In today’s message you will find: 

• COVID-19 Situation Update
• Vaccine Update
• Attack at Seven Oaks
• 2022 DRMB Awards Nominations are now open
• Join us at the 2021 Awards Celebration on November 20
• Medical Students’ Insurance Information Event
• Provincial and Federal Political updates
• A few other items of note, ICYMI

COVID Update

Since our last update on Tuesday, October 26:

• Daily cases up: 376 new cases of COVID-19 have been identified, a daily average of 125 (up from 102). This includes 141 new cases today. The total case count in Manitoba now stands at 63,353.
• Test positivity down slightly: The provincial five-day test positivity rate is 3.9%, down from 4.3%.
• Active cases up: There are 1,217 active COVID-19 cases province-wide, up from 1,069.
• Hospitalizations up: There are 85 people in Manitoba hospitals due to COVID-19, up from 78. This includes 25 COVID-related patients in Manitoba ICUs, up from 17. 
• Nine more people have died from COVID-19. This brings the total COVID-19 related deaths to 1,246.

According to Health Canada’s tracking, Manitoba had 54 cases per 100,000 over the last seven days, up from 49 on Tuesday. While this is still the lowest among western provinces, it is higher than all of the provinces east of Manitoba. 

Vaccine & Testing Mandate Update

On Wednesday, Dr. Jazz Atwal provided an update on the implementation of the COVID-19 vaccination and testing requirement in the public sector. 

Among the approximately 42,000 direct care workers in the health care system, as of Wednesday:

• Only about 5% are reported to have selected testing (1,788 people) or refused either option (184 people).
• So far, 36,269 have indicated they are fully vaccinated.
• The remaining few thousand who have not responded are predominantly casual employees who have not worked recently. 

In the education system, there are about 41,000 staff. Of these, 36,540 have provided proof of vaccination and 3,129 have chosen testing. There are 143 on unpaid leave for not complying with the requirements. 

Halloween COVID Advice

Manitoba public health has issued advice for a COVID careful Halloween this year, especially as children under age 12 aren’t yet able to be vaccinated.
The tips, which can be found here, include:

• Staying home if you’re sick, even if symptoms are mild.
• Frequent hand washing/​sanitizing and use contactless candy distribution (e.g. tongs or candy chute). 
• Trick-or-treating with a small group who have normal social interactions, maintaining physical distancing between groups.
• Wear masks when physical distancing can’t be maintained, including in crowded outdoor settings. 
• Plan for outdoor activities as much as possible, and decorating houses/​yards for distance viewing.

→ View Manitoba Halloween COVID Tips

Vaccine Updates

Eligibility was expanded this week for COVID-19 booster shots, to include residents of congregate elderly person housing sites, such as assisted living (see public health memo). The booster shot should be given at least six months after the second dose. 

There are no other changes to eligibility this week. Previous groups identified for third doses or booster shots are listed at Man​i​to​baVac​cine​.ca. Please note that the eligibility for third doses for immuno-compromised individuals has not changed and includes individuals who are moderately to severely immuno-compromised, with specific conditions identified in the clinical practice guidelines and reflected at Man​i​to​baVac​cine​.ca.

Get Ready Now for Surge in Vaccine Demand

Physicians should get ready now for a surge in COVID-19 vaccine demand in their offices. More and more Manitobans will be eligible for booster shots, with seniors potentially eligible as early as next week, and all Manitobans could eligible in the next few months. It is also expected that federal regulators will make a decision on Pfizer’s vaccine for children age five to 11. 

We are encouraging physicians to support the ongoing COVID-19 vaccination campaign in the weeks ahead. The issues that made this challenging last winter and spring have largely been addressed, and there is a bigger role for physicians to play. There is now ample supply in the province, and we understand from the province that physicians should not experience delivery delays or disruptions this fall. We have worked with government to ensure remuneration for COVID-19 vaccination reflects the additional work required in supporting informed consent and addressing vaccine hesitancy. In many cases, physicians can claim $20 for the injection plus a patient visit (see our billing advice). We’ve also negotiated additional funding for physicians and clinics to support patient outreach and for holding COVID-19 vaccine information and immunization clinics. Learn more about that initiative here.

This opportunity is still open to all physicians, even if you have not ordered or administered COVID vaccines so far. If you haven’t yet signed up to offer the vaccine, visit the province’s site here to register.

Contact our team with any questions at covid19@​doctorsmanitoba.​ca.

More Evidence on Vaccine Effectiveness

New data out this week in Ontario adds to the compelling evidence about how effective the COVID-19 vaccines are. The Ontario Science Table’s analysis found that compared to fully vaccinated individuals, unvaccinated people have a 7‑fold higher risk of symptomatic COVID-19 disease, a 17-fold higher risk of being in hospital with COVID, and a 23-fold higher risk of being in the ICU.

Looking at data available in Manitoba, a similar trend can easily be identified. Among the 538 cases identified this week, 71% are among people not fully vaccinated, and unvaccinated people were 6 times more likely this week to test positive for COVID-19. Unvaccinated people are also currently 9 times more likely to be hospitalized with COVID-19 and 15 times more likely to be in ICU. 

