More Manitoba physicians have gone public with an open letter calling out the provincial government for what they say is an inadequate response to the spike in COVID-19 cases.
The letter, which was sent to Premier Brian Pallister, is signed by more than 200 physicians and academics who share a "unanimous alarm regarding the COVID-19 crisis in Manitoba." The letter states mathematical modelling from around the world shows "we are in grave peril."
On Monday, Pallister said little to address the growing concern by Manitoba doctors.
"I'm totally confident in our health experts’ plan to address the issues doctors are raising," Pallister said at a news conference Monday on the first day of code red restrictions for the Winnipeg metropolitan region.
He said the government is acting on most of the issues the Nov. 1 letter raised including freeing up staff and resources by postponing some elective non-urgent surgeries.
But health-care workers like Dr. Eric Jacobson, an intensive care physician and anesthesiologist in Winnipeg, remain critical of provincial officials' recent statements that the health system still has the capacity to handle the rising number of COVID-19 cases.
"The implications are a week down the line for hospitalizations, and for critical care capacity is one to two weeks down the line," Jacobson said Monday. "We’re dealing with ICUs that are running at near full capacity, but the increase in ICU admissions that will inevitably result from the several hundred cases per day is down the road."
Health-care capacity, which ranges from available beds to available critical care staff, is already stretched thin even as cases continue to rise exponentially across the province, Jacobson said.
"We want to emphasize that capacity is not just where people can be 'kept' or cared for when they are sick. Capacity also includes the physical toll and exhaustion being encountered chronically across nursing, medical, lab and hospital staff."
The letter said Dr. Brent Roussin, Manitoba's chief public health officer, is not being afforded "the budget nor the resources to adequately protect our population from this virus," and laid out seven urgent requests, including the immediate allocation of financial resources to support contact tracing and public education and to increase virus-testing capacity.
It also calls on the government to be transparent and accountable by expanding its incident-command centre — which the government reinstated Monday — to include the voices of physicians, Indigenous leaders and advocates for disadvantaged communities.
"It’s a plea to those who are running the pandemic, or paying for it, to make certain that we have access to the appropriate resources including testing and tracing," Jacobson said, acknowledging the financial implications of such an ask will be steep.
"All we’re saying is please make certain that there are no corners cut in making the resources available."
The letter says regional health authorities should "swiftly take over any (personal-care) home that is not clearly controlling its outbreak," calls for expansion of the recently imposed code-red shutdown and seeks a commitment to establish an emergency child-care strategy to support health-care workers and vulnerable children.
It also calls on the province to directly support Manitobans whose incomes drop precipitously owing to increased public-health restrictions.
Jacobson said the letter is intended to close gaps in communication from public health, and urges both Manitobans and government officials to make the necessary changes to curb the spread of the virus. The province has long been a leader in infectious disease and critical care, Jacobson said, meaning the expertise to navigate the present crisis is available.
The letter comes on the heels of another open letter last week to Pallister and Health Minister Cameron Friesen from several of the province's physicians, calling for a province-wide lockdown to avoid overwhelming the health-care system.
Friesen said Monday he shares the doctors' concerns, adding the province is addressing many of them.
"I think that the greatest point of agreement that I have with those doctors is when they write that we are at a critical juncture right now and that Manitobans all must take care right now to reduce their contacts, to stay home and help do their part to avoid spreading the virus," he said.
Friesen noted he spoke Sunday to federal Health Minister Patty Hajdu about rapid testing. "Manitoba needs timely access to those machines the doctors are talking about," he said. More people are being hired and human resources are being redeployed to "procure the right tools and hire the right people" where needed, the minister said Monday.
When asked if hospitals are on the brink as the doctors suggested, Friesen didn't offer a direct answer.
"As we see the hospitalization numbers rise, as we see there are more people in the ICU than last week, (Manitobans) want to know, is there a plan to reorient our health-care system to the challenge it is facing?," Friesen said. "There is a plan being led by health-system experts."
Meanwhile, Doctors Manitoba warned hospital resources could be completely exhausted in a matter of days if people do not act immediately to curb the spread of COVID-19.
In a news release Monday morning, the physicians issued an urgent "red alert" statement, asking Manitobans to adhere to the restrictions put in place for Winnipeg and to follow Roussin's advice as intensive care units in the province rapidly approach their limits.
"Our health-care system is always a lean operation. We have never operated with a plethora or excess of resources," said Dr. Kendiss Olafson, a critical care physician in Winnipeg who helps run the quality improvement of ICUs across the region.
Olafson urged Manitobans to go above and beyond public health orders by limiting contact outside the household beyond the five-person maximum for gatherings, wearing masks at all times outside the home, washing hands frequently, maintaining distance from people outside their household and staying home when sick, even with mild symptoms.
"The public order is really the minimum of what people have to do," she added.
— with files from Carol Sanders
Julia-Simone Rutgers is a general-assignment reporter.