School closures coming, province discourages gatherings over 250: What Manitobans need to know about COVID-19

By | March 10, 2020

The latest for Friday, March 13:

Manitoba is ramping up its health-care system to take on COVID-19, after the province announced on March 12 it had identified its first presumptive cases of the illness caused by the coronavirus.

Here’s a rundown on what Manitobans need to know about how the health-care system is responding, what to do if you think you’re sick and how to help stem the spread of the coronavirus.

Should I be worried?

Dr. Brent Roussin, the province’s chief medical officer, says Manitoba’s health-care system was expecting and prepared for the arrival of COVID-19.

“I want to be clear that we are not helpless against this virus,” Roussin said on March 12, while announcing the first presumptive positive case.

“Fear and panic will not help against COVID-19. But our preparedness and credible information will.”

Samples from the individual identified as the first presumptive case in the province have been confirmed by the National Microbiology Lab, Roussin said Friday.

The patient, a Winnipeg woman in her 40s who had travelled to the Philippines, is now in isolation.

Both the second and third presumptive cases are men in their 30s who live in Winnipeg and were likely exposed to the virus during recent travel, the province said.

A fourth presumptive case was announced Friday, March 13, involving a Winnipeg man in his 40s who may have been exposed to COVID-19 while travelling in South Korea, the Philippines or Japan.

As of March 12, the province had completed 403 tests for the virus, but that number is growing. Friesen said health-care workers took 500 swabs to be tested on March 11 alone — up from an average of roughly 40 in the days beforehand.

The province says it will provide daily updates on the status of the virus.

How is the province preparing for COVID-19?

Right now, the province is using a containment strategy — meaning it’s focused on reducing opportunities for COVID-19 to spread within the community — based on the understanding that the coronavirus which causes the illness is primarily spread by people who are showing symptoms.

However, the province’s planning has turned from prevention to planning for a “robust system response,” Siragusa said on March 12. That means increasing staffing, adding capacity and expanding access to testing.

To help curb the spread of the virus, Manitoba schools will suspend classes starting March 23, Manitoba Education Minister Kelvin Goertzen said on Friday, March 13.

The province will end classes a week ahead of spring break and keep kids out until April 13.

Earlier that day, the province also said it recommends organizations cancel or postpone any gatherings involving more than 250 people.

Roussin said hospitals are already in the process of looking for space for patients and keeping staff up-to-date. Public health officials have sent a memo to health-care workers discouraging any non-essential travel out of the province.

Most COVID-19 patients can be put up in any single room for isolation, Manitoba Health says. However, hospitals are also preparing negative pressure rooms, Roussin said, which are special, private rooms that control ventilation to allow air in, but not out, to prevent cross-contamination. The rooms would be used to conduct any procedures that could generate aerosols from a person’s airway, including intubation.

The province has dozens of negative pressure rooms in all five health regions, a Manitoba Health spokesperson said in an email Wednesday. It also has positive pressure rooms, which are protective environments for patients with compromised immune systems.

On March 13, the province posted signs at long-term care centres discouraging visits from ill or potentially exposed people. They’re also limiting all visits to one visitor at a time, and are asking people who have travelled internationally in the past 14 days not to come at all.

Right now, Friesen said officials are contemplating how to use remote delivery tools like Telehealth more efficiently to connect health-care providers across the province.

How can I protect myself?

The novel coronavirus is almost exclusively transmitted within communities by those who have symptoms, and through close contact with those who have symptoms, said Roussin.

Public health officials are generally adivsing everyone to practise social distancing techniques, which include these recommendations:

  • Minimize prolonged contact (more than 10 minutes) and close contact (less than two metres) with people in public.
  • Avoid greetings that involve touching (like handshakes).
  • Disinfect frequently used surfaces.
  • Consider avoiding travel, as well as crowded places and events, especially if you are at higher risk.

Follow standard flu or cold prevention techniques. That means washing your hands often, using soap and warm water, for at least 20 seconds before drying thoroughly.

