Situation Update

COVID-19 Surveillance Update

Since our update on Friday:

• Another 242 new cases of COVID-19 have been identified, including 77 today. This brings the total case count in Manitoba to 34,052.
• Test positivity down: The five-day test positivity rate is 4.3%, down slightly from 4.4%. It is 3.5% in Winnipeg, down slightly from 3.6%.
• Active cases up: There are 1,197 active COVID-19 cases province-wide, up slightly from 1,169.
• There are 150 people in hospital, up from 142 . This includes 31 people in ICU.
• Two new deaths related to COVID-19 were identified, though there were no new reported deaths today. The total number of deaths is 934.

Manitoba has broadened how it is counting variant of concern cases. Previously, only confirmed sequenced cases were reported after the sophisticated follow-up testing was complete. The province will now report screened cases too. This change resulted in a jump in cases largely driven by the inclusion of screened cases. This approach added 136 new variant of concern screened or sequenced cases yesterday, and 11 more today. Overall there have been a total of 250 screened or sequenced variant of concern cases, including:

• 199 of the B.1.1.7 variant (UK)
• 14 of the B.1.351 variant (South Africa)
• 37 cases that have not yet been categorized

Earlier, public health officials confirmed variant cases make up about one third of new cases in Manitoba, and expect this to rise. Expanded case and contact isolation and tracing efforts are in place to help slow the spread.

Vaccine Situation Update

• 178,281 doses have been administered, up from 157,399 on Friday.
• 11.4% of Manitoba adults have received their first vaccination, up from 9.9% on Friday.
• Eligibility was expanded yesterday to age 64 and older, or 44 and older among First Nations people. Those with high-risk medical conditions, age 55 – 64, continue to be eligible at a medical clinic or pharmacy. There are still a few locations that are reporting having doses available.
• More pop-up clinics have been planned for April in a number of rural communities.

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.

Recommendations to Improve Vaccine Rollout

Today, we submitted a report to the provincial government about physicians’ roles in the immunization rollout so far, and the potential for physicians to help more going forward.

A few weeks ago, dozens of clinics and pharmacies received a small number of doses from the initial shipment of AstraZeneca Covishield as part of a provincial pilot project. We conducted a survey of those clinics and incorporated other feedback we’ve received from physicians and the public into a report, which recognizes what has worked well and what can be improved.

Overall, we heard positive feedback about the provincial registration process, delivery of vaccines and supplies, and the use of physicians to target scarce vaccine resources to those most at risk.

We also identified opportunities to improve the rollout, better support Manitobans, and address vaccine hesitancy. 

We include seven recommendations, including improving communications with physicians about the vaccine, addressing issues with vaccine eligibility, and increasing the supply of vaccine to medical clinics. This recognizes the role physicians can play in addressing vaccine hesitancy. We also recommend offering mRNA vaccines through medical clinics and using doctor’s offices to serve as pop-up clinic locations in some communities.

You can review the full report here. Provincial officials have been receptive to the report and recommendations, and we look forward to a more formal response from them soon.

Responding to Patient Concerns About AstraZeneca

Yesterday, we provided a technical update about the latest change to guidance on using the AstraZeneca vaccine, following rare reports of ​“vaccine-induced prothrombotic immune thrombocytopenia” or VIPIT. 

We’ve heard from many physicians today, fielding calls from patients whose confidence in this vaccine has been shaken by this latest development. Physicians are a trusted source of information, and Doctors Manitoba is here to support you in preserving the trust you’ve built with your patients. Below you will find a sample of key messages to use with patients, and some common questions and answers you might expect. These were developed with a group of physicians and vaccine hesitancy experts. We recommend physicians consider reaching out to patients under 55 who received the vaccine in your clinic. Proactive follow up will help to maintain and strengthen your patients’ trust in you as their physician. You might even consider following up with patients over 55 too.

