In today’s message you will find:

COVID-19 Surveillance Update

Since our last update on Thursday, August 12:

  • Daily cases decrease again: 183 new cases of COVID-19 have been identified since last Friday, a daily average of 26 (down from 31 last week). This includes 27 new cases today. The total case count in Manitoba now stands at 58,134.
  • Test positivity down: The five-day test positivity rate is 1.9%, down from 2.6%. It is 1.4% in Winnipeg. 
  • Active cases down: There are 297 active COVID-19 cases province-wide, down significantly from 586 last Friday. This is the lowest number since last September. 
  • Hospitalizations: There are 69 people in Manitoba hospitals due to COVID-19, down from 75. This includes 14 COVID-related patients in Manitoba ICUs, up from 11.
  • Four more people have died from COVID-19, bringing the total COVID-19 related deaths to 1,188.

According to Health Canada’s tracking, Manitoba has had 14 cases per 100,000 over the last seven days, a decrease from 16 the week before. Manitoba has the lowest case rate outside of the Atlantic provinces. Alberta continues to lead the provinces with 82 cases per 100,000, a significant increase from 58 last week. Alberta, along with BC (72 cases/100,000) and Saskatchewan (73 cases/100,000) have all seen cases increase in the last few weeks, and they are now all in a range defined by the CDC as substantial transmission. When transmission reaches the substantial (5099 cases/​100K) or high levels (100+/100K), the CDC recommends indoor mask use. All three of these provinces discontinued mandatory mask mandates along with nearly all other restrictions in early July.

In Alberta, facing increasing case rates with no public restrictions in place, the government is pausing its plans to also lift all containment measures against
COVID-19. The changes, originally planned for earlier this week, would end isolation requirements and mask requirements on public transit and taxis. They have been delayed for six weeks until September 27. The changes, originally planned for earlier this week, would end isolation requirements and mask requirements on public transit and taxis. They have been delayed for six weeks until September 27

Meanwhile in Ontario, with 24 cases per 100,000, the government has paused its reopening plans as it prepares for a delta-fueled fourth wave. It is also taking other steps to expand vaccination rates, including mandatory vaccination for health care and some other higher-risk public sectors, opening up vaccine eligibility to children born in 2009, and offering a third dose to select vulnerable populations.

Vaccine Update

Eligibility for COVID-19 was amended earlier this week, to extend access to children born in 2009, or who will turn 12 this year. Previously, children had to be 12 to receive the vaccine. 

Since our last update on August 12:

  • 81.0% of Manitobans age 12 and up have received at least one dose, up from 80.7% a week ago. The Labour Day target was 80%.
  • 74.6% have received two doses, up from 73.5% a week ago. The Labour Day target is 75%.

Booster Shots — Coming Soon?

Manitoba has not yet announced any plans to offer booster shots. However, the third doses are going ahead in several other jurisdictions, most of which are closer to, or in the middle, of their fourth wave. 

Earlier this week, Ontario announced plans to offer a booster to select vulnerable populations. Those initially eligible will include transplant recipients, patients with hematological cancers, recipients of an anti-CD20 agent, who will be contacted for a third dose eight weeks after their second shot. Residents in long-term care homes and retirement homes will be eligible a minimum of five months after their second doses. 

The decision was made as more evidence emerges that some populations may still be vulnerable after two doses due to a sub-optimal or waning immune response.
The U.S. had adopted a similar policy earlier this month for individuals with compromised immune systems, including organ transplant recipients and others with similarly weakened immune systems. The CDC estimates that this accounts for about 3 percent of U.S. adults.

Then earlier this week, the U.S. went further, announcing plans for all adults to qualify for a booster shot eight months after their second dose. That plan is only a proposal at this point, and needs to be reviewed by the CDC and the FDA. The move was immediately criticized by the World Health Organization and many other experts, who are still focused on ensuring people living in lower income countries can get access to a first dose and see booster shots in wealthier countries as a risk to those efforts. 

About three dozen countries around the world will offer booster shots or are actively considering the issue. This includes Israel, already offering shots to people over 50, and the UK, which is finalizing its plans for a booster shot set to begin next month. 

Doctors Manitoba will monitor the situation closely and advise physicians when a decision is made in Manitoba. We are also advising government that physicians are ready to offer third doses when a plan is finalized. In the meantime, doctors can track patient interest in a third dose and are in the best position to identify those who might fit more stringent criteria, such as individuals with compromised immune systems. 