Cough or sneeze into your sleeve, or use a tissue (which you should then throw out, before washing your hands). If you’re sick, stay home, even if your symptoms are mild. If you have kids, make sure they avoid sharing food or drinks, or anything that goes into their mouths, with others.

“All Manitobans have a role to play,” in stopping the spread of the virus, Roussin said. Health Minister Friesen says those simple measures have been proven to help “flatten the curve” of the virus’s spread.

Roussin said the virus spreads almost exclusively through close contact to infected individuals who are showing symptoms. He stressed the greatest risk comes from close, prolonged exposure to someone who is sick.

He advised all Manitobans to carefully review their travel plans. He recommends making plans for what you would do if you fell ill while travelling, or how you would self-isolate.

WATCH | Travel tips to protect yourself from the coronavirus:

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Last week, Friesen said there’s no need to start stockpiling groceries or other gear in preparation for isolation — despite advice from federal Health Minister Patty Hajdu, who said in February it would be wise for Canadians to set aside a week’s supply of medicine and food. Friesen has said, however, it’s always smart to ensure you have a good supply of any medications you take.

On March 13, Roussin cautioned Manitobans against “panic buying.”

“We’re certainly advising against fear,” Roussin said. “But I’m all for credible information, making informed choices and getting ourselves prepared for seeing this virus in our community, and really making those changes to our lives.

“If you’re not making even the smallest change to the way you live your life, you’re not playing your role in minimizing the spread of this virus.”

What should I do if I think I have COVID-19?

If you’ve been exposed to COVID-19 but don’t have symptoms, don’t go to a health-care facility unless absolutely necessary. If you do have to go, call Health Links – Info Santé at 204-788-8200 or toll-free 1-888-315-9257.

If you think you’re sick, the first thing you should do — if it’s not an emergency — is call Health Links. The service is available 24/7 and staffed by nurses.

Lanette Siragusa, provincial lead on health system integration for Shared Health, said on March 13 that staffing levels for Health Links have been doubled, with more staff being trained now, in response to a spike in call volumes that caused delays.

Health Links staff have been given shorter scripts to speed up interactions, and the service has added a dedicated COVID-19 phone line option in an effort to cut wait times, Siragusa said.

The nurse will ask you a series of six questions about your symptoms, your travel history and possible exposures to figure out whether you need to be tested or start self-monitoring. You can find the questions here.

Depending on your answers, they may advise you to monitor your symptoms on your own, staying in self-isolation or go to the hospital to get tested.

WATCH | What we know about the coronavirus:

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But if you have to go to the hospital, you or the nurse you’re talking to must phone ahead to let health-care workers at that centre know that you’re coming. When you arrive, you’ll be given a mask to wear and put in isolation, to ensure no one else gets sick.

If it is an emergency, the province says to call 911 before you go to an emergency department or urgent care centre.

Don’t show up without calling ahead first so the centre can get ready for your arrival.

How does testing work in Manitoba?

Right now, testing in Manitoba is being done only for patients showing symptoms. As of March 13, tests are being offered at four sites in Winnipeg:

  • Access Winnipeg West (280 Booth Dr.).
  • Access Fort Garry (135 Plaza Dr.).
  • Access Transcona (845 Regent Ave. W)
  • Mount Carmel Clinic (886 Main St.)

Those centres will stay open for regular business, too, but patients there for testing will wait and get treated in separate areas from other patients. If you’re there for testing, you’ll be given a mask when you arrive and asked to clean your hands. You’re also advised not to just show up — call Health Links first, to give them time to notify the clinics so they can prepare for your arrival.

The centres are open Monday to Friday from 9 a.m. to 7 p.m., and on weekends from 9 a.m. to 4 p.m. Outside of those hours, you’ll have to go an urgent care centre or an emergency room.

The province is now working on plans to open additional testing sites outside of Winnipeg, Siragusa said on March 13.

