Member Message — July 29 2021
In today’s message you will find:
- Situation Update
- Vaccine Update
- Webinar — Practice Issues in the “New Normal”
- Vaccine Hesitancy Tariff Confirmed
- Recall Notice — Philips Respironics
Since our update on Friday, July 23:
- Daily cases continue to decrease: 189 new cases of COVID-19 have been identified since last Friday, a daily average of 32 (down from 41 the previous week). This includes 47 new cases today. The total case count in Manitoba now stands at 57,548.
- Test positivity down: The five-day test positivity rate is 2.1%, down from 3.0%. It is 1.1% in Winnipeg, down from 2.1%.
- Active cases stable: There are 526 active COVID-19 cases province-wide, down from 537 last Friday.
- Hospitalizations: There are 102 people in Manitoba hospitals due to COVID-19, down from 106. This includes 29 COVID-related patients in Manitoba ICUs, up from 24.
- Seven more people have died from COVID-19, including two reported today, bringing the total COVID-19 related deaths to 1,177.
While the situation has improved in Manitoba overall, the Interlake-Eastern health region is seeing active cases increase and now accounts for more than any other region including Winnipeg. Of the current active cases, 235 or over 40% are from the Interlake-Eastern region. Most active cases are from the Fisher/Peguis and Powerview/Pine Falls health districts.
Restrictions here and across Canada
Current restrictions in Manitoba continue to be in place for just over a week, until August 7. We are anticipating changes will be announced next week, as Manitoba nears the labour day vaccination target early, and COVID cases have reached much lower levels. Furthermore, restrictions in some provinces are being eased and, in some cases, lifted.
Here’s a summary of the current status in select provinces:
- BC (16 cases/100K in last 7 days): The state of emergency was lifted July 1 as the province lifted most restrictions. This means there are no limits on outdoor or indoor personal gatherings, recreational travel is allowed, and masks are now recommended in many settings, but no longer required. Yesterday, however, an outbreak was declared in the Central Okanagan due to a surge in cases, which has resulted in the mask mandate being reimposed and travel to and from the region is discouraged.
- Alberta (21 cases/100K in last 7 days): Nearly all restrictions were lifted on July 1. There are no longer capacity limits on social gatherings, organized gatherings such as weddings, gyms, restaurants, retail or places of worship. Just yesterday, the province announced plans to eliminate the requirement to self-isolate after a positive test starting August 16, recommending isolation instead. People with mild symptoms will no longer need a test either.
- Saskatchewan (26 cases/100K in last 7 days): All restrictions were lifted on July 11, including gathering restrictions and mask mandates. The government signaled it has shifted controlling COVID-19 from restrictions to vaccination.
- Ontario (8 cases/100K in last 7 days): Some restrictions were lifted on July 16, including larger outdoor gatherings of up to 100 people, with indoor gatherings limited to 25 people. Indoor religious services and weddings are permitted with distancing, and indoor dining has also resumed. Gyms are limited to 50% capacity and other setting, like retail, only require physical distancing. Masks continue to be required.
- Quebec (8 cases/100K in last 7 days): Starting July 12, physical distancing was reduced from 2 metres to 1 metre and this new measure is used to guide operations in retail stores and other settings, though more specific capacity measures have been lifted. Masks are still required. Theatres and other venues can operate with one empty seat between households.
American Update: Surges and Mask Mandates
In the United States, a summer surge in cases is occurring. This has been called the pandemic of the unvaccinated, as outbreaks primarily spread in populations with lower vaccination rates. This can even include communities with higher rates that still have a large concentrated population of unvaccinated people. Cases are now increasing in all 50 states.
The surge, fueled by the more transmissible Delta variant, has resulted in the CDC reversing its advice on masks for the fully vaccinated. After advising fully vaccinated individuals that they could stop wearing masks indoors, the CDC now recommends everyone, including the fully vaccinated, wear masks indoors in public places in areas with substantial or high transmission. The CDC defines substantial transmission as 50 – 100 cases per 100,000 residents over seven days, and high transmission as more than 100 cases per 100,000 people over seven days. The rate across the US is 140.4 for the last seven days, and is highest in Florida, Louisiana, Alabama, Arkansas and Mississippi.
New estimates released this week in the U.S. suggest life expectancy in 2020 dropped by 1.5 years, the largest single year decrease since the second world war. The change is largely attributed to COVID-19, and Black and Hispanic communities saw the biggest declines.