Attack at Seven Oaks

By now, most of you have heard about the horrific attack on a manager at Seven Oaks General Hospital earlier this week. The nurse manager was stabbed mid-afternoon on Wednesday at a hospital clinic. After physicians and nurses attended to her injuries, she was transferred to HSC where she remains in critical, but stable, condition. A hospital employee — reported by the Free Press to be an ​“vehemently anti-vaccine nurse” — has been apprehended by police. He is also accused of murdering his mother just South of Winnipeg and his father in Winnipeg on Wednesday. 

We understand several physicians, nurses and other hospital employees witnessed the attempted murder, and were involved in intervening to end the attack and provide care to the victim. Whether or not you were present, or work at Seven Oaks, hearing about a daytime violent attack on a health care worker in a hospital can certainly be distressing news. 

Yesterday, our CEO Theresa Oswald sent a message to Seven Oaks physicians offering our support and sharing physician health resources so they are easily accessible for physicians and medical learners. These include:

• The Physician and Family Support Program, which offers 24/7 access for counseling, wellness information and more. Phone 1−844−436−2762 anytime for help, or visit Guidance Resources (register using DOCSMB as company ID). Learn more about this program here.
• MDCare, a comprehensive clinic offering practicing physicians with a full range of psychiatric and psychological services. Contact the confidential self-referral intake line at 204−480−1310. Learn more about MDCare here.
• Physicians at Risk (PAR), offering individual and peer support for social, relationship, financial, behavioural or substance-abuse issues. Contact the confidential self-referral intake line at 204−237−8320. Learn more about PAR here.
• Student Services @ Bannatyne Campus offers counselling, mental health supports and other help to students. Contact SS@BC by emailing bcstudentservices@​umanitoba.​ca or phoning 204−272−3190.

Our attention this week is on ensuring physicians impacted by this incident have the support they need. Reach out to colleagues and offer support, and keep these resources in case a colleague needs them. 

There will be time in the days and weeks ahead to recognize how physicians and others intervened during the attack and provided care afterwards. For now, please remember that as information emerges, some of it factual and some of it incomplete or inaccurate. Watch for information from officials sources. 

Your Safety During the Pandemic

We don’t yet know if this incident had a connection to COVID-19 or vaccination, but we are seeing a rise in concerning behaviour in this area, such as threats, bullying, harassment and verbal abuse. If you’re worried about this, or have been the victim of such behaviour, please review the following Doctors Manitoba resources:

• Guide to Physician Safety During the Pandemic
• Report incidents confidentially to Doctors Manitoba

Nominations Open for Doctors Manitoba 2022 Awards! 

We are pleased to announce that nominations are now open for the 2022 Doctors Manitoba Awards! Nominations are due by December 15, 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.

There are five different awards available to recognize physicians: 

• Doctors Manitoba Medal of Excellence – a relatively new honour to recognize those who demonstrate excellence in the medical profession and whose actions are a source of inspiration for other physicians.
• Physician of the Year Award – to celebrate an exceptional achievement or contribution to the practice of medicine and/​or to the community by a member of Doctors Manitoba.
• Distinguished Service Award – to recognize a long career of services to patients and the community that embodies the highest standards and ideals of the medical profession, and in the promotion of the art and science of medicine through teaching, writing and administration. This is an excellent option to consider for physicians approaching retirement or who have recently retired.
• Resident of the Year – for excellence in academic and clinical training and noteworthy contributions to the resident’s home program/​specialty or residency program.
• Dr. Jack Armstrong Humanitarian Award – to celebrate outstanding contributions by a member or former member of Doctors Manitoba in the service of humanity either within Canada or abroad. Awarded only when a suitable candidate is identified.

Learn more about the awards criteria and nomination requirements here.

Get Your Tickets — Doctors Manitoba Awards Celebration

In just 22 days, we will gather (safely and responsibly) to celebrate our 2021 Doctors Manitoba award recipients. Please join us for the physician event of the year — tickets are available now! 

Date: Saturday, November 20,
Time: Cocktail Reception at 6pm, Dinner and Awards Program at 7PM
Where: RBC Convention Centre

→ Learn more and get tickets here!

Based on member feedback, an in-person event at the RBC Convention Centre has been planned. We haven’t had an in-person award celebration since May 2019 — over two years ago. This year’s event will be an opportunity to connect with colleagues, celebrate our profession, and support each other through the next stages of the pandemic and vaccination campaign. Of course, the event will follow public health guidance to ensure the safety of all attendees. If the pandemic situation requires it, we will change to a virtual format and all tickets will be refunded. Read more about the event and get your tickets HERE.

Insurance Event for Medical Students

Calling all medical students! Mark your calendar for this Tuesday, November 2 at 12:00pm for an Insurance Literacy session hosted by the CFMA and Doctors Manitoba. It will cover what insurance products are best suited for students and how Doctors Manitoba can assist you in protecting you and your family from life’s unplanned events.

