The intense pressure of COVID-19 on Manitoba’s hospital system — which forced 57 critically ill patients out of province for care — was greater than all its western peers, leaving officials trying to understand why.
Last month, as the third pandemic curve was trending downward, Manitoba public health reached out to federal counterparts at the Public Health Agency of Canada with a question: Was the proportion of COVID-19 cases in Manitoba requiring hospital care greater than what was seen in other provinces?
An early analysis conducted by the federal agency in consultation with local health officials suggested that was the case, according to the Manitoba government.
"Our acute care system did get overwhelmed here in Manitoba. Proportionally speaking, our acute care system was more impacted than any other province," Dr. Jazz Atwal, deputy chief provincial public health officer, said during a July 2 news conference.
The revelation Manitobans who caught COVID-19 were more likely to be hospitalized than patients in other provinces came after Atwal was asked if the province might adopt an elimination strategy, similar to Atlantic Canadian provinces, going forward.
Atwal would not offer any reasons for Manitoba’s higher hospitalization rate other than to say research is underway to understand the dynamics.
"That’s going to take a lot of time because it means reviewing all the cases, it means getting together with all these other jurisdictions to understand definitions, and to review all the data. And you want to be accurate with that data, as well," he said.
Between March 27 and June 5 — the period that roughly spans the third wave in Manitoba — there were 1,250 COVID-19 hospital admissions, including 412 intensive care unit admissions, according to provincial reports. There were about 18,840 confirmed cases of COVID-19 in that period.
"We’re going to look at the information on who was a severe outcome, who got hospitalized, who ended up in the ICU in Manitoba, and we’re going to provide that information with other provinces as well and try to understand that entire issue," Atwal said.
The Free Press requested to review the report and presentation prepared by the Public Health Agency of Canada for Manitoba health officials, but was denied.
"Manitoba is not able to share the presentation, as it is very preliminary. Additionally, the report includes data that falls outside Manitoba’s jurisdiction," a public health spokesperson said in a statement.
A request to the Public Health Agency of Canada to review the presentation and to respond to questions posed by the Free Press was not met by deadline.
Neither the province nor the Public Health Agency of Canada specified how much greater the hospitalization rate was in Manitoba when compared to the average for provinces outside of Atlantic Canada.
The review compared case hospitalization rates in Alberta, British Columbia, Ontario and Quebec to Manitoba, according to the provincial spokesperson. Some data from Saskatchewan was also included.
The preliminary report suggested the highest proportion of hospitalized cases were in Manitoba, compared to other provinces, the spokesperson said.
"There are many reasons why differences between Manitoba and other provinces may have been observed… exploring some of these reasons will require further discussions and more in-depth research projects."
The suggestion Manitobans were worse off than residents of other provinces because of unknown factors is "sleight of hand," said Dr. Anand Kumar.
"The major question is: why did we do so poorly overall?" the attending physician at the Health Sciences Centre in Winnipeg said in an interview with the Free Press.
"We used a strategy where we tried to just avoid overloading ICU capacity and health-system capacity, and when you do that with an illness that has exponential increases, it’s very easy to overshoot the mark."
There is some variation across provinces and populations that could affect the rate of hospitalization related to COVID-19, but any differences would be marginal, Kumar said.
Rather, the government implemented restrictions too late in the third wave to avoid overloading a health-care system that had yet to recover from the second, he said.
In comparison to the Atlantic provinces, where the pursuit of a maximum suppression strategy resulted in markedly fewer deaths, the question Manitoba should be asking is what did they do right that we did wrong? Kumar said.
"The simple fact is we didn’t have to have the worst outcomes; the worst outcomes that we had were primarily a consequence of decisions that the provincial government made."
The Free Press requested an interview with Health Minister Heather Stefanson. Her office sent a statement by email saying she was reviewing the data.
Danielle Da Silva
Danielle Da Silva is a general assignment reporter.