Seeing red: Why Manitoba is running out of time to impose more restrictions on Winnipeg

If Manitoba is planning to take more drastic measures to control the spread of COVID-19, the window of opportunity is closing faster than a drive-thru window on a blustery night.

This is partly because of increasing demands on the health-care system — and partly because the calendar demands action now and not in the middle of the Christmas holiday season.

On the health-care front, the province is running out of open beds in intensive care units, especially in Winnipeg. St. Boniface Hospital ran out of ICU room entirely on Thursday evening.

The winter flu season, now only beginning, brings the promise of more respiratory patients in need of attention from the same medical teams already busy treating severe cases of COVID-19.

As well, roughly three dozen health-care workers across the province can not work right now because they have been diagnosed with COVID-19. An undisclosed number of other workers are isolating due to exposure to infected colleagues or patients.

Each tranche of new COVID cases — like the record-breaking tally of 193 announced on Thursday — translates into more people requiring medical attention in hospitals and more exposed or infected health-care workers several weeks down the road.

No matter how many new COVID-19 cases are announced in the coming days and weeks,  the health-care system is expected to be under even more stress in the middle of November than it is right now.

This left officials no choice but to signal the Friday announcement of new public health orders.

"It is clear from the numbers these last number of days that the cases continue to increase primarily, but not exclusively in Winnipeg," Health Minister Cameron Friesen said Thursday, following question period at the Manitoba Legislature.

"That causes the chief provincial public health officer to surmise that what we are doing is not yet working to the extent that we would want it to, and so that discussion of what to do next is underway right now."

Multiple options for pandemic code red

Should Dr. Brent Roussin decide to move the Winnipeg health region up from orange to red on the pandemic response system, he has a range of tools at his disposal.

Students could be sent home from school again, except for children of essential workers. Restaurants could be limited to takeout, as they were in April. Museums, galleries, libraries and recreational facilities could be closed again, along with non-essential workplaces, services, retail stores and places of worship.

Some medical procedures could be cancelled. Some medical services, such as dental clinics and therapists, could be limited to emergencies.

Roussin could also order something he's been recommending all week — no socialization whatsoever with people outside your household.

NDP Leader Wab Kinew said Thursday he would welcome the zero-gathering rule as an order, rather than a recommendation.

"I don't think there should be a difference between the advice and the order," said Kinew. "Why don't we just have a very clear regime where if Dr. Roussin is going to say 'Stop socializing outside of your household,' then that's actually the rule that people are being asked to abide by."

The psychology is simple: As long as it's legal to do something, some people will continue to do it.

Right now, it remains legal for Winnipeggers to go get a beer, even as Roussin effectively recommends you don't have any friends come over to play board games or watch Netflix. 

The health minister conceded there are inconsistencies in the public-health regime, as it stands.

"Right now, some people might say 'I perceive an area of unfairness.' We have in all these things, of course, tried to create an environment of fairness," said Friesen, suggesting he expects Roussin to simplify his public health orders on Friday.

"It will be done with an attempt to keep things fair, but to keep things predominantly safe."

Nobody wants to kill Christmas

There is another reason Roussin has to act now: The winter holiday season is on the horizon. Failing to control the pandemic before December could literally kill Christmas in Manitoba.

The reason for the crunch is simple arithmetic. If a no-socialization order comes into effect on Monday, it would drastically reduce the spread of COVID-19 within two weeks, the maximum length of an incubation period. 

At the end of two weeks, there would still be some residual spread of the disease within households. That would require the order to be in place for another two weeks.

The communication from the province could work something like this: Observe a painful restriction for one month in November, and you can have a Christmas shopping and holiday season with some semblance of quasi-normalcy in December.

Anyone who screws up in November would run the risk of spoiling the Christmas holidays for everyone else. Peer pressure could then accomplish what Manitoba's nearly nonexistent enforcement regime has failed to do since the start of the pandemic: Keep the most selfish idiots in line.

This, of course, only works if the new measures begin very soon. If Roussin waits, or the Progressive Conservative cabinet forces him to wait, then a lockdown could extend into December, when you can bet more Manitobans would defy a no-socialization order.

So many Winnipeggers defied Roussin's advice to avoid Thanksgiving gatherings, it's safe to assume even more would flout the rules at Christmas.

In other words, Winnipeggers have reached the pay-now-or-pay-later stage of the pandemic. For some, the price of delay will not be holiday-season inconvenience, but sickness, hospitalization and death.