Manitoba's reopening plan lacks key details, experts say

Some infectious disease experts say the first glimpse of Manitoba's reopening plan on Thursday lacked key details — especially as cases of a more contagious coronavirus variant that vaccines appear to be less effective against have surged in recent days.

Epidemiologist Souradet Shaw said he was glad to see Manitoba's reopening strategy involves targets for people getting both their first and second vaccine doses.

But he thought there should have also been an emphasis on indicators like case counts, intensive care admissions and test positivity rates.

"Although I certainly appreciate the province coming up with a plan, I think the plan lacks substantive detail," said Shaw, an assistant professor at the University of Manitoba and Canada Research Chair in program science and global public health.

"And in public health, unfortunately, the devil is always in the details."

At a news conference on Thursday, Premier Brian Pallister and Dr. Brent Roussin, Manitoba's chief public health officer, laid out the broad strokes of the province's path out of COVID-19 restrictions based on vaccination rates over the summer months.

That plan is tied to holidays and immunization targets, with some restrictions set to ease if more than 70 per cent of Manitobans 12 and older have gotten their first dose (and if 25 per cent have gotten their second) by Canada Day. 

As of Thursday, about 68 per cent of Manitobans 12 and up had gotten their first dose, while roughly 14.2 per cent had gotten their second.

Higher vaccine targets were also unveiled for the August long weekend (75 and 50 per cent) and the Sept. 6 Labour Day (80 and 75 per cent). If the vaccine targets are reached sooner, things will reopen sooner, Pallister said.

Shaw said the announcement would have been a good time for the province to share more of its pandemic modelling data, which could be used to support the targets officials announced and provide signals for when to stray from that plan if things go awry.

"I think it's one thing to hope for the best. But at the same time, we also need to plan for the worst," he said.

The update comes days after Manitoba reported a significant jump in COVID-19 cases linked to the B.1617.2 variant, also known as the delta variant, which was first identified in India. 

Early signs suggest that while a single COVID-19 shot offers fairly robust protection against other strains of the coronavirus that causes COVID-19, that first dose might only be about 33 per cent effective against the delta variant.

Focus on vulnerable communities needed

Shaw said he would have liked to see plans for how the province will work to mitigate spread in schools and how it will reach marginalized populations that have been hit disproportionately hard by COVID-19 and may not have equal access to vaccines.

"We know that COVID is a disease of inequity, and so are vaccines," he said. "We know that this virus will find those pockets of unvaccinated folks and hit them hard."

That's a concern echoed by Dr. Renate Singh, an anesthesiologist at Health Sciences Centre Winnipeg and Grace Hospital.

"We still do have a lot of vulnerable people in our community [who] need to access at least one dose," Singh said.

"I would really like to see what that number looks like by Canada Day before we hatch ambitious reopening plans."

Singh said she felt the optimism she saw in the province's plan felt premature, given current infection and vaccination rates in Manitoba and the emergence of the delta variant.

"We're assuming that we're going to meet those vaccination targets and in the middle of all of this, we now have a variant that's emerging," she said.

"How that's going to impact us is still a big unknown."

Virologist Jason Kindrachuk said Manitoba is still in a crisis and needs to figure out how to get second doses out as soon as possible — particularly to priority populations and those living in COVID-19 hot spots.

Getting back into communities with low overall first dose uptake will be crucial too, he said.

"There are communities that unfortunately are hit disproportionately harder with this virus," said Kindrachuk, an assistant professor and Canada research chair in emerging viruses at the University of Manitoba.

"Getting vaccines out to those communities in an equitable fashion, [making] sure that they're protected, is one of our first and foremost aspects that we have to consider."

Continued vaccine uptake in Manitoba will likely put the province in a very different position in the next couple of months, Kindrachuk said.

And he said it will be important for Manitoba's strategy to stay cautious and flexible as more data trickles out about the delta variant.