ICU numbers just one piece in big puzzle, experts warn

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Manitoba needs a new approach to get a handle on the Omicron variant, rather than relying on ICU numbers to decide whether to impose public health restrictions, science and policy experts say.

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This article was published 06/01/2022 (217 days ago), so information in it may no longer be current.

Manitoba needs a new approach to get a handle on the Omicron variant, rather than relying on ICU numbers to decide whether to impose public health restrictions, science and policy experts say.

Public health officials and Premier Heather Stefanson said this week they’re keeping a close eye on ICU admissions and hospitalizations before ordering a potential lockdown or other ramped-up measures to slow the spread of COVID-19.

Even if ICUs aren’t overwhelmed, vital services Manitobans need in daily lives will likely be disrupted by Omicron, said virologist Jason Kindrachuk.

The medical intensive care unit at the Health Sciences Centre Mikaela MacKenzie/Free Press files

The normally reserved University of Manitoba medical microbiologist raised the alarm Thursday about the impact of many essential service workers — from pharmacy, grocery, transit and health to protective services — catching the virus.

“What happens if a significant proportion of your work staff are all sick at the same time and unable to work? That now has an impact not only on your operations but also on the ability for people to get the goods and services they need,” said Kindrachuk.

“Those things are crucially important for us to consider.”

On Thursday, the City of Winnipeg reported 351 of its workers were dealing with COVID-19 — including 76 Transit staff and 85 in the Winnipeg Fire Paramedic Service

In the health-care system, between Dec. 25 and Jan. 1, 915 staff — including nurses, doctors, allied health professionals — tested positive for COVID-19, Shared Health said Thursday. That’s more than double the 423 who tested positive the week before.

“We have to appreciate health-care capacity and the importance of preserving that, but we also have to look at other aspects and appreciate that we’re all interconnected,” Kindrachuk said.

The government isn’t likely to act unless ICU capacity is overwhelmed, according to the former clerk of the executive council.

“Can’t stress enough that this is the most important metric government watches in deciding on future public health restrictions,” David McLaughlin said Wednesday on Twitter.

Manitoba has critical care capacity for 114 ICU patients, and the “prevailing government view” is the system isn’t overwhelmed until it has 115, said the former premier Brian Pallister appointee.

Until then, it sees the health-care system as “strained, stressed,” he tweeted, “but not ‘overwhelmed.’”

On Thursday, the system was under more strain and stress, as Shared Health reported 95 patients in ICUs (33 with active COVID-19, one post-infectious) —three more than was reported Wednesday. Eighteen were unvaccinated and 14 were fully vaccinated, it said.

Shared Health said it didn’t know how many had received a third dose and couldn’t say how many had underlying conditions. There was a record 2,548 new infections and a record-high test positivity rate of 43.5 per cent reported Thursday in Manitoba.

By waiting to see if ICU admissions rise before imposing more restrictions, the Progressive Conservative government is “rolling the dice with Manitobans lives,” said NDP house leader Nahanni Fontaine.

“Why wait until we get to a point where we’re going to have to contemplate sending people out of province?” the MLA said, after calling on the provincial government to reconvene the house to deal with the public health crisis.

During the third wave of the pandemic, overwhelmed Manitoba ICUs had to send 57 pandemic patients out of province for care. Now that neighbouring provinces are struggling with hospitalizations, that may not be an option.

“Ontario is in their own mess,” Fontaine said. “The reality is that there are consequences to sitting on the fence and doing nothing until the last minute —and the consequences are Manitobans’ lives.”

The province could benefit from reaching out to non-governmental experts for new ideas to set policy and navigate the pandemic, said University of Manitoba political studies Prof. Karine Levasseur.

The new premier had promised to take a new approach and to listen and be more collaborative than the combative Pallister had been, noted Levasseur, whose area of expertise is public service and administration. “Two months in, and we’re not seeing this with Heather Stefanson.”

Whatever metrics the province is using to determine the public health orders that are needed, they’re not working, said outspoken law and public health Prof. Amir Attaran in Ottawa.

Given Manitoba’s ICU capacity, soaring COVID-19 cases and unvaccinated pockets of the population, Attaran estimates the province will run out of critical care capacity early next week.

The province could have adopted stricter measures sooner but seems to be “hoping to borrow someone else’s lifeboat as the ship goes down,” the University of Ottawa professor said.

Manitoba can’t count on outside help this time with the super-infectious Omicron wave hitting most of Canada right now, he added.

“Every province, very soon, will be slammed for ICU beds,” said Attaran. “Nor can Manitoba expect the military to bail it out, either. Other provinces will be making the same request… We really are in it together this time.”

— with files from Danielle Da Silva

carol.sanders@freepress.mb.ca

Carol Sanders

Carol Sanders
Legislature reporter

After 20 years of reporting on the growing diversity of people calling Manitoba home, Carol moved to the legislature bureau in early 2020.

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