In today’s message you will find:

COVID Surveillance Update

Serious Outcome Surveillance:

  • Hospitalizations up: There are 297 people in hospitals due to COVID-19, up from 228 on Monday. This has nearly doubled in nearly three weeks. 
  • Daily hospital admissions up: There were 22 people admitted to hospital yesterday with COVID-19. So far this week, daily COVID-19 hospital admissions have average 30 per day.
  • ICU census up: Of the hospitalizations reported above, 34 patients are in ICU, up from 32 on Monday. There have been three to four COVID-related ICU admissions per day over the last week. There are a total of 96 patients in ICUs.
  • Ten more people have died from COVID-19. This brings the total COVID-19 related deaths to 1,408.

According to the COVID-19 Tracker Canada Project, Manitoba has 21.5 people people hospitalized with COVID-19 per 100,000, up from 16.5 on Monday. This is second only to Quebec, with 24.8 COVID hospitalizations per 100,000 residents.

Surveillance indicators (interpret with caution due to PCR testing prioritization):

  • Daily cases up significantly: 9,343 new cases of COVID-19 have been identified since Monday, a daily average of 2,336. This includes a record breaking 3,265 new cases today, though a portion of this includes a catch up on the backlog of tests. The total case count in Manitoba now stands at 94,850.
  • Test positivity jumps: The provincial five-day test positivity rate is 44.4%, from 37.9% on Monday.
  • Active cases jump: There are 24,595 active COVID-19 cases province-wide, up from 15,318 on Monday.

On Wednesday, Dr. Jazz Atwal provided an update to Manitobans and said the daily case counts, while record breaking, are also a significant under count. Public Health estimates the true number of new daily cases could be eight to ten times as high. 

According to Health Canada’s tracking, Manitoba had 939 cases per 100,000 over the last seven days, up from 417 a week ago. Manitoba’s rate is second to Quebec, with (1,273 cases per 100,000), though comparing jurisdictions is becoming challenging as testing capacity is strained and prioritized in many provinces. 

COVID Town Hall for Physicians

Join us this Wednesday for an exclusive COVID-19 Update for Physicians, with Dr. Brent Roussin, Dr. Joss Reimer, Dr. Allen Kraut and Dr. Jose Francois.

Omicron has been a game changer, and we are hearing many of the same questions from physicians that we heard at the beginning of the pandemic about appropriate precautions to take in their work place, how to see and treat symptomatic patients, and what might come next in the pandemic. 

Doctors Manitoba has organized this town hall-style update with an expert panel, to provide physicians with important updates and to take your questions, The panel includes:

  • Dr. Brent Roussin, Chief Provincial Public Health Officer, who will provide an update on what to expect next with Omicron as well as updates on isolation requirements and testing. 
  • Dr. Joss Reimer, the Medical Lead for the Vaccine Implementation Task Force, to provide an update on the latest evidence about COVID-19 vaccines and Omicron.
  • Dr. Allen Kraut, Medical Director of Occupational Health, who will share updated data about health care worker infections and the latest guidance about workplace precautions, isolation and return-to-work.
  • Dr. Jose Francois, Provincial Specialty Lead for Primary Care, who will offer insights on how to continue providing outpatient care during this Omicron surge. 

The Town Hall is open to physicians and medical learners only, and advance registration is required:

Attendees can submit questions in advance for the panel. They can also be submitted live during the webinar. We will do our best to answer all of the questions submitted. 

Pandemic Restrictions Extended

The current public health orders in Manitoba have been extended to February 1. They had been set to to expire after Monday, January 10. In announcing the extension today, Health Minister Audrey Gordon explained that while these orders remain in place, we continue to take steps to improve supply and access to testing and other important initiatives that support our pandemic response and protect our health system. Nothing is off the table and we will act swiftly in the weeks ahead if further action is required to protect Manitobans.” 

Manitoba remains at Restricted (Orange) on the pandemic response system. Some have criticized this decision, suggesting the criteria for Critical (Red) clearly reflects the current pandemic situation in Manitoba. The Red criteria includes:

  • The virus is being transmitted at levels that public health and the health system cannot manage.
  • Extensive community transmission is occurring.
  • There are widespread outbreaks and new clusters that cannot be controlled through testing and contact tracing.
  • The health care system may be close to or over capacity. 

