Member Message — February 23, 2022
In today’s message you will find:
- COVID Surveillance Update
- Vaccine & Treatment Updates
- Our new Bannatyne Office opens on Monday
- Surgery & Diagnostic Backlog update
- Town Hall with Backlog Task Force
- Mental Health and Community Wellness Roadmap unveiled
- RAAM On-Call Reminder
- Wordle Challenge extended
- ICYMI — reminders and previous updates
- Fantastic Physicians
- Events & Learning Opportunities
Since our last update on Monday February 14…
Serious Outcome Surveillance:
- Hospitalizations decreasing steadily, but still high: There are 543 people in hospitals with COVID-19, down from 633 last Monday
- Hospital admissions continue to decline: There were 13 people admitted to hospital yesterday with COVID-19. The average over the last seven days has been 21 admissions per day, down from 30 per day the previous seven days.
- ICU occupancy high and steady: Of the hospitalizations reported above, 40 patients are in ICU, down from 42 last Monday.
- COVID-related ICU admissions have averaged one to two per day over the last seven days, with three admitted yesterday. This is down from three to four admissions per day during the previous seven day period.
- 26 more people have died from COVID-19 since last Wednesday with the total now at 1,663.
According to the COVID-19 Tracker Canada Project, Manitoba has an average of 40 hospitalizations per 100,000, down from 46 on February 14 and the highest in Canada.
*Comparing hospitalizations by jurisdictions continues to be challenging as some provinces may use slightly different standards (e.g. only reporting patients with active COVID-19 infections and not recovered, or only reporting patients admitted because of COVID-19 and not with — Manitoba still reports both using a broader strategy).
Surveillance indicators (interpret with caution due to PCR testing changes):
- Daily cases high remain high*: 2,647 new cases of COVID-19 have been identified since last Monday, including 369 cases reported today. This is a daily average 294, down from 458 the week preceding February 14. The total case count in Manitoba now stands at 129,657.
- Test positivity high but declining considerably*: The provincial five-day test positivity rate is 14.8%, down from 22.3% on last Monday.
- Active cases decrease*: There are 12,549 active COVID-19 cases province-wide, down from 14,938 on February 14.
* A reminder that daily cases are likely significantly under-estimated and test positivity may be over-estimated as rapid test results are not counted in the provincial statistics.
According to Health Canada’s tracking, Manitoba’s seven day rate of COVID-19 is 137 per 100,000, above the Canadian average of 113 but down from 171 last Monday.
Seroprevalence in Manitoba
The COVID-19 Immunity Task Force has updated its estimates on seroprevalence of COVID-19 antibodies using blood donation monitoring to the end of December, 2021, including the emergence of Omicron.
Nationally, the number of donors with antibodies due to infection rose to 6.4%, up from 5.1% in November, with most of those infections among the unvaccinated. In Manitoba, infection-acquired seropositivity was at 8.2% in December, the second highest among all participating provinces.
PCH/Hospital Visitation Relaxed
As public health restrictions across Manitoba begin to lift in the coming weeks, LTC and Acute Care facilities will take a phased approach to expanded in-person visitation. These phases, which take into consideration COVID-19 indicators in addition to changes to public health orders, will allow expanded visitor access to both residents in long-term care and inpatients within Manitoba hospitals, beginning with:
- fully vaccinated general (social) visitors (in LTC and Acute facilities);
- unvaccinated visitors in designated visitation shelters and spaces (in LTC);
- where physical distancing can be maintained (from other patients and their accompanying essential care partner), fully vaccinated essential care partners may be permitted to join a patient for outpatient appointments or during a visit to emergency/urgent care.
The vaccination status of residents/patients and their roommates (if a shared room) is no longer a consideration when determining visitation. These changes have taken effect for both long-term care and acute care facilities. Visitors are encouraged to call ahead or check the website/social media of the specific facility they plan to visit, before they go. Appointments continue to be required for general visitation at LTCs and visitor hours may vary at acute care locations. Implementation dates may vary by individual facility and appointments will continue to be required for many visits. Find additional information, posters, FAQs and other resources here.
