Dr. Brent Roussin will provide a special live update tonight at 6PM about new restrictions to slow the spread of COVID-19. The unusual evening update follows a day in court for Dr. Roussin, defending the constitutionality of the existing public health orders. Major TV news networks may carry his update live. You should be able to also watch it here. We will post a summary on Twitter as well.

In today’s message you will find:

Situation Update

COVID-19 Situation

The COVID-19 situation is escalating rapidly. Since our last update on Wednesday, COVID surveillance indicators have increased:

  • Daily cases up: Another 855 new cases of COVID-19 have been identified in just two days, including 502 today. This brings the total case count in Manitoba to 40,940.
  • Test positivity up: The five-day test positivity rate is 9.6%, up from 8.8%. It is 11.3% in Winnipeg, up from 9.2%.
  • Active cases up: There are 2,989 active COVID-19 cases province-wide, up from our last report of 2,780.
  • Hospitalizations increasing: There are 201 people in hospital due to COVID-19, a significant jump from 184 on Wednesday. This includes 56 people in ICU, a near record high during the pandemic and up from 47
  • Five new deaths related to COVID-19 were identified, including one reported today. The total number of deaths is 987.

Testing volumes are also up significantly, with 4,723 tests completed yesterday.
Variants of concern continue to dominate new cases. Since Wednesday, 604 new variant of concern cases have been confirmed. While the B.1.1.7 continues to account for the majority of VoC cases, Dr. Jazz Atwal disclosed today that four cases of B.1.617 (a variant of interest first identified in India) have been confirmed in Manitoba.

Vaccine Update

Manitoba has resumed expanding eligibility based on age. Today, eligibility for mRNA vaccines expanded to include those age 40 and up. Others may be eligible if they live in hot spot” communities, work in certain occupations, or fit other criteria, like women who are pregnant. 

This means that for now, the general eligibility for mRNA vaccines is aligned with AstraZeneca — age 40 and up. Those age 30 – 39 with high risk medical conditions continue to have early access to AstraZeneca.

We anticipate the next change in eligibility for mRNA vaccines to occur on Monday, as the province works towards expanding eligibility to everyone age 12 and up by May 21.

So far, 41.6% of Manitoba adults (or 32% of Manitobans of all ages) have received at least one dose, up from 40.1% on Wednesday.

mRNA Vaccine Pilot in Doctors’ Offices

Following months of regular advocacy from Doctors Manitoba, the government announced today that it is piloting the use of mRNA COVID-19 vaccine in doctors’ offices. 

The pilot begins today, with six clinics participating along with a few pharmacy locations. The participating locations will share 2,000 Moderna doses, with special training offered on the storage, safe handling and administration of these vaccines.

The clinics had to agree to use their doses within five days of delivery, with the locations receiving their supply today. They must also accept public appointments. At the time of writing these update, the participating clinics had indicated their doses were already fully subscribed.

Doctors’ offices and pharmacies must follow the same eligibility criteria for the Moderna vaccines that is in use at government super sites and pop-up clinics. This is different than the AstraZeneca eligibility.

The clinics were selected by the Vaccine Implementation Task Force based on their location in or near designated hot spot” communities and their recent submission to a clinic capacity survey used to prepare for the initial Johnson & Johnson shipment. The J&J doses are still being held by the federal government for a quality control check.

Manitoba Health also considered clinics’ compliance with timely reporting of inventory, submission of claims and following other procedures and guidelines. Doctors Manitoba is available to help clinics review what is expected of you and ensure you are meeting the provincial expectations.

We hope this pilot opens the door to more clinics receiving mRNA vaccine in the weeks ahead. We know from our own public polling that doctors’ offices are the preferred location to get the vaccine for Manitobans, and will help to address vaccine hesitancy.

Hospital Capacity Update

Shared Health provided a public update today about the state of hospitals facing a surge in admissions, and their plans to expand capacity to meet increasing patient need.

There are now 201 people, either with an active COVID-19 infection or are still recovering from a past infection. There are a total of 118 patients in ICU right now, and 56 of these are current or recovering COVID-19 infections. This is near the peak during the second wave. ERs are seeing increased pressure as well.

Shared Health says they are focused on freeing up hospital capacity in stages. Ongoing strategies to get ready for the surge include a virtual COVID-19 outpatient program, which monitors stable patients at home, many of whom require oxygen, as well as moving patients to PCHs.

