None of us needs to be reminded the COVID-19 pandemic we’re still living through dominated headlines in 2021.
Case counts that formed record-high peaks in the spring look like valleys now; grim new records are being set almost every day with capacity exceeded for testing, contact tracing and hospital staffing.
Limited, too, may be collective capacity for thoughtful reflection as we brace for the beginning of Year 3 of a pandemic that is pushing health-care resources over the edge and exposing systemic failures across sectors. Looking back, however, gives some context for where we’re headed.
In the past year, Manitoba ramped-up vaccine distribution amid a vocal minority of anti-vax sentiment, dealt with overflowing intensive care units and emergency rooms, and turned to other provinces for help as infection rates soared.
In hindsight, we can look back on the pandemic response of 2021 as one that saw 78 per cent of eligible Manitobans get double-vaccinated, revealed a backlog of more than 30,000 surgeries, and resulted in 57 critically ill COVID-19 patients airlifted to out-of-province ICUs in unprecedented desperation.
Enduring four different dominant strains of COVID-19 over the past year, each more contagious than the last, meant the province repeatedly ran out of health system capacity and had to postpone or cancel surgeries and non-urgent — but still crucial — procedures and tests.
The waves of COVID-19 transmission reached Manitoba more slowly than in many provinces, but four months into the year when the third wave hit, public health officials described the disproportionately high rate of ICU admissions that arose as "a little unexpected," in the words of deputy chief provincial public health officer Dr. Jazz Atwal.
"Obviously, it got bad. We ran out of room here," Atwal said in July, after the last Manitoba patient returned from a hospital in Ontario.
Amid surging hospitalizations and ICU nursing job vacancy rates, medical staff scrambled to send 57 Manitoba patients to hospitals in Ontario, Alberta and Saskatchewan over a three-week period in late May to early June.
Twelve Manitobans died of COVID-19 out of province.
At the time, Manitoba was the only province to transfer critically ill COVID-19 patients across its borders — and those snap decisions laid the groundwork for an in-province transfer policy that has patients not seriously ill transported for care, sometimes hundreds of kilometres away, as hospitals fill up with COVID-19 patients.
Premier Heather Stefanson and Health Minister Audrey Gordon have repeatedly said Manitoba will do whatever it can to avoid sending patients out of province again — a message the premier reiterated as recently as Dec. 27.
Stefanson said something similar the same day the first Manitoba patients were airlifted out of province in May. The then-health minister said the province still had capacity to increase its ICU bed numbers and didn’t expect to ration them.
"Obviously, we’re doing everything that we can to ensure that it doesn’t get to a point where we need to go in that direction," Stefanson said about ICU triage decisions May 18. It was later announced the first two patients had been transferred to Thunder Bay, Ont.
Increasing ICU capacity requires hiring more highly trained critical care nurses — a reality Manitoba has long struggled with. At the height of the third COVID-19 wave, health officials said they had turned over every rock looking for critical care staff to fill in.
The chronic, crushing shortage prompted nurses to increasingly speak out, despite fearing for their jobs by doing so. Exacerbated by exhaustion, the staffing crisis was even worse in the fourth wave.
"This winter, there is no reserve left," one St. Boniface Hospital nurse said in November. "We are on our last legs. It will take very little to push more nurses out of the profession."
Health-care staff saw more death than ever before.
More than 720 Manitobans died of COVID-19 in 2021, surpassing 2020’s death toll of 661.
Amid the despair were some surges of hope. Many lives were saved.
Like many residents of privileged countries, most Manitobans got their first (and second) COVID-19 vaccine doses in 2021.
A lack of supply early in the year and a few procedural hiccups as a rush of eager, elderly Manitobans turned up for their first shots transitioned to an efficient mass immunization campaign, which, as of this week, had administered third (or booster) doses to about 20 per cent of adults in the province.
Well before the first doses arrived, anti-vaccine rhetoric simmered on social media and at anti-mask/anti-lockdown rallies in Manitoba, taking hold overtly in the Southern Health region. Over the course of the past year, some communities in southern Manitoba have been among the lowest vaccinated places in the country, with tragic consequences as hospitalizations and deaths continue to climb.
In June, Maxime Bernier, leader of the People’s Party of Canada, was arrested in St.-Pierre-Jolys between attending anti-restriction rallies, and must still face in court Public Health Act charges for gathering and failing to follow quarantine rules.
By October, the province had enacted region-specific restrictions to try to target the transmission that was spreading largely among unvaccinated Southern Health residents — some of whom have continued to eschew mask requirements and surreptitiously flout indoor capacity limits for gatherings and church services.
Approval of a pediatric vaccine prompted thousands of anxious parents to flood the provincial booking website to secure appointments for their children, bringing some relief to vigilant and exhausted families in November, as Manitoba’s infection rates rose fastest among young children. Vaccine appointment slots went quickest for kids, too. Within the first three days of booking, nearly 20 per cent of eligible five- to 11-year-olds had secured appointments.
That age group is now booking for second doses.
"It took two seconds to get it done," nine-year-old Charlee Wolfe said after she became one of the first Manitoba children to get her COVID-19 vaccine Nov. 24. Her mom, Kelly Wolfe, like so many parents, set an early alarm to ensure she’d get an appointment as soon as possible.
"I just wanted her to get vaccinated so she can return — briefly — to everything she could do before all this," she said at the time.
The reminiscence of what "before all this" meant for Manitoba’s chronically strained health-care system, and what it means for each of us, does not change the unending uncertainty — or dread — about what comes next.
For certain, though, many Manitobans are just glad to be alive. After 43-year-old Miles Kasprick returned from an Ontario ICU in July, he said he was "beyond grateful" to have been transferred out of province.
"I believe that I wouldn’t be alive today if I wasn’t."
Katie May is a general-assignment reporter for the Free Press.