Businesses, services and facilities can open with limited restrictions in place|
Earlier this week, the Manitoba Nurses Union confirmed that 98% of nurses voted in favour of a strike, with over 11,000 votes cast. We’ve heard from many physicians who are concerned about their nursing colleagues, worried about the nursing shortage, and now anxious about what a strike mandate means.
We don’t know with any certainty what will happen next, but here is what we know so far:
- Any strike or labour action in the health care sector is limited, as an essential service, to limit major disruptions to patient care
- Both MNU and management have expressed a desire to continue negotiating. MNU “remains committed to continuing with collective bargaining in an effort to reach a revised collective agreement” and they may be seeking an arbitrated settlement.
- A strike vote is a necessary step to seek an arbitrated settlement if negotiations are unsuccessful.
Doctors Manitoba has offered public support to nurses, particularly those working in hospitals, through social media and news media. We have heard from critical care specialists who have told us a lack of nurses is a key limiting factor to opening more ICU beds. ER physicians have raised concerns about the vacancy rate for emergency nurses, and they are worried the shortage will affect patient care. Surgeons have identified the nursing shortage as the top barrier to addressing the surgery backlog.
There are a number of webinars this month that may be of interest to physicians, including a PHAC webinar on NACI’s recommendations on vaccine interchangeability and orientation sessions for our mentorship program.
- Mentor Orientation — Mentorship Webinar — Tuesday, June 15, 2021 12 – 1:30 pm
- (NEW) NACI Recommendations on COVID-19 Vaccine Interchangeability (ENGLISH) — Webinar — June 16, 2021 12:30 – 1:30 pm
- Mentor Orientation — Mentorship Webinar (alternate time slot) — Thursday, June 17, 2021 6 – 7:30 pm
- Early Age Onset Colorectal Cancer Virtual Symposium, Thursday, June 17th 2021 1:30 – 6 pm
- (NEW) Webinaire de l’ASPC Recommandations du CCNI sur l’interchangeabilité des vaccins contre la COVID-19 — June 18, 2021 1:00 – 2:00 pm
- Increased Risk Management for Colorectal Cancer — Thursday, June 24, 2021 12 – 1 pm
Manitoba physicians are again attracting local and national recognition!
Dr. Marcia Anderson has been awarded the 2021 Royal College Dr. Thomas Dignan Indigenous Health Award for her system-level work to transform Indigenous health care. Dr. Anderson, a mentor who has held roles as co-chair of the Aboriginal Health Task Group of the Association of Faculties of Medicine of Canada and president of the Indigenous Physicians Association of Canada, is vice-dean, Indigenous Health and the executive director, Indigenous Academic Affairs, at Ongomiizwin, the University of Manitoba’s Indigenous Institute of Health and Healing.
Dr. Gigi Osler was awarded the 2021 May Cohen Equity, Diversity and Gender Award from the Association of Faculties of Medicine of Canada (AFMC) for her work developing CMA’s first ever policy on equity and diversity in medicine while she was CMA President in 2018 – 19. Dr. Osler is the third Manitoban to be recognized since it was first awarded in 2003. Dr. Catherine Cook (2011) and Dr. Bruce Martin (2017) both received the award as well.
Dr. Melanie Morris, an Indigenous pediatric surgeon, received the 2021 Pediatric Chairs of Canada Emerging Academic Leader Award. She is leading the transformation of the Children’s Hospital into a culturally safe space for Indigenous children and their families. She has done extensive work in outreach clinics in Northern Manitoba, is a fellow of the Royal College of Physicians and Surgeons of Canada and a standing member of the Indigenous Physicians Association of Canada.
Dr. Eric Sigurdson has been awarded the Manitoba Psychiatric Associations’ first annual Maimonides Award for Scholarly Contributions to the Humanities in Psychiatry for his commitment and contribution to the specialty of Psychiatry and the larger field of Mental Health. Dr. Sigurdson is a Child and Adolescent Psychiatrist working at the Health Sciences Center. He is a past president of the Manitoba Psychiatric Association, past president of the College of Physicians and Surgeons of Manitoba (CPSM) and continues to serve on the executive of the CPSM. He is also the author of two children’s books: Baba’s Red Talking Chair and Afi’s Silver Pocket Watch.
If you know of a physician or medical learner who has been recognized with an award or honour, please let us know by emailing firstname.lastname@example.org!