COVID-19 Update-May 5, 2021
In today’s update you find information about the following
Since our last update on Monday, most COVID surveillance indicators have held steady or increased:
- Daily cases up: Another 561 new cases of COVID-19 have been identified, including 272 today. This brings the total case count in Manitoba to 40,085.
- Test positivity up: The five-day test positivity rate is 8.8%, up from 8.0%. It is 9.2% in Winnipeg, up from 8.7%.
- Active cases up: There are 2,780 active COVID-19 cases province-wide, up from our last report of 2,593.
- Hospitalizations increasing: There are 184 people in hospital due to COVID-19, up from 178. This includes 47 people in ICU, up from 45.
- Three new deaths related to COVID-19 were identified, including two reported today. The total number of deaths is 982.
Public health is now operating under the assumption that all new cases are variants of concern, now that they dominate new cases in the province, in particular the B.1.1.7 variant originally found in the UK. The total number of cases involving variants of concern has grown to 2,789, up 694 from Friday, with 956 of these cases still considered active.
A few updates today from the Vaccine Implementation Task Force, including to eligibility, vaccine approvals for youth, and the provincial vaccine rollout plans.
General eligibility expanded today to age 45 and up for government-run vaccine clinics. More community “hot spots” were added yesterday, which means all adults (age 18+) who live in these designated communities, or work in specific public-facing jobs, are eligible at government run clinics, or in a doctor’s office if they meet AstraZeneca criteria. The new “hot spot” communities include:
- River East (Elmwood / Chalmers)
- St. Vital North (North of Bishop Grandin)
- Seven Oaks East (Garden City, West Kildonan, North Main)
Several other communities were designated earlier, including other areas in Winnipeg, Brandon, Powerview/Pine Falls and Northern Manitoba. You can see the full list of communities here.
In doctors’ offices, the criteria remains unchanged. Those age 40 – 45, as well as those age 30 – 39 with high risk conditions, continue to be eligible for AstraZeneca in doctors’ offices and other community locations.
Health Canada Approves Pfizer for Age 12+
Health Canada expanded its approval for Pfizer today to ages 12 and older. Clinical trial results involving over 2,200 12 – 15 year olds showed the vaccine had 100% efficacy and was well tolerated. The vaccine is already approved for ages 16 and up. Approval in the US by the FDA is expected soon too.
Dr. Joss Reimer, Medical Lead on the Vaccine Task Force, formally confirmed today that Manitobans age 12 and up will be part of the vaccine rollout plan, but the province is waiting on the analysis and recommendations from the National Advisory Committee on Immunization (NACI) before finalizing its plans.
Doctors Manitoba’s Vaccine Advisory Group met with Dr. Reimer a few weeks ago and recommended Manitoba adopt this change as soon as federal approvals were in place. Manitoba confirmed this change within hours today of Health Canada’s approval.
You can use this image to help connect with parents of youth and children to encourage them to sign up to be notified when their kids become eligible.
Immunization Rollout Update
As Pfizer shipments increase, the Vaccine Task Force updated their projections for when Manitobans will be eligible:
- All Manitobans age 12 and older should e eligible to book an appointment by May 21.
- They expected that 70% of adults (age 18+) will receive their first dose by June 4 to 8, depending on supply.
Dr. Reimer reassured Manitobans that “if it’s not your turn yet, it will be soon.”
Second dose appointments can be booked after eligibility is open to everyone age 12 and over. They anticipate this will be May 22. Second dose appointments will initially be offered to individuals who are immunocompromised or have specific priority medical conditions. Then eligibility will be expanded based on when a person received their first dose.
An additional vaccine super site will open in Gimli at the Gimli Recreation Centre later in May. Other locations are slated to open soon, including at the Leila Soccer Complex in Winnipeg (May 7), in Dauphin (May 10) and in Steinbach (May 18).
So far, 40.1% of Manitoba adults (or 31% of Manitobans of all ages) have received at least one dose, up from 38.7% on Monday.
Vaccine Effectiveness and NACI
One question a lot of doctors get is “which vaccine should I get” or “should I wait for a vaccine that is more effective.” The public has been bombarded with news stories citing different efficacy levels for different COVID-19 vaccines, with many perceiving AstraZeneca to be less effective than mRNA vaccines. This was only made more confusing by coverage of NACI’s recent recommendations on Johnson & Johnson which said in some situations, mRNA vaccines are considered a better option.
