Doctor warns of 3rd wave, lockdowns as cases rise slightly amid Manitoba reopening

Some health professionals aren't convinced Manitoba should be reopening at its current pace, due to the increase of coronavirus variants in the province and a test positivity rate that's beginning to creep up again.

Manitoba has gradually relaxed COVID-19 restrictions since the new year as daily cases, test positivity rates, deaths and hospitalizations have declined.

Most businesses are allowed to be open by now at limited capacities. As of this weekend, people from different households can eat together at outdoor restaurant patios. Worshippers are allowed to take their masks off, if they're sitting a fair distance from people who they don't live with.

Dr. Anand Kumar worries it's too much, too soon. He's concerned a third wave could hit by mid-May and again overwhelm Manitoba's health-care system.

Kumar, an infectious disease expert and intensive care unit physician at Health Sciences Centre in Winnipeg, expects people will become more complacent with winter in the rearview and patios opening.

"We're still very much in the middle of this situation and the idea that we're going to be miraculously better come summer I think is a gross oversimplification," he said. "I think it's distinctly possible that we may have more restrictions yet. In fact I think we'll get at least some restrictions if not a full lockdown."

From mid-October, Manitoba went nearly three straight months with triple-figure daily case loads. Provincial test positivity rates dipped below 10 per cent for the first time in two months in the middle of January.

That led to the gradual lifting of restrictions that now allow families to form a bubble with another home, or have two designated visitors over, as well as business reopenings.

Kumar points to recent rises in Manitoba's daily caseloads and test positivity rates as early warning signs that the hospital system could be overrun again if things get out of control. 

The seven-day average for cases was 75 on Monday, compared to 53 a week-and-a-half ago, and the number of coronavirus variants detected in Manitoba nearly doubled as of Monday, from 23 to 41.

"What we really need to be focused on is where we're going, not where we are," Kumar told Information Radio host Marcy Markusa.

Variants concerning

The provincial test positivity rate is creeping up again — it was at 4.5 per cent on Monday, compared to three per cent a week-and-a-half ago.

Carlos Farkas shares some of Kumar's concerns about the potential for the health-care system becoming strained again. The post-doctoral researcher at the University of Manitoba's Rady Faculty of Medicine has studied the variants and said they're considerably more transmissible. 

Farkas thinks more testing is in order amid reopening.

"If the province [is] planning to do that in steps, to loosen restrictions for economic reasons, we need to be prepared in terms of more testing," he said.

'Jab the elderly and test the young'

Epidemiologist Dr. Prabhat Jha agrees, but says it's possible to reopen gradually in a safe way so long as a variety of other measures are in place. One of those is increasing testing of younger generations, and another is ensuring reasonably high levels of older generations have been vaccinated. 

"Jab the elderly and test the young," said Jha, the director for the Centre for Global Health Research at St. Michael's Hospital and a professor of epidemiology at the University of Toronto. 

Jha said it's reassuring to see over six per cent of Manitoba's population has been inoculated against COVID-19, a good portion of them people over 60, who are vulnerable.

He thinks rapid testing should be more widely available for people between the ages of 18 and 60 if Manitoba wants to mitigate the risks of reopening.

He'd also like to see a "no app, no entry" policy at restaurants and bars. People would be forced to prove they have the federal COVID-19 alert tracking app downloaded on their phone. 

Finding right balance

Kumar would prefer a "COVID-zero" approach like what's been done in places such as New Zealand, where the country essentially shuts down entirely after a few cases are identified. 

Jha doesn't think aiming for zero cases should be the policy objective.

"I wouldn't be too worried about slightly rising case counts.... You should focus on the health system capacity."

Dr. Brent Roussin, Manitoba's chief public health officer, said the province has already begun to boost a variety of measures alongside reopening.

He said work is underway to expand contact tracing capacity, and last week the province began screening all COVID tests dating back to early last month for the two variants that have been detected in Manitoba so far.

"Obviously COVID is not the only issue related to people's health, so we can't only focus on that. We know that these restrictions have a significant impact on health as well, so we have to try and find that balance."