In today’s message you can find:

• Covid-19 Situation and Hospital Update
• Slight Restriction Changes
• Covid-19 Vaccine Update
• Vaccine Immunization Card
• Vaccine Lottery announced to encourage uptake
• Another letter of support from a student in 5/6 class at Inkster School
  

Situation Update

Since our last update on Monday:

• Daily cases continue to come down: 484 new cases of COVID-19 have been identified, including 250 today. The total case count in Manitoba now stands at 53,403.
• Test positivity: the five-day test positivity rate is 11.5%, down from 11.9%. It is 12.3% in Winnipeg, down from 12.7%.
• Active cases down slightly: There are 3,786 active COVID-19 cases province-wide, down from 3,962.
• Hospitalizations remain high: There are 293 people in Manitoba hospitals due to COVID-19, down from 308. This includes 67 COVID-related patients in Manitoba ICUs, up from 66. There are also 30 Manitoba patients in out-of-province ICUs, down from 36, for a total of 97 Manitoban COVID-19 patients in ICUs, down from 103.
• Four new deaths were identified related to COVID-19, including two deaths reported today. The total number of deaths is now 1,081.

Variant of Concern Update

While the Alpha variant of concern (B.1.1.7 first identified in the UK) is still the dominant variant in Manitoba, an increase in the Delta variant (B.1.617.2 first identified in India) has also been noted. A total of 59 cases of the Delta variant have been identified in Manitoba.

The Delta variant is considered more transmissible and more serious than the Alpha variant, and original ​“wild” strain of COVID-19. Research from the UK, where Delta is leading to an increase in cases, has found that two doses of the vaccine are still effective against this variant, with 88% effectiveness against symptomatic disease compared to 93% for the Alpha variant. Single doses are less effective than two generally, but that appears to be especially true against the Delta variant with only 33% effectiveness against symptomatic disease. 

Hospital Update

There are 151 Manitoba patients in ICUs today. This includes 121 in Manitoba ICUs and 30 out of province, including 27 in Ontario, 2 in Alberta and 1 in Saskatchewan. Of these, 97 are COVID-related patients, including 67 in Manitoba and 30 out of province. 

Normal ICU capacity in Manitoba is 72, after the consolidation of hospital services in Winnipeg. 

No patients have been transferred out of province since June 4 for critical care. 

The situation, however, continues to affect surgery with significant slow downs in place in many hospitals. Two cardiac cases were transferred out of province for surgery last week, and today Shared Health confirmed additional patients may be sent out of province for surgery. 

Restriction Changes and Physician Views

Dr. Brent Roussin provided an update today, noting that COVID-19 case numbers are starting to decrease, but emphasized that ICU numbers are still very high. This means a very cautious approach to restriction changes is required, and the current situation allows Manitoba to ​“slowly ease” some public health orders, beginning with small outdoor gatherings. 

A new set of public health orders start on Saturday, June 12 at 12:01 a.m. and include provisions for outdoor gatherings with up to five people in public spaces and on private property:

• Outdoor gatherings in public places can include up to five people
• Outdoor gatherings on private property can include up to five people from up to two different households, in addition to those who reside at the hosting household.

All other restrictions remain in place for now, including no indoor gatherings, no indoor or patio dining, very limited retail capacity, no personal services, and requiring employers to let staff work from home if possible. 

Physician Views on Restrictions

We submitted physicians’ views on restrictions to the province, based on feedback received earlier this week from over 500 doctors. This feedback found that:

• 80% of physicians believe restrictions are appropriate and/​or should be cautiously eased. 10% believe restrictions should be tighter.
• There was strong support for outdoor gatherings in public places and private property.
• Physicians were also concerned about youth, many of whom have been stuck in remote learning, wanting to see youth organized sports and summer day camps prioritized in the weeks ahead. 

When it comes to privileges for the fully vaccinated, 90% of physicians support this approach, with many explaining this will help to support vaccine uptake while reducing mental health and isolation issues. Some physicians raised ethical and practical compliance concerns, with 8% disagreeing with the approach. 

So far, over 99% of physicians have been vaccinated, with 92% fully immunized and another 7.4% partially vaccinated at this point. This is a significant signal of the trust and confidence physicians have in the COVID-19 vaccines. 

You can view a full summary of our survey results here, which was submitted to provincial officials.

The views of physicians are not dissimilar from public opinion about restrictions. In a public survey administered by the province, which included over 33,000 responses, 93 per cent said the ability to gather with friends and family outdoors on private property would improve their quality of life significantly. Additionally, 85 per cent indicated the ability to gather with friends and family in outdoor public places would improve their quality of life. The public survey report can be found here.

Vaccine Updates

Eligibility has expanded for second doses, to those who received their first dose on or before May 4. We are maintaining up-to-date eligibility and access information at Man​i​to​baVac​cine​.ca.

Manitoba hit a new milestone today, with 70% of adults now vaccinated with 1^st dose. 

Mixed Second Dose Updates

For patients who received AstraZeneca for a first dose, the province continues to recommend an mRNA vaccine for their second dose. While all vaccines are considered safe, the mRNA vaccines are considered safer and their supply is much more robust in Canada. 

A solution is being put into place for patients who want AstraZeneca for their second dose, possibly because of serious allergies to ingredients in mRNA vaccines.