The government sets the pandemic response level. 

Return-to-School Delay Raises Concerns

Earlier this week, the government announced its plan to further delay the return to in-class learning to January 17. Remote learning will begin on Monday January 10, though in-person classes will be available for students of critical service workers in kindergarten to Grade 6 and all high-risk students and students with special learning needs in kindergarten to Grade 12 to attend school if no alternate care is available. 

The move followed concerns raised by teachers about safety of returning to in-person instruction. The Premier and Education Minister, in announcing the change, said this week would provide schools time to be better prepared for in-person learning, including planning for expected staffing shortages and implementing enhanced measures” to reduce the spread of COVID-19. The government will be distributing more medical masks and rapid test kits to schools and will continue to support ventilation improvements. 

Pediatricians in Manitoba have raised serious concerns about delaying in-person learning for children. In advance of the school announcement, the Manitoba Pediatric Society wrote to the government strongly recommending that in-person learning remain a priority, noting the importance to children’s mental, physical and developmental health. They group supported measures to support health and safety in schools, including higher quality masks for school staff, encouraging vaccine uptake, improving ventilation and expanding the use of rapid tests. 

In-person learning is so vital to children, and pausing it again will have negative impacts on their mental and physical health,” said Dr. Marni Hanna, President of the Manitoba Pediatric Society. Just like hospitals, schools are an essential service and should remain open. If a closure is needed, schools should be one of the last services to be locked down.”

Dr. Ruth Grimes, President of the Canadian Paediatric Society, agrees. She explains that the evidence here and from other jurisdictions confirms that with appropriate precautions in place, schools are not a driver of transmission, but simply reflect broader community transmission.” 

Dr. Grimes and Dr. Hanna have written jointly to the government about the importance of proceeding with safe, in-person learning on January 17. You can see a copy of their letter here.

The views of pediatricians in Manitoba are not unique. In Ontario, where schools have also delayed in-person classes until January 17, over 500 physicians signed an open letter asking the government to keep schools open, and not use school closures as a means to control the spread of COVID-19.

Dr. Hanna remains hopeful that schools will reopen to in-person learning on January 17th. I sincerely hope the government uses this extra week to ensure schools are ready to reopen with the additional precautions in place, and that they also use this time to work with teachers, school administrators and others to share evidence and offer reassurance about a safe return to in-person learning,” she added. 

Physicians can help over the next week by reinforcing these perspectives with parents and patients. They can also help parents prepare their children for a return to in-person learning by offering tips on wearing a tight-fitting, appropriately sized mask, providing guidance on how to correctly put on and remove the mask, and reminders about hand hygiene.

It is likely that cases will increase among children and teachers, including some hospitalizations, even if schools reopen, because of how highly transmissible Omicron is. The pediatricians we connected with today have an important message about this: This does not mean schools are not safe or that they need to be shut down or that the various interventions that have been introduced are failing. It is a reflection of the communicability of the omicron variant in the community as a whole and that the safest option for children for their long-term health, for a variety of reasons, remains in-person schooling.” 

How does Manitoba’s Approach Compare?

BC, Alberta and Saskatchewan are proceeding with in-person classes resuming this week or on Monday. Most other provinces are resuming classes on Monday with remote learning, with plans to resume in-person classes on January 17. New Brunswick is the only province that has delayed in-person learning, with plans to resume on January 24

HCW Infections / Get Boosted

COVID-19 infections in health care workers have sky-rocketed over the last few weeks, though most of the infections appear to be acquired outside of work.

The first case of Omicron was discovered in Manitoba on December 7. Up to that point, there had been 3,061 positive cases identified among health care workers during the pandemic. By New Year’s Day — just four weeks later — 1,440 more cases were identified, including 915 in just the last week of December.

So far, 184 cases have been identified in physicians, residents and medical students, a steep increase from the 103 cases that had been identified through the pandemic before Omicron arrived.

While we don’t have physician-specific information, we’ve heard that many of the health care worker cases being identified have not received their booster shots. Third doses offer stronger protection. Please encourage your colleagues and staff to get boosted as soon as possible. You can refer people to Man​i​to​baVac​cine​.ca (add link) to find a physician near them offering COVID-19 vaccines.

According to public health reporting, people who are not fully vaccinated with two doses are twice as likely to test positive for COVID-19, seven times more likely to be hospitalized, 26 times more likely to require intensive care and 14 times more likely to die with COVID-19. This protection only improves with a booster shot.

Testing Guidance Updated Again

On Wednesday, public health updated COVID-19 testing guidance again to ensure PCR testing is prioritized appropriately for specific groups. All symptomatic individuals continue to be eligible for testing in Manitoba, unlike some other provinces, but many attending provincial testing sites will receive take-home rapid antigen tests instead of a PCR test. Asymptomatic people should not access testing, unless specifically directed by public health or listed in the eligibility list. 

Health care workers providing direct patient care continue to be eligible for a PCR test after testing positive on a rapid antigen test. 

According to information on the provincial testing page, the following individuals are eligible for rapid test kits at provincial testing sites: individuals age five and older with COVID-19 symptoms, asymptomatic household close contacts who are exempt from self-isolation, and those directed by public health. 

PCR testing are being prioritized for the following symptomatic people:

  • Hospitalized patients
  • Patients seeing a physician if the physician determines a PCR test is important for medical management
  • People who may be eligible for a COVID-19 treatment and a PCR test is required by the prescribing clinician
  • Children or others unable to do a take-home test
  • People with moderate to severe compromised immune systems
  • Underhoused or homeless individuals
  • People who have travelled outside of Canada in the past 14 days. 

PCR testing is available following a positive rapid test for individuals who are:

  • Health care workers or first responders providing direct patient care
  • Staff and designated family caregivers with direct contact with patients or residents in hospitals or congregate living settings (PCH, assisted living, group homes, shelters, correctional facilities)
  • Asymptomatic unvaccinated staff in designated settings, including health care
  • Children and staff at K‑12 schools and childcare centres

PCR testing is also available to people being admitted to hospital or PCH, for pre-operative assessment, residents of First Nations communities and people traveling to and from First Nations and Indigenous Northern Affairs communities.

Fantastic Physicians

Congratulations to Dr. Barry Lavallee who received the 2022 Certificate of Merit from the University of Manitoba. Dr. Lavallee, the Chief Executive Officer of Keewatinohk Inniniw Minoayawin Inc., was also named a 2021 Honorary Fellow of Royal College of Physicians and Surgeons of Canada and he and his team also received the UNIVANTS of Healthcare Excellence Award for their Kidney Check program. Congratulations, Dr. Lavallee!

Congratulations to medical student Stefon Irvine, and medical residents Dr. Fiona Vickers and Gabrielle Wilson on receiving the 2022 Rising Star Certificate of Excellence from the University of Manitoba and Canadian Association of Medical Education.

Upcoming Events

A Portrait of Omicron to Date — What We Know and Projected Consequences —  CanCOVID Speaker Series — January 11, 2pm (CST)

Join Dr. Peter Jüni as he shares a summary of global knowledge to date regarding efforts to understand the spread, interventions and projected consequences for this current wave, and strategies for recovery.

Peter Jüni, MD, FESC, Network Scientific Advisor, CanCOVID, Scientific Director, Ontario COVID-19 Science Advisory Table, Professor of Medicine and Epidemiology, Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Director, Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital

ZOOM link: https://​us06web​.zoom​.us/​j​/8198
Meeting ID: 819 8513 2912
Passcode: 016150
Click here to learn more about this event. 

While we encourage you to share this event within your networks, we ask that you not share the Zoom link or password directly on social media. This is to help limit hackers from accessing our event.

Managing Disruptive Behaviour (PLI) for Physicians Practicing in PMH, NHR, or IERHA

Your colleagues, Doctors Manitoba, CMA Joule, and PMH 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 the virtual Physician Leadership Institute (PLI) course, Managing Disruptive Behaviour, as a small contribution toward this goal. A formal leadership role is not required. Both courses are aligned with the LEADS in a Caring Environment framework. Questions? Email: jmacdonald@​doctorsmanitoba.​ca.

Managing Disruptive Behaviour — February 11 & 18 — 9am-4pm
Cost: $200 (subsidized) — 14 accredited CPD hours
Costs may be eligible for reimbursement through the DRMB CME Rebate
Learn more and register here before January 21

Demystifying Retirement Webinar presented by MD Financial Management Tuesday, January 25 2022 — 6 p.m. CST 

Guided by the results of the 2021 MD Physician Retirement Readiness Study, this webinar will explore strategies that you can leverage to help shift your retirement perspectives and how values-based financial planning can help set you up to live a truly fulfilled life in the chapters after your career in medicine.

Register or Register for recording

Physician Leadership Speaker Series — One Event Left!

Don’t miss: Mentorship and sponsorship models that promote equity in our educational & healthcare systems with Dr. Jamiu Busari — January 17 at 6pm CST.

ICYMI: Watch the on-demand video of the Psychological Safety talk with Dr. Ming-ka Chan and Dr. Anne Matlow here.

Physician Leadership in Challenging Times: Building Capacity Through Connection is a four-part speaker series to give physicians an opportunity to build their leadership skills and knowledge and create opportunities for growth. The series was created in partnership with Doctors Manitoba and the University of Manitoba, Office of Leadership Education for Rady Faculty of Health Sciences is offered with generous support from Canadian Medical Association. It is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. Learn more about Dr. Busari’s presentation here.

Immigrant and Refugee Mental Health Course

Funded by Immigration, Refugees and Citizenship Canada (IRCC), the course offers evidence-based information, tools and resources for service providers to provide mental health care and support to both immigrants and refugees arriving in Canada. The online course offers an overview on the social determinants of health and its impact on mental health, the role of migration trajectories and highlights the specific needs of sub populations.The course is designed to provide a uniquely interactive learning experience where service providers can consult with experts in the field, share ideas and experiences with hundreds of peers from all over Canada, and learn strategies to use on-the-job.For full details and registration information click here.

Autism and Neurodiversity in Primary Care — Part 1: ASD Diagnosis: Recognize & Refer

UBC CPD has partnered with the UBC Centre for Interdisciplinary Research and Collaboration in Autism (CIRCA) to create a two-part program on autism and neurodiversity filled with useful activities and videos. Part 1 is available now and is designed to assist primary care providers to better understand autism, recognize indicators of autism, and learn how to better support patients of all ages as they navigate the diagnostic process in BC. Part 2 will be available in late 2022 and will focus on the ongoing management of autism in primary care.Primary care is often the first point of contact with the healthcare system for individuals with autism. It is critical that you can recognize, refer, and manage autism in your practice.The course is on-demand through elearning and eligible for up to 2.0 Mainpro+ credits. You can learn more and register HERE.

Physician Leadership: Engaging Others — 2 day Virtual Course February 4 & 5, 2022 | 9:00am – 4:30pm (CT) — Register now.

In this PLI course, facilitated by Paul Mohapel, PhD and Monica Olsen, BScN, BA, MHRD, you will focus on the core skills and practical tools you need to nurture an engaged organizational culture. Please note that there is pre-course work that is due on January 12th. It is estimated to take 2.25 hours to complete the assessments and review the results.This program has been accredited by the College of Family Physicians of Canada for a minimum of 14.25 Mainpro-M1 credits. This event is a accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada and approved for a minimum of 14.25 credits. Participants should only claim credit for the actual number of hours attended.

Physician Leadership: Leading Change — 2 day Virtual Course March 10 & 11, 2022 | 9:00 am – 3:30 pm (CT) — Register now.

In this PLI course, facilitated by Brian Golden, MS, PhD, FCAHS and Joshua Tepper, MD, FCFP, MPH, MBA, you will learn the strategies you need to motivate, implement and sustain change in the complex system in which you practice. Although the course structure is guided by key readings and insight from your instructors, it is primarily conversation and experience based. Anticipate participating in discussions as you work through the challenges you are facing in real time. Please note that there is pre-course work for this event.This program has been accredited by the College of Family Physicians of Canada for a minimum of 11.5 Mainpro-M1 credits. This event is a accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada and approved for a minimum of 11.5 credits. Participants should only claim credit for the actual number of hours attended.

Allyship Webinar

Equity in Medicine and Sanokondu have made available for on demand viewing the recent workshop Effective Allyship: Advancing Women in Healthcare Leadership. With expertise and experience, panelists shared practical tips on how to be a good ally to advance women in healthcare leadership. You can view the webinar here.