ICU space is stretched, and Shared Health has acknowledged that these staff never got a break from the second wave. Space and equipment is apparently available, but staffing and physician coverage is a limiting factor.

The next stage to support Shared Health’s COVID response is now underway, involving the cancellation of elective surgeries to free up staff to support the COVID response, particularly in ICU. Shared Health says efforts are being made to avoid disruption to urgent, cardiac and cancer surgeries. Some surgeries may move to different facilities, such as Concordia in Winnipeg, or rural hospitals. The backlog from the first two waves is already over 11,000 procedures, and the selective postponement of surgeries now will add to this growing problem.

Shared Health reported that ICU capacity is being expanded as demand increases, with the following plan in place:

  • HSC: Increase to 58 beds from the current 52. Baseline is 41 beds
  • Grace Hospital: Increase to 16 beds from the current 12. Baseline is 10 beds. 
  • St. Boniface Hospital: Increase to 28 beds from the current 24. Baseline is 14. This excludes cardiac ICU beds, which the hospital is trying to preserve for cardiac surgery patients. 
  • Brandon: Increase to 13 beds from the current baseline of 9 beds. 

A new group of ICU nurses has graduated and will help with coverage, and a crash course” is being offered to other nurses to help fill in and extend coverage as well. 

Other measures include redeploying ambulatory care staff to ERs to help with monitoring and following up.
We will share more information as it becomes available.

A copy of the Shared Health hospital capacity plan is available here.

Shared health also shared an update from Dr. Roussin, Lanette Siragusa and others about the third wave today too. You can view it here.

What is Doctors Manitoba doing to help?

We’ve been anticipating a third wave, and the potential for renewed strain on hospital services for months. Now that we’re in it, please remember to reach out if you need support or have ideas on how we can advocate for a stronger response. 

Here are a few things we’ve been working on to support physicians through this third wave:

  • Continued advocacy to improve hospital capacity, with over 20 recommendations based on advice from physicians
  • Outreach with critical care specialists
  • Advocacy for investments to address surgical backlog ($50 million subsequently announced in provincial budget, which is a good start) 

We’re working hard to update our COVID-19 resources, and we continue for a more rapid vaccine rollout to help address the spread of COVID-19 too. 

Contact us anytime with your ideas, or if you need support at covid19@​doctorsmanitoba.​ca. A reminder that specialized physician health programming is available to you and those in your household too.

Dr. Kristjan Thompson New Doctors Manitoba President

Last night at the 113th Annual General Meeting of Doctors Manitoba, a virtual event, Dr. Kristjan Thompson was installed as President for the 2021 – 2022 year. Dr. Thompson is an emergency physician at St. Boniface Hospital in Winnipeg. During his inaugural speech, Dr. Thompson pledged to advocate for the support and tools physicians need so they can offer exceptional care to their patients.

I’m honoured to become President of Doctors Manitoba,” said Dr. Thompson. I am dedicated to Doctors Manitoba’s mission to strengthen and support the whole physician, and for our Association to continue its unwavering advocacy for physicians and their patients.“

Dr. Thompson also emphasized the importance of a human approach in the practice of medicine, especially as doctors support patients through the third pandemic wave and the COVID-19 immunization campaign. It was the humanity of medicine that brought me to this career, and it’s the human connection physicians make with patients that will help Manitoba get through this pandemic.”

Dr. Cory Baillie has completed his year as President, and now becomes Past President and Chair of the Board of Directors. This pandemic has been challenging and disruptive, and I’d like to thank physicians for all of their hard work this past year to keep Manitobans healthy,” Dr. Baillie said. I know that the stress of worrying about the health of your patients, your families, and yourselves has been incredible. Today, I’m thinking about our critical care colleagues and other physicians working in hospitals responding to a surge in admissions. I’m thinking about surgeons and radiologists who are preparing for their procedures to be disrupted. And I’m thinking about community-based physicians, like me, who will have to pivot again to more virtual visits as much as we can.“

The President-Elect was also confirmed by members at the AGM. Dr. Candace Bradshaw, a family physician from Winnipeg, is now President-Elect and will become President in May 2022.

The Board and membership thanked Dr. Fourie Smith, who completed his term as Past President, for his leadership on the Board and contributions to the medical community. Dr. Smith was President when the last Master Agreement was negotiated, and fought for a successful resolution to proposed legislation (Bill 10) that would have stripped physicians of their right to appeal unfair government audits.