Member Message — September 23, 2021
Physicians Key to Next Stage of Vaccination
New school case and isolation definitions
Feedback Sought on Mental Health Services
COVID Update
Since our last update on Thursday September 16:
- Daily cases up: 478 new cases of COVID-19 have been identified since last Thursday, a daily average of 68 (up from 61 last week). This includes 67 new cases today. The total case count in Manitoba now stands at 59,944.
- Test positivity down: The provincial five-day test positivity rate is 2.3%, down from 2.9%. In Winnipeg, it is 1.0%.
- Active cases down: There are 498 active COVID-19 cases province-wide, down from 584 last week.
- Variants of concern: 256, or 54%, of active cases have been identified as a variant of concern. Delta is the dominant variant of concern in Manitoba.
- Hospitalizations steady: There are 68 people in Manitoba hospitals due to COVID-19, down from 69. This includes 14 COVID-related patients in Manitoba ICUs, down from 15.
- Four more people have died from COVID-19 since last Thursday, including two reported today. This brings the total COVID-19 related deaths to 1,207.
According to Health Canada’s tracking, Manitoba had 30 cases per 100,000 over the last seven days, unchanged from last week. Manitoba continues to have the lowest case rate outside of the Atlantic region. Alberta and Saskatchewan continue to lead the provinces with 277 cases per 100,000 in Saskatchewan (up from 241 last week) and 254 in Alberta (up from 233 last week).
Beware: Fake Medical Exemptions
Reports are emerging of some individuals showing fake medical mask exemption cards in the province. There are no such official cards issued in the province. Guidance on providing exemptions for medical masks can be found here.
Vaccine Update
Since our last update on Thursday, September 16:
- 84.5% of Manitobans age 12 and up have received at least one dose, up only slightly from 83.9% a week ago.
- 79.8% have received two doses, up from 78.9% a week ago.
For current active cases in Manitoba, 25% are fully vaccinated, while 12% are partially vaccinated and 63% are unvaccinated. This suggests unvaccinated people are nearly 7 times more likely right now to test positive for COVID-19, and about 20 times more likely to require ICU admission.
New Names, Same Vaccines
This week Health Canada announced the new names for three of the vaccines that are approved for use in Canada. Pfizer’s COVID-19 vaccine is now called Comirnaty, Moderna’s vaccine is called Spikevax and the AstraZeneca shot is named Vaxzevria. PHAC assured Canadians these are only name changes, and the vaccines themselves are unchanged. The naming of the vaccines is a branding exercise decided by the vaccine manufacturers and is very common. Infectious disease specialist Dr. Isaac Bogoch believes both doctors and patients will still use the manufacturer names when referring to the vaccines.
This also means that both the Pfizer and Moderna vaccines have full Health Canada approval.
We have added a public version of this update to ManitobaVaccine.ca.
Third Dose Eligibility Expanded
This week Dr. Joss Reimer and Dr. Marcia Anderson, head of the Manitoba First Nations pandemic response team, announced that the province will expand eligibility for third doses to all residents and staff of First Nations personal care homes, giving 200 residents and 400 staff at 10 personal care homes added protection. Residents and staff from other personal care homes are expected to become eligible in October.
Last month an outbreak at the George M. Guimond Care Centre in Sagkeeng First Nation resulted in 2 deaths, with 37 residents and staff contracting the virus. Nearly all were fully vaccinated. A recent report from the United Kingdom showed that personal care home residents and immunocompromised people may have less protection than others from two doses. Dr. Reimer assured the public that there is no need for the general population to receive a third dose at this time, but the province will continue to monitor the data.
This builds on initial eligibility for third doses announced earlier this month, including individuals considered moderately or severely immuno-compromised, individuals who require a third dose to travel, and individuals who received a vaccine overseas that is not approved by Health Canada.
→ You can see our summary of the announcement here.
→ You can see the full eligibility at ManitobaVaccine.ca
Doctors Manitoba continues to pursue the potential for health care worker eligibility for a third dose, given the vulnerability that some health services could easily be overwhelmed with a fourth wave.
U.S. FDA on Boosters
Yesterday the FDA Authorized Booster shots of the of Pfizer Vaccine for certain populations. This is considered an emergency use authorization, rather than full approval. The booster shot should be administered at least six months after completion of the primary series.
The following individuals are eligible:
- individuals 65 years of age and older;
- individuals 18 through 64 years of age at high risk of severe COVID-19, for example due to underlying medical issues; and
- individuals 18 through 64 years of age working in health care or other settings, whose frequent occupational exposure to COVID-19 puts them at high risk of serious complications or illness.