Public Health Shifting Approach as Restrictions Ease
A variety of pandemic restriction were eased last week by the Manitoba government, mostly easing or removing capacity limits (see summary here). On March 1, proof of vaccination requirements will be lifted in “most” settings and on March 15, mask requirements will also be eased in most settings. The moves in Manitoba are similar to those being adopted by several other provinces and jurisdictions, though some are still worried about the changes moving too fast.Last week, all chief medical officers of health (CMOHs) across Canada, including Dr. Brent Roussin, issued a joint statement on the “next phase of the COVID-19 pandemic response.” The CMOH group were clear that their goal has not changed and they remain focused on “minimizing serious illness and overall deaths, while minimizing societal disruption.”
As Omicron declines, they explain it is “now time to rebalance our collective efforts towards a more sustainable approach to long term management of COVID-19.” As provinces and other jurisdictions gradually shift from restrictions and mandates to public health guidance and recommendations, they reinforced the need for individual and collective actions.
“We are now all more knowledgeable and better equipped to make informed risk-based decisions for ourselves and those around us. This includes keeping COVID-19 vaccinations up to date, being aware of personal and family risks, and maintaining individual public health measures such as wearing masks, staying home when sick, increased hand washing, and improving ventilation of indoor spaces so that we return to enjoying the things we love the most.
The CMOHs anticipate future waves and outbreaks, and Dr. Roussin has said restrictions may again be needed in the future. The group recognized that “future COVID-19 activity will depend on factors such as waning immunity, potential for repeated emergence of highly immune-evasive and/or more severe variants of concern, and seasonal dynamics.”
They also stressed the need to focus on “building the capacity of our health care systems to ensure enhanced surge capacity for future crises is equally important.”
Vaccine & Treatment Updates
Updated Treatment Resources
Manitoba’s uptake on COVID treatments has not been as high as anticipated because patients who are eligible are seeking testing too late in their infection. We’ve also heard from some physicians who are having trouble finding current information on eligibility and referrals.
Here are the latest resources to assist you in guiding and referring your patients:
- “At-a-glance” COVID-19 treatment recommendations for both outpatient and inpatient care, including alternatives that can be considered based on patient preferences, contraindications or supply issues.
- Shared Health COVID-19 Treatment Resources: You will find information on both MAB monoclonal antibodies and Paxlovid antivirals, including eligibility, information for providers, referral forms and patient information sheets, as well as educational videos.
- Public information on COVID-19 treatments from Manitoba Health.
New Vaccine Approved
The Novavax vaccine known as Nuvaxovid has been approved in Canada for people 18 and older. Clinical trials which took place when the Alpha variant was the dominant strain and included about 45,000 people showed it to be 90% effective one week after the second dose. Lab-based studies show that neutralizing antibodies are formed by the vaccine for Omicron variant infections. The recommended interval is 21 days. NACI is still advising that mRNA vaccines are preferred, but also issued guidelines for Nuvaxovid indicating it can be used for a primary series or a third dose for “people who have been unable due to contraindications, or not willing to, receive an mRNA COVID19 vaccine.” Side effects are all similar to the four previously approved vaccines now in use in Canada. While there are plans for the vaccine to be produced at the National Research Council (NRC) in Montréal, delivery and distribution of the vaccine is not expected until March. The company has under-delivered on its promises to countries who approved the drug late in 2021 and has yet to deliver on its largest contract for 1.1 billion doses for COVAX.
Nuvaxovid offers hope to increase vaccination rates as it is not a new type of vaccine technology. It is a protein subunit vaccine, a technology used for existing vaccines such as hepatitis B. These contain only a small purified piece of protein, and not the virus itself.
Free Vaccine Hesitancy Course
The Manitoba Government, in partnership with the Crisis & Trauma Resource Institute, has created a vaccine hesitancy course to help medical professionals engage in difficult conversations with vaccine hesitant patients.
