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Nearly two weeks after the Winnipeg metropolitan region increased restrictions to staunch the spread of COVID-19, the city continues to face high transmission of the virus, with 40 new cases announced Sunday afternoon.

Province-wide, 54 new cases were identified, bringing the total active caseload to 1,063, with 3.1 per cent of all tests completed over the last five days leading to a positive result. Of those 1,063, 913 — about 86 per cent — are in Winnipeg. No other health region in Manitoba had higher than 84 active cases as of Sunday.

On Monday, the Winnipeg region will enter the second 14-day stretch of orange level restrictions, a period that public health experts say will be crucial in limiting the spread of the virus and its potential to infect more Manitobans while putting additional strain on the health-care system.

"We have been in orange (level restrictions) for one incubation period, and it usually takes that amount of time until you see changes," said Dr. Joss Reimer, a public health physician at the University of Manitoba. "The real key will be what happens this week."

"Nothing has changed in terms of what we’ve been asked to do," said epidemiologist Cynthia Carr of the challenges ahead as the city approaches a potential tipping point. "We are the only ones who can block this chain of transmission."

When the Prairie Mountain Health region began orange level restrictions in August amid a spike in cases, the turnaround was quicker than it has been in Winnipeg; that can likely be attributed to more well-defined understandings of which groups were exposed, Reimer said. In Winnipeg, the spread has been wider, and appears more difficult to target and control.

Onlookers might consider the new cases announced on Thanksgiving Sunday as an improvement over Saturday, when nearly 100 instances of COVID-19 were confirmed in Manitoba. However, both Carr and Reimer cautioned against reacting solely to daily counts, which only give partial insight into long-term trends.

"54 cases might look good, but three days ago, it would be viewed as a number of great concern," said Reimer. "It’s still very high."

Since mid-July, when the cumulative curve of COVID-19 cases was relatively flat in Manitoba, it has experienced a steady increase, and despite added restrictions, continues to rise: between Sept. 9 and Oct. 9, the cumulative case load increased by 67 per cent.

At the same time, the number of Manitobans killed by the virus has increased from 18 to 32 in the last three weeks, with two deaths announced Saturday. Hospitalizations have also increased to 24, with four people in the intensive care unit.

The seemingly sudden increase in deaths is an example of epidemiological lag, Carr and Reimer say: the bulk of infection occurs in populations who tend to have less risk of developing severe outcomes due to lack of underlying health conditions. Over time, the spread reaches vulnerable populations, like seniors, people who live in crowded conditions, and people with underlying chronic conditions, leading to illness, hospitalization and death.

In Manitoba, roughly 70 per cent of all people to test positive since the start of the pandemic have been between 20 and 39 years old. As of yet, each of the 32 Manitobans to die of the virus have been over the age of 50, with most older than 70, although every demographic faces risk of infection.

"It’s very challenging month after month to keep being vigilant … We’re seeing these increases in many jurisdictions," said Reimer, who didn’t want to assign blame to any particular group. "The consequences of letting our guard down are severe, and for some people, it’s life or death."

Carr said the virus is not known to have become more deadly, but it is opportunistic, which is why it’s essential to strictly adhere to guidelines in place. It may appear the last two weeks haven’t led to much progress yet, she said, but it’s probable the situation would have been much worse if the orange restrictions — no gatherings of more than 10 people, mandatory mask use in any public indoor spaces — were not implemented.

The fact that case counts continue to tick upward show that residents cannot let up in their efforts, she said.

"Our behaviour is what’s going to push this (virus) back or give it opportunity to spread," Carr said.

If this crucial two-week period doesn’t slow the spread in the Winnipeg region, Reimer said she’d anticipate public health officials would need to discuss whether stricter measures are necessary.

ben.waldman@freepress.mb.ca

Ben Waldman

Ben Waldman
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Ben Waldman covers a little bit of everything for the Free Press.

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