Stop me if you've heard this one before: Manitoba stands at yet another pandemic crossroads

If the pandemic was scripted television, you could be forgiven for complaining you've already seen the current scene before.

For the past two weeks, the average daily COVID-19 case count has been rising in Manitoba. The percentage of COVID-19 samples testing positive has also been on the rise.

The chief provincial public health officer is musing about imposing more sanctions. The health minister, in response, worries what that will mean for business.

This series of events transpired in late October, when COVID-19 case counts rose dramatically in Manitoba but officials chose to tinker with minor restrictions instead of taking early, decisive action to squash Canada's most dramatic second wave.

It's taking place again in the middle of April, a full 13 months into the pandemic, at the start of Manitoba's third COVID-19 wave.

The only question is whether Manitoba is doomed to repeat the lessons of the very recent past — something the chief provincial public health officer made entirely clear during his Monday briefing.

Changing the trajectory

"The third wave is here. How hard it hits us is really up to us," said Dr. Brent Roussin, apparently speaking to Manitobans as a whole as well as to the health minister who signs off on his orders.

"We have a lot of control right now to change this trajectory, but it's very likely that we're going to need to change the public health orders again to ensure that we have all Manitobans on board."

The trajectory in question can be seen clearly in the following chart. The seven-day average daily case count in Manitoba during the the last 10 days of October 2020 is rising at roughly the same rate as the same measure during the previous 10 days of this month.

As anyone who's been paying attention to the pandemic knows by now, the exponential spread of a highly infectious disease will only continue if measures are not taken to control that spread. This is Epidemiology 101 — a real-life course we've all been forcibly enrolled in for more than a year.

There are, of course, two key differences between late October and right now. Back then, we didn't have COVID-19 vaccines. We also didn't have more contagious coronavirus variants of concern.

The vaccines prevent the potential spread of the disease. The variants are capable of spreading more quickly.

Whether these two factors cancel each other out may be unknown in Manitoba. But when you look at the rest of Canada's large provinces, the variants of concern appear to be winning.

Manitoba did well to get this far

As of Tuesday, Manitoba continued to sport the lowest new COVID-19 infection rate among provinces west of the Maritimes: a daily average of 61 new cases per 100,000 people over the past week.

This is an achievement worthy of being the world's tallest Dachshund.

The fact Manitoba has done relatively well to date in keeping variants of concern at bay no longer matters, because the variants are here.

On Monday, variant of concern cases made up 11 per cent of Manitoba's 1,370 active COVID-19 cases.

This means it is very likely Manitoba is only a couple of weeks away from looking more like Saskatchewan and Ontario, which have two-and-a-half to three times our daily infection rate despite boasting slightly more efficient vaccine rollouts.

Roussin made it clear on Monday he does not wish to waste that grace period, especially given the lag time between new cases and hospitalizations.

"If we look at jurisdictions around us where those variants of concern have been introduced, we can see a rapid climb in the transmission of the virus, as well as in hospitalization and ICU rates," Roussin said.

"So we know that from those other jurisdictions that a greater proportion of people being admitted to hospital require ICU admissions, we see younger people requiring ICU admissions, we see longer hospital and ICU stays in those jurisdictions."

Of outdoor masks and indoor regulations

To ward off a similar situation here, Roussin posited new restrictions that could include an outdoor mask mandate — something tried once before in Manitoba, in the Prairie Mountain health region back in August — and the re-imposition of tougher new restrictions on indoor gatherings.

Roussin said he would have more to say about these restrictions later in the week.

Manitoba Health Minister Heather Stefanson was asked why the province is stalling.

"I don't think we are waiting," said Stefanson, who insisted Manitoba is being cautious.

"We want to take a very balanced approach, obviously looking at businesses that have been negatively impacted in the community and ensure that we weigh the balance there."

A continuing pandemic with rising case counts, hospitalizations and deaths would also be very bad for business, as sick and dead people tend to be lousy consumers.

Vaccinations won't stop the short-term spread

Manitobans have already seen what happens when officials take a wait-and-see approach.

Manitoba's vaccination program has just come off a good week, recording a daily average of 10,720 doses on paper from April 5-11. This number, however, was inflated by the clearance of a data backlog. 

It is, quite frankly, too late for an increase in the pace of vaccinations to allow Manitoba to escape the need for new restrictions. The math ought to be clear to anyone who knows the difference between arithmetic and geometric growth.

The vaccination program confers immunity on people at an incremental growth rate of a few thousand more people every day. COVID-19 is spreading exponentially right now among the 83 per cent of the population that does not have a vaccine shot.

The chief public health officer understands arithmetic. One can only assume members of provincial cabinet do as well.