Modelling shows Manitoba ICUs could be overrun again this fall even though three-quarters of the eligible population is fully vaccinated against COVID-19.
"We need to see higher vaccine uptake," deputy chief provincial public health officer Dr. Jazz Atwal said Tuesday.
Close to one-third of the population has not received a single dose of the COVID-19 vaccine, the modelling report said. While ICU occupancy has decreased, it’s still quite high and the health-care system could be "significantly affected" if ICU demand increased due to a rise in COVID-19 cases.
Without higher rates of vaccination and stricter public health measures, the acute-care system could be overwhelmed within four months, Atwal said in an online briefing for reporters Tuesday.
He said they can't predict when the fourth wave of COVID-19 will arrive in Manitoba, but when it hits, it will hit hard.
"The delta variant is changing the game," Atwal said. The modelling is based on 290 parameters that take into account things like behaviour and public health measures. It describes three main scenarios — controlled, severe and extreme — and it's hard to predict where Manitoba will go, Atwal said.
"We have been all over the map," he said, referring to the three scenarios that all have played out in Manitoba during the pandemic. The arrival of the flu season in October and November could spell trouble for the acute-care system depending on how severe it is and how many hospitalizations result, Atwal said.
"We need to see higher vaccine uptake." — Deputy chief provincial public health officer Dr. Jazz Atwal
"We don't have a model for influenza," he said. Atwal wouldn't say what the plan is if Manitoba can't send ICU patients out of province because its critical-care beds are overwhelmed at the same time as other provinces.
Rather than talk about what that worst-case scenario would look like, he urged people to get vaccinated, follow the COVID-19 fundamentals, stay home when they're sick, get tested and co-operate with contact-tracing efforts.
A spokesman for Shared Health issued a statement later on Tuesday that said Manitoba will ensure every patient who needs critical-care services will receive it.
"As evidenced by the third wave, that approach included transferring patients to facilities outside of the province as needed to ensure local ICU capacity was not overwhelmed," he said in an email.
"The threat of exceeding local capacity is directly related to the number of unvaccinated individuals." He repeated the mantra of health officials everywhere. "This has become the pandemic of the unvaccinated."
Shared Health's clinical teams are focused on maximizing capacity locally and "developing contingency plans in order to serve all." The spokesman did not respond to a request to see the triage protocol that will help decide which patients would receive care if ICU beds become scarce.
"To benefit care for all, we continue to encourage all eligible Manitobans who have yet to be fully vaccinated from COVID-19 to do so," he said.
"The threat of exceeding local capacity is directly related to the number of unvaccinated individuals... This has become the pandemic of the unvaccinated." — Spokesman for Shared Health
On Tuesday, the province said it would require provincial workers to be vaccinated. It also requires people to be fully vaccinated to access public events and to wear masks indoors. Atwal said those measures could help Manitobans avoid a worst-case scenario.
Still, more people need to get vaccinated, otherwise there will be a surge in hospitalizations as the virus runs rampant in unvaccinated Manitobans. The fewer the vaccinated, the greater the amount of COVID-19 transmission chains, said Atwal.
Current COVID-19 modelling shows that ICU capacity could be heavily strained for COVID-19 alone within one month of the start of the fourth wave.
"While additional beds can be added through cancelled surgeries and other service adjustments, this has negative effects on individuals seeking care," the modelling document says.
Atwal said the start of the fourth wave will be determined by a number of variables, including daily case counts, test positivity rates and the R-naught or reproductive rate of the virus. Other provinces that relaxed restrictions prior to Manitoba — such as B.C. and Alberta — had low daily case numbers for weeks — but then saw them shoot up tenfold, thanks to the fast-spreading delta variant.
In Manitoba, under an extreme scenario, the daily case count could climb to more than 2,400 by December; in a severe situation, it could be upwards of 250; and in a controlled situation, it would remain low.
"It's hard to predict," Atwal said, hammering away at the need for Manitobans to get vaccinated.
"It reinforces the strong concern doctors have about the capacity in our hospitals, and just how close hospitals are to being overwhelmed again by another surge in COVID-19 admissions." — Doctors Manitoba spokesman Keir Johnson
"The vast majority of people in hospital and the ICU are not vaccinated," said Atwal. Of the 27 COVID-19 cases reported in Manitoba on Monday, 21 of those infected were unvaccinated, he noted.
Doctors Manitoba reviewed the projection model released by the province Tuesday, saying they're not surprised.
"Physicians aren't surprised by the new fourth-wave projections, which are very much in line with what other jurisdictions ahead of us are already experiencing," said the organization that represents more than 4,000 doctors, medical students and retirees.
"It reinforces the strong concern doctors have about the capacity in our hospitals, and just how close hospitals are to being overwhelmed again by another surge in COVID-19 admissions," spokesman Keir Johnson said in an email.
Last month, Doctors Manitoba estimated there was a backlog of 110,000 elective surgeries and diagnostic procedures that were delayed as a result of COVID-19 overwhelming hospitals.
"Manitoba could again see thousands more surgeries cancelled and more patients sent out of province for life-saving ICU care," Johnson said.
That's why Doctors Manitoba recommended on Sunday that health-care workers be required to get vaccinated. On Tuesday, Premier Brian Pallister announced such a measure.
The Manitoba NDP accused the Progressive Conservative government of sitting on the dire fourth wave COVID-19 projections.
"At the peak of the third wave, Pallister’s health minister, Heather Stefanson, told Manitobans our ICUs had additional capacity – and the next day we transferred critically ill patients to Ontario," said NDP health critic Uzoma Asagwara.
"No one wants to see that happen again. But modelling that’s been finally released (Tuesday), after being hidden for months by the PCs, proves that what health-care workers have been warning us about is real," Asagwara said.
"The PCs failed to staff up and prepare our hospitals for the fourth wave, and if they don’t take action today we could be back in the same situation."
After 20 years of reporting on the growing diversity of people calling Manitoba home, Carol moved to the legislature bureau in early 2020.