No family ‘bubbles’: Caution will guide Manitoba’s reopening, top doctor says

By | April 28, 2020

Manitobans will get their first look Wednesday at what the province’s chief public health officer says will be a “cautious” plan to reopen the economy, but officials have already said it won’t include the “bubble” strategy for socializing seen elsewhere in Canada.

“Numbers will be our guides to this strategy,” Dr. Brent Roussin said Tuesday.

Manitoba is set to unveil its plan Wednesday to allow a resumption of some of the economic activity put on hold by restrictions intended to fight the COVID-19 pandemic, Roussin said. From there, it will be a slow-moving process of easing rules, followed by closely watching case numbers.

One element that won’t be included is the “bubble” system already in place in New Brunswick, Roussin said. That province announced last week a plan to ease limits on large groups by allowing social gatherings involving two households forming a so-called “bubble.”

“That’s not likely going to be specifically part of our strategy,” Roussin said Tuesday.

Roussin and his counterpart Lanette Siragusa, chief nursing officer for Shared Health, promised Tuesday the province has the capacity to handle reopening.

That includes work in several categories outlined in a new federal-provincial framework for reopening released Tuesday.

The joint framework says first ministers agreed to a “gradual and phased approach” to lifting restrictions, with a focus on protecting the health of Canadians, shielding high-risk groups and ensuring the health-care system has the capacity for future outbreaks.

The document outlines seven key criteria provinces need to consider before rolling back restrictions.

That includes a requirement that COVID-19 transmission be under control, so health-care systems can handle the number of new cases with “substantial” additional capacity at the ready and a stable number of hospitalizations (with the possible exception of isolated outbreaks).

Provinces must also have:

  • Sufficient public health capacity for testing, contact tracing and isolation of confirmed cases, as well as quarantining and monitoring close contacts.
  • Surge capacity for COVID-19 patients — and non-COVID-19 patients — including personal protective equipment, drugs and other medical supplies.
  • Supports for vulnerable groups and communities, including seniors, inmates and those who are homeless.
  • Measures to prevent spread of COVID-19 in workplaces.
  • A co-ordinated plan to ease restrictions on domestic travel (reopening of international borders may only happen in later stages).
  • Engagement and support for communities and industry to manage local disease activity, including in the areas of child care, schools and public transportation.

‘We want to be prepared for anything’

On Tuesday, Siragusa was confident Manitoba has capacity in its health-care system, including in acute care centres, to handle a surge in cases.

“There has been work for months now [preparing for] if we need to expand beyond our baseline — so looking at hundreds of beds within medicine as well as critical care,” she said.

“We’re also even making contingency plans beyond that.… We want to be prepared for anything that comes our way, so a lot of the preliminary planning is done so that if we need to, we can mobilize it quickly as it happens.”

Work is continuing on developing staffing models for those scenarios, Siragusa added.

“There’s space, there’s equipment, there’s supplies and there are staff.”

The province has also been working on supports for vulnerable people, Siragusa said.

One isolation shelter has been set up for people who can’t isolate safely at home or don’t currently have a home, she said. The shelter received 22 referrals last week and currently has 11 occupants, she said.

Another isolation centre has been set up in a Winnipeg hotel open to people who are referred there, including health-care workers, people with COVID-19 and close contacts of known cases. Thirty people have been referred there, including 21 who met the criteria and eight who accepted the offer.

Expanded testing

Roussin said the province is ready for more testing, after Premier Brian Pallister announced Tuesday morning that tests will now be open to anyone with symptoms and a referral.

Pallister said he expects the province to be able to complete up to 3,000 tests per day — roughly triple the current capacity — as Ontario-based Dynacare steps up to process more tests for Manitoba.

“We need to be prepared for more circulation of the virus, so we need to be able to ensure our testing capacity is wide so that we can still actively find cases, do aggressive contact tracing and limit the spread further,” Roussin said.

“We feel that we’re in a good spot right now with our capacity.”

When the province does start rolling back restrictions, public health officials will assess their success based on multiple factors, Roussin said.

Those include presentations of influenza-like illness to acute care centres, hospital bed occupancy rates and the proportion of COVID-19 tests coming back positive, he said. Most of those will be assessed based on “seven-day running averages,” he added.

Regional approaches

Across Canada, provinces and territories have taken their own approaches to reopening. Where plans have been made public, officials have shared varying levels of detail and specifics.

On Tuesday, Quebec Premier François Legault laid out a timeline to begin reopening some businesses in May, starting with manufacturing, construction and civil engineering, and some retail stores.

Ontario made its framework public on Monday, although it was short on details and didn’t offer any firm dates.

Premier Doug Ford said the process will begin with certain workplaces and some small gatherings, gradually adding more workplaces, outdoor areas and some larger gatherings.

However, Ford said large-scale public gatherings like concerts and sporting events “will continue to be restricted for the foreseeable future.”

Saskatchewan and New Brunswick have also shared more detailed plans. Saskatchewan’s included a five-phase process set to start on Monday.

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