Member Message — July 8, 2021
In today’s member message you can find:
Covid Situation Update
BIPOC COVID Analysis
CIHI Surgery Backlog Report
Physician Health Leader Change
MMSA Vaccine Hesitancy Sticker Campaign
Critical and Extended Health Insurance Reminders
Travel Restriction Changes
President’s Letter for 2021
This week’s Fantastic Physician
Occupational Medicine Course
COVID Situation Update
Since our last update on June 30:
- Daily cases continue to decrease: 500 new cases of COVID-19 have been identified since last Wednesday, a daily average of 63. This includes 86 new cases today. The total case count in Manitoba now stands at 56,667.
- Test positivity down: the five-day test positivity rate is 5.4%, down from 6.2%. It is 5.2% in Winnipeg, down from 5.6%.
- Active cases continue on a downward trend: There are 1,016 active COVID-19 cases province-wide, down from 1,395 last Wednesday.
- Hospitalizations are coming down: There are 137 people in Manitoba hospitals due to COVID-19, down from 164. This includes 34 COVID-related patients in Manitoba ICUs, down from 46. There are also five Manitoba patients in out-of-province ICUs, down from nine.
- Sixteen more people have died from COVID-19, including three today. The total of COVID-19 related deaths to 1,157.
Earlier this week, with the situation improving in Manitoba, Dr. Roussin looked ahead to what a post-pandemic province could look like. He said public health restrictions will be replaced, eventually, with public health recommendations which often exist for other diseases and risks. While he had an optimistic tone, he was also clear that the pandemic is not yet behind us. Modeling is being updated with new variants of concern and vaccination information, and various scenarios are being developed to support planning for a potential fourth wave.
Earlier this week, Manitoba surpassed the August long weekend vaccination target, which sought to reach 75% of those age 12+ with first doses and 50% with second doses. As of today, 75.6% of eligible Manitobans have received at least one dose, and 54% have received two doses. Over 1.55 million doses have been administered.
Because the August target was passed nearly a month ahead of schedule, we are anticipating an announcement on changes to restrictions on Monday.
While this target was achieved ahead of schedule, the provincial vaccine task force made a notable change to their forecast for the Labour Day target of 80% first dose and 75% second doses. The target, they say, is on track, “subject to demand changes.” Officials acknowledged that demand for first doses has slowed down dramatically, and supply of vaccines is now larger than demand.
This is being felt on the ground by doctors’ offices offering the shot. There are now over 50 clinics with appointments available. Physicians are encouraged to refer patients to medical clinics, many of which can offer appointments within a few days. We are maintaining a list and searchable map of medical clinics with vaccine in stock at ManitobaVaccine.ca.
Participating clinics are encouraged to focus on creative outreach strategies to reach more Manitobans with first doses. Grants are available to physicians to support initiatives outside of regular clinic operations. Contact firstname.lastname@example.org for more information and support on applying for grants.
Manitobans who are fully-immunized can apply for a Manitoba immunization card. People can visit www.gov.mb.ca/covid19/vaccine/immunization-record.html to apply. Effective today, individuals without access to the internet can call 1 – 844-MAN-VACC (1−844−626−8222) and follow the prompts to request their immunization card.
The supply of Pfizer is picking up after a shortage the last few weeks. Pfizer is currently the only option for individuals age 12 to 17.
As of this afternoon, Pfizer appointments are available at super sites on July 24 in Winnipeg, July 16 in Morden, July 17 in Brandon, July 13 in The Pas and July 13 in Thompson, for example. Moderna continue to be available sooner.
On July 14, all vaccine super sites throughout the province will be offering walk-in vaccinations only, and Pfizer will be earmarked for use in youth between 12 and 17 years old. Moderna will be available for adults at each site.
BIPOC COVID Analysis
Earlier this week, a detailed Manitoba analysis was released about the disproportionate impact COVID-19 has had on Black, Indigenous and People of Colour (BIPOC) individuals.
Dr. Marcia Anderson, public health lead of Manitoba First Nation Pandemic Response Coordination Team, released the report alongside Dr. Brent Roussin.
The analysis finds BIPOC groups had higher COVID-19 infection rates than white Manitobans, sometimes as much as 21.7 times higher for certain groups.
