As the Omicron wave recedes, Manitoba plunges into post-pandemic waters

As the Omicron wave of the COVID-19 pandemic continues to recede, Manitoba is justified in easing some of the measures it had in place to mitigate the severity of the pandemic.

The pace at which those measures are disappearing, however, has prompted concern from medical experts and some members of the public alike.

This is partly because of the absence of data to support the speed at which some of these moves are taking place. It's also because the data that is available suggests some measures ought to remain a little longer.

First, let's look at the overall pandemic picture in Manitoba, which is far more encouraging than it was a month ago.

For starters, COVID-19 hospitalizations are dropping. On Feb. 2, a record 744 COVID-19 patients were receiving care in Manitoba hospitals. A little over a month later, that number is down 44 per cent, to 420 patients.

The COVID death rate is also receding. During the week ending Feb. 2, Manitoba suffered 3.8 COVID-19 deaths for every 100,000 people. That rate has since receded by two-thirds: It was 1.2 deaths per 100,000 people during the week ending on Thursday.

These are the only measures the public has to assess the severity of the pandemic in this province.

Reliable COVID-19 testing has been restricted by the province, rendering official daily case counts completely meaningless. Wastewater monitoring for the virus that causes COVID is not made public. Neither are the workplace absenteeism reports that public health uses to assess the prevalence of COVID infections.

On top of this, the province routinely refuses to publish projections of future hospitalizations and deaths, either under a scenario where existing public health measures remain in place, or under scenarios when some or all are removed.

Nonetheless, Premier Heather Stefanson, Health Minister Audrey Gordon and public health officers routinely refer to positive modelling scenarios when they speak about their decisions to remove public health measures.

This places Manitobans in a situation where we must accept their statements as a matter of faith. This is unrealistic, as two years into this pandemic, many citizens have become adept at comprehending data officials characterize as too arcane to be understood by the general population.

Data supports some easing

Still, the data does support some easing of pandemic restrictions.

From a political perspective, it was understandable one of the first to go would be the required use of vaccination cards. 

This is mainly because the vax-card mandate provided some of the impetus for the vocal anti-government demonstrations that took place during the month of February.

From a public health perspective, it is fair to say vaccine cards did their jobs: They initially drove up vaccination rates and, perhaps ironically, protected unvaccinated Manitobans from COVID infection by keeping them away from indoor public places.

Two other public health measures set to disappear soon are more difficult to explain, either politically or scientifically. On March 15, Manitoba is doing away with both the mask mandate for indoor public places and mandatory quarantine for people infected with COVID.

Unlike vaccine cards, the use of masks is a low-impact means of reducing the spread of COVID-19. It does not restrict the movement of people. 

Mandatory quarantine, meanwhile, provides additional impetus for symptomatic people to avoid carrying COVID into the workplace.

Dr. Jazz Atwal, Manitoba's deputy provincial public health officer, struggled Wednesday to explain the medical or scientific rationale for removing both measures on March 15, as opposed to whenever COVID hospitalizations recede to pre-Omicron numbers.

"We're moving to more of an endemic state. You know, we never had an order or a law in place in relation to any other infection, per se, prior to this," Atwal said.

At the same time, Atwal and Health Minister Audrey Gordon said the elimination of the mask and quarantine mandates simultaneously may result in more COVID-19 cases in the short term.

Gordon, however, stated she chooses to be optimistic that cases will not spike, regardless.

Dr. Alexander Wong, a Regina infectious disease physician who keeps tabs on pandemic measures across the Canadian Prairies, said he would have preferred to see officials justify changes to pandemic measures on the basis of something other than hope.

"It would be nice to hear again from our elected and public health officials that there were real, meaningful metrics in place," he said.

He acknowledges those same officials are under political pressure from citizens who see restrictions disappearing in places where Omicron arrived earlier.

"You look at other North American jurisdictions and you see, particularly in the United States, how quickly their Omicron waves have come down, even in settings, frankly, where there have been limited or essentially no meaningful public health measures or protections in place," he said.

"I think our public health officials are sort of relying on that reality to … win the day."

The bottom line for Manitoba, however, is our hospitals remain busy. The COVID-19 patient burden remains nearly three times what it was before Omicron.

Hospitals cannot return more staff to work in surgical wards until the COVID patient burden recedes. That means more cases could compound efforts to reduce the surgical backlog.

It is impossible to improve the backlog in a significant manner and manage a new spike in COVID-19 patients. This is the real balancing act the premier and the health minister must manage in the coming weeks and days.