This follows a review by the FDA’s advisory committee last week that rejected Pfizer’s initial application for a booster shot for everyone age 16 and older. The committee instead recommended the narrower criteria that the FDA authorized yesterday, noting that waning immunity was highest among older adults.
Pfizer Pursuing Regulatory Review for Younger Children
On Monday, Pfizer and BioNTech announced clinical trials had shown their COVID-19 vaccine is safe and effective for kids age five to 11, and they plan to ask for authorization to use the vaccine in children in that age range in Canada as soon as possible. The companies said the vaccine generated an immune response in the five- to 11-year-olds in their Phase II/III clinical trial that matched what they had previously observed in 16- to 25-year-olds. The safety profile was also generally comparable to the older age group, they said.
The vaccine was well-tolerated, with side effects generally comparable to those observed in participants between 16 and 25 years of age. While both the Pfizer and Moderna vaccines have been linked by regulators to rare cases of heart inflammation in adolescents and young adults, particularly young men, Pfizer reports it did not see any instances of heart inflammation in the trial participants.
Health Canada anticipates vaccine manufacturers will provide data regarding children in the coming months, but has so far not received any submission for the approval of any COVID-19 vaccine in children under 12 years of age.
Physicians Key to Next Stage of Vaccination
On Tuesday, our President Dr. Kristjan Thompson joined Manitoba Premier Kelvin Goertzen and Health Minister Audrey Gordon to announce new provincial support for physicians in the COVID-19 vaccination campaign. Representatives from the Manitoba College of Family Physicians (MCFP) and Pharmacists Manitoba also participated.
→ Physicians are encouraged to join our webinar on Tuesday at 6:30PM to learn more!
Perhaps the most significant part of the event came when Premier Goertzen acknowledged that we are at a different stage in the vaccination campaign, and that “at this point, many months in, those who remain unvaccinated are not interested anymore in hearing from politicians.” He went on to explain that doctors have “earned the trust of Manitobans in many different ways and for many different reasons” and they are in the best position to reach these individuals. This comes as provincial super sites continue to wind down, and vaccination efforts shift to doctors, pharmacists, public health nurses, and other traditional delivery methods.
Health Minister Audrey Gordon explained that the new provincial funding will help doctors “engage in more targeted, local outreach.” She explained that doctors and others will be able to work together to “develop their own strategies to connect with patients” based on their local knowledge.
Overall, the province announced $14 million in funding, which will support vaccination efforts by physicians, pharmacists and RHAs. The focus is on reaching the next 100,000 individuals who need a first and/or second dose. Doctors Manitoba has actively pushed for additional supports to help doctors’ offices have more time for vaccine outreach and visits.
For physicians, this funding will support:
- Outreach by email and phone to unvaccinated or partially vaccinated patients in your practice.
- Holding vaccine information and immunization clinics by guaranteeing a minimum hourly rate of remuneration, to help eliminate the uncertainty of dedicating time for this initiative with the risk of low or unpredictable patient volumes. If your visit and vaccine injection claims don’t reach the hourly rate, the difference will be paid to help cover your costs. An administrative stipend will also be offered to support holding vaccine clinics.
- Participation in an community outreach initiatives, where community facilitators will bring together physicians and other front line providers to plan and undertake targeted community vaccination outreach.
→ You can watch the full announcement here.
The MCFP and the University of Manitoba Department of Family Medicine will train facilitators and support the community outreach initiatives using an evidence-informed approach. See a recent Winnipeg Free Press article describing the initiative.
Join Webinar on Tuesday
Physicians interested in learning more about the new financial supports and community outreach initiatives should join our webinar.
The webinar will include an update on COVID immunization progress and information about the new remuneration and funding support for physicians. It will also include an overview of the community outreach initiative and the latest from vaccine hesitancy research, including practical strategies for addressing vaccine hesitancy.
The expert panel will include:
- Dr. Joss Reimer, Medical Lead with the provincial Vaccine Implementation Task Force
- Dr. Jose Francois, Head of Department of Family Medicine (University of Manitoba) and Provincial Specialty Lead for Family Medicine (Shared Health)
- Dr. Alex Singer, Associate Professor and Director of Research and Quality Improvement with the Department of Family Medicine (University of Manitoba)
- Professor Michelle Driedger, a researcher specializing in vaccine hesitancy
- Allison Crolly, Doctors Manitoba
- Ms. Lisa Goss, Executive Director of the Manitoba College of Family Physicians.