The report includes data from 14,047 individuals from March 31 to June 7, and finds:
- White people accounted for 35% of infections during this period, but account for 64% of Manitoba’s population. This represents a case rate of 4.8 per 1,000 white people.
- Many BIPOC groups experienced much higher rates of infection. South-East Asians had rates 21.7 times higher than white people. Rates were also higher for African (8.7 times), South Asian (8 times), Latin American (6.4 times), Black (5.7 times), and Filipino (3.6 times) groups. The rate reported for Indigenous Peoples of 2.1 times higher than white people is likely low because of missing data.
- The hospitalization rate among BIPOC groups was 3.5 times higher than white people and for ICU admission it was 4 times higher. The average age of hospitalization was 46 years among BIPOC groups, 14 years younger than white people.
The data also showed the difference in severe outcomes among BIPOC peoples are not due to differences in chronic conditions. For hospital admissions not requiring ICU care, 73% of cases among white people had a chronic condition compared to 56% among BIPOC peoples. This implies that BIPOC peoples experiencing severe outcomes were both younger and healthier than white people experiencing severe outcomes.
The data also showed that lower income levels were associated with higher rates of severe outcomes in both white and BIPOC peoples, but the differences were much larger among BIPOC groups. Dr. Anderson pointed to other structural factors that could contribute to a higher risk among BIPOC groups, including crowded housing, educational opportunities, and occupational settings.
Because eligibility for the vaccines was largely based on age, with the exception of First Nations peoples, this meant that BIPOC individuals at their average age of hospitalization (46) weren’t eligible for protection for 23 days longer than White people at their average age of hospitalization (60).
While age as a primary risk factor was used initially for vaccine eligibility, a neighbourhood-based approach was introduced to accelerate access based on place of residence. Dr. Roussin acknowledged the importance of the new BIPOC analysis, and how it would be used in future planning.
In the short term, Dr. Anderson recommended focusing on outreach efforts to increase vaccination uptake among BIPOC groups, as well as using the planning for future waves of the pandemic or for potential booster doses. Longer term, she said action is needed on structural causes, such as housing, employment and income inequality.
New CIHI Report Reinforces Need for Surgery Plan
A new report released today by the Canadian Institute for Health Information confirms a growing backlog of surgeries resulting from the pandemic response, helping to better understand the magnitude of serious surgery delays as well as how Manitoba’s backlog compares to other provinces.
“CIHI’s reporting clearly shows the staggering backlog of surgical procedures in Manitoba,” said Dr. Kristjan Thompson, President of Doctors Manitoba.“Thousands of patients have been affected, experiencing distress, complications and harm during extended waits for care.”
What’s most concerning is the disruption of surgical services during the second wave of the pandemic. From October to December last year, surgery volumes decreased by 29% in Manitoba, compared to just a 4% decrease on average across Canada.
“By the second wave of the pandemic, most provinces had found ways to minimize the disruption to surgical services when faced with surges in COVID-19 admissions, but in Manitoba thousands of surgeries were canceled or postponed,” added Dr. Thompson.
The CIHI report looks at the impact on hospital services from March to December 2020 compared to the same months from 2019. The report finds:
- Manitoba experienced a decrease of 18,398 surgical procedures in the first 10 months of the pandemic, a 22% decrease overall.
- Many surgical procedures were affected, including an 11% decrease in cardiac surgeries and an 8% decrease in cancer surgeries.
The new data from CIHI validates a report from Doctors Manitoba released last month. Our report included an additional five months, estimating the backlog of surgery cases to have reached over 39,000 by May 2021. We also estimated a backlog of over 44,000 diagnostic imaging tests and 32,000 other procedures, such as endoscopies, allergy tests and mammograms.
Our analysis of the new CIHI data has been shared with the government, and we have renewed our call for the concrete commitment and a comprehensive plan to address the backlog in surgery and diagnostic procedures.
Dr. Thompson was busy today providing updates to major media outlets to help raise awareness with the public about the surgery and diagnostic backlog. Early stories are already available from CBC and Global News.
Physician Health Changes and Updates
After over ten years of service, Dr. Michael Loudon is stepping down over the summer as the Physician Lead with the Physicians at Risk Program. Over his time with the program, Dr. Loudon has provided individual and group based peer support to hundreds of physicians and medical learners throughout Manitoba. He has been a reliable and trustworthy presence during some of the most challenging times in his colleague’s lives.