This three-hour workshop focuses on delivering the Motivational Interviewing skills needed to break down barriers and address uncertainty and resistance around immunization. Specifically designed for doctors and other healthcare practitioners, the 20-person training sessions are facilitated by accredited professionals and are available virtually weekdays, evenings and weekends in March 2022. For further information on this course, or to register, please contact Troy Popadynetz at email@example.com. Registration is currently open for the following time slots:
- February 26, 2022 – 9:30am to 12:30pm
- March 1, 2022 – 6:00 to 9:00pm
- March 7 – 6:00 to 9:00pm
- March 10 – 12:30 to 3:30pm
- March 12 – 9:30am to 12:30pm
- March 15 – 12:30 to 3:30pm
- March 15 – 6:00 to 9:00pm
- March 17 — 8:30 to 11:30am
Vaccine Safety Study
CANVAS-COVID is an initiative that is monitoring the safety of COVID-19 vaccines in Canada. Over one million Canadians are enrolled to monitor health events after vaccination. Their updated results, current to February 16, found that:
- 52% of people experienced pain, swelling or redness at the injection site.
- 91% of people did not develop any other health events within 7 days after a first or second dose, and 95% did not develop a health event that prevented daily activities, work or required a medical visit.
- The most common other health events reported include flu-like symptoms (4.6%), headache or migraine (3.4%),or nausea, vomiting or diarrhea (2.0%).
- They have also found that shingles is not occurring more frequently after vaccination.
Latest on Vaccine Effectiveness
A pair of U.S. CDC studies add to the evidence about the effectiveness of COVID-19 vaccines:
- mRNA vaccines offer strong protection against hospitalization, with 91% effectiveness against hospitalization during the 2 months after a booster dose, compared to 54% five months or longer after a second dose. This was measured during the Omicron-dominant period. See the CDC MMWR report here.
- Completion of the two-dose mRNA vaccine during pregnancy appears to pass on protection to infants, with 61% effectiveness against hospitalization within the first 6 months after birth. See the relevant CDC MMWR report here.
Our New Bannatyne Office!
We are excited to announce that we have opened a second office, Doctors Manitoba @ Bannatyne. This responds to feedback from members, including residents, students and GFTs, who wanted Doctors Manitoba to be more accessible.
Location: Our Bannatyne office is located on the second floor of the Basic Medical Sciences building, across the hall from the lecture theatres. Hours: We will have staff present in the office for drop-ins or appointments several days per week.
See our schedule and a map with our location at DRMB.ca/bannatyne. The University has restricted campus access during the pandemic. If you do not have swipe card access to the Bannatyne campus, make arrangements with our staff for access to the building.
Free Notary Services
Once per month, we will have lawyers on site to assist with legal advice and referrals. This includes offering complimentary notary services for our members, including students and residents. Often, physicians and medical learners need official documents notarized, including applications for fellowships, credentials and travel. Ensure you bring appropriate photo ID with you if documents require your identity to be certified. Our legal advice extends to other areas too. For example, some may need advice about agreements they may be asked to sign for positions or return-of-service after residency.
Our General Counsel, Andrew Swan, will be at our Bannatyne Office this Monday, February 28 from 9 – 4PM. Our Director of Negotiations, Allison Crolly, is also a lawyer and will be on site periodically as well.
Backlog Grows to 161,000
Last week we announced that Manitoba’s Diagnostic and Surgical backlog has grown to a staggering 161,585 cases, an increase of 7,748 in one month. This includes:
- 52,327 surgeries, up 2,168 over the last month.
- 42,524 diagnostic imaging procedures, a decrease of 35 cases over the last month.
- 66,786 other diagnostic procedures, including allergy tests, endoscopies, mammograms, sleep disorder studies, and lung function tests, an increase of 5,615 cases over the last month.
This estimate includes a variety of specialized lung function and respiratory tests used to diagnose, treat, and monitor acute and chronic lung conditions, such as COPD, asthma and pulmonary fibrosis, as well as shortness of breath after COVID. These tests are also used to assess fitness for surgery, including for lung cancer.
Specialized tests include pulmonary function tests, six-minute walk tests, gas exchanges and pulmonary provocations. It does not include spirometry.
Based on Doctors Manitoba’s analysis, there is an estimated backlog of 8,848 lung function tests as of January 2022, including both adult and pediatric patients. The volume of these tests completed during the pandemic appears to have decreased by about 40%. Lung function tests are primarily performed in hospital, though there is potential for more to be done in non-hospital settings such as clinics.
We continue to keep track of the estimated backlog on our website.
Town Hall with Task Force
Join us on March 2 for a special virtual Town Hall with the Diagnostic and Surgical Recovery Task Force, organized by Doctors Manitoba for the medical community.
