Broad-based restrictions in Manitoba have barely edged the province out of its worst-case scenario for daily COVID-19 cases, but helped avoid catastrophic pressure on the medical system, newly released projections show.

Manitoba’s daily COVID-19 case numbers started to exceed its worst-case or “extreme” scenarios in early October, new data shows, and stayed in that range well into November.

The worst-case or “extreme” scenario predicts what would happen if the province had “minimal restrictions and poor compliance.” That scenario would put the province at between 419 and 1,055 cases per day, an average of 825 cases per day, by Dec. 6, Chief Provincial Public Health Officer Dr. Brent Roussin said Friday.

Early in the fall, the province tried to contain COVID-19 spread with more targeted restrictions zeroing in on certain sectors.

But the daily case trend didn’t start to drop until after Nov. 12, when the entire province moved to the red, or critical, level on the province’s pandemic response scale, bringing restrictions that included closing churches, non-essential businesses and in-restaurant dining.

“This is the benefit of hindsight on these type of things,” Roussin said Friday.

Low public buy-in and the time of year — fall is usually respiratory virus season — meant lower-level, targeted restrictions weren’t effective in the rest of the province the way they were in Prairie Mountain Health over the summer, he said.

“At the time, we tried that targeted approach, it didn’t work, and we had to continue to escalate our restrictions.”

This slide from the province shows the projected number of new COVID-19 cases in Manitoba in different scenarios. (Manitoba Government)

Now case numbers are hovering around the bottom end of the “extreme” range, and dropping into the “severe” range on some days, Roussin said. However, the province’s high test positivity rate means it’s still too soon to say where the trend is headed.

“I think that Manitobans, just like probably everyone else in the world, you know, want to be done with this virus and want to be done with these restrictions,” he said. “But unfortunately we’re not.”

The province’s modelling projected four scenarios for COVID-19: extreme, with minimal restrictions and poor compliance, severe, with some restrictions and poor compliance, moderate, with more restrictions and good compliance, and controlled, with full restrictions and good compliance.

On average, the modelling shows that for every 48 Manitobans who test positive for COVID-19, three people end up in hospital and one person dies.

‘Dodged a crisis’ in health care

The projections show the province’s partial lockdown and health-care expansions have helped avoid the worst projections for the health-care system, Shared Health Chief Nursing Officer Lanette Siragusa said Friday.

“We dodged a crisis,” Siragusa said.

The province’s rate of hospitalizations and intensive care occupancy for COVID-19 fall within the moderate range, Siragusa said. That scenario predicted how many Manitobans would be admitted to hospitals and ICU occupancy for COVID-19 based on more restrictions and good compliance.

At the worst end of that range, COVID-19 patients would have accounted for 100 per cent of intensive care capacity in the province by Nov. 23.

This slide from the province shows a projection of intensive care unit admissions tracking against a moderate COVID-19 scenario. (Manitoba Government)

As it is, the province is on track to see half of all its ICU beds taken by COVID-19 patients this year, Siragusa said.

“Even in the current trajectory, case counts are still too high for our health system to be able to support the resulting pressure on hospitals and intensive care units for days and weeks on end,” she said.

“The restrictions in place now are trying to avoid a catastrophic impact on our health system’s capacity.”

Manitoba hospital occupancy is tracking within the “severe” scenario, said Lanette Siragusa, Chief Nursing Officer for Shared Health. (Manitoba Government)

Total hospital occupancy — which covers all clinical beds in the province’s health-care system rather than just daily COVID-19 hospital numbers — is too high, Siragusa said. The province is currently in the “severe” or second-worst-case scenario range for clinical bed occupancy.

That’s even with increased capacity in the province’s hospitals, which expanded from 2,457 medicine and surgical beds in March 2020 to 3,084 in November. 

“Our health-care workers and our clinical leaders are working daily to increase our capacity to care for those who may need us,” Siragusa said.

WATCH | Full news conference on COVID-19 | Dec. 4, 2020:

Provincial officials give update on COVID-19 outbreak: Friday, December 4, 2020. 1:18:03

“But these case counts over the past month have put us on a collision course to quickly reach the limits of what our health-care system can support.”

Manitoba’s current public health orders are set to expire on Dec. 11. Roussin said Friday that more information on future restrictions will likely come next week.

Roussin stressed that models are mathematical tools and are difficult to interpret on their own.

The province’s modelling is intended to simulate the real lives of Manitobans, including relationships and socialization, disease progression in affected individuals and decisions about whether to seek testing if symptoms arise.

The modelling released Friday shows projections for numbers as far as late December.

See the new projections here:

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