“After many years, it is time I fully embrace what I support others to do — make more time for the people and things that bring you joy,” explained Dr. Loudon. “The pandemic has made it clear what is truly important. I look forward to this new chapter to spend more time with my family and getting back to hobbies I love, such as flying.”
Dr. Loudon was integral in working with Doctors Manitoba to determine how his position could be augmented to provide more support to Doctors Manitoba and its members. This work led to the development of the newly created Doctors Manitoba Physician Health and Wellness Medical Lead position. This role will encompass all of the peer support and Physicians at Risk responsibilities but also assist Doctors Manitoba in providing strategic direction for physician health and enhance the current work to ensure our physician health program is comprehensive, accessible, and has appropriate programming and supports from prevention to treatment.
“Our mandate as an organization is to support the whole physician,” said Dr. Kristjan Thompson, President of Doctors Manitoba. “Advocating for the health and wellness of all of our members is one of our five strategic pillars. We know physicians and learners were under enormous strain and experienced significant burnout before the pandemic. COVID has only exacerbated this. Our recent member survey indicated an increase to 47% of members are experiencing burnout. By creating this new Medical Lead position, Doctors Manitoba will have increased capacity to support physicians and medical learners in Manitoba.”
We are pleased to announce Dr. Shelley Anderson as the new Doctors Manitoba Physician Health and Wellness Medical Lead. Dr. Anderson is a Geriatric Psychiatrist who, throughout her nearly 20 years in practice, has worked in both rural community and urban academic settings. With roots in the Interlake and Eastern shores of Lake Winnipeg, she completed her medical school and residency training at the University of Manitoba and has never called anywhere else home. Her clinical work and leadership roles have been varied and have now broadened to include physician health and wellness.
“I am grateful for this opportunity from Doctors Manitoba, and am committed to hearing from and supporting my medical colleagues and their families in the days and years to come,” said Dr. Anderson. “I look forward to working with Dr. Loudon over the summer to ensure a seamless transition for the Physicians at Risk staff and program participants.”
Medical student sticker initiative
Addressing vaccine hesitancy is complex and requires multiple solutions. While trusted advice from a physician remains a powerful tool, seeing peers accepting the vaccine has also helped many people decide to get immunized.
Two medical students saw vaccine hesitancy as a major barrier to reaching herd immunity and stepped up to the plate to help. In collaboration with the Manitoba Medical Student Association (MMSA) and Doctors Manitoba, Anmol Mann and Philip Kawalec, created a sticker campaign to help reduce vaccine hesitancy in Manitoba by allowing those who get vaccinated to share their decision with their friends and family online. The second-year medical students “wanted to start a campaign that engages healthcare professionals, particularly medical students, to combat vaccine hesitancy. This is our small way of making a difference and we hope you will join us in making this campaign a success!”
The students came up with the idea several weeks before the green ProtectMB stickers were introduced at government vaccine clinics. The students’ initiative sees campaign stickers distributed to doctors’ offices across the province as well as to medical students as they get immunized.
Stickers are worn by those who have been immunized, with the hope it may inspire or encourage others in their social spheres to get vaccinated against COVID-19. Dr. Michael Loudon from the Teulon Medical Clinic was happy to participate in helping curb vaccine hesitancy. His office received vaccines and quickly administered them, along with stickers, to willing patients. On April 17 alone, the team at the clinic administered 110 doses to patients in the Interlake and images quickly appeared on social media.
If your clinic would like to participate in the sticker campaign, please contact Braden Kalichuk. We would love to see participating clinics’ and medical students’ pictures, and encourage vaccinated patients to take photos wearing their sticker and post to social media with the hashtag #SaveMBLives. Social media can have a significant influence on our communities. We encourage you to use your social media presence to highlight the importance of getting a COVID-19 vaccine! Critical
Illness insurance reminder
A sudden illness can make covering day-to-day expenses difficult, but you can avoid financial strain and stress for you and your family with Doctors Manitoba Critical Illness Insurance. It covers 24 illnesses, and members along with their partner/spouse and dependent children are eligible. Coverage of up to $500,000 per person is available. New members and their partner/spouse are eligible for up to $60,000 each, and $20,000 per child on a guaranteed basis, with no medical question for up to 30 days from becoming a member or from a life event, such as marriage or birth/adoption. Find out more about Critical Illness Insurance here.
