In today’s message you will find:

• COVID situation update
• Vaccine update
• Takeaways from our Back-to-School Town Hall
• N95 mask recall news
• HPV Webinar

COVID Situation Update 

Since our last update on Friday, August 27:

• Daily cases down: 287 new cases of COVID-19 have been identified since last Thursday, a daily average of 48 (down from 53 last week). This includes 36 new cases today — 24 of these new cases are not fully vaccinated. The total case count in Manitoba now stands at 58,793.
• Test positivity: The provincial five-day test positivity rate is 2.4%, down from 2.8%. It is remains steady at 1.5% in Winnipeg
• Active cases steady: There are 430 active COVID-19 cases province-wide, unchanged from last week.
• Hospitalizations: There are 70 people in Manitoba hospitals due to COVID-19, up from 65. This includes 15 COVID-related patients in Manitoba ICUs, down from 21.
• Three more people have died from COVID-19, bringing the total COVID-19 related deaths to 1,192.

Manitoba is winding down the operation of the testing site at the Winnipeg Richardson International Airport tomorrow. COVID-19 testing for domestic travellers is provided in multiple locations across Manitoba, and sites can be found HERE.

According to Health Canada’s tracking, Manitoba had 24 cases per 100,000 over the last seven days, down slightly from from 25 a week ago. Manitoba continues to have the lowest case rate outside of the Atlantic region. Alberta and Saskatchewan continue to lead the provinces with 156 cases per 100,000 in Saskatchewan (up from 100 last week) and 171 in Alberta (up from 125 last week). When transmission reaches the substantial (50−99 cases/​100K) or high levels (100+/100K), the CDC recommends indoor mask use, however neither Alberta nor Saskatchewan has reintroduced an indoor masks mandate.

Alberta Health Services announced this week that it will require employees to be vaccinated against COVID-19. The CEO, Dr. Verna Yiu, made it clear the AHS made this decision independent from the Alberta government. Those unable to be vaccinated due to a medical reason or protected ground under Alberta human rights will be ​“reasonably accommodated” in some way, but it’s not yet clear what this means.

Restrictions

New public health restrictions, announced last week, take effect tomorrow in all health regions of the province. Today, final details were released by Dr. Brent Roussin.

The new public health orders require masks to be worn in indoor public places, and outline the situations in which proof of vaccination will be required. 

Starting tomorrow, September 3, the following public places will require proof of vaccination:

• Restaurants, nightclubs and other licenses premises, both for indoor and outdoor dining
• Theatre, dance and symphony events
• Casinos, bingo halls and VLT lounges;
• Movie theatres;
• Fitness centres, gyms and indoor sporting and recreational facilities, excluding youth recreational sport
• Organized indoor group recreational classes and activities, and indoor recreational business.

Starting September 7, permitted outdoor gathering sizes will reduce to 500 from 1,500. Vaccine cards will be required in the following additional areas: 

• Museums and galleries
• Wedding venues with liquor licenses
• Food courts for dining (takeout orders excluded)

Children born after December 31, 2009 who are not yet eligible to be immunized will be able to attend events and activities with a fully-immunized adult.
Private businesses and organizations are being encouraged to mandate vaccines for employees. 

You can read more about the restrictions here.

Vaccine Update

Since our last update on Friday, August 27:

• 82.3% of Manitobans age 12 and up have received at least one dose, up only slightly from 81.7% a week ago. 
• 77.1% have received two doses, up from 76.2% a week ago.

The Leila Vaccine Super Site in Winnipeg is now closed, and some other locations are changing their hours. Physicians not offering the vaccine in their office are encouraged to refer patients to a doctors’ office for the shot, using the listing at Man​i​to​baVac​cine​.ca.

Improved Home Clinic List of Unvaccinated Patients

Shared Health and Manitoba Health have made improvements to the Primary Care Home Clinic report. This listing will continue to include all unvaccinated patients, as well as patients who are only partially vaccinated. 

The report is intended to support family physicians with targeting their outreach to enrolled patients not yet fully vaccinated. The improvements to the new report include:

• Patients who are partially vaccinated and still require a second dose
• Adjusted age range to reflect expanded eligibility to those born in 2009 or earlier
• Additional filtering to exclude deceased patients.

Doctors Manitoba is working with government officials to develop new financial supports to help clinics with patient outreach and removing the risk and uncertainty of planning vaccine clinics. We hope to have an update on this soon.

Please see a letter to primary care clinics from Doctors Manitoba and the Manitoba College of Family Physicians about the new report.

Immunization Card Access Improved

Individuals who do not have a Manitoba Health card are now able to obtain a provincial immunization card to access restaurants and other services.

Individuals must meet the following requirements to qualify:

• Received two doses of Pfizer, Moderna or AstraZeneca or one dose of Johnson & Johnson vaccine, with the final dose more than 14 days ago; and
• Submitted proof of vaccination(s) that occurred out-of-province to public health. This can be submitted using an online form.