Since our last update on July 23:
- 79.3% of Manitobans age 12 and up have received at least one dose, up from 78.2% a week ago. The labour day target is 80%.
- 68.6% have received two doses, up from 64.3% a week ago. The labour day target is 75%.
- 2nd doses continue to account for about 80% of doses administered
So far, over 950,000 people have received at least one shot. Everyone who receives a does by August 2 will be eligible for the Vax to Win lottery.
Focus for Doctors’ Offices
As the vaccination rollout continues, we have confirmed the following changes for medical clinics participating in the vaccine rollout:
- Clinics are now encouraged to focus on both 1st and 2nd doses. For the last several weeks, clinics were asked to focus on first doses.
- A modest amount of vaccine wastage can be tolerated due to the improved supply situation. If physicians have to choose between not opening a vial due to insufficient patient interest or opening the vial and risking not using all of the doses, the latter is recommended to ensure patients are vaccinated without delay when they consent.
Breakthrough Infections and Vaccine Effectiveness
New data this week continue to show that breakthrough infections are rare, and more importantly severe outcomes among the fully vaccinated are extremely rare.
Among the 740,023 fully vaccinated Manitobans, there have been just 375 “breakthrough” infections, or a rate of only 0.05%. There have been only 42 hospitalizations (includes ICU admissions) and 11 deaths, with two of the deaths in people in their 60s and the remainder among people age 70 or older.
Vaccine Card Printing Resumes
After a shortage of blank cards caused delays, printing has resumed for proof of vaccination cards. Digital cards have always been available almost instantly two weeks after a second dose. Individuals can order their card online or by phone.
Webinar — Practice Issues in the “New Normal”
Join us for a special Doctors Manitoba webinar on Tuesday, August 17, as we consider the issues physician practices will face in the “new normal” with a panel of medical and legal experts. We have an expert panel to help us consider how precautions could change along with other issues you may encounter in the weeks and months ahead, such as vaccination status with employees in your practice.
Public health restrictions will soon be eased and replaced with public health recommendations. Masks and other precautions may no longer be required in retail settings, but what about clinics? Some employers are considering requiring vaccination, or at least proof of vaccination status. Physicians are starting to ask what their obligations are as an employer to staff and to their patients.
Join our expert panel as we consider these issues and offer guidance for the pandemic recovery period. The panel includes:
- Dr. Jose Francois, Provincial Specialty Lead for Family Medicine and head, Department of Family Medicine with Max Rady College of Medicine
- Dr. Allen Kraut, Medical Director, WRHA Occupational Health and Associate Professor with Max Rady College of Medicine
- Ms. Kristin Kersey, a lawyer with expertise in labour, employment and human rights law from Thompson Dorfman and Sweatman (TDS) LLP.
When: Tuesday, August 17 at 6:30 pm
Register: Register in advance online
Vaccine Hesitancy Tariff Confirmed
Two weeks ago, we announced a new tariff to support vaccine hesitancy counselling when patients visit you for other unrelated issues. A tariff code has been assigned by Manitoba Health, so claims can be submitted.
Please use tariff 8330 in order to claim for this service. Additionally, please be aware of ICD code V655 — Person with feared complaint in whom no diagnosis was made. This ICD code should be considered when claiming for this service.
You can read more about this tariff, as well as billing advice for vaccine visits and injections in our billing guide.
Recall Notice — Phillips Respironics
A voluntary recall has been issued for certain Philips Respironics Continuous and Non-Continuous Ventilators, including CPAP, BILEVEL and Continuous Ventilator
devices. There is a risk that the foam used in some models could degrade into particles or emit a gas that could be ingested or inhaled by the user. ResMed machines are not affected by this recall.
Shared Health has issued an advisory for health care professionals today about the recall, and a complete list of affected devises is available here.
Patients who are enrolled in the Provincial CPAP Program and/or are followed by the Sleep Disorder Center (SDC) or the Long Term Mechanical Ventilation Program (LTMVP), and who use affected machines, have been identified and are being contacted by their vendors (Medigas and VitalAire) or by the LTMVP. Other patients may need to register their machines directly with Respironics. Replacement equipment will be prioritized based on the severity of the underlying breathing disorder.
For questions about equipment’s warranty, replacement or repair, please direct patients to contact their vendor directly:
- MediGas: 204-786-4719
- VitalAire: 855-309-8301