No more flattening the curve: Manitoba will soon learn what it takes to climb down from an Omicron tower

No talks about flattening the curve anymore. For one thing, the Omicron wave looks more like a spire.

This province already has Canada's worst COVID death and hospitalization rates

From this point on, Manitoba's COVID case counts are only approximations of the spread of the disease. The province is struggling to slow the rapid transmission of the Omicron variant. (Jaison Empson/CBC)

At the start of the pandemic, the main goal of every public health authority on the planet was to "flatten the curve" of COVID-19 cases.

That didn't mean eradicating COVID. It simply meant doing whatever it took to slow the spread of the disease to the point where at any given time, the number of serious cases would not overwhelm the health-care system.

During the first COVID wave, Manitoba accomplished this goal so spectacularly, that initial crop of cases is barely visible as a ripple on the pandemic timeline.

The second and third waves look more like mountains. During the fall of 2020 and the spring of this year, the province's reluctance or inability to take sufficient precautions resulted in enormous outbreaks that claimed hundreds of lives and vastly reduced the quality of thousands more because the provincial health-care system could not fulfil many of its usual functions.

No one is talking about flattening the curve of this Omicron-heightened fourth wave. For one thing, it doesn't even look like a wave, as cases have risen so quickly the supposed curve looks more like a spire.

It also doesn't appear the curve can be flattened at this point, at least not without taking measures so Draconian, it's hard to imagine Premier Heather Stefanson signing off on them.

Many of the preventive tools Manitoba has used to combat COVID-19 are no longer in the arsenal. "Test and trace," another early pandemic mantra, has proven impossible to fulfil over the Christmas holidays.

Manitoba effectively abandoned comprehensive contact tracing in mid-December, when public health advised people who test positive to notify everyone they may have exposed.

Comprehensive COVID testing was abandoned last weekend, when screeners at provincial testing sites started sending people home with rapid antigen tests instead of collecting a swab sample for a PCR test.

As of Thursday, some testing sites were only issuing rapid antigen tests. From this point forward, it is fair to describe official case counts as mere approximations of the true prevalence of COVID-19 in Manitoba. 

The extreme transmissibility of the Omicron variant is mainly to blame for all this. The variant has spread so quickly, every public health authority in Canada has been caught off-guard.

Nonetheless, it would be fair to place some of the responsibility for the current COVID spike on the shoulders of the province for taking what medical leaders have described as tentative steps to slow the spread of Omicron.

There will be time later for yet another post-mortem of the province's pandemic management. In the meantime, Omicron is still ripping through the community.

The question now is whether anything can be done to reduce the amplitude of this current wave, at least to the point where COVID patients and other critically ill people in need of intensive care don't die from a lack of resources.

This is a genuine possibility in the coming month, even if Omicron is indeed far less severe than previous COVID strains. Simple arithmetic suggests Manitobans are in for a very rough ride.

In the space of two weeks, the running average COVID case count in Manitoba has jumped from 181 cases a day for the week ending Dec. 16 to 827 daily cases for the week ending Dec. 30. That's a nearly five-fold increase in cases at a time when the province still had something of an accurate picture of the way the disease is spreading. 

Growth like this means the Omicron variant doesn't just have to be less severe than Delta to avoid putting people in hospital beds at an unsustainable rate. In Manitoba, Omicron has to be at least one-fifth as severe as Delta — that is, 80 per cent less likely to put someone in a hospital — to prevent Manitoba's COVID patient burden from growing.

Of course, Omicron is still spreading so rapidly, we could easily end up with even higher daily case counts in the coming weeks. That would require Omicron to have only a tiny fraction of Delta's severity if Manitoba hopes to avoid a horrific experience in January.

Manitoba's death rate 3x the national average

At this point, a very unpleasant month appears likely. Since the start of the second wave of the pandemic, Manitoba has had more COVID deaths per person than any other province. This pattern is continuing in the Omicron era.

Over the past week, Manitoba sported Canada's highest COVID death rate: 1.2 deaths per 100,000 people for the seven-day period ending Dec. 30, according to Health Canada. That's three times the national average of 0.4 COVID deaths per 100,000 residents.

Twice as many people are dying of COVID on a proportional basis in Manitoba right now than are dying in Quebec, where the COVID infection rate is more than twice as high.

Manitoba also has Canada's highest COVID hospitalization rate vs. the background population: 13.7 COVID patients in hospital per 100,000 residents. More infectious Quebec has a COVID hospitalization rate of 10.1 patients per 100,000 residents.

This is where Manitoba is starting from as the first batch of Omicron cases translate into hospitalizations. 

Montrealers line up for rapid COVID tests outside a drugstore earlier this month. Quebec has more than double Manitoba's COVID infection rate — but fewer people per capita in hospital with the disease right now and only half Manitoba's COVID death rate over the past week. (CBC / Radio-Canada)

For whatever reason — underlying conditions, access to health care or the quality of health care — COVID is simply deadlier in this province.

On Thursday, Shared Health CEO Adam Topp said Manitoba isn't betting on Omicron being less severe.

"Indications are that it may be less, but we're certainly thinking about the worst-case scenario in our planning assumptions," he said during a briefing about hospital preparations for the coming Omicron surge.

Where we are right now, meanwhile, is already worse than it is in Quebec, which announced a new lockdown on Thursday.

By the time the Stefanson government decides to follow suit — if it ever makes such a decision — the proper analogy likely won't involve flattening any curve. It may involve putting a genie back in a bottle.


Bartley Kives

Senior reporter, CBC Manitoba

Bartley Kives joined CBC Manitoba in 2016. Prior to that, he spent three years at the Winnipeg Sun and 18 at the Winnipeg Free Press, writing about politics, music, food and outdoor recreation. He's the author of the Canadian bestseller A Daytripper's Guide to Manitoba: Exploring Canada's Undiscovered Province and co-author of both Stuck in the Middle: Dissenting Views of Winnipeg and Stuck In The Middle 2: Defining Views of Manitoba.