Struggling to keep up with testing as COVID-19 cases soar, Manitoba has abruptly changed how it will diagnose most infections — a move that could leave thousands of cases off the province’s official record.

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Struggling to keep up with testing as COVID-19 cases soar, Manitoba has abruptly changed how it will diagnose most infections — a move that could leave thousands of cases off the province’s official record.

Almost all new cases in Manitoba will be diagnosed using rapid antigen tests going forward, deputy chief provincial public health officer Dr. Jazz Atwal announced Wednesday.

With provincial laboratories already overwhelmed, capacity needs to be preserved to perform the more sensitive polymerase chain reaction (PCR) tests for Manitobans in high-risk settings while Omicron throttles public health resources.

"We’re already shifting in how we manage COVID-19," Atwal told reporters during a virtual news conference Wednesday afternoon. "There’s lots of cases out there. There’s lots of cases we don’t know about."

On Wednesday, 1,790 new cases of COVID-19 were reported in Manitoba, including 1,320 in Winnipeg. Due to a significant testing backlog of roughly 6,800 swabs, case counts are under-reported.

The government has not yet established a way for the public to report their positive rapid test results, Atwal said. Only results from PCR tests are available to public health officials.

Almost all new COVID cases in Manitoba from now on will be diagnosed using rapid antigen tests. Pictured is a positive test on the left and a negative test on the right. (Jeff McIntosh / The Canadian Press files)

Almost all new COVID cases in Manitoba from now on will be diagnosed using rapid antigen tests. Pictured is a positive test on the left and a negative test on the right. (Jeff McIntosh / The Canadian Press files)

The province is looking at ways to collect that data but "that will be much more difficult," he said. Last week, the government distributed 500,000 rapid tests to Manitobans and another 500,000 should be distributed by the end of next week, he said.

With limited information on new COVID-19 infections expected, officials will be monitoring other pandemic data including modelling, hospitalizations and COVID-19 in wastewater, to help the health system prepare for increased demand related to the virus, Atwal said.

For every case of Omicron that is confirmed, another eight to 10 go undetected, Atwal said. More than 10,000 cases of the highly infectious variant have been confirmed in the province in the past week.

"Because of the sheer number of cases, this is more about the impacts on the acute care system, so a lot more focus will be done on the acute care system, and hospitalizations and ICU use," Atwal said.

"We use every piece of information we can get our hands on to determine what is the best approach for Manitoba."

The province’s move shows it has lost control of the pandemic, epidemiologists say.

The change reflects an unfortunate reality that Omicron has overwhelmed Manitoba’s capacity to track it accurately in real time, University of Manitoba epidemiologist Souradet Shaw said, noting it’s important to track the virus in populations, places and time.

"This is a fundamental function of surveillance and is important for things like disease prevention," Shaw said

However, the need to switch to rapid tests is happening across Canada, said Nazeem Muhajarine, a professor of community health and epidemiology at the University of Saskatchewan.

"It is really unfortunate for a country like Canada, with the kinds of infrastructure and development we have, to get to the point where our public health system has run out of capacity for testing — it is quite telling," said Muhajarine. "When we get out of this pandemic, we’ll have to see how we got here."

Shaw warned against relying on hospitalization rates to inform the province.

"It will be much more challenging to change course if we wait for the acute care system to tell us it is overwhelmed," Shaw said.

As of Wednesday, most Manitobans five and older with COVID-19 symptoms will be provided a rapid test kit to use at home with few exceptions, Atwal said. Previously, fully vaccinated Manitobans were given rapid tests and asked to return for a PCR test if they received a positive result.

People who regularly attend vulnerable settings, including health-care facilities, schools and daycares, may still be asked to return for a PCR test if they have a positive result.

Children who cannot use the self-test, people with weakened immune systems or eligible for COVID-19 treatment, those experiencing homelessness and people who have travelled outside of the country within 14 days can receive a PCR test without first testing positive on a rapid test.

Despite the change, a significant volume of PCR testing is expected to continue, Atwal said.

"We’ll have a good idea in general about case numbers. There are other jurisdictions that are leading this as well, so we will learn from those jurisdictions."

Manitobans should expect to see daily case counts rise for at least the next seven days as laboratories work through the testing backlog, he added.

On Wednesday, the five day test-positivity rate was 40.3 per cent in Manitoba and 48 per cent in Winnipeg — record highs.

As of Wednesday, there were 252 COVID-19 patients in hospital, including 30 in intensive care.

Full PCR testing eligibility is available here.

— with files from Kevin Rollason and Katie May

danielle.dasilva@freepress.mb.ca

Danielle Da Silva

Danielle Da Silva
Reporter

Danielle Da Silva is a general assignment reporter.