Third-wave ICU crisis continues to serve as Heather Stefanson's Achilles heel

When Heather Stefansonbecame Manitoba's premier, the Tuxedo MLA's performance as health minister during the pandemic's third wave was always going to be an Achilles' heel.

Stefansonwas responsible for healthduring the spring of 2021, when Manitobahospitals wereso overwhelmed by severe COVID-19 cases, Shared Health had to transfer 57 intensive-carepatientsto other provinces.

Stefanson was forced to address her record during the PC leadership race, which she eventually won by a narrow and disputed margin.

Asked why she didn't push for tougher third-wave restrictions earlier especially after Manitoba's disastrous experience during the second wave she said she was listening to advