In this week’s message you will find:

• COVID-19 Situation Update
• Vaccine Update
• Pediatric COVID-19 Vaccine Town Hall
• Surgery & Diagnostic Backlog in the News
• Have your say: Surveys
• Celebrate Physicians
• Saturday is Physician Assistant Day
• Events & Webinars

COVID Updates

Since our last update on Thursday, November 18:

• Daily cases up: 1,091 new cases of COVID-19 have been identified, a daily average of 181 (up from 136). This includes 183 new cases today. The total case count in Manitoba now stands at 67,275.
• Test positivity up slightly: The provincial five-day test positivity rate is 5.5%, up from 5.4%. In Winnipeg, it is 2.5% in Winnipeg, down from 2.9% last week. 
• Active cases up: There are 1,493 active COVID-19 cases province-wide, up from 1,404.
• Hospitalizations down: There are 136 people in Manitoba hospitals due to COVID-19, down from 157 from last week. This includes 24 COVID-related patients in Manitoba ICUs, down from 30 last week. 
• Twenty-three more people have died from COVID-19. This brings the total COVID-19 related deaths to 1,304.

According to Health Canada’s tracking, Manitoba had 80 cases per 100,000 over the last seven days, up from 72 last week. Manitoba now leads all provinces with the highest rate of new cases, though still much lower than rates reached earlier this fall in Alberta and Saskatchewan. The overall national average stands at 47 per 100,000.

Seroprevalence Dashboard

The COVID-19 Immunity Task Force is now publishing a dashboard to show COVID-19 anti-bodies among blood donors. The latest results are from August 2021 and find that 96% of Canadians showed evidence of antibodies, primarily due to vaccination as only 4.4% of antibodies were from a past infection. This is very similar to the results for Manitoba, with antibodies found in 95% of blood donors. However, the rate of past infections is higher at 7.5%. You can view the dashboard here.

International Travel Testing and Vaccination Updates

Starting November 30, fully-vaccinated Canadians and permanent residents who leave and return to Canada within 72 hours of leaving will no longer have to provide a pre-entry PCR (molecular) test result. This will also apply to their accompanying children under 12, regardless of vaccination status. A negative PCR test will still be required for international trips that last longer than 72 hours.

Also starting November 30, Health Canada will begin recognizing vaccines authorized by the World Health Organization for travel entry, including Bharat Biotect, Sinopharm and Sinovac. Mixed doses will also be recognized.

Further information is available on the government of Canada’s travel information page.

Province Invests in School Ventilation UpgradesThe provincial government announced today that it is investing nearly $7 million to improve school ventilation, with priority given to schools in regions with higher levels of community transmission of COVID-19. This is in addition to $2.1 million already spent by schools on upgrading ventilation systems. 

Vaccine Updates

The pediatric COVID-19 vaccine has been authorized by Health Canada and is now available in Manitoba. The first children received their first doses yesterday. The province has signaled it will rely more on physicians and pharmacists for this portion of the immunization roll-out, so we have several updates and resources for you!
Pediatric Doses in Physicians’ OfficesWe understand deliveries of pediatric doses of the Pfizer COVID-19 to doctors’ offices and pharmacies began yesterday and should be complete by Monday, for those locations that ordered before the initial deadline. The weekly order form now includes the pediatric vaccine. 

If you have not yet signed up to offer COVID vaccines in your practice, you can register here.

New Pediatric Dose Tariff

Like other COVID-19 vaccines, physicians must submit a claim for each pediatric dose administered within 48 hours. The remuneration for each dose is $20, recognizing the additional time and resources involved with administering COVID-19 vaccines. The tariff for a pediatric Pfizer dose is 8292.

You can view all COVID-19 vaccine tariffs in our billing guide here. Note, this includes a new tariff for Moderna half doses, used for booster shots.

It is essential for physicians use the correct tariff code and promptly submit their claims.

Pediatric Vaccine Resources for Physicians

With the support of a group of pediatricians, Doctors Manitoba has produced two documents to support you with your pediatric COVID-19 vaccination efforts:

• Key Messages and Q&A: This document includes key messages to use when discussing the vaccine with patients, and a summary of evidence and information presented in a Q&A format. This is a good resource for physicians to have answers to common questions, with links to studies and other sources for further reading.
• Pain Management During Immunizations: Two out of three children experience needle fears. Physicians play an important role in providing a safe and comfortable environment for children to be immunized. This document reviews the ​“4 Ps of Pain Management” including tips for vaccine administration procedure techniques, body positioning, psychological strategies, and medication pain supports.

You and your patients may also be interested in this video created by Shared Health to prepare children for their vaccine. The video features pediatrician Dr. William Li, also part of Doctors Manitoba’s Board of Directors, and his friend, a sock puppet named Noname. Access the video here.

In addition, we have curated a list of other resources you may find helpful:

• Position Statement on COVID-19 Vaccine for Children 5 to 11 years of age (Canadian Paediatric Society)
• Clinical Practice Guidelines, updated with guidance for the pediatric population beginning on page 34 (Manitoba Health)
• Memo to providers about vaccine for children age five to 11, including details on packaging, dilution, dosage and storage (Manitoba Health)
• Public Fact Sheet for COVID-19 Vaccine for Children 5 to 11 years old (Manitoba Public Health)
• Summary of Recommendations from National Advisory Committee on Immunization (NACI)
• Full Recommendations and Evidence Summary from National Advisory Committee on Immunization (NACI)

Public Town Hall — Pediatric COVID-19 Vaccine

Please share this information with colleagues and patients! Next Tuesday, November 30 at 7pm, Doctors Manitoba will host a virtual town hall to answer questions about the COVID-19 vaccines for children age 5 – 11. Our panel of pediatric and vaccine experts include:

• Dr. Marni Hanna, President of the Manitoba Pediatric Society
• Dr. Ruth Grimes, President of the Canadian Paediatric Society
• Dr. Jared Bullard, Section Head of Pediatric Infectious Diseases and Associate Medical Director of Cadham Lab
• Dr. Joss Reimer, provincial COVID-19 vaccine Medical Lead and Medical Officer of Health
• Dr. Ashley Chopek, pediatric oncology and bone marrow transplant specialist

You can learn more about the town hall at Man​i​to​baVac​cine​.ca/​t​o​w​nhall. We encourage you to share the town hall with patients and on social media channels using the graphics here.

Surgery and Diagnostic Backlog Update

Doctors Manitoba is continuing our advocacy to address the backlog of surgery and diagnostic procedures. Earlier this week, we updated our estimate of the backlog and we launched a new dashboard to monitor the size of this staggering and growing backlog. Our new estimate suggests the backlog has grown to over 136,000 cases, an increase of more than 6,000 since last month. With more and more stories about Manitobans waiting for potentially life-saving procedures, others not able to lead their normal lives without surgery and still others who are taking their health into their own hands and travelling abroad for treatment, the health care system is in crisis and a plan needs to be made to address the backlog.

With coverage from media such as Global, and the Winnipeg Free Press Doctors Manitoba is advocating for a more bold commitment to addressing the backlog. You can monitor our backlog dashboard at Doc​tors​Man​i​to​ba​.ca/​b​a​cklog

On Tuesday, Manitoba’s new Premier Heather Stefanson’s agenda was presented in The Speech from the Throne. Our President, Dr. Kristjan Thompson, issued a statement on behalf of Doctors Manitoba, indicating we are encouraged the province will move forward with a task force to address the backlog, but we were disappointed more specifics weren’t included. The government missed an opportunity to set a bold target date to clear the backlog, as was done in BC. Dr. Thompson spent the afternoon answering reporters questions about Doctors Manitoba’s reaction to the Throne Speech, ensuring physicians’ views were featured prominently in the news coverage. You can view Dr. Thompson’s statement here.

Talking to patients about the backlog

Patients are understandably upset and frustrated by longer wait lists and a lack of certainty about when they will get their surgery or diagnostic test. When you connect with patients who have faced cancellations or who are caught in the backlog, take an empathetic approach that also encourages patients to have their voice and concerns heard. Below you will find a template, which you can adapt for use in your practice.

Sample Patient Message

Your surgery/​test is delayed because of the enormous backlog that has accumulated during the pandemic.

I understand the wait list is long. While this is frustrating for me, I know it must be more frustrating and difficult for you. As a physician, I am not able to get my patients in faster without more capacity in our health system. Wait lists are being managed based on patient urgency and date of referral. If you feel your situation has changed, please contact your doctor to review your situation. If your situation becomes an emergency, call 911 or go to the nearest ER or urgent care centre.
Physicians are advocating for a plan to address this backlog, and reduce wait times for patients like you who are unfairly affected by this issue. While all provinces have seen some surgeries and diagnostic tests cancelled during the pandemic, Manitoba has been particularly hard hit. This situation was created partly because of the pandemic response, but also because our health care system was not prepared to handle the surge in COVID-19 patient admissions. This has led to surgeries and diagnostic tests being disrupted more than other in other provinces. 

Physicians are ready to pick up extra surgeries and tests to help the province catch up, but the health system still lacks the capacity and resources needed to make this happen. Doctors Manitoba, our professional association, is doing everything it can to advocate for more capacity. They are monitoring the backlog closely on behalf of physicians and their patients, and pressing health system leaders for urgent action and solutions. You can see their work at Doc​tors​Man​i​to​ba​.ca/​b​a​cklog.

If you are frustrated by the wait, please consider contacting your MLA or the Minister of Health to share your story and express your support for an urgent solution to this massive issue. 

Physician Views Needed!

Last Chance — Harassment and Abuse Survey

With frustrations mounting as a result of vaccine mandates and surgery and diagnostic testing backlog, physicians are facing a significant increase in threats, harassment and abuse. Our preliminary findings are very concerning, suggesting over half of physicians have experienced an increase in these incidents.
Please take a few minutes to complete our brief survey to share your experience, whether or not you have experienced these incidents. The survey should take about five minutes to complete. 

→ Take survey now.

National Physician Survey Closes Friday

The Canadian Medical Association (CMA) is inviting all practicing physicians and medical learners to participate in its 2021 National Physician Health Survey, even if you are not a CMA member. This is a critical time to understand the key factors affecting your practice, daily interactions, lifestyle, and mental health, as well as how the pandemic has affected pre-existing challenges or brought about new ones. By sharing your experiences, you will be supporting the CMA and other stakeholders in identifying the individual and system-level changes needed to better support physicians, create a healthier medical culture and guide our country’s post-pandemic recovery. We will have access to data specific to Manitoba, which will help us inform programming and supports for our members.The survey should take less than 20 minutes; your time is greatly appreciated. You do not need to be a CMA member to participate. → Complete the survey by Nov. 26

COVID-19 Palliative Care Survey for Physicians

Dignity in Care Research, based out of the Department of Psychiatry at the University of Manitoba and led by Dr. Harvey Chochinov, is currently conducting a national research study on understanding the Experiences of Frontline Healthcare Providers Who Have Cared for Dying Patients during the COVID-19 Pandemic. Take the survey HERE.

Contact the research team at dignityincare@​umanitoba.​ca if you have any further questions or click HERE to learn more.

Celebrate Manitoba’s Physicians

See Highlights and Videos from our Awards Celebration! 

On Saturday, about 400 guests gathered at the RBC Convention Centre for our in-person Awards Celebration Dinner. This was the first in-person awards celebration since May 2019. With pandemic precautions in place, physicians gathered to celebrate our profession, reconnected with colleagues and offer each other support through this difficult period. 

For those who attended, and for those who were not able to join us, we have photos and videos from the event! Check out our recap here, and share the videos with colleagues in your professional networks. 

Our 2022 Awards Nominations are Due December 15!

We are pleased to announce that nominations are now open for the 2022 Doctors Manitoba Awards! Nominations are due by December 14, 2021​.As the pandemic continues to disrupt medical care and so many other things in our lives, we don’t want to lose sight of recognizing excellence in the medical profession. The Doctors Manitoba Awards are the highest honour in the province for physicians. There are no shortage of physicians who have been demonstrating excellence this year. For some, this has meant contributing to the pandemic response and vaccination campaign in some way. For others, it has meant persevering during the pandemic to continue their work on patient care, research and other priorities. 

→ Nominate a colleague today.

CMA Awards — Call for Nominations

Nominations are now open for the 2022 Canadian Medical Association (CMA) Awards. The CMA Awards recognize the dedication, successes and talents of Canadians who are making significant contributions to our health and health care. For information on how to nominate a colleague click here. The submission deadline is November 30, 2021.

Nominate Jets Health Care Heroes

Shared Health and the Winnipeg Jets have teamed up to bring you Scheif’s Healthcare Heroes. You can now nominate a colleague or peer to be featured and celebrated at a Winnipeg Jets home game. Nominees will have​“stepped up in immeasurable ways, supporting patients, residents and clients navigate the additional stress of accessing health services during a pandemic.” Each home game will celebrate a Manitoban working in healthcare who has made an impact during the pandemic. You can nominate someone here. Nominations are open now, until December 31. A new call for nominees will open in the New Year.

Saturday is National Physician Assistant Day!

We encourage physicians to support and celebrate Manitoba’s Physician Assistants on Saturday. National Physician Assistant Day is an opportunity to recognize physician assistant (PA) profession and its contribution to health care in Canada. These past two years PAs have worked tirelessly, contributing on the front lines of the pandemic. Their contribution as team members in collaborative healthcare allows physicians to find great work life balance by stabilizing patient access and easing workload. Use your social media channels and #CanadaNeedsPAs or personally thank a PA who you have worked with this Saturday.

Upcoming Events & Workshops

Physician Leadership Speaker Series Continues!

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 the series here. Download and print a poster to share with colleagues. 

WCB Workshop

The Workers Compensation Board of Manitoba invites physicians to a free online workshop: Supporting Return to Health and Work after an InjuryOn Wednesday, December 15, 2021; 6 p.m. to 8 p.m. join Dr. Mitch Cosman, Chief Medical Officer, and Dr. Cam Stacey, Medical Consultant to the WCB, for a two-hour online session covering best practice for fitness for work determination and use case studies applicable for you in your day-to-day practice. At the end of the workshop, the WCB will conduct a brief focus group to gather information for the development of future workshops.

You can find more information here 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 12^th. 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.