In today’s message you will find:

Situation Update

Since our last update on Friday:

  • Daily cases up: Another 1,390 new cases of COVID-19 have been identified over the last three days, including 430 today. The total case count in Manitoba now stands at 44,189.
  • Test positivity steady: The five-day test positivity rate is 12.7%, up from 11.8%. It is 14.3% in Winnipeg, up from 14.2%.
  • Active cases up: There are 4,568 active COVID-19 cases province-wide, up from our last report of 4,163.
  • Hospitalizations increasing: There are 265 people in hospital due to COVID-19, up from 239. This includes 73 people in ICU, up from 67.
  • Nine new deaths related to COVID-19 were identified, including one reported today. The total number of deaths is now 1,011.

Dr. Brent Roussin noted that it usually takes about two weeks to see the full benefit of public health restrictions, and we’re only about one week into the latest public health orders.
Manitoba now has the highest rate of new cases per capita across the country, at 232 per 100,000 people over the last seven days. Dr. Roussin noted that our third wave is peaking later in Manitoba than other provinces, which are now declining. Alberta, which had been the highest in Canada, peaked at a rate of 325 earlier in May.

Vaccine Updates and Q&A

Manitoba has surpassed the 50% threshold on the proportion of adults who have received at least one dose. As of today, 52.3% of adults have been vaccinated and over 650,000 doses have been administered.
All individuals age 12 and over are now eligible for their first dose. Earlier today, the next available appointment at super site locations ranged from May 23 to June 8:

  • Winnipeg (RBC Convention Centre): June 8
  • Winnipeg (Leila Soccer Complex): May 24
  • Brandon: June 1
  • Thompson: May 26
  • Selkirk: May 31
  • Morden: June 5
  • Gimli: June 3
  • Dauphin: May 23
  • Steinbach: June 2

Second dose booking are still expected to start May 22

What about AstraZeneca second doses?

Most doses of this vaccine should now be held for second-dose immunizations only, so people who have received their first dose of this vaccine will be able to receive their second dose within the recommended time frames. Public health officials are also monitoring the evidence to determine whether different types of vaccines can be used for second doses. Remaining doses of AstraZeneca should only be used for first doses with people who might not otherwise be immunized at other sites.” 

Will Doctors’ Offices Get more mRNA Vaccine?

After we recommended the option to the province, a pilot was successfully run with six medical clinics. The clinics involved and the provincial vaccine task force officials all agreed the pilot was very successful, though there is room for improvement on providing clinics with more notice. We are continuing to push for this pilot to be expanded, and we anticipate the province will allocate more Moderna vaccine to medical clinics as more supply becomes available. This could happen as early as June. 

Are the vaccines having an impact?

The short answer, is yes. But with our high daily case counts and hospital situation, it’s a fair question many of your patients may be asking right now. 

Real-world studies from England, Scotland and the US have found that just one dose of vaccine can be 70 – 90% effective at preventing COVID-19 symptoms or hospitalizations. A second dose is still required to get stronger protection, but this is very encouraging. 

In Manitoba, an analysis a few weeks ago found that out of 481,119 Manitobans with one vaccine dose, only 410 contracted COVID-19 more than two weeks after that dose. That’s an infection rate of 0.09 per cent. 26 of those 481,119 were hospitalized and 7 died, all over age 65.

Today, Dr. Roussin emphasized that we are seeing the biggest impact in PCHs where outbreaks have dropped significantly, and also among older Manitobans where we see very high vaccine uptake and decreasing positive cases and hospitalizations.

However, it is also important to ensure your patients don’t feel immune and abandon taking the standard precautions. Shared Health reported today that among the approximate 300 patients admitted to ICU since January 1, 34 had received their first dose of vaccine and these patients were admitted within 3 weeks of their shot. 

Hospital Capacity

Shared Health Chief Nursing Officer, Lanette Siragusa, provided an update on hospital capacity today, noting that Manitoba’s health care system continues to be stretched.”

There are 120 patients in ICUs today, and 73 of these are linked to COVID-19. The regular baseline ICU capacity in Manitoba is 72. The surge in admissions, beyond what was projected in Manitoba’s worst case” scenario, is again resulting in surgery cancellations, adding to a backlog that was already over 16,000 cases. About 100 surgery staff, including 82 nurses, have been redeployed to support the COVID response. Medicine units are at 82% capacity. 

Children’s ER is now accepting patients who are age 17 to 19 to help support adult ERs. So far, 27 additional patients (56 per day) have been diverted to Children’s ER.

Shared Health says they are recruiting more nurses to help address the backlog, with 28 nurses half way through an intensive two-week orientation. Another 14 nurses start the orientation today. Ms. Siragusa also recognized physicians stepping up to cover more shifts, and encouraged staff or physicians with concerns to raise them internally: we want to hear from you,” she said.

While we encourage physicians to continue raising their concerns, we know it’s not always easy or comfortable to do this internally with confidence that your feedback will reach those making the decisions. We have launched a brief survey with critical care and emergency physicians today so we can continue to escalate their concerns with provincial officials and advocate for more action and support. 

As always, please contact us directly with concerns or feedback at covid19@​doctorsmanitoba.​ca.

Presumed Consent for Organ Donation

The Manitoba Law Reform Commission has launched a consultation process to recommend changes to Manitoba’s laws respecting organ donation. Nova Scotia recently changed its laws to presume consent for organ donation after death, following several European countries. Several other provinces are now considering similar legislation. You can find the consultation document online. Interested members are encouraged to provide feedback directly to the Law Reform Commission by July 302021.

Upcoming Events

There are a number of webinars coming up that you may be interested in, including about vaccine hesitancy, mental health during the pandemic, safe patient communications, and our Urban Locum Pilot Program.

May 19: Vaccine Hesitancy Webinar (PHAC)

The Public Health Agency of Canada (PHAC) and the National Collaborating Centre for Infectious Diseases (NCCID) are hosting a webinar to inform health care providers on addressing COVID-19 vaccine hesitancy in clinical practice. The session is moderated by Manitoba’s own Dr. Yoav Keyman, with other experts joining the panel from across Canada. A french panel will be held on May 20.

May 20: Urban Locum Information Session (Doctors Manitoba)

Research has shown that not taking time away from practice contributes significantly to physician stress and burnout. Now, there’s one more option to help physicians get time away while ensuring coverage for their patients. Learn more about the new Urban Locum Program and how you can register to become a locum provider or access the services of a locum. Participants will also learn more about the Rural and Northern Locum Program.

May 26: Is it safe to ask YOU? (MIPS)

This webinar from the Manitoba Institute for Patient Safety will focus on making patient communications safer and more effective. There are many factors as to why communication can be complicated between physicians and patients, this is why there is always room for improvement. Understanding these reasons better can transform a physicians daily practice and patients’ lives. 

June 6: Mental Health in a Pandemic (Part 1)

The University of Toronto, Department of Psychiatry, and Disaster Psychiatry Canada have developed this CME opportunities to explore different tools and tactics that can help both physicians and the patients they care for deal with the mental health impact of the pandemic. This session focuses preventing and managing traumatic stress related disorders applied to the pandemic and practicing psychological first aid among other topics. 

June 11: Mental Health in a Pandemic (Part 2)

This second part in the series will focus on prolonged grief, inequities in disaster response, the use of virtual care and exploring disaster psychiatry training. This initiative is developed by the University of Toronto, Department of Psychiatry, and Disaster Psychiatry Canada. This session focuses preventing and managing traumatic stress related disorders applied to the pandemic and practicing psychological first aid among other topics.