Registration Details:
When: Tuesday, September 28 at 6:30 PM
Register: Click here to register in advance.
Thank you to Nine Circles
A big thank you to Nine Circles Community Health Centre for hosting this announcement. Nine Circles has extensive experience with community outreach and vaccination. This week, Nine Circles is hosting its annual fundraiser, a Virtual Red Ribbon Walk & Run! This is Manitoba’s largest fundraiser for people with HIV. Physicians are encouraged to learn more and participate to support Nine Circles.
New school case and isolation definitions
Earlier this week, public health and education officials announced changes to the close contact identification and management protocols in schools.
In schools, public health will consider vaccination status and consistent mask use when assessing risk and determining isolation requirements for close contacts. The changes include the following:
- Self-isolation requirements for close contacts in schools will reduce from 14 days to 10 days, consistent with other public health requirements. Testing is recommended at day seven. These requirements may change if community transmission increases.
- School cases are now defined as a staff, student or volunteer in the school during the 14 days prior to symptom onset or positive test date if asymptomatic, or within 10 days of illness onset or positive test date if asymptomatic.
- School outbreaks will now include at least three school cases within 14 days within a specific cohort. The cases would be assessed as potentially acquired in school and linked to a known school cases.
School cases do not mean the case was acquired or transmitted at a school, but rather that it was present in a school during the defined periods. This allows officials to monitor overall cases that may be associated with a school.
There have been 70 school cases so far this school year, out of 720 total cases in Manitoba during this period. Of these, 60 cases were among students and 10 in staff at 46 different schools. No schools are currently shifted to remote learning.
The toolkit for notification of cases in schools has been updated to reflect these changes.
Physicians should reinforce with all school-age patients and parents that everyone should stay home if they have symptoms.
You can access general definitions and advice for close contacts outside of school settings here. Guidance on self isolation is available here.
Upcoming Events
There are several webinars and events coming up that we encourage you to consider attending. As always, you can keep tabs on our events by visiting our Events Page on our website
Vaccine Webinar for Physicians — Tuesday, September 28 at 6:30pm — Register here.
For physicians and their staff only, this webinar will help physicians understand the new supports and opportunities to get involved with the COVID-19 immunization campaign. This will include an update on COVID immunization progress and information about the new remuneration and funding support for physicians. It will also include an overview of the community outreach initiative and the latest from vaccine hesitancy research, including practical strategies for addressing vaccine hesitancy.
COVID-19 and Kids — Wednesday, September 29 at 12:00 noon — Register here.
The COVID-19 Immunity Task Force and CanCOVID have teamed up to offer this national seminar about the risks and impacts of the pandemic on kids, their parents and teachers. This will include the latest research and policy implications.
New to Practice Webinar — Tuesday, October 12, 2021 6pm — Register here.
Starting your practice is a major milestone for young physicians, and this milestone has only become more complex during COVID-19. We’re here to help you navigate this transition in your journey as a physician. This popular annual session will provide an overview of what Doctors Manitoba offers you, exclusive benefits and insurance available to physicians, billing tips, virtual care and more.
25th Annual Bug Day — Tuesday, October 19, 2021- Register here.
Hosted by HSC Winnipeg in collaboration with the University of Manitoba’s Continuing Professional Development (CPD) Medicine Program, Bug Day is Manitoba’s largest healthcare education event. It’s FREE and accredited. It focuses on prevention and control of communicable diseases, as well as health issues in the community or healthcare setting. Find out more here.
2021 Doctors Manitoba Annual Awards Gala - Saturday, November 20, 2021 — Details will be updated here.
SAVE THE DATE — Join us for our annual gala, where we will recognize our 2021 Doctors Manitoba award winners. This is an opportunity to connect with colleagues, celebrate our profession, and support each other through the next stages of the pandemic recovery and vaccination campaign. We are hopeful an in-person celebration will be possible. This will follow public health guidance to ensure the safety of all attendees. If the pandemic situation requires it, we will change this event to a virtual format. Further details will be released soon and ticket sales will open in early October.
Feedback Sought on Mental Health Services
The provincial government is seeking further feedback on mental health services from individuals with personal experience as well as health care experts. The feedback will help to inform the development of a new action plan for mental health, wellness and recovery.
An online survey is available, which you can access here. Round table discussions will also be held in the next few weeks with people with direct experience with mental health and substance-use challenges, as well as their families and caregivers.
To view previous messages, click here.