April 14, 2022
In today’s message you will find:
- COVID Update
- Vaccine Updates
- COVID Testing Shifts to Primary Care tomorrow
- Our Reaction to the Provincial Budget
- Newborn Screening Results Now in eChart
- Manitoba HIV PrEP Program
- WRHA’s New CMO
- MD Webinar Recording
- ICYMI — Recent Updates
- Upcoming Events
Public Health now posts weekly COVID-19 Surveillance Reports on Thursdays. Today’s report, which is showing “increasing activity” covers the week ending on April 9. Highlights include:
- Severe outcomes from COVID-19 remain“moderately low.” There were 177 hospital admissions, up from 141 last week (there were 111 the previous week). This includes 19 ICU admissions, up from 11 the previous week. There were 5 deaths recorded, down from 6 the previous week.
- There were 1,694 lab-confirmed cases reported in Manitoba over the week, up from 1,359 the previous week. The test positivity rate was 20.7%, up from 18.6%
Meanwhile, monitoring in Ontario is suggesting that their sixth wave may have peaked. Wastewater signals there are levelling off or declining, and the pace of hospitalizations appears to be plateauing, according to infectious disease expert Dr. Isaac Bogoch.
COVID-19 vaccine eligibility has been expanded again. Youth age 12 – 17 are now all eligible for a first booster shot. Previously, boosters were only recommended for youth who have underlying health conditions, belong to racialized or marginalized communities, or live in shelters, group homes or correctional facilities. Now, all youth age 12 – 17 can received a first booster shot.
Last week, a second booster shot (or fourth dose) was introduced for those at the highest risk, including:
- Residents of personal care homes and elderly persons housing congregate living sites (such as supportive housing and assisted living) with no age limit.
- Individuals aged 70 or older who live in the community.
- First Nations, Inuit and Métis people aged 50 or older, regardless of where they live.
Both first and second booster shots should generally be administered six months after the previous dose.
The Novavax vaccine has arrived in Manitoba and will start to be delivered next week to the clinics and pharmacies that have ordered this vaccine. If you receive Novavax, be sure to update your status on the Vaccine Finder. Novavax is approved for people aged 18 and older. Two doses are recommended to be considered fully immunized with at least eight weeks between doses. It is hoped that some who have been hesitant to accept an mRNA vaccine may be more open to Novavax, given that it is a more traditional protein subunit vaccine.
COVID Testing Changes Start Tomorrow
All provincial COVID-19 test sites will close after today and the responsibility for this testing has shifted to primary care. Most patients will use self-administered rapid tests, but some will require a rapid or PCR test administered by a physician or health care professional. This is primarily to inform medical management and treatment decisions only.
These changes to testing reflect the dramatic decrease the province has seen in PCR testing in recent weeks, with fewer than 150 PCR tests being completed per day from test sites.
We have created a COVID-19 Testing and Treatment resource page to help physicians get ready for this change. It has been updated with tariff codes for rapid and PCR tests administered in a physicians’ office, along with billing advice. The page also includes:
- Clinical guidance and a clinical algorithm to ensure you and your staff are ready for patients who call in with COVID-19 or influenza-like symptoms, and may need a test
- Instructions on ordering free rapid tests or PCR testing supplies
- Patient information resources
- Patient notification responsibilities
- COVID-19 treatment information, referral forms and resources
Webinar: Watch our webinar now about testing and treating COVID-19 in primary care. The recording can be viewed here.
See our COVID-19 Testing and Treatment resource page for links and resources highlighted in today’s webinar.
Changes to Pre-Operative COVID-19 Testing
Shared Health confirmed changes today to pre-operative COVID-19 testing. Patients requiring the Day 10 pre-operative swab should be directed to see their primary care provider for a PCR test, with results to be completed at Cadham Provincial Lab. In the event a Day 10 pre-operative swab is not able to be scheduled, due to clinic closure or other reason, a swab collected up to and including Day 15 pre-op will be accepted. If this isn’t possible, a self-administered RAT can be accepted. If positive, the patient should inform the surgeon’s office.
Starting April 19, the “day 1” test, conducted the day before surgery, will change to a “day 0” test. A rapid test will be conducted in a designated area within the surgical site.
You can see the full memo here.
Provincial Budget — Our Reaction
Earlier this week, the Manitoba government unveiled its 2022 provincial budget. The government has attempted to achieve three goals at the same time: decrease the deficit, reduce taxes, and increase funding for health care.
For health care, the budget delivers an overall increase of about 2.5%, aside from costs related directly to the COVID-19 response. The funding includes:
- $110 million to address the massive pandemic backlog in surgical and diagnostic procedures
- $17 million to implement the first year of the new five-year Mental Health and Community Wellness plan
- $32 million to implement all 17 recommendations from the Stevenson Review, which investigated COVID-19 outbreaks in Manitoba’s PCHs.
- $11 million to expand nurse training programs
- $9 million to expand ICU capacity, as previously announced
The budget also includes funding for the 1% increase in medical remuneration, negotiated as part of the current Master Agreement.
Doctors Manitoba had been active in advance of the budget, advocating for physician’s priorities to be included in the budget. This included expanding hospital capacity, addressing the pandemic backlog, and recruiting and retaining more nurses, physicians and other health care workers. Doctors Manitoba President, Dr. Kristjan Thompson, was invited to attend the Legislature for the budget the speech, the first time a President has attended in many years. He met with the Minister of Health and the Premier, and provided our candid reaction to journalists as well.