Leila Supersite Closing August 31

The government’s Leila vaccine supersite will close its doors at the end of the month while the RBC supersite will continue until at least. Doctors Manitoba thanks the dozens of physicians who worked at the Leila site, helping patients with informed consent. As the supersites wind down across Manitoba, we are anticipating doctors’ offices will play a bigger role with reaching hesitant Manitobans for their first and second dose, as well as potential plans for booster shots. We continue to advocate for stronger supports for physicians to address the risk and uncertainty that comes with offering vaccine clinics in your practice.

Physicians are encouraged to refer patients looking to get their shot to a nearby medical clinic. Use the vaccine finder at Man​i​to​baVac​cine​.ca.

Worth a Watch!

Earlier this week, Manitoba announced the winners of its Vax to Win lottery. We highly recommend you watch this one-minute video of 22-year old Trent Fingler on why he was vaccinated. Spoiler alert: it had nothing to do with the lottery, but everything to do with the trust he has in physicians and scientists. 

In the face of stronger anti-vax messages lately, a video like this reminds us all about the impact of the individual conversations doctors have with patients about vaccination. 

Continued Push for Permanent Virtual Care

Today, Doctors Manitoba released a summary of a trio of research studies that all help to demonstrate the value of virtual visits, including the strong satisfaction with virtual care among both patients and physicians, and the desire to see it continue as a permanent care option after the pandemic. This includes a report released today by the Canadian Institute for Health Information (CIHI), a study last week from Canada Health Infoway, and a Probe Research public survey commissioned by Doctors Manitoba earlier this year. 

With more than a year of experience and over three million virtual visits, doctors and patients are finding that phone and video visits can often be a safe and effective option for patient care,” said Dr. Kristjan Thompson, President of Doctors Manitoba.​“For many health concerns, nothing will ever replace an in person visit with your doctor, but for some issues virtual care has proven itself to be an appropriate option, improving access, quality and efficiency in medicine.” 

The key findings across this research include:

  • About 86% of physicians in Manitoba offered virtual visits during the pandemic (CIHI).
  • Strong satisfaction with virtual care, including 90% of Manitobans (Probe) and 79% of Manitoba physicians (Infoway)
  • Overwhelming support to see virtual care continue as an option after the pandemic, including 99% of Manitoba physicians (Infoway) and 90% of patients (Probe)

Doctors Manitoba and provincial government officials have been actively discussing how to continue virtual care after the pandemic is over, to maintain access to this invaluable patient care tool on a permanent basis. Dr. Thompson noted​“the former Minister of Health indicated she was receptive to seeing virtual care continue, and we are now raising this issue with the new Health Minister on behalf of physicians and patients.”

Virtual visits by phone or video were approved in March 2020 by the Manitoba government to help continue medical care as COVID-19 entered the province, but they were only approved for use during the pandemic. Additional types of visits were approved for virtual care as the second wave approached, following advocacy from Doctors Manitoba. Since March 2020, there have been over 3.1 million virtual visits with physicians in Manitoba. 

Please review our backgrounder for additional information about the three research studies.

ICYMI — Watch our Webinar on Clinic Precautions and Mandatory Vaccination

On Tuesday, we held a very successful webinar with an expert panel with over 100 participants. The discussion focused on what precautions medical clinics and other workplaces should take as some restrictions ease, and the potential for mandatory vaccination in health care settings. You can now watch a recording at your convenience. 

The panel of medical and legal experts considered a number of issues:

  • Precautions: Medical clinics should continue the same precautions as before. This includes requiring patients to wear masks (see mask poster for your practice), infection prevention and control measures, PPE use and staff screening. See updated Shared Health guidance.
  • Virtual care: Physicians should be increasing the use of in-person visits right now, though virtual visits still help to control traffic and congestion in your office. Physicians should not limit themselves to virtual visits as their only option at this time. 
  • There are legal and human rights risks with asking staff about their vaccination status or mandating vaccination in your workplace, but there are also potential benefits given the risks posed by COVID-19. Watch our webinar for more details and scan the related webinars from TDS, a local law firm, as well. The legal expert on the panel, Ms. Kristin Kersey, can be contacted for professional advice.
  • Resources for other workplaces are available from the provincial government.