Topics will include: 

• Medical Student Financial Risk Management 
• What is Life, Disability, Critical Illness Insurance 
• Find out what happens to your student insurance in residency, 
• Your provincial medical association special student offers 

No registration is required. Click here to join on MS Teams at 12:00 noon on Tuesday, November 2.

Doctors Manitoba’s insurance is non-profit, designed by physicians for physicians. Any profits are returned as rebates, rather than going to shareholders. Learn more about our insurance options here.

Political Updates

Tomorrow, the PC Party of Manitoba will elect its new leader, and thus the new Premier of Manitoba. Earlier this week, we posted the responses we received from both Shelly Glover and Heather Stefanson to the top questions and concerns from physicians and their patients. Both candidates answered questions about tackling the surgery and diagnostic backlog, making virtual care permanent, and accepting medical advice from public health profess officials. 

Highlights of their responses include:

• Surgical backlog: Mrs. Stefanson recognized Doctors Manitoba’s advocacy and said after the 4^th wave there is no higher priority than addressing the backlog. She said she is committed to Doctors Manitoba’s three recommendations. Ms. Glover was silent on our recommendations, but committed to taking immediate action in a collaborative way, and committed to removing the cap on knee and hip surgeries.
• Virtual Care: Both candidates committed to making virtual care permanent in Manitoba after the pandemic. Doctors Manitoba has already been preparing to negotiate this on behalf of physicians in Manitoba. 
• Acting on Public Health and Medical Advice: Both candidates responded that they will seek out and act on public health and medical advice during the pandemic and recovery period, as well as consult physicians through Doctors Manitoba on challenges or significant changes to health care. 
• Health Workforce Recovery: Both candidates committed to address burnout among front line health care professionals. Mrs. Stefanson added that she will do ​“whatever it takes” to ensure there is enough trained and qualified staff in health facilities to help address burnout.
• Addressing added pandemic costs in physician practices: Neither candidate committed to covering the costs associated with added pandemic precautions in independent physician practices to put them on an equal footing with RHA-run clinics and facilities. Doctors Manitoba will continue to pursue this issue after a leader is selected. 

You can view the full, unedited responses from both candidates here.

Ms. Glover and Mrs. Stefanson also responded to questions from the Free Press this week, including what mistakes were made with the pandemic response, and the use of vaccine mandates and restrictions on unvaccinated people. On the latter, Ms. Glover suggested the vaccine or testing mandate should be broader, to include antibody testing for those who have recovered from a COVID infection. Mrs. Stefanson said she supports the vaccine and testing mandate in its current form. 

On the issue of further health care reforms, Ms. Glover said she would reconsider the plan to reorganize Winnipeg’s hospitals, and that all options are on the table including reopening ERs converted to urgent care centres just a few years ago. Mrs. Stefanson was optimistic that a new MNU contract would help to address the nursing shortages that have contributed to wait times and backlog in the system.

Doctors Manitoba has worked with Premier Kelvin Goertzen, who is covering the role during the leadership race. We will reach out to Manitoba’s new Premier next week to ensure physicians’ concerns and priorities are heard without delay. 

Health Care Top Issue: New Poll

Manitoba’s new Premier should A new Angus Reid poll this week found that 76% of Manitobans believe the government is doing a poor job of handling health care. This is the second highest poor rating in Canada, behind only Alberta. Only 20% of Manitobans responded that the government is doing a good job on health care, down from 40% last year. Meanwhile, Manitoba’s views on the government’s pandemic response have improved, with 46% rating the government’s performance on COVID-19 as good, an improvement from less than 30% in June. 

New Federal Health Minister 

Earlier this week, Prime Minister Trudeau shuffled his cabinet. With 38 cabinet members sworn in, less than 10 will remain in positions they held previously. Minister Carolyn Bennett, a family doctor and previously the minister of Crown-Indigenous relations, has taken on the role of Mental Health and Addictions and Associate Minister of Health. Jean-Yves Duclos, an economics expert, author and co-founder of the Poverty and Economic Policy Research Network, will take the reins as Minister of Health. Dan Vandal, named Minister of Affairs and Prairies Economic Development Canada and Canadian Northern Economic Development Agency, is the only cabinet minister from Manitoba. The CMA wasted no time in responding, calling on the new minister of health to ​‘address the health workforce crisis.’

In Case You Missed It:

There was lots of interest in a few other updates over the last week. We’re sharing them again, in case you missed it:

• The Pan-Canadian proof of vaccination is now available from Shared Health to support out-of-province travel. Learn more here.
• The CMA National Physician Health Survey is now underway, and we are encouraging all practicing physicians and medical learners to participate! Doctors Manitoba will get a summary of our provincial data, and this will help us to advocate for what doctors need. Complete the survey by November 15.
• Manitoba study suggests antibiotics are being overprescribed. The Manitoba Centre for Health Policy study suggests antibiotics are often prescribed for bronchitis when this condition doesn’t generally need it, or the wrong type of antibiotics were often used for pneumonia in children or for bladder infections. Learn more about the study here.