Dr. Thompson was encouraged to hear the Minister of Finance say the government will “do whatever it takes” to address the surgical and diagnostic backlog. While the $110 million committed this year could be called “seed money,” it is a strong step towards addressing the massive backlog. He explained that “Manitobans should be encouraged by the government’s significant investment to address the massive backlog of surgical and diagnostic procedures, though physicians and their patients are still waiting for a firm commitment on when that backlog will be cleared.”
While the budget has clearly prioritized health care, Dr. Thompson stressed that “results will be measured not by dollars spent but by shortening wait times, clearing the pandemic backlog, and recruiting and retaining more nurses, doctors and other health care workers to ensure patients get the care they need. The significant investment in health care is an important step toward rebuilding a medical system that has been under tremendous pressure, not only over the last two years due to the pandemic but also from the staffing shortages and primary focus on efficiency in the years before COVID-19. While this can’t be undone with money alone, matching the government’s financial investment with a meaningful partnership with physicians will help to ensure our medical system recovers and is better prepared for the next health crisis.”
In further reviewing the budget, Dr. Thompson noted additional important investments while emphasizing other areas that need more attention. “The budget makes progress in a number of other areas, including training more nurses, expanding mental health and addictions services and capital investments in our hospitals, though physicians would have liked to also see more immediate steps in other priority areas such as making virtual care permanent and taking steps to retain doctors, nurses and other health care workers who are feeling burnt out, devalued and distressed.”
Newborn Screening Results Now in eChart
The Manitoba Newborn Screening results reporting into eChart, launched on April 12, 2022. The full screen will be available as a set of results rather than as a single result, and reports will still be made available by fax to ordering practitioners. In cases where no health care practitioner is provided, or this information is discrepant, reports will continue to be sent to hospital medical records departments.
Complete and accurate completion of the newborn screening card with particular attention to infant demographics and chart number is critical to populating eChart correctly. Please reinforce with your teams the importance of proper completion of the newborn cards, as the highest rate of reporting failure is as a result of missing or incorrect identifiers
Manitoba HIV PrEP Program
Manitoba has the second highest rate of HIV infection in Canada, and incidence are on the rise. How can you help prevent HIV in Manitoba? Physicians can:
- Become a PrEP prescriber. It’s easy! Register here.
- Promote your services on our HIV services map! Add your clinic here.
- Attend our PrEP and PEP webinar. Register here.
Please use this poster and circulate to colleagues in primary care. Together we can help prevent HIV in Manitoba!
WRHA’s New CMO
Dr. Joss Reimer has accepted a new role as WRHA’s Chief Medical Officer.
Of course, Dr. Reimer has been a Medical Officer of Health and the Medical Lead for the province’s COVID-19 Vaccine Implementation Task Force. She is also the recipient of Doctors Manitoba’s Humanitarian Award for this year for her role in helping Manitobans accept and access COVID-19 vaccines and the protection they afford.
Dr. Reimer starts as CMO on Monday, April 18, 2022.
Doctors Manitoba would like to congratulate the new PARIM President Dr. Rachel Bethune and the new MMSA Senior Stick Anthony Wightman. We are looking forward to our continued partnerships with both organizations to best serve our members in all stages of their medical careers. Join us in wishing continued success to Dr. Josh Aquin who served as PARIM President and Chris Moskal who served as MMSA Senior Stick and worked diligently in their roles over the past year.
Insurance Webinar Takeaways
As we explored in this week’s webinar, there are a number of misconceptions about insurance that can impact both your earning power and your level of protection for the unexpected. The recording of the session is now available. If you’d like to review your insurance options, or speak to speak with someone ensure you’re protected for the future, the Doctors Manitoba team can be reached here.
Remember, MD Financial Management and Doctors Manitoba are here to help you plan for the future, whatever your career stage.
Here are some important and popular recent updates, in case you missed them:
- MD Financial and Doctors Manitoba hosted an Insurance Webinar on Tuesday, you can watch it here.
- There are updated Isolation & Return to Work Guidelines for Health Care Workers that may change your isolation period. And remember, Doctors Manitoba has negotiated an isolation benefit for physicians.
- We shared the new Endoscopy Referral Form & Guidelines now that FIT testing has been introduced in Manitoba.
- We’re developing a public Prevention Awareness Campaign and we are looking for physicians with a passion for prevention and expertise in healthy living and screening.
- We shared our Analysis of the CPSM and Government Consultations last week.
Bookmark our Events Calendar to be sure you don’t miss any events or learning opportunities that interest you.
Save the date for our 2022 Doctors Manitoba AGM & Awards Gala on Thursday, May 19!
Some other notable upcoming events include:
- The MCFP’s Annual Scientific Assembly is being held April 28 – 29. Find out more and register here.
- Canadian Conference on Physician Leadership, May 6 – 7 in person in Toronto with a learner-centred pre-conference event May 5 Welcome to the Canadian Conference on Physician Leadership 2022
- International Healthcare Leadership Conference, May 2 – 3 offered virtually 2022 Healthcare Leadership Conference — International Leadership Association
- Leadership Through Connection Panel Discussion Series — Early Career — May 2 — Mid Career — May 9 — Late Career — May 3