COVID-19 surge pushing Manitoba's health-care capacity to brink, microbiologist says

Manitoba's health-care system is at the tipping point of a breakdownif the surge in COVID-19 cases isn't immediately curtailed, a Winnipeg doctor says.

"There's basically aperfect storm of situations that is making things extremely difficult," said Philippe Lagac-Wiens, a medical microbiologist and physician at St. Boniface Hospital.

There's an increase in COVID-19 cases with no known transmission lines, along with a growing number of hospital outbreaks, and those are on a collision course with an ever-reduced capacity to deal with them, he said.

When hospital staff are exposed, they are removed from the pool of workers who can treat the deluge of patients, Lagac-Wiens said Monday morning.

"So what I'm really imploring people to do is to really step up to reduce transmission."

He and his colleagues are worriedManitoba could get to a situation that could be similar "to those the horror stories that you heard coming out of Europe back in April and May," Lagac-Wienssaid.

"I don't think it's there yet.I think there's still capacity, but it has the potential of becoming very concerning pretty quickly. There's still an opportunity to turn this around. It's just that we're getting to the point where it might be a tipping point."

Manitoba is experiencing record hospitalizations of COVID-19 patients, with 77 reported Sunday. Of those, 15 are in intensive care.

Morethan 300 new cases were added over the weekend, and sixdeaths were reported.

On Saturday,Lagac-Wienstook to Facebook to express his alarm about the situation.

"Resources are getting strained. ICUs are full. We are on the brink," he wrote. "This is what happens when we let our guard down, have too many contacts, relax and go out with too many people.

"The recent explosion of hospital cases and ICU cases are all caused by the disease we didn't prevent two to threeweeks ago.Without a turnaround, we are within days of being at the limit of ICU capacity."

'We're the wild card'

From the beginning, the conceptof flattening the curve was really about protecting the health-care system, which is already pretty lean in terms of vacancy without the pressure from COVID-19, said Cynthia Carr,Winnipeg-based epidemiologist and founder of EPI Research Inc.

She echoesLagac-Wiens' call for people to go back to basics and keep their distance.

"My concern is, with more and more cases, there's more chance to spread," she said."We're a highly-interconnected society."

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Lanette Siragusa, chief nursing officer for Manitoba Shared Health, empathized with health-care staff over fears of escalating cases in hospital and how those are putting pressure on the system.

If a community has a reproduction rate of two so one person can infect two other peopleand doesn't get that under control immediately, 100 cases will become 3,200 cases just 40 days later, Carr explained.

"That's how quickly and exponentially this can spread," she said.

Bringing the reproduction rate down to less than one, say 0.7, those 100 cases on Day 1 wouldfall to just 17 by Day 40.

"So this exponential increase can become anexponential decrease with the right strategies," Carr said.

But as of right now, "we are pushing our system and our public health leadership, such as Dr. [Brent] Roussin[the province's chief provincial public health officer]into a situation where he might be running out of options for targeted approaches" and have to resort to another full shutdown like Manitoba had in spring.

"It's up to us to stop it. We're the wild card. The infection can't get into the health-care system or into a personal care home or into a school if it's not in the community," Carr said. "We bring it there."

Beyond exhaustion

Pretty well everyone in the field of medicine and nursing is exhausted,Lagac-Wienssaid.

"But they are strong people and they will continue to do their jobs as best as they possiblycan to the point of beyond exhaustion. I don't want them to get there, but they will eventually, if this demand on their time and ability continues," he said.

"They are heroes and will keep working very hard for us."'

In the meantime, everyone else can do their part to reduce the strain.The solution is clear, Lagac-Wienssaid: no more social outings, work from home if you can, distance from others outside your householdeven loved ones wash your hands andwear a mask indoors.

"It's in all our hands."