The Task Force was appointed by the government in December to address the growing backlog of surgeries and diagnostic procedures caused by pandemic disruptions. This was one of three recommendations Doctors Manitoba made in June last year in our first report on the backlog.
The Town Hall will feature a presentation from the Task Force leads followed by an extended Q&A to take questions and suggestions from physicians.The panel will include:
- Dr. Peter MacDonald, Chair of the Task Force and an orthopedic surgeon in Winnipeg
- Dr. Ed Buchel, Provincial Specialty Lead for Surgery
- Dr. Marco Essig, Provincial Specialty Lead for Diagnostic Imaging
- Mr. Matthew Lister, Task Force Director
Please join us for this important event. Registration in advance is required
- Date: Wednesday, March 2
- Time: 6:30PM
- Where: Registration for Zoom Town Hall is required: Click here.
When you register, you will have the opportunity to submit a question or suggestion for the Task Force. You will also be able to submit questions live during the Town Hall. We will do our best to get to as many questions as possible during the event. For background, you can learn more about the Task Force here:
- Task Force Website, including links to its mandate, membership, and progress updates.
- Message to Physicians from Task Force Chair
Mental Health and Community Wellness Roadmap Unveiled
The province unveiled its Mental Health and Community Wellness Roadmap. The five-year plan, aimed at creating an integrated, responsive and accessible system to improve wellness, mental health, substance use and addictions services and programs in Manitoba, was developed after gathering data from experts, advocates and those with lived experience. With Manitoba leading the country in mental health and substance use and addiction needs, having the highest suicide rate in the country, and seeing an increased strain that COVID-19 has had on Manitobans, the plan will focus on five strategic focus areas over the next five years. They include:
- Equitable Access and Coordination
- Mental Well-Being and Chronic Disease Prevention
- Quality and Innovation
- Governance and Accountability
- Indigenous Partnership and Wellness
Last week the province announced that they will invest $2 million towards supports for post-pandemic mental health and addictions recovery. $2.9 million will also be contributed from United Way donors. This funding partnership enables community-based organizations to receive up to $225,000 over a three-year period to address significant needs such as counselling wait times and culturally relevant mental health and addictions service provision. The funding expected to increase capacity and offer better support to all Manitobans, but especially to marginalized people who have been disproportionately impacted by the pandemic.
RAAM On-Call Reminder
Shared Health and all 5 health regions have joined together to provide RAAM On-Call as a resource for physicians and other health providers who need urgent 24/7 assistance with patients associated with a Rapid Access to Addiction Medicine (RAAM) clinic when staff are unavailable. When calling the hotline, you should have the patient’s full name, DOB, and PHIN. Clinical details need for the call include patient’s active diagnoses, their current medications, pharmacy information, their last clinical assessment details, the next planned clinic date and any other relevant information to the call.
Patients can access RAAM clinics in Winnipeg, Brandon, Selkirk and Thompson. To learn more about the program and to find clinic locations and hours, click here.
Wordle Challenge Extended!
We are extending our Wordle challenge deadline! You will now have until March 15 to enter. We are making the change because as the game was migrated over to the New York Times websites, some have reported losing their stats.
Note: you can try to fix this by clicking the original Wordle link using the same device and browser you’ve been playing on, and your previous stats are supposed to migrate over to the new site. However, this may not work for everyone.
A reminder on how to play and how to enter the contest:
- You must complete at least 20 Wordles and submit your entry by March 15, 2022.
- You must play on the official site (bookmark this link). No apps or imitators qualify.
- After playing at least 20 rounds, submit a screenshot of your Wordle statistics using this entry form. (See sample here)
To win, you must have the lowest average (mean) after at least 20 plays. In the event of a tie, the winner will be selected from the tied contestants by random draw. The winner must be a Doctors Manitoba member. Doctors Manitoba reserves the right to disqualify submissions that don’t appear genuine it its own judgment.
What do you win? The winner will receive a $200 gift card for a local business of their choice that will improve their joy and well-being.
What is Wordle? Designed by a software engineer for his word-game-loving wife, web-based word puzzle has quickly become popular. You have six attempts to guess the a five-letter word. With each guess, the game uses colour coding to indicate which letter is correct and in the right spot, correct but in the wrong spot, or not in the answer at all that day. A new puzzle is released daily and you can only play it on that day.
