Omicron in Manitoba: Why hospitals are bracing for another influx of unvaccinated patients

The rapid spread of COVID-19 in Manitoba has created uncertainty about what lies ahead in the coming weeks.

The road is likely rockiest for the unvaccinated.

On Christmas Eve, Manitoba announced a pandemic-record 742 COVID cases. As well, the seven-day average COVID case count in the province more than doubled in a week, from 186 on Dec. 17 to 401 on Dec. 24.

While those are eye-popping numbers, the true prevalence of the disease is believed to be broader because the province has run out of capacity to conduct either COVID testing or contact tracing.

Things are at the point where Dr. Brent Roussin, the chief provincial public health officer, has asked young and healthy Manitobans with mild symptoms to simply assume they have COVID and isolate instead of trying to get a test.

As dire as that sounds, the prevalence of the disease is not really a source of uncertainty. For all intents and purposes, COVID-19 is everywhere, especially in the Winnipeg health region, which now has the highest COVID infection rate in Manitoba.

Rather, the uncertainty surrounds what's about to happen to hospitals in Manitoba, which already have more COVID patients per capita than hospitals in any other province.

As of Friday, there were 9.7 COVID patients in Manitoba hospitals for every 100,000 residents of this province. That's more than double the national average and nearly triple the COVID hospitalization rate in Ontario.

The existing COVID-19 case burden in Manitoba hospitals — 135 cases as of Friday — follows weeks of  COVID-19 cases that were assumed to be result of the Delta variant. 

If Dr. Roussin is correct and most of the rapid spread right now involves the more-transmissible Omicron strain, then Manitoba will learn what this means for hospitalization numbers in the coming weeks and days.

"Given that we're still learning about Omicron, we can not rely on some of the reports of Omicron being less severe because we have so many more cases being transmitted," Roussin said on Friday. "We know this will strain our health-care system."

Even if Omicron's case-severity ratio is lower than Delta, hospitals can still get slammed, mainly because there are still hundreds of thousands of Manitobans who remain unvaccinated.

There is a growing consensus that two vaccine doses do little to prevent Omicron infection. But the same two doses provide good protection against getting sick enough to place you in a hospital bed or intensive care ward.

This means unvaccinated Manitobans are in an even more dangerous situation than they were mere weeks ago. COVID-19 is now spreading rapidly among everyone — but the unvaccinated, who already account for most of our ICU cases, stand to get infected in even greater numbers.

The elderly, people with compromised immune systems and people with other serious health issues are also at a greater risk of developing serious illness.

This is why Dr. Joss Reimer, the medical lead of the vaccine implementation team, is imploring as many Manitobans as possible to get a booster shot, which protects against Omicron infection as well as serious illness.

The bottom line is, routine social interactions have suddenly become risky for the unvaccinated and immunocompromised alike.

"If you're at high risk, you shouldn't be out Boxing Day shopping," Roussin said on Friday, when he implored Manitobans to reduce the number of people they see.

More spread is inevitable, with or without more restrictions in Manitoba. Roussin hinted on Friday large gatherings will be forbidden, starting some time this week.

"Manitobans do need to prepare in the coming days to be hearing about more types of restrictions," Roussin said. "Manitobans need to prepare that next week we're not going to be having large gatherings."

In the mean time, hospitals are bracing for the dual threat of losing staff to Omicron-exposure isolation and rising COVID patient burdens.

This is not a pleasant prospect. Intensive care wards have been struggling for weeks to treat a total COVID and non-COVID patient burden that has fluctuated between 87 and 104 people.

That is far lower than the total ICU patient burden during the worst of the third wave, which peaked at 131,  but hospitals now have fewer and less experienced ICU nurses to handle the load.

On Friday, Health Minister Audrey Gordon promised the province is preparing.

"I want Manitobans to know that public health officials and myself, we are working over the holidays and we are monitoring very closely what is happening with the surge and the increase that we're starting to see," she said.

"We are monitoring very closely what is happening in our health care system, because if Manitobans can not access the care they need, something needs to be done."

That something means more restrictions, possibly enacted too late to prevent widespread transmission from becoming omnipresent transmission.

The most frustrating part is the people least willing to listen to public health advice are the most likely to suffer as a result.