Situation Update

Eased Restrictions

Vaccine Updates

Town Hall Success

Surgery Backlog Update

Physician Audits

Fantastic Physician Friday

Situation Update

COVID-19 Surveillance

Since our last update on Wednesday:

  • Daily cases continue to come down: 188 new cases of COVID-19 have been identified since Wednesday, including 85 today. The total case count in Manitoba now stands at 55,777.
  • Test positivity continuing to decline: the five-day test positivity rate is 5.9%, down from 7.1%. It is 6.5% in Winnipeg, down from 6.6%.
  • Active cases continue on a downward trend: There are 1,635 active COVID-19 cases province-wide, down from 1,789.
  • Hospitalizations are coming down: There are 185 people in Manitoba hospitals due to COVID-19, down from 209 . This includes 54 COVID-related patients in Manitoba ICUs, down from 57 on Wednesday. There are also 12 Manitoba patients in out-of-province ICUs, down from 13
  • Three more people have died from COVID-19, including one today. The total of COVID-19 related deaths to 1,135.

You can view explore surveillance indicators and trends on the government’s COVID-19 dashboard.

Eased Restrictions and Change to Orange Status

Tomorrow, a new set of public health orders take effect with eased restrictions. You can see a summary of the changes in our update from Wednesday.

The new public health orders are now posted online. The orders offer more detail, such as requiring restaurants to close for indoor dining by 10pm, requiring food to be served with alcohol, no dancing in licensed premises, and requiring mask wearing in gyms. 

Today, public health confirmed that the changes also mean that Manitoba’s status on the Pandemic Response System will be decreased from Red (critical) to Orange (restricted). This level recognizes that community transmission is occurring, but the virus is being transmitted at levels the public health and health system can manage. Dr. Atwal, in announcing the change, acknowledged that hospital capacity is still under strain and urged Manitobans to follow public health precautions to avoid increases in spread. 

The change to Orange status does not change visitor access to PCHs or hospitals.

New PHAC Guidance for Fully Immunized

The Public Health Agency of Canada released guidance today for different situations for unvaccinated, partially vaccinated and fully vaccinated people. Individuals still have to follow local public health guidelines.

The guidelines focus primarily on precautions that should be taken by unvaccinated, partially vaccinated and fully vaccinated individuals in different social situations.

For fully vaccinated individuals:

  • For outdoor gatherings, masks and physical distancing are not required.
  • For indoor gatherings, masks and physical distancing are not required when gathering with other fully vaccinated individuals. For indoor gatherings with other households where people are not fully vaccinated, masking is suggested for people at risk of more severe disease. 
  • For large indoor gatherings where physical distancing isn’t possible, masks should be considered. 

For partially or unvaccinated individuals:

  • For outdoor gatherings, consider wearing a mask if physical distancing cannot be maintained, unless everyone else is fully vaccinated.
  • For indoor gatherings, masks and physical distancing are strongly recommended. If everyone else is fully vaccinated, however, masks and physical distancing may not be needed if everyone is comfortable with this. 
  • For large indoor or outdoor gatherings where physical distancing isn’t possible, masks are strongly recommended, and people are urged to maintain physical distancing whenever possible. 

For indoor gatherings, hosts are encouraged to keep windows and doors open when possible to improve ventilation.
You can view the full guidelines from PHAC here.

Vaccine Updates

Everyone is now eligible for their second dose, as long a it has been 28 days after their first dose. Second dose eligibility, which delayed second dosing, had been in place for several months because of limited supply of vaccines. With Moderna arriving in much larger quantities, there is no longer a need for second dose eligibility limits. 

Medical clinics will be receiving increasing volumes of vaccines in the next few weeks. There are now over 20 medical clinics accepting appointments, listed on our Vaccine Finder, including some offering AstraZeneca second doses.

Doctors who want to begin offering vaccine can still sign up.

Allergy Assessment Referrals

If a patient you have seen has had an allergic reaction to a COVID-19 vaccine, it is recommended to request a referral for allergy assessment for guidance on future doses of the vaccine by faxing a referral request to the Allergy Clinic of Health Sciences Center at (204) 9402223. Please include the following information in the referral request:

  • Brand of COVID-19 vaccine
  • 1st or 2nd dose 
  • Details of the reaction

You should also report the reaction as an adverse event following immunization (AEFI) within 7 days.

Town Hall Success!

This week, we held our first every online public town halls. Thousands of Manitobans have watched, with physicians responding to questions and concerns about the vaccines.

Recordings of all four town halls are now available to watch anytime, on demand.

If you are interested in planning a town hall for a specific community or group, Doctors Manitoba would like to help! Send us an email at covid19@​doctorsmanitoba.​ca.