- Masks in Doctor’s Offices: We have confirmed that doctors’ offices can and should continue to require patients to wear masks for the time being, even after the provincial mask requirements are lifted on March 15. Dr. Roussin also re-inforced this last week, indicating that some businesses and health facilities may continue requiring masks. We have mask posters you can use in your office: full colour version and low-ink version.
- PaRx — Manitoba physicians can now prescribe the outdoors to their patients through the new PaRx program. Learn more here.
- We’ve advocated for RATs for Rural & Norther Doctors’ offices & an extension for Isolation Benefits
- Rapid tests are now available for pick-up at provincial test sites for anyone, including those who are asymptomatic. Public Health is not recommending their use for general asymptomatic testing of the public, but rather to keep on hand at home should symptoms develop.
The 2021 Martha Donovan Women’s Leadership Development Awards provide leadership opportunities for women in the Rady Faculty of Health Sciences. Congratulations to this year’s recipients, which include 3 of our members:
- Dr. Aviva Goldberg
- Dr. Erin Knight
- Ms. Allison Balasko
Congratulations to Dr. Paul Van Caeseele, one of our 2021 Medal of Excellence recipients, who was recently recognized as one of Scheif’s Healthcare Heroes for his tireless efforts researching and investigating COVID-19, improving testing and supporting public health efforts.
We want to share physician accomplishments with our members! Do you know of a colleague who has received an award or recognition for the work they do? We’d like to hear about it. If you know of a physician or medical learner who has been recognized with an award or honour, please let us know by emailing firstname.lastname@example.org!Let’s get more Manitoba physicians recognized:
- Nominations are open for the Canadian Medical Hall of Fame, due June 13. Read nomination FAQs about nomination here and tips on creating a compelling nomination package here.
- The WXN Top 100 Most Powerful Women Awards are open for nominations, due May 17. The awards celebrate Canada’s women leaders who lead selflessly with humility and authenticity, lift others up around them and who face adversity with bravery and strength. Nominate a colleague or yourself today!
- Do you know a UM graduate who has achieved outstanding accomplishments in their professional and personal lives? Nominate them for a Distinguished Alumni Award. Find out more here and nominate someone here.
Upcoming Events & Learning Opportunities
Bookmark our Events Calendar to be sure you don’t miss any events or learning opportunities that interest you.
The Continuing Professional Development (CPD) Medicine Program recently launched its new online learning platform. The program provides evidence-informed educational opportunities for lifelong learning, competence and sustained practice change, in a culturally safe and responsive manner. You can learn about upcoming courses and learning modules here and here.
Practical Strategies for Meaningful Allyship in Indigenous Health and Beyond
This webinar is being offered on two separate dates: March 4 and 11 from 12 – 1pm.By the end of the session, participants will be able to define the concept of allyship and how it is distinct or complementary to other related concepts health professions education. Participants will learn to identify strategies to build and enact allyship within one’s individual and collective spheres of influence.For more information, please contact Angie Horrock at email@example.com
Early Career Learning Series
CMA Joule recognizes the challenges new physicians face and is offering a Early Career Learning Series to help early career physicians increase awareness and competency in key areas crucial to success. Learn more about the four sessions being offered here.
Physician Leadership Institute Course for Physicians Practicing in PMH, NHR, or IERHA
Your colleagues, Doctors Manitoba, CMA Joule, and IERHA, through the Affinity-funded Physician Health and Wellness Community of Practice, want to reduce physician burnout and increase physician wellness. Since leadership skills have a measurable impact on burnout and satisfaction we are pleased to offer all three participating pilot regions the opportunity to participate in these virtual Physician Leadership Institute (PLI) courses as a small contribution toward this goal. A formal leadership role is not required. The course is aligned with the LEADS in a Caring Environment framework.Questions? Email: firstname.lastname@example.org.
Leading with Emotional Intelligence — March 3 & 10 — 9am‑3:30pm11.5 accredited CPD hours
Learn more and register here before February 1 (limited spots available)
Cost: $200 each course (subsidized) Costs may be eligible for reimbursement through the DRMB CME Rebate