If you need to be tested, a health-care worker will take a nasopharyngeal swab, which involves sticking a long, skinny cotton swab into your nose and throat. They’ll send that to a lab to be tested.

The swabs don’t require specialized training or equipment, and get processed at the Cadham Provincial Lab. If the swab comes up as possible coronavirus, it will be sent to the National Microbiology Lab to make sure. If your symptoms are severe, health-care workers may request deep lung specimens, too.

Once the test gets to the lab, results are expected to come in 24 to 48 hours. Roussin said the province’s lab has ramped up capacity to do testing.

While you’re waiting for your results, you’ll be asked to self-isolate and self-monitor. Manitoba Health cautions that this process can be stressful, so don’t neglect your mental health. Connect with friends and family by phone, email or social media, and focus on hobbies or tasks while you wait.

Right now, there are no home-testing or mail-testing options.

What’s self-monitoring?

If you haven’t shown symptoms yet but you were exposed to the virus, or potentially exposed, you might be asked to self-monitor. You could also be asked to do this while you’re in self-isolation.

Self-monitoring means monitoring your general well-being to see if symptoms develop. It also means taking your temperature twice daily. You might be asked to avoid taking acetaminophen or ibuprofen, which could hide symptoms like fever.

If you develop a fever of 38 C or higher, or if you have any COVID-19 symptoms, you need to self-isolate right away — avoid physical contact with others — and get tested. That’s when you’d call Health Links, to give them time to let the healthcare facility know to expect you and prepare for your arrival.

The symptoms you need to be watching for are fever, cough, shortness of breath or breathing difficulties, muscle aches, weakness, headache, sore throat, runny nose or diarrhea.

What’s self-isolating?

Manitoba Health says most people who get COVID-19 will have mild symptoms. Those people will be asked to self-isolate at home, instead of heading to the hospital (which will only be recommended for the severely ill).

Self-isolation means staying home and keeping yourself out of situations where you might infect other people. That means you can’t go anywhere you might be in contact with people — or, basically, anywhere.

You’ll need to limit contact with people who haven’t been exposed, even if they’re family members or people you live with. If you need groceries or supplies, ask friends or family to pick them up for you, or use a grocery delivery or pickup service, and instruct whoever drops them off to leave the package at your door to avoid direct contact. 

If you have service providers who come into your home, cancel their visit if you can. If they provide necessary care, like home care, you need to notify them. Otherwise, no visitors.

If you live with someone, avoid situations where you could have close contact, avoid sharing household items and wash items thoroughly with soap and warm water after using them.

Stay in your own room or separated from others — at least two meters, or six feet, away. If you can, use a separate bathroom, flush with the toilet lid shut and clean everything frequently. Clean commonly-touched objects like door knobs and computers regularly, and wear disposable gloves while you clean. Ensure your home is properly ventilated by opening windows and doors if weather allows.

You still need wash your hands regularly and cover up coughs and sneezes.

Does the province have enough equipment to deal with COVID-19?

As of March 12, Manitoba had 243 ventilators and had ordered 20 more, Siragusa said. That doesn’t include ventilators currently in operating rooms, she said.

The health minister says Manitoba, like other provinces, is taking inventory of the personal protective equipment and other supplies currently in the province, and planning for what else would be needed if there’s an outbreak here. Personal protective equipment, also called PPE, includes special masks, N95 respirators, gloves, gowns and eye protection.

Friesen said the province currently has enough equipment in stock for months to come. But out of an “abundance of caution,” he said the province is buying more.

The province will spend roughly $35.2 million to buy supplies that can go to regional health authorities, service delivery organizations, personal care homes and fee-for-service clinics. The equipment ordered will also include disinfectant wipes and hand sanitizer.

Training and refresher lessons are being offered to staff on how to use the equipment properly, a provincial spokesperson said in an email Wednesday. Fit-testing for the N95 respirators, which need to be fitted to the wearer, is also ongoing.

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