After a deadly pandemic January, Manitoba ponders what comes next

As the month draws to a close, the friends and relatives of 170 Manitobans won't take solace in the notion the Omicron variant is milder than any other previous.

January 2022 is now the third-deadliest month of the pandemic in this province. From New Year's Day to Jan. 31, 170 people diagnosed with COVID-19 lost their lives.

The monthly death toll was only higher during the second wave of COVID-19, when the virus tore through personal care homes, killing hundreds of helpless Manitoba seniors.

A total of 243 Manitobans died of COVID in November 2020, while 355 died that December.

At first glance, it may be difficult to reconcile the notion Omicron is milder with the loss of life over the past month. But Omicron is only milder on a case-fatality basis, meaning the percentage of people who die from it is lower than it was for previous variants.

Omicron transmission, however, is so widespread, Manitoba lost the ability to track it nearly a month ago. It is possible more people contracted COVID over the past few weeks than did the previous 12 months.

"The problem with Omicron is that there's just so much of it," said Dr. David Fisman, a University of Toronto epidemiologist. 

"If you have 30 or 40 times as many infections, it doesn't matter if you're 30 per cent less likely to die."

Another factor in the death toll this January may be the persistence of the Delta variant, which is far more deadly than Omicron.

The province has not conducted enough genetic sequencing to determine how widespread Delta continues to be.

"Indications are that hospitals – and ICUs specifically – are continuing to see the presence of both the Omicron and Delta variants amongst our inpatients," a spokesperson for Manitoba Shared Health said last week.

Whatever the Delta-Omicron split happens to be, COVID hospitalizations are continuing to challenge Manitoba.

The province set a new pandemic record on Monday, when 735 patients diagnosed with COVID-19 occupied hospital beds. Of that patient burden, 56 were getting intensive care — a record for this wave of the pandemic, thus far.

The continuing pressure on health care may lead Heather Stefanson's Progressive Conservative government to phase out pandemic restrictions more slowly than it had hoped.

On Friday, Health Minister Audrey Gordon said the premier will unveil a roadmap of sorts for relaxing restrictions. The continuing strain on hospitals pushes the implementation of that plan further into the future.

Manitoba's existing public health order does not expire until Feb. 8. Medical experts urge the province to hang on even longer, or at least as long as it becomes clear more transmission won't result in more cases than hospitals can handle.

"We're going to get through this. It's going to end. But if we just turn all the dials in one direction at once, what you're going to do is just wind up in a situation where you reimpose restrictions in a month or a month and a half, because you've really kind of created a nasty situation for health care," Fisman said.

"So I understand the temptation. I think everybody's very, very tired of the pandemic, but a place like Manitoba is already starting with very little capacity for a surge in cases."

This may not be what many Manitobans want to hear. Many have grown weary of restrictions on gatherings and businesses, whether they support the use of public health measures or not.

Dr. Alex Wong, an infectious disease physician in Regina, is urging political leaders across the Prairie provinces in particular to resist the pressure to relax measures too quickly.

"I would just implore to the best of our ability all policymakers to just try to leave what you have in place in place for the next two or three weeks," he said, noting Manitoba hospitals are struggling now and Saskatchewan health-care will follow soon.

There is no guarantee the Omicron wave will be the final crest of this pandemic. Efforts at prognostication have failed before.

There was euphoria in Manitoba during the spring of 2020, when the first wave subsided without infecting many people at all in this province. There was the expectation in 2021 that vaccines would end the pandemic once and for all.

COVID came back with a vengeance in 2020 and vaccines did not turn out to be a magic bullet late last year. They are, however, very effective at preventing an Omicron infection from putting you in a hospital bed or graveyard — especially when you get three doses.

It would be wise to be skeptical of claims everything will get back to normal after this wave subsides. The idea that no one will need to moderate their behaviour in the coming months is just as much of a fantasy as the idea restrictions can remain in place in perpetuity. 

When officials say we have to live with the virus, they don't mean we have to live with infection. They mean we have to at least try to avoid the virus whenever possible and more importantly, do whatever it takes to avoid passing it on.