Brightening Manitoba pandemic picture can't obscure Canada's second-worst COVID kill rate

More than six weeks after public health authorities imposed pandemic restrictions on every corner of Manitoba, the province is finally seeing dividends.

Compared with the worst moment of the fall COVID-19 surge — the final week of November — daily case counts are down dramatically.

They're still not low enough to allow restrictions to be eased, but the numbers are as clear as they are statistically significant. 

On Nov. 24, arguably the apex of the pandemic so far, the seven-day average daily case count in this province stood at 424 new COVID-19 diagnoses every day.

As of Monday, that seven-day average count was down to 176 new cases per day.

That's a drop of almost 59 per cent in almost five weeks.

This alone is not enough to allow Manitobans to celebrate just yet — and certainly not with people outside their households.

Some of the most recent low case counts took place on days when a relatively low number of COVID-19 tests were processed in the lab. The provincial test-positivity rate remains four times the maximum acceptable number.

There also are 343 COVID-19 patients in hospital, which is down from a peak of 398 but still too high for the health-care system to easily manage.

Finally, it remains unknown what effect the Christmas holiday season will have on future case counts, once indoor December exposures to the virus translate into new cases in January.

All those caveats aside, Manitoba sits in a far better position as the year dwindles away than it did during the frightening, gut-wrenching days of late November.

That's because every 100 new COVID-19 cases translates into six new hospitalizations a few weeks down the road.

Across the world, 100 new COVID cases usually translates into two more COVID deaths. But not in Manitoba.

In this province, every hundred new cases yields closer to three more deaths. With 654 deaths resulting from 24,252 COVID-19 cases, Manitoba's infection-fatality rate is 2.7 per cent.

That is the third-worst rate in Canada, after Nova Scotia (4.4 per cent) and Quebec (4.1 per cent).

Only the Quebec comparison is significant, however, as Nova Scotia's infection-fatality rate is skewed by low case and death counts overall: To date, the Bluenose province has only had 1,478 cases of COVID-19 and 65 deaths.

Manitoba fares just as poorly on another measure of pandemic lethality: per-capita deaths due to COVID-19.

As of Monday, 47.8 out of every 100,000 Manitobans have lost their lives to COVID-19. Only Quebec is worse, with 95.3 COVID deaths for every 100,000 people.

There are a number of reasons why Manitoba COVID-19 cases are more likely to result in more deaths than anywhere else in Canada except Quebec.

One of the reasons for the high provincial COVID-19 death rate is the most lamentable legacies of colonialism: Indigenous Manitobans tend to have worse access to health-care services than non-Indigenous Manitobans.

Combine this bit of structural racism with a large Indigenous population, and you have a recipe for a more lethal pandemic outcome.

"We're completely attuned to how vulnerable we really are," said Arlen Dumas, Grand Chief of the Assembly of Manitoba Chiefs.

"We appreciate the difficulty we have with access to resources, to access to health care, even just the logistical difficulty of travelling to an appointment." 

"That's just the regular life. So here we are in the midst of a pandemic [and] all of those things are amplified exponentially."

This certainly bears out in terms of the over-representation of First Nations Manitobans in particular when it comes to COVID-19 cases and hospitalizations.

A Manitoban with a treaty card is more likely to contract COVID-19 and suffer worse health outcomes once they have the disease.

About 10.5 per cent of Manitobans identify as First Nations. As of Thursday, First Nations residents of this province accounted for 23 per cent of the total provincial COVID-19 caseload, a third of the current COVID hospitalizations and 40 per cent of the COVID patients getting intensive care.

First Nations are also over-represented among Manitoban COVID-19 deaths, albeit not to the same extent. As of Thursday, First Nations COVID deaths accounted for 15 per cent of Manitoba's total pandemic death toll.

That proportion may grow as outbreaks on remote, northern First Nations drag on. But as of this moment, Manitoba's Indigenous population does not account for the high COVID death rate alone.

The other factor dragging Manitoba into the depths of lethality is the same one that's made the pandemic even deadlier in Quebec: A failure to protect residents of long-term care homes.

As of Monday, 306 Manitobans who lived in personal care homes died of COVID-19. So did 13 residents of assisted living facilities.

Together, those  deaths represent 49 per cent of Manitoba's 654-person pandemic death toll.

On Monday, eight out of nine new pandemic deaths in Manitoba were residents of long-term care homes.

Even as the pandemic picture brightens, this province's failure to protect its most vulnerable citizens — elderly, infirm, incarcerated and Indigenous — is a stain history will never wash away.