The Progressive Conservative government is being accused of downplaying the impact of COVID-19, as doctors question Manitoba’s reporting of coronavirus hospitalizations compared with patients facing separate issues who end up testing positive.
Their concern stems from comments made last Wednesday by Health Minister Audrey Gordon.
"Only one-third of Manitoba’s COVID-positive hospitalizations are being hospitalized because of COVID. The other two-thirds are being hospitalized for another medical reason, but happen to be COVID-positive," she said on Jan. 12.
Gordon said that number stemmed from experts reviewing patients’ files.
"We are doing chart-by-chart reviews, to ensure that when we report — and when I come out here and share that information — that it is indeed accurate."
Front-line physicians argue it’s anything but.
They were surprised that evening, when Dr. Jazz Atwal, Manitoba’s deputy chief public health officer, told a Doctors Manitoba webinar that the two-thirds figure pertained to a single hospital, as well as to children admitted to various hospitals.
The next day, Atwal’s superior, Dr. Brent Roussin, explained that math at a news conference. He said that 46 kids aged 0 to 18 with COVID-19 ended up in hospital between Dec. 1, 2021 and Jan. 10, of which "31 or two-thirds were admitted to hospital for other reasons."
Children tend to have less-severe symptoms of COVID-19, and so the virus is statistically less likely to send them to hospital than adults.
“It is a crisis, and the fact that the word ‘crisis’ is not being used by our current elected leadership is very troublesome to me." –Dr. Renate Singh
According to the Canadian Nosocomial Infection Surveillance Program, a long-standing federal project where hospitals report data on admissions, "pediatric patients were less frequently admitted due to COVID-19 compared to adults" in all four waves of the pandemic.
In the ongoing fourth wave, 70.8 per cent of COVID-positive adult patients across Canada were admitted to hospitals specifically due to the virus instead of another reason, compared with 41.7 of pediatric patients.
In a Public Health Agency of Canada summary of provinces’ latest data published last Friday, Manitoba is far offside its peers in its ratio of primary hospitalizations (caused by COVID-19) to incidental ones (hospitalized for a different reason, but the patient has COVID-19).
In the past month, Saskatchewan, Ontario, Quebec and New Brunswick all reported 50 to 64 per cent of COVID-positive hospital patients being primary cases, compared to just 33 per cent in Manitoba, the only other reporting jurisdiction.
Gordon’s office did not respond to interview requests Friday and Monday.
Dr. Doug Eyolfson, who works on the ICU ward at Grace Hospital, said he found her statement deceptive.
"I find it astonishing that she’d give a figure like that, and not tell us that this was for children," said Eyolfson, a former Liberal MP.
"I won’t actually call her a liar, because why would she lie to us?"
In a statement, Shared Health said that beyond the children’s data, a separate chart review started Jan. 3 involving 193 patients with COVID-19 at the Health Sciences Centre, which the agency warned does not have a COVID-19 ward.
"Because of the type and acuity of services provided at HSC, it is likely the proportion of patients with incidental COVID will be higher than in facilities with dedicated COVID medicine units and/or lower-acuity facilities," an unnamed spokesperson wrote.
"That’s like saying you’re on the Titanic, it hits an iceberg and then you’re in the water, drowning, and your last thought is, ‘Was it really the iceberg? Or was it the structural defect in the hull?’" –Dr. Dan Roberts
The agency also cautioned that 90 per cent of HSC Winnipeg’s critical-care patients are there for COVID-19.
Shared Health would not share any of the instructions or forms used to parse out incidental versus primary cases of COVID-19 hospitalization, but says it plans to review charts at other hospitals.
Front-line doctors argue the public is being misled.
"It’s a bit of a false flag," said Dr. Renate Singh, an anesthesiologist who works at Grace Hospital and HSC Winnipeg.
She noted that patients with COVID-19 require isolated rooms, whether they are admitted to hospital "for" or "with" the coronavirus.
"Any way you slice it, it requires the closure of beds and the limitation of space," said Singh.
That proportion will likely get more attention as COVID-19 hospitalizations mount. Manitoba reported Monday 82 new COVID in-patients since Friday, compared with an average of 49 patients per day in the prior week.
"It is a crisis, and the fact that the word ‘crisis’ is not being used by our current elected leadership is very troublesome to me," Singh said.
Dr. Dan Roberts, a Winnipeg critical-care physician, said the terminology is a distraction.
"That’s like saying you’re on the Titanic, it hits an iceberg and then you’re in the water, drowning, and your last thought is, ‘Was it really the iceberg? Or was it the structural defect in the hull?’
"If someone needs their hip fixed and comes into hospital and then catches COVID and dies, they (still) died of COVID; this is not incidental." –Dr. Doug Eyolfson
"I mean, that’s nonsense. It’s just deflection. To try to say that most of these admissions are not due to COVID is completely absurd."
NDP Opposition Leader Wab Kinew expressed suspicions that the province is publishing the numbers only at a time of intense scrutiny around hospital capacity.
"It’s cherry-picking statistics, at a time that the government is trying to take political advantage of the crisis that Manitobans are very concerned about," he claimed.
Kinew noted that the debate over whether people are hospitalized with or for COVID-19 is prevalent in online groups that claim the pandemic is a hoax.
"It’s very concerning to me that two years into the pandemic, the PC government is starting to parrot the talking points that we see in anti-vaxxer circles on social media," he said.
Yet Dr. Theresa Tam, Canada’s chief public health officer, said provinces can measure the prevalence of incidental and primary infections to anticipate critical-care use.
The numbers can also help them get a sense of how long patients will need hospital beds, as well as how widespread COVID-19 might be in the community, she said.
"It does help with local-level planning, but it’s much more important for provincial levels," Tam said last week, adding that Ottawa is trying to help provinces report data constituently.
"We are sharing the methodologies on how that is done… some of it is also disaggregating the (infections) acquired inside the hospital."
That’s the part that annoys Eyolfson about the debate over incidental versus primary COVID-19.
"If someone needs their hip fixed and comes into hospital and then catches COVID and dies, they (still) died of COVID; this is not incidental," he said, even though that’s exactly how many provinces would record it.
"That terminology around incidental COVID is minimizing the actual scope of this, and it’s very wrong."
— With files from Katie May
Parliamentary bureau chief
In Ottawa, Dylan enjoys snooping through freedom-of-information requests and asking politicians: "What about Manitoba?"