Individuals can then call 1−844−626−8222 to request a client identification number to obtain a digital immunization card and/​or to request a physical card.

Vaccine Passport Adopted in Ontario

Ontario will create a vaccine certificate for individuals to access many services and businesses starting September 22. This includes restaurants, nightclubs, convention centres, gyms, sporting events, and theatres. The government has justified the move with data that suggests unvaccinated people are seven times more likely of developing COVID-19 symptoms, 27 times more likely to end up in hospital, and 42 times more likely to need intensive care.

Ontario joins Quebec, PEI and BC in adopting vaccine certificates, along with Manitoba which was the first province to introduce a vaccine card.

While it is encouraging to see more provinces adopting vaccine certification to access public places, the CMA issued a caution this week about the patchwork approach. The CMA called on all governments to make vaccine certificates interoperable, so they will work across provinces. This would optimize privacy and equitable access.

Town Hall Recording

On Tuesday, we hosted a Back-to-School COVID-19 Town Hall where six pediatric physicians addressed concerns and questions about a resuming in-school learning this fall. Over 3,000 people have tuned in to view the event!

The panel answered questions from parents and students about the risks of COVID, precautions to decrease the risk in schools, the impacts on children’s mental health and learning, and COVID vaccines. We also extended the reach of this message with extensive media coverage, including stories from CTV, CBC, the Winnipeg Free Press and other outlets. 

→ The Town Hall can be viewed anytime on-demand by visiting Doc​tors​Man​i​to​ba​.ca/​s​chool.

Key takeaways from the physician panel include the following:
Risks:

• While children are at a lower risk of severe outcomes from COVID-19 infections than adults, they are still at risk for hospitalization, death, or long COVID.
• The Delta variant is a ​“game changer” because it is much more transmissible than earlier variants, and could result in more serious outcomes.

Precautions Decrease the Risk:

• Precautions can continue to significantly lower the risk of transmission in schools. These precautions include wearing masks, physical distancing, hand hygiene and staying home if you are sick.
• Our panelists recommended outdoor learning when possible, keeping windows and doors cracked open and fans running to increase airflow to learning spaces.
• Of course, having all eligible individuals in household over the age of 12 vaccinated is an important way of protecting those not yet eligible to get the vaccine, especially when one considers that most spread for school-aged children thus far occurred at home, not at school.
• Immuno-compromised children returning to school should be decided on a case-by-case basis, but with precautions in place it should be recommended for these children to return to school and benefit from in-person learning and socialization. 

Impacts on Children’s Health and Learning:

• The pandemic and all these precautions are having an impact on children’s mental health and development, but not necessarily in all the ways parents fear.
• While mental health diagnoses may be increasing among children, the main cause of depression, negative behaviours and anxiety among children is social isolation. A safe return to school, to prevent more remote learning, is thus a priority.
• Parents were reminded that their children pick up on what adults are doing, so it’s best not to be overly anxious or fearful of COVID around children. Parents should avoid excessive information and to make decisions based on public health recommendations and not individual anxieties or fear.
• Mask wearing generally does not pose a risk to physical health, breathing or lung development. Masks also don’t appear to affect learning or linguistic development.

Vaccines:

• The vaccines are not yet approved for children born after December 31, 2009, but that approval could come soon. Viewers were reminded that vaccines are safe and effective, and strongly recommended by physicians. All eligible Manitobans who have not been vaccinated were invited to find answers to their questions at Man​i​to​baVac​cine​.ca and to talk to their doctor or find one at Man​i​to​baVac​cine​.ca/​v​a​c​c​i​n​e​-​f​inder

If you missed the town hall or want to revisit it, you can do so anytime on-demand here.

N95 Mask Recall

On Aug. 28, 2021 Health Canada recommended discontinuing use of the Dasheng respirators in settings that require NIOSH certification. This followed action on August 13, 2021, NIOSH (National Institute for Occupational Safety and Health), an Agency of the US Centers for Disease Control (CDC), revoked approvals for Dasheng N95 respirators, including a model commonly used in Manitoba – the DTC3Z because the company failed to implement or maintain a quality management system for the design, labeling, and quality of their products.

Health Canada acknowledged that it could take time to find replacement respirators and that the Dasheng product could be used in the interim. It recommended respirators be sent for testing, which Shared Health had done proactively earlier in August. These tests confirmed the respirators in Manitoba meet NIOSH criteria for breathability, particulate filtration efficiency and the ASTM blood penetration criteria. Shared Health is now looking for alternative respirators to eventually replace the Dasheng product. 

The full memo from Shared Health is available here.

Webinar

Join Dr. S. Kean, CervixCheck, CancerCare Manitoba Medical Lead on Friday October 22, 2021 from 12 – 1pm for an interactive webinar titled HPV Triage: Enhancing cervical cancer screening in Manitoba. The webinar will address how the implementation of HPV Triage changes the cervical cancer screening pathway and primary care practice. To learn more and register, click here.