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COVID Update

Since our update on Wednesday…

  • Hospital occupancy continues to decrease: There are 513 people in hospitals with COVID-19, down from 543 on Wednesday.
  • Hospital admissions continue to decline: There were 16 people admitted to hospital yesterday with COVID-19. The average over the last seven days has been 20 admissions per day, down from 28 per day the previous seven days. 
  • ICU occupancy high but declining: Of the hospitalizations reported above, 29 patients are in ICU, down from 40 on Wednesday. 
  • COVID-related ICU admissions have averaged one to two per day over the last seven days, with four admitted yesterday. This is down from three to four admissions per day during the previous seven day period. 
  • 12 more people have died from COVID-19 since Tuesday with the total now at 1,675.

According to the COVID-19 Tracker Canada Project, Manitoba has an average of 37 hospitalizations per 100,000, down from 40 on Tuesday 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).

BA.2 Variant
Emerging studies have found that the Omicron BA.2 sub-variant could be more contagious but it doesn’t appear more severe than the original strain of Omicron. The World Health Organization advises that BA.2 should be considered a variant of concern, and remain classified as Omicron. Monitoring in some countries, such as South Africa, have found that BA.2 has become the dominant strain. There is limited evidence of reinfection with BA.2 after BA.1, and it appears those infected with BA.1 have strong protection against BA.2 infections.

Dr. Peter Jüni, scientific director of Ontario’s COVID-19 Science Advisory Table, explained why he is cautiously optimistic about BA.2 in the Toronto Star: ​“We can expect that our wall of immunity that we built up through three-dose rollout and infection will hold. We also see preliminary data that suggests that it’s not the case that BA.2 results in higher risk of serious outcomes such as hospitalization, ICU admission or death than BA.1. We don’t have evidence to suggest that. All of that taken together is actually quite good news.”

Dr. Brent Roussin confirmed yesterday that two cases have been identified so far in Manitoba, though cases are hard to identify when most do not receive PCR testing. 

Vaccination/​Test Mandate Changes

Yesterday the government announced that the vaccination-or-testing requirement will end on March 1 for public sector workers, including for health-care workers.

The move caught many off-guard, including Doctors Manitoba President Dr. Kristjan Thompson. ​“I was surprised to learn today that the vaccine/​testing requirement for healthcare workers will be lifted on Tuesday,” he explained. ​“While the Omicron wave is receding, we are at a critical transitional stage in this pandemic, and our health facilities are not yet back to normal.”

The change coincides with the previously-announced end of the proof-of-vaccination requirement for many public places, like restaurants, gyms and other businesses. Yesterday, Dr. Roussin confirmed that while the requirement will end on March 1, businesses can opt to maintain the practice if they wish. Both the vaccine card and verifier apps will continue functioning. Within hours, the Winnipeg Jets, MTC and WSO all confirmed they will retain proof-of-vaccination for at least several weeks after the requirement ends on Tuesday.

What about Doctors’ Offices?

While the requirement will end in hospitals and other RHA-run facilities, Doctors Manitoba advises that independent medical clinics and doctors’ offices may be able to continue the policy in their practice. If a vaccine-or-test requirement is already in place for employees in your clinic, it is likely within your discretion as an employer to continue that policy beyond March 1. Members can reach out to Doctors Manitoba General Counsel Andrew Swan for general advice by emailing aswan@​doctorsmanitoba.​ca although specific legal advice for your clinic’s employment situation may be recommended.

Doctors’ offices, along with other businesses, can continue to require masks after that requirement ends on March 15. We have mask posters you can use in your office: full colour version and low-ink version.

Vaccine Update

Another COVID-19 vaccine has been approved by Health Canada. The vaccine, called Covifenz, was developed by Medicago, a biotechnology company based in Quebec City using plant-based technology. A plant host is used to make virus-like particles that help the body’s immune system make antibodies. Dr. Supriya Sharma, chief medical adviser at Health Canada, said the vaccine’s active ingredients consist of particles that mimic the spike protein of the virus that causes COVID-19, which allows the body to recognize them and spark an immune response. The virus-like particles mimic the natural structure of the virus without containing any of its genetic material, which makes the person’s immune system able to recognize the particles without causing infection.Other vaccines, including for HPV and hepatitis B, use virus-like particles, but Covifenz is the first to use plant-based technology.

Clinical trials suggested the vaccine — a two-dose series administered on a 21-day interval — was 71 per cent effective in protecting against COVID-19 infection one week after the second dose, and 100% effective against severe disease. Health Canada has authorized the vaccine for ages 18 – 64. The clinical trials had trouble recruiting enough participants age 65+ as so many had already been vaccinated, but research continues for this age group. Trials were conducted before Omicron became the dominant variant, but did take place with other variants, including Delta. Preliminary lab studies suggests the vaccine could be effective against Omicron as well.

The vaccine is expected to be available in May.