For these patients, a second dose of AstraZeneca will require:

• Being assessed by a health care provider who can advise them of the comparative benefits and risks of AstraZeneca and mRNA vaccines
• Meeting the AstraZeneca vaccine eligibility (anyone who received a first dose in Manitoba should still be eligible)

To meet this need, Manitoba has requested an additional 7,500 doses from the federal government. Clinics and pharmacies are being surveyed right now to gauge their interest in serving as a regional AZ hub for these patients.

Moderna and Pfizer Interchangeable?

The Moderna and Pfizer mRNA vaccines are considered equivalent, and both are safe and effective. While it is recommended that people receive the same mRNA vaccine for their first and second doses where possible, the public is encouraged to take either for their second dose if they would otherwise face a delay to get the same vaccine product. 

When the same vaccine is not readily available, individuals can book an appointment for either Pfizer or Moderna as the second dose. 

This interchangeability applies to adults only, as youth (age 12 to 17) only have Pfizer as a vaccine option right now.

mRNA Vaccine in Medical Clinics

The province has started rolling out bi-weekly deliveries to medical clinics and pharmacies. Last week, 23 pharmacies and clinics received vaccine supplies.

Going forward, all of the nearly 500 clinic and pharmacy locations are split into two groups, with group A and group B ordering on alternating weeks. Orders are due on Wednesdays, with allocation details shared on Friday, and deliveries starting as early as the following Wednesday. 

This week, 6,000 doses of Moderna will be delivered to 125 clinics and pharmacies. Participating physicians are reminded to use their allocated doses within 7 days. Your ability to use doses quickly will judge the success of this model, and we anticipate will result in larger vaccine allocations to clinics in the coming weeks. 

New Research on Vaccines

A study out of Alberta that looked at the population who had received one and two doses has further validated the effectiveness of the vaccines in real-world settings. Looking at data from January 1, 2021, the public health update found:

• The vast majority of cases, hospitalizations and deaths occurred among people who were unvaccinated or diagnosed within two weeks of receiving their first dose:
  • 96% of cases
  • 93% of hospitalized cases
  • 88% of deaths

• The Pfizer vaccine is 73% effective after the first dose, and 90% effective after the second dose. The Moderna vaccine is 82% effective after one dose and 93% effective after the second dose. 
• The analysis also reports strong effectiveness against the Alpha (B.1.1.7) and Gamma (P1 originally found in Brazil) variants. 

A summary published in Nature also reinforces the effectiveness of the COVID-19 vaccines in real-world settings, now that over 1.7 billion doses have been administered worldwide. Studies in Israel, Russia and the UK have found very strong protection from vaccines against COVID-19. The authors are also optimistic about how long immunity could last, using natural immunity as a guide. Some studies are finding immunity is lasting as long as over year. As this is a new disease, immunity beyond this point is still difficult to determine. 

Immunization Cards

Manitobans who have been fully immunized can now apply for secure immunization cards, a first among Canadian provinces.

Two weeks after a second dose of the vaccine, individuals who have a Manitoba Health Card can apply for the digital and physical card online through the new online portal. The card, which will carry no personal health information and will have a QR code for scanning, will allow the carrier to avoid self-isolation upon return to Manitoba from domestic travel and give fully immunized individuals visitation privileges to health care facilities if both patient/​resident and the visitor of are fully immunized.

Other benefits to being fully vaccinated are expected to be announced in the coming weeks. Access to the digital card will be immediate and the physical card will arrive in the mail within 14 days. Those without internet access can call the Manitoba Health and Seniors Care at 204−786−7101 or 1−800−392−1207 (toll-free) to request a card.

If you or a patient received a dose outside of Manitoba, public health officials will upload this information in Manitoba, which will be reflected in provincial. Individuals immunized outside of Manitoba can now contact covidimmunizationrecordsinformation@​gov.​mb.​ca to update that information. This email address can also be used to request other updates or corrections to a COVID-19 immunization. Individuals may also contact their local public health office with out-of-province vaccine documentation if needed. 

Lottery for Vaccinated Manitobans

The government announced today that all vaccinated Manitobans aged 12 & up will be entered into a vaccine lottery, which will award a total of $2M in cash or scholarships to those who choose to be vaccinated. Manitobans 12+ who get their first dose of the vaccine by Aug. 2 will be eligible for the first draw and those who get their second dose before September 6 will be eligible for the 2^nd draw. Anyone immunized by these deadlines will automatically be entered. 

Each draw (August 2 and September 6 cutoff) will award:

• three prizes of $100,000 in the WRHA (excluding Churchill)
• one prize of $100,000 for each of the other four regional health authorities (Churchill will be included in the NHR lottery)
• 10 scholarships worth $25,000 each for Manitobans aged 12 – 17 across the province. 

Dr. Joss Reimer explained today that a lottery is different than an individual cash incentive to induce vaccination. While cash incentives could be seen as a bribe or unfair way for government to coerce people into vaccination, a lottery, can create excitement with just an opportunity to win. The lottery approach has been used elsewhere, such as in Ohio where officials claim it has increased vaccine uptake.

A Letter of Support

Here is another heartfelt letter from a student in Ms. Mcgregor’s Grade 5/6 class at Inkster school in Winnipeg.