In addition to questions about vaccine development, safety, effectiveness, and access, the panels tackled common concerns circulating right now in different communities:

  • Questions about potential alternative treatments, such as the anti-parasite drug ivermectin, were addressed in detail. The doctors indicated they would gladly adopt existing drugs to help prevent and treat COVID-19, but they can only do this if and when the scientific evidence indicates it is safe and beneficial. You can read a summary here.
  • Concerns about the vaccines causing myocarditis in younger people, an inflammation of the heart, were also covered. The doctors indicated that it’s not clear yet if the vaccine can cause this, but even if there is a link the side effect is incredibly rare (12.6 cases per million), symptoms are usually mild, and it is treatable. The risks posed by a COVID-19 infection are much greater. You can read more about this issue here.
  • Rumours that the World Health Organization has advised children (under age 18) should not be vaccinated, noting the advice was taken out of context, is now outdated, and the WHO has noted that the Pfizer vaccine is suitable for age 12 and up. There is more background on this issue here.
  • The panelists responded to a theory raised recently by a scientist about the vaccine causing harm to internal organs. Watch a thoughtful response here from Dr. Curtis Krahn, who took the concern seriously, reviewed the theory and the responses to it in detail, and ultimately concluded that the theory is not bearing out to be true in the real world with over 2.7 billion doses of the vaccines administered so far.

We had a remarkable group of physicians participate, and we want to recognize and thank them all: Dr. Don Klassen, Dr. Kevin Convery, Dr. Kaytey Martin, Dr. Joss Reimer, Dr. Ruth Grimes, Dr. William Li, Dr. Marni Hanna, Dr. Jared Bullard, Dr. Gigi Osler, Dr. Alex Singer, Dr. Jennifer Potter, Dr. Amila Heendeniya, Dr. Vanessa Poliquin, Dr. Chrystyna Kalicisnky, Dr. Curtis Krahn, Dr. José François, Dr. Jayson Barkman, and Dr. Chris Burnett.

Surgery Backlog Update

Last week, we released a major report on the surgical and diagnostic backlog in Manitoba. This has been a top priority for Doctors Manitoba because it has been a top concern for physicians – not only for surgeons and radiologists, but also for referring physicians who are watching their patients wait longer for care.

Since the release, we have had a lot of interest in the report, the concerns we raise, and the recommendations to start addressing the backlog with urgency. In addition to widespread media coverage, the CMA has requested a copy as they look at the issue nationally. 

Perhaps the most important update, however, is that our President Dr. Kristjan Thompson and CEO Theresa Oswald met with acting Health Minister Kelvin Goertzen just days after we submitted to report. They discussed the issue in detail and how to move forward. The Minister shared physicians’ concern about the staggering size of the backlog and did not dispute our findings. There was a genuine agreement to work together on addressing the issue, and an openness to government setting a target to fully address the backlog. Dr. Thompson emphasized the need for strong, continued oversight on addressing the backlog, with the ongoing involvement of and engagement with front line physicians. 

You can see a summary of the report and recommendations, and access the full report, here.

Getting audited? Call us first

We continue to monitor physician billing audits, now conducted by the Comptrollership and Compliance Unit within the Department of Finance. These audits usually begin with an audit letter” sent to the physician advising that there is some concern/​interest in a particular aspect of the physician’s billing. The physician is asked to provide the auditor with access to copies of selected patient charts, and sometimes also with copies of day sheets, appointment books, etc. There is generally a 30 day time limit to respond.

If you receive an audit letter, please let us know. We can offer advice on your response, and we will assist you should the matter go any further. Your contact also helps us to monitor the practice areas and billing profiles of physicians being selected for audits.

Please contact Allison Crolly acrolly@​doctorsmanitoba.​ca (204) 9855856 or Andrew Swan aswan@​doctorsmanitoba.​ca (204) 9855860 if you receive an audit letter.

Fantastic Physician Friday

Another week, and more physicians have been recognized with distinguished honours! 

Dr. Harsahil Singh was one of the 2021 CCPE Recipients. The Canadian Certified Physician Executive (CCPE) credential recognizes and advances physician leadership and excellence through a national, peer-generated, standards-based assessment process. Recently named the Chief Medical Officer for the Northern Regional Health Authority, Dr. Singh is also the Medical Director of Primary Care Clinics, and was the Physician Champion for NHR with the Physician Health and Wellness Community of Practice Project. 

Dr. Catherine Cook was awarded the 2021 Indspire Award for Health. The Indspire Awards represent the highest honour the Indigenous community bestows on its people. One of the first Métis female physicians in Canada, Dr. Cook advocates for Indigenous health, working at both the University of Manitoba and in the health care system. She dedicates time to mentor Indigenous medical students and in her many advisory roles on different committees, councils and boards and was just recently named Vice-President (Indigenous) at the University of Manitoba.

If you know of a physician or medical learner who has received an award or has been recognized with an honour, let us know by emailing Jody at jsie@​doctorsmanitoba.​ca.

To view previous updates, click here.