Doctors have warned the province to slow down its reopening plans in advance of a fourth wave of COVID-19 dominated by the highly transmissible Delta variant.
Plans to reopen businesses and services to 25 per cent capacity as of July 1, contingent on provincewide vaccine uptake, should be reconsidered because they don't take into account the faster-spreading and more dangerous Delta B.1617 variant, a group of senior physicians says.
As they did leading up to the second and third waves of the pandemic, several local doctors are again raising concerns that the reopening plans won't help the province curb the impending fourth wave, particularly for students heading back to school in September.
Second-dose vaccination benchmarks should be higher, and daily case counts and test positivity rates should be much lower, before more facilities reopen, they say. The province should improve ventilation in schools and contact tracing in workplaces, they say.
The group of six critical-care, infectious-disease and internal-medicine doctors — Dan Roberts, Eric Jacobsohn, Anand Kumar, Pamela Orr, Jillian Horton and Christine Peschken — held a Friday news conference in which they urged the provincial government to listen to their recommendations. Eleven doctors signed a letter in support of the group's views.
Roberts, an ICU physician at Health Sciences Centre, said it's a big problem that the most recent COVID-19 projections — released by the province last week — don't take into account the Delta variant. Public health officials have said they're updating the models to include the potential impact of the variant.
"We had well over 100 cases (Thursday). Our test positivity rate (Thursday) was 8.8 per cent. It's just completely irrational to propose to ease restrictions with those numbers," Roberts said.
On Friday, deputy chief provincial public health officer Dr. Jazz Atwal said more information on the updated modelling is expected to be released next week, and "subtle changes" to the provincial strategy could be announced. Currently, about 70 per cent of Manitobans have received their first vaccine dose and about 22 per cent have received their second shot.
Several of the same doctors issued similar warnings last October and again this spring before the third wave peaked.
"We were ignored then, but we weren't wrong. So I think it would be prudent for them to heed this advice. We don't have any illusions about whether they'll take the advice, but the impact on our health-care system and on our children if we make a mistake and we don't act prudently and cautiously, is going to be indefensible," Roberts said.
The doctors predict the Delta variant could be the dominant strain here by mid-summer and a fourth wave could occur within four to six weeks.
"We were ignored then, but we weren't wrong. So I think it would be prudent for them to heed this advice." – Dr. Dan Roberts
The spread of the Delta variant in the U.K. resulted in officials pausing reopening plans despite having double-dose vaccination rates of more than 50 per cent of the population. The U.K.'s experience has shown hospitalization rates can remain high even as more people are fully vaccinated, Dr. Pamela Orr said.
Early data show the virus can have lasting health consequences in children who have even mild infections, she said.
Kumar, an ICU physician, said he would like to see Manitoba's daily case counts drop to fewer than 50, and test positivity rates fall to two or three per cent, before the province significantly reopens. He wants higher targets and a more aggressive rollout for second doses. The existing targets weren't developed with the more contagious variants in mind, he pointed out.
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Jacobsohn, an anesthesiologist and critical care physician, estimated it could take five years to clear pandemic surgical backlogs if surgical staffing complements get back to baseline. He said it's very unlikely they'll get there within the next few months given high vacancy rates, and the health-care system can't handle another disastrous wave of the pandemic.
Too few 12- to 17-year-olds will be vaccinated by September to safely reopen schools, and the risk of outbreaks with the more contagious Delta variant is still too high, the doctors said. They said they want to see schools open in the fall without having to close again, so theyare pushing the province to take precautions now.
The variant is more resistant to existing vaccines and spreads much faster than the strain that is dominant now (B.117/ U.K.). The Delta variant has been shown to be twice as likely to lead to hospitalizations, and while two doses of vaccine are still effective, reports from other countries have shown one dose has only about 30 per cent effectiveness against severe outcomes in teens and adults.
One Manitoban has died of the Delta variant and as of Friday, there were 154 confirmed cases of the it, across all regions of the province. Manitoba's first four cases were confirmed May 7. So far, less than one per cent -- 0.19 per cent -- of Manitobans who've contracted the Delta variant have been hospitalized, a provincial spokesperson said, saying there are currently no patients in hospital with that variant. The presence of the variant has to be confirmed via genomic sequencing because quicker screening tests haven't been developed yet. Cadham Provincial Laboratory and Dynacare labs are sequencing 12 to 15 per cent of COVID tests to check for variants, and a federal sequencing program monitors international travellers.
Katie May Reporter
Katie May reports on courts, crime and justice for the Free Press.
As public health officials promised an update next week on the impact of the delta variant in Manitoba, opposition politicians expressed concern Friday that provincial modelling has not yet provided a full picture.
The most recent models for projected case counts and hospital admissions didn't take the faster-spreading B.1617 variant into account, and the deputy chief provincial public health officer said new Delta-inclusive projections are on the way.
Responding to concerns raised by a group of local doctors Friday, NDP Leader Wab Kinew said it's "irresponsible" of the government to introduce reopening plans without doing that complete modelling first.
"I think at this point in the pandemic, we're all feeling that fatigue, and so we don't want to risk a reopening, never mind risk people's health simply because the government hasn't taken this into account in the modelling. So that's got to happen right away," Kinew told reporters.
Manitoba Liberal Leader Dougald Lamont said he didn't see any indication the government has learned from previous waves of the pandemic.
"I don't want to alarm people, but based on the record of this government, if there's going to be a bad fourth wave anywhere in Canada, it's going to be here in Manitoba, because the PCs... don't learn anything. They reopen too fast and they don't give people the supports they need," Lamont said.