This comes on the heels of Health Canada approving Novavax’s COVID-19 vaccine earlier this month. Doses for that vaccine could be available mid-March. Both vaccines offer hope of reaching some who have been hesitant to accept mRNA or viral vector vaccines.

Claim Vaccine Expenses Now

If you’ve helped to promote and/​or administer COVID-19 vaccines, please ensure you apply for special funding we’ve negotiated in addition to fee-for-service visit and injection claims. The funding approved last year covers eligible expenses for patient outreach initiatives to email and phone patients about the vaccine, as well as scheduled vaccine clinics expenses including an administrative stipend and a minimum hourly remuneration guarantee for physicians.

So far, participating clinics are applying for an average of $2,000 in funding for their initial claims.

Funding is available until March 31, 2022, for vaccine outreach and clinic activities beginning:

  • September 21, 2021 if initiatives focused on first or second doses for age 12+
  • December 21, 2021 for all doses and eligible ages.

You can access a brief guide to tariffs and vaccine funding initiatives here. The claim forms are available here. Before submitting expenses, ensure your clinic is registered, and if necessary, that individual physicians are registered as well for direct deposit payment. 

Order Rapid Tests for Your Patients

Physicians can now order rapid test kits through Doctors Manitoba to provide to patients for their future home-use. The test kits will be shipped from the provincial government, who now has an ample supply to offer rapid test kits to the public more broadly.

These test kits, like those now available at provincial test sites, should be provided to asymptomatic patients for future at-home use, should they develop symptoms and need to self-test. The hope is that as physicians see patients for in-person appointments, you can offer patients free take-home rapid test kits for future use. This is also a good opportunity to remind them to be cautious as restrictions are lifted.

We recommend all doctors’ officers order test kits to offer to their patients. The province will announce publicly late next week that test kits will be available in doctors’ offices for patients who have appointments, but not for general public pick up.

You can order rapid tests now using this simple Doctors Manitoba form. We suggest one order per clinic or doctors’ office.

Combined Oral-Nasal Samples with Omicron The Ontario Science Table has issued a new Science Brief about the sensitivity of rapid antigen tests to detect Omicron cases, and the best way to use them.

The key findings from their review of the evidence find:

  • A combined oral-nasal sample helps rapid tests to more reliably detect infections cases of the Omicron variant. Individuals can obtain these samples by swabbing both cheeks, followed by the back of the tongue or throat, and then both nostrils. Video instructions on how to perform a combined oral-nasal swab can be found here for adults and here for children.
  • Rapid tests that rely solely on nasal swabs are less sensitive in detecting Omicron cases than Delta. The pooled sensitivity across several studies was 81% for Delta, but only 37% for Omicron, but this improves significantly with a combined oral-nasal sample.
  • A single positive rapid test result should reinforce the need for isolation and precautions and trigger consideration for early treatment. A single negative test result for a suspect case, however, should not be used as a ​“green light” for abandoning precautions or isolation.

Return-to-Canada Travel Testing As of Monday, February 28, travellers entering Canada will no longer have to take a pre-arrival PCR or other molecular test. Instead, travellers can opt for an ​“authorized” rapid antigen test taken no more than one day before their scheduled flight or arrival at a land border. PCR tests will still be accepted, but they are generally more expensive. Rapid tests must be authorized in the country and administered by a lab, healthcare entity or telehealth service. 

The advisory against non-essential international travel is also lifted.

Read more details in the Government of Canada’s update.

Black History Month

Doctors Manitoba celebrates the contributions that Black Canadians have made & continue to make in the field of medicine & across all disciplines.We have made Equity, Diversity & Inclusion a top priority when serving our members. Read our feature story about the University of Manitoba’s first Black female medical student, Dr. June James or read Shared Health’s recent story about the career of esteemed Pediatric Infectious Disease Specialist, Dr. Jared Bullard.

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

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.

ICYMI

A few recent updates, in case you missed them:

Upcoming Events and Training

Bookmark our Events Calendar to be sure you don’t miss any events or learning opportunities that interest you.

IHI Leaders in Safety Course (on-demand) — Register here.
In this free IHI Open School online course, you’ll explore the foundational role of leaders in keeping the health care workforce safe and strategies that have succeeded in reducing physical harm and improving psychological safety across organizations. 

MCFP Annual Scientific Assembly April 28 – 29 — Registerhere. Register for Manitoba’s premier family medicine conference in live streaming webinar format April 28 & 29. The MCFP Annual Scientific Assembly (ASA) provides the highest quality, expertly vetted, evidence-based education specific to the practice of Family Medicine. Since its inception, the MCFP has recognized the importance of providing members with continuing professional development opportunities and this year’s program will not disappoint.Certified for 1 credit per hour.

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 troy.​popadynetz@​gov.​mb.​ca. 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

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 ahorrock@​exchange.​hsc.​mb.​ca

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: jmacdonald@​doctorsmanitoba.​ca.
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

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