Manitoba doctors prescribe healthy dose of caution when relaxing public health orders
'It takes very little to go past overload,' says infectious disease expert Dr. Anand Kumar
Easing too many of Manitoba's COVID-19 restrictions too quickly could lead to another surge of infections in the province, say three doctors who signed a letter calling for a provincewide lockdown in the fall.
"Based on what I'm seeing, it seems to me that there's a very high probability that if we implement all of the lifting of restrictions that were listed, we're going to be right back with restrictions in, you know, three, four weeks," said Dr. Anand Kumar, an infectious disease expert and Winnipeg intensive care specialist.
While all of Manitoba is at the critical level on Manitoba's pandemic response system, the province announced Tuesday it was considering relaxing some of the current health measures, in all regions but the north, as early as Saturday.
Possible changes include allowing people to have two visitors inside their home, five guests outside on their property and increasing the number of people allowed at a funeral to 10.
The province is also considering allowing stores to reopen, as long as they comply with occupancy limits and physical distancing measures, and removing restrictions on the purchase of non-essential items.
Additionally, hair salons and barber shops are on the list of businesses that could begin operating again.
Kumar said one-on-one services like those offered at a hair salon are lower risk as long as safety measures, including masking, are in place.
However, he said he'd like to see the province wait until the number of new infections reported daily is around 40 or 50, which he thinks would allow for aggressive contact tracing, and a test positivity rate closer to five per cent before making too many changes at once.
Kumar said new, more infectious variants of COVID-19 have been detected in Canada and the province's health care system needs to be able to respond if case numbers soar.
"If you just push the numbers below what will cause overload, it takes very little to go past overload," said Kumar. "If we get the new infectious variant and we have that level of where we are just managing to handle it, we're overloaded in two weeks."
Manitoba reported 154 new cases of COVID-19 on Wednesday, including 70 cases in the northern health region. Winnipeg's five-day test positivity rate dropped to 6.7 per cent, the lowest it has been since October. Manitoba's five-day test positivity rate was 9.5 per cent.
Dr. Kelly MacDonald, an infectious disease expert and professor at the University of Manitoba, said people need to remember that even if infection rates are lower in Winnipeg and parts of southern Manitoba, case numbers are surging in the northern region and the health care system serves the entire province.
"It doesn't matter if you're from Treherne, Man., from Churchill, or from Flin Flon or from Winnipeg. If you need cardiac surgery you need to go to St. Boniface hospital," said MacDonald. "If that ICU is full of COVID patients, you're out of luck. So we need to make sure that we, you know, deal with capacity issues for everybody in the whole province."
MacDonald said she is among a group of physicians who at the beginning of January cautioned the provincial government against easing restrictions too quickly.
"My thinking is that if we are going to loosen things up, we should do so in a stepwise manner so that we know what the impact is," said MacDonald. "And that we let people know that this is a … sort of temporary measure to see the impact."
Manitoba's acting deputy chief public health officer, Dr. Jazz Atwal, said at a news conference Wednesday that the province would be making careful choices about what will be allowed to reopen.
"We need to take our time to do this, to do it right, so we don't have to go back and forth. Opening and closing, opening and closing is not something we want to do."
Dr. Philippe Lagacé-Wiens, a microbiologist and physician at St. Boniface Hospital, said he has concerns about allowing large shopping centres like malls to reopen.
"Even at 25 per cent of capacity, there's going to be a lot of people congregating there, a lot of people congregating in food courts and things like that," he said. "I think that is a substantial risk that needs to be reconsidered."
Manitobans should remember that even as restrictions ease, they still need to protect themselves against COVID-19, he said.
That includes wearing masks when visiting with another household, physical distancing, maximizing things like curbside pickup and deliveries and following public health guidelines about gathering sizes.
"Keep those individuals consistent," he said.
"It can very, very damaging to the process if you decide, 'I'm allowed to have two people, but I'm going to have two people today, and two different people tomorrow and two different people the day after that.' At that point, it becomes essentially the same as gathering of a large number of people over time."
With files from Cameron MacLean and Caitlyn Gowriluk