Key Messages for Use With Patients (key phrases in bold and italics)

• I know it’s concerning to hear the recommendations change for a new vaccine, and it’s natural to feel worried about this.
• As your physician, I will be open and transparent with you about what we know, and why we still trust the safety and effectiveness of this vaccine.
• On March 29, the use of AstraZeneca was paused in Canada for those under the age of 55. This vaccine has not been declared unsafe.
• This is as a precautionary step to allow regulators to investigate a very rare potential issue that has emerged in Europe.
• A very small number of younger people in Europe developed a rare type of blood clot after receiving the AstraZeneca vaccine. When we say very rare, we mean one to four in a million. This is similar to your odds of getting struck by lightning.
• There have been no blood clot issues identified in Canada following vaccination with the AstraZeneca vaccine, or any other COVID vaccine.
• The blood clot condition is treatable, and the issue is similar to a very rare side effect for people who take Heparin, a blood thinner medication.
• It is very possible these recommendations will change again, as the issue is investigated and more is learned.
• While changes like this can leave us feeling uncertain, they demonstrate just how cautious the approach is to vaccine safety monitoring in Canada. Even very rare potential issues identified on another continent lead to a cautious response here in Canada. This is why I trust the Canadian vaccine approval and monitoring system.

Additional messages – patients 55 and over

• The AstraZeneca vaccine is still considered safe and highly effective for you. It is still recommended by medical experts and regulators in Canada and countries around the world, and I still recommend it.
• The very rare, potential blood clot issue identified in Europe seemed to happen in much younger adults. That’s why this vaccine was not paused for those age 55 and over. 

Additional messages – patients under 55 who received the vaccine

• It can be very concerning to hear news reports about safety issues for a vaccine you just received.
• I want to reassure you that the chances of you having this side effect are extremely rare.
• There have been no reports of this blood clot issue in Canada.
• The change happened because of a very small number of cases reported in Europe. This could be less than one to four in a million, similar to your odds of getting struck by lightning.
• The condition is treatable, and is similar to a very rare side effect seen in people who take Heparin, a blood thinner drug.
• Symptoms are similar to a stroke or heart attack and seem to show up 4 to 20 days after you received the shot. If you see any of these symptoms, seek medical attention quickly and let them know you received the AstraZeneca vaccine.

What do I do for my second dose of vaccine?

• It will still be important for you to a get a second dose of the vaccine to be fully vaccinated.
• Your second dose is not needed for up to 16 weeks after your first dose (likely late June or early July).
• More will be known by then following the investigations and we will have more complete information to advise you about your second dose. Until then, as your physician, I am here for you for any questions you might have.

It’s important now, more than ever, to be empathetic and responsive to your patients’ concerns about the vaccines. You can see more tips in our Guide to Vaccine Hesitancy.

More Patient Q&A’s Added to Man​i​to​baVac​cine​.ca

Yesterday, we added answers to common vaccine questions from the public on our vaccine hub, Man​i​to​baVac​cine​.ca.

We’ve received thousands of questions from the public, through the website, social media and from physicians. Answers posted to Man​i​to​baVac​cine​.ca respond to questions about the safety and effectiveness of the new vaccines, as well as personal health situations and eligibility status. All of the questions were carefully reviewed, and a team of physicians developed answers to over 30 of the most common inquiries.

“Hundreds of thousands of people have visited our site for reliable information from physicians about the COVID-19 vaccines,” added Dr. Cory Baillie, President of Doctors Manitoba. ​“Some people want to learn more about the vaccines, while others just want to know when they will be eligible and to get notified when it’s their turn.”

Since launching four weeks ago, over 153,000 people have checked when they will be eligible for a COVID-19 vaccine at Man​i​to​baVac​cine​.ca. In addition to estimating when individuals can get the vaccine, the Doctors Manitoba service offers same-day eligibility notifications by email or text with up-to-date information about where to book an immunization appointment when it’s your turn. Family members or loved ones can also be signed up.

Our new vaccine resources received broad media coverage yesterday, including on CTV and the Winnipeg Free Press.

To view previous updates, click here.