Doctors Manitoba has issued several statements reassuring Manitobans about safety and effectiveness of both vaccines, and a recent CTV story helps to explain this. Today, Dr. Reimer addressed the issue, explaining provincial experts considered NACI’s recommendations, looked at the local risk and epidemiology, and strongly recommend anyone eligible for AstraZeneca should get it:
“Our clinical team continues to believe and continues to recommend that Manitobans should get whatever vaccine is first available to them. For those people who are eligible for AstraZeneca, choosing to delay vaccine in order to receive mRNA could mean that you end up being infected and end up in the hospital.. We want you to be protected as soon as possible.” — Dr. Joss Reimer, Medical Lead, Manitoba Vaccine Task Force.
Another concern doctors hear frequently is about the policy to delay second doses, an approach adopted in Canada to reach more people with their first dose sooner.
There is more emerging evidence about the strong effectiveness of the COVID-19 vaccines, even after just one dose:
- A recent study in the UK published in The Lancet found that Pfizer was at least 70 percent effective at preventing COVID-19 among health care workers three weeks after their first dose. Another UK study found “no evidence that the benefits varied between Oxford-AstraZeneca and Pfizer-BioNTech vaccines.”
- A similar study published in The Lancet looking at the general Scottish population, including 1.3 million individuals who were vaccinated, and found very strong effectiveness for both the Pfizer and AstraZeneca vaccines preventing hospitalization four to five weeks after the initial dose. Both vaccines had very similar effects of 91% (Pfizer) and 88% (AstraZeneca),
- A new study by Public Health England shows that one dose of vaccine can reduce household transmission of the virus by up to half. This includes both Pfizer and AstraZeneca vaccines. Protection was seen from around 14 days after vaccination, with similar levels of protection regardless of age of cases or contacts.
- An American study by the CDC found that fully vaccinated seniors were 94% less likely to be hospitalized
- Health Canada released an analysis that showed only 1.3% of those who had tested positive for COVID-19 has been vaccinated with one dose. An even smaller share has become seriously ill or died.
If you’ve spotted useful evidence, or helpful videos or stories that help explain effectiveness to your patients, please let us know! For example, we recently watched this video from Vox that explains the problems comparing efficacy rates among vaccines. It’s worth a watch!
AGM Tomorrow — Join Us!
A reminder to join us this Thursday at 6PM for our Annual General Meeting. You can register now for what will be an exciting event that includes a keynote speaker from Stanford University, the unveiling of our 2021 award winners, and important updates from our outgoing and incoming Presidents! We have added the agenda (order of business), motion for the rules of order and the CMA corporate update online for you to view as well.
At our AGM this year, you will:
- Hear from Dr. Tait Shanafelt, a global thought-leader on physician wellness who leads WellMD at Stanford University
- Be the first to learn who has won a 2021 Doctors Manitoba award. We will still plan an awards gala this fall to celebrate, but you won’t want to miss the unveiling of this very impressive group of honourees!
- Receive an update from our Board on how Doctors Manitoba has been growing to respond to your priorities, and see our new President take office.
Hospital Situation Becoming Critical
The situation in Manitoba’s hospitals is reaching a critical state. Critical care physicians and staff, still recovering from the second wave as the third wave ramps up, are showing signs of burnout. ICU admissions are increasing, with reports of younger and otherwise healthy patients needing ventilators.
Yesterday, Dr. Kendiss Olafson spoke to the CBC to help explain what critical care doctors and staff are going through. While there may be a stickpile of beds, ventilators and PPE, “there isn’t a stockpile of extra ICU physicians, nurses or respiratory therapists,” she explained.
“I am tired. I am exhausted, I am bracing myself for the third wave, anticipating the tsunami of patients that will be coming. And scared, as I hear the stories of my colleagues in Ontario.” Dr. Kendiss Olafson on CBC News
Yesterday, an open letter to Manitobans from medical leaders was released by Shared Health, calling on the public to follow public health orders to prevent hospitals from being overwhelmed. Last month, at a Doctors Manitoba town hall with hundreds of physicians, Dr. Brent Roussin explained that a lot of spread was happening“outside” of the existing public health orders, signaling that non-compliance with current restrictions was increasingly leading to more spread. The open letter includes Medical Leads for critical care, medicine, primary care and emergency medicine, as well leads for surgery, diagnostic imaging and other oncology which have faced disruptions to their practice due to surges in COVID-19 admissions.
Doctors Manitoba has reached out to critical care specialists to understand their concerns and needs. During the second wave, we sent a series of recommendations to Shared Health to address hospital capacity, based on the feedback from physicians. We are following up on these recommendations.