The expert panel included Dr. Jose Francois, Provincial Medical Lead for Family Medicine, Dr. Allen Kraut, WRHA Medical Director of Occupational Health, Ms, Kerstin Kersey, a labour and employment lawyer from TDS, and Dr. Denise Koh, the Chief Occupational Medical Officer and Medical Officer of Health with the Province of Manitoba. 

Watch the Webinar on Demand

CIHI Report Focused on HCW Infections

As mandatory vaccination is considered in Manitoba for health care workers, CIHI released a report today with updated numbers on health care worker infections and deaths. Over 94,000 HCWs have been infected with COVID-19 across Canada, including 2,491 in Manitoba. So far, 43 HCWs have died from COVID-19, including four in Manitoba. This would mean two more HCW deaths in Manitoba since the last count by CIHI in January. 

It’s Election Season

There are now two election campaigns underway. While Doctors Manitoba is a strictly non-political and non-partisan organization, we will be monitoring the campaigns for any potential impact on the medical community and your patients. Elections matter and it is important to know what party leaders and candidates say about health care issues.

The Federal Election will be held on Monday, September 20. Unlike previous elections, we may have to wait a day or more for final results as many Canadians will choose to vote by mail. You can vote in advance polls on September 10, 11, 12, and 13 from 9 a.m. until 9 p.m. Elections Canada will mail voting information directly to you, and we expect to hear more about the precautions and extra measures they will offer during the pandemic. 

We expect the CMA will ask the federal parties for their position on important health issues, and provide its advice for renewed federal investment in health care and other priorities. We will share this with you in the weeks ahead.

Premier Brian Pallister’s decision to step down has triggered a leadership race in the Progressive Conservative Party of Manitoba. The winner will become the next party leader, and Premier. Only Manitobans who are PC party members can vote for the new leader. Yesterday, Heather Stefanson, the MLA for Tuxedo, resigned as Health Minister to pursue a leadership bid. She is reported to have strong support from over half of her caucus. Other candidates may emerge in the days ahead. 

Health care restructuring and the government’s response to the pandemic have been important issues for our members and for many Manitobans. We expect each leadership candidate will present their own vision for the future of health care in Manitoba. We also expect they will seek out the advice, support, and financial contribution of our members. Doctors Manitoba has provided the provincial government with our members’ views on key issues — most recently the need for a comprehensive surgical and diagnostic recovery plan, the need for a commitment to permanent virtual care, among other topics. 

New Health MinisterWith the resignation of Heather Stefanson from cabinet yesterday, Audrey Gordon has been appointed as Minister of Health. Minister Gordon was previously Minister of Mental Health, Wellness and Recovery, a role she will retain for the time being. Doctors Manitoba is focused on getting the new Minister up to speed on current issues and priorities for the medical community.

Interested in Mentorship?

Are you interested in Mentorship? Doctors Manitoba, MMSA, PARIM, PGME and UGME Student Affairs are excited to be moving into the next steps of the Medical Learner Mentorship Program. Recruitment is ongoing, register now to participate in the Fall groupings! The program offers a variety of supports for participant including complimentary training through CMA-Joule! Learn more about the program and register to participate.

Travel/​Border Advice

As a reminder, the government of Canada continues to recommend no non-essential travel outside Canada. For those needing to travel, monitor government websites to stay up-to-date on travel requirements such as steps for the fully vaccinated traveller exemption.

Please note, Manitoba’s immunization card is not accepted at the border. Ensure you print and keep your full COVID-19 immunization record for out-of-province travel. Though a national standardized proof of vaccine is in development, if travelling prior to that have ensure your immunization record with you. 

CMPA Fees Decreasing

Physicians can expect a reduction in their CMPA fees in 2022. Aggregate member fees (an average rate) will drop 4% in Manitoba. The average fee in the Manitoba region will be $3,364 per member next year.

CMPA made the announcement earlier this week, citing strong returns in its investment portfolio and a slowdown in the growth of medico-legal fees as key reasons for the reduction. The membership fee schedule is available here.

New Issue: UM Journal of Medicine

Medical students have worked tirelessly to produce the first issue of the fourth volume of the University of Manitoba Journal of Medicine. Doctors Manitoba invites all physicians to review the exciting new issue.

The new issue features several new articles, including:

  • Frailty in acute care assessment during COVID-19 and beyond
  • Social isolation in older adults
  • Science communication: a tool against misinformation
  • A book review of When Breath Becomes Air

UMJM is a student-run, peer-reviewed medical journal producing two issues per year with open access.