Physical distancing appears to be working in Manitoba … prepare to keep at it until the leaves turn

By | April 9, 2020

Four weeks after the World Health Organization declared COVID-19 a global pandemic, there are positive signs in Manitoba about the highly infectious disease.

It looks like physical distancing measures intended to slow the spread of the virus are having their desired effect in this province, at least at this very moment.

The evidence comes from a number of places.

For starters, the number of known cases of COVID-19 in the province has increased only in dribs and drabs in recent days. From Sunday through Wednesday, the province reported an average of only five new cases a day.

A four-day sample, of course, does not mean all that much when you tag it on to the end of a 2½-week period when the number of cases of the disease was doubling every four days.

But there is an even stronger indication the COVID-19 growth curve in Manitoba is about to climb on to a plateau: The number of active cases is flattening out.

Active cases of COVID-19 represent the number of people who are actually sick from the disease at any given time. The active number of cases does not include people who have died from the virus or have recovered from it.

When it comes to health care, the number of active cases of COVID-19 is far more important than the total number of cases. That’s because active cases represent the largest number of people who may conceivably require medical attention — and a small but significant percentage of those people need the form of attention that involves scarce intensive-care beds and ventilators.

(Jacques Marcoux/CBC)

As of Wednesday,  the number of active cases of COVID-19 in Manitoba was 149, which is lower than it was a week before. A third of the Manitobans who contracted COVID-19 and tested positive for the illness have recovered from it, public health workers found when they followed up on earlier cases.

The two measures combined — much slower growth in total cases and no growth at all in active cases — prompted Manitoba’s chief public health officer to utter a few rare, encouraging words.

“These numbers may be a reflection of the benefit of our enhanced social distancing strategies and the hard work Manitobans put into this,” Dr. Brent Roussin said Wednesday during a daily COVID-19 update.

Roussin is saying out loud what nerds in the data-analysis world have been surmising for the better part of the week: At some point, there ought to be evidence that public health orders are starting to bend the COVID-19 growth curve in a more horizontal manner.

(Jacques Marcoux/CBC)

A logarithmic growth chart, like the one above, clearly illustrates this effect for Manitoba and most Canadian provinces. 

This is, in a genuine sense, a form of flattening the curve. Roussin, however, does not want anyone to draw that inference.

“We can not interpret this as a flattening of our curve. It’s way too soon to judge that,” he said, insisting more cases of the disease are coming. 

“I think that we can make some inferences that our work is is contributing to this, and that Manitobans’ efforts at social distancing are certainly contributing to this, but the message has to be clear that we can not lower our guard right now.”

Roussin is correct: There appears to be no point in engaging in physical distancing for only a few weeks.

Some epidemiological models suggest a month of distancing merely kicks a spike in COVID-19 cases down the road for another month, and just as many people get sick as they would have without distancing.

Those same models suggest three months of social distancing actually do lower the height of the caseload curve, but still not enough to prevent health-care systems from getting overwhelmed.

See you in September?

Ideally, social distancing lasts long enough to prevent hospitals from ever running out of ICU beds and ventilators for COVID-19 patients, so doctors don’t have to make heartbreaking decisions.

This is why Roussin did something Premier Brian Pallister has declined to do on numerous occasions: Tell Manitobans plainly they can expect some form of physical distancing to persist until the leaves start turning yellow.

“It’s really difficult to predict what we’re going to look like in July and August [but] you know I think that certainly we’re going to have some sort of physical distancing strategies in place at that time,” he said.

He did not elaborate on that form, but he did make clear any relaxation of public health orders will depend on the continued ability for hospitals and health-care workers to treat the most severely ill COVID-19 patients.

“The real measure is going to be the demand on our health-care system,” he said. “If we’re able to manage the demand on our health-care system and it’s not overrun and we see that the capacity is maintained, then at that point we may be able to back off on some of the social distancing strategies.”

That could mean allowing people to eat in restaurants again. It could mean allowing people to gather in groups of 50.

It’s unlikely, however, to mean the quick return of international travel or professional sports events with thousands of people in stands from all over the Winnipeg region and beyond.

“No matter how much we try, we’re not going to be in isolation from from other areas,” said Roussin, evoking the shadow of the United States, where COVID-19 is spreading at an alarming rate.

Keep you foot on that brake

This is why Roussin is so adamant Wednesday’s good news is not taken as an excuse for Manitobans to take their feet off the brakes and start leaving their homes again.

The COVID-19 threat won’t fully go away until a vaccine is developed, an achievement that may be 18 months away.

There’s also nothing preventing Manitoba and other western Canadian provinces from becoming more like Ontario and Quebec, where the disease is growing more rapidly, if people in this province stop being as diligent as they are about staying the heck away from each other.

Nonetheless, Manitoba appears to have flattened its active caseload at the moment and is close to flattening the logarithmic growth curve as well.

Good news doesn’t necessarily lead to covidiocy on the part of the populace, especially one as educated about the common good as flood-hardened, winter-impervious Manitobans.

Rather, a little bit of good news — as cautiously presented as it was — can serve to validate the pleas of public health officials and reward Manitobans for listening to them.

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