Routine medical expenses like prescription drugs, glasses, semi-private hospital rooms, ambulance expenses, physiotherapy and more are covered through the Doctors Manitoba Extended Health Benefits program. Created and designed with physicians in mind, insurability is guaranteed, even with pre-existing conditions. Coverage is subject to enrollment rules. Find out more about Extended Health Benefits here.
Travel Restrictions Easing
Effective July 5, travel restrictions changed for fully vaccinated individuals entering the country. Individuals who meet the new guidelines and restrictions may be exempt from quarantine, hotel stopovers and day‑8 testing requirement. Individuals who are exempt must:
- Be eligible to enter Canada.
- Be asymptomatic.
- Be fully vaccinated according to federal rules. In order to be considered fully vaccianted, you must have had all the required doses for one of the four COVID-19 vaccines approved in Canada – Pfizer, Moderna, AstraZeneca or Johnson & Johnson – with your last dose at least 14 days ago. Individuals who have received another type of vaccine, like China’s Sinopharm or Snovac, will be treated as an unvaccinated person.
- Have met all other entry requirements. Arrival by air travel requires pre-entry COVID-19 testing, a suitable quarantine plan if a government representative determines you need to do so, testing upon arrival, and proof of vaccination using the ArriveCan app. Land border crossings require individuals to provide a negative COVID-19 test result.
When returning to Manitoba from travel within Canada, fully vaccinated individuals no longer have to self isolate for 14 days. To find out if you’re eligible to enter Canada you can answer this questionnaire. Read more about the details on travel restrictions set out by the Government of Canadahere.
PPE Sale — Over 50% Off!
We are offering our remaining stock of personal protective equipment (PPE) at major discounts of 50% off or more. Early in the pandemic, when supplies were scarce, Doctors Manitoba was able to secure a large stock of medical grade PPE that we have been providing to members on a cost-recovery basis. We have seen a reduction in demand over the last few months as the supply and demand has been restored in the market. With a large inventory left, we are excited to offer it to members at a substantially reduced price:
|PPE Item||Sale Price||Original Price|
|3‑Ply Medical Grade Masks (package of 100)||$40 (65% off)||$115|
|Medical Grade Nitrile Gloves (package of 100)||$8 (53% off)||$17|
|Dasheng DTC3Z N95 (box of 20)||$30 (50% off)||$60|
ICYMI — President’s Update
Last week, Doctors Manitoba President Dr. Kristjan Thompson sent an update to all members. In case you missed it, his letter provides an update on our efforts to advocate for physicians through our pandemic response and our commitment to continue that advocacy with our pandemic recovery planning. He also asked members to save-the-date for November 20, 2021, as we are hopeful to gather in person for our Doctors Manitoba Gala to reflect on the pandemic and recognize this year’s award winners. We are also preparing for hybrid and virtual options, just in case. Dr. Thompson also unveiled key results from our annual member survey, outlining how Doctors Manitoba has responded to our member priorities and what our plans are going forward. In case you missed it, you can read Dr. Thompson’s full letterhere.
More Physician Recognition
Dr. Barry Lavallee received even more well-deserved recognition for his work. After winning the UNIVANTS of Healthcare Excellence Award just a few weeks ago, last week he was named a 2021 Honorary Fellow of Royal College of Physicians and Surgeons of Canada. While he says the awards are nice, what matters most to him is inspiring young Indigenous people to reach their educational and professional goals. “I want young people to know that, despite the challenges we face as Indigenous people, you can be the best in your field. You can rise to the top.” He wants people in the Indigenous community to recognize that their “ancestors who attended and made it through residential schools suffered so that we didn’t have to.” He sees the need for change-makers in the community.
Learn about Occupational Medicine
The University of Alberta is offering a Foundation Course In Occupational Medicine (Part A), virtually from September 2021 to June 2022. The course is a blended education course designed to help community based family physicians manage patients with work-related ill-health issues in their office. Monthly modules are sent by email for independent study and review over a period of four weeks. Every month, participants are expected to join a two hour tutorial (via video conference), led by both a senior family physician and an occupational medicine specialist.
To get the full CME credits for the course, participants will also be required to attend two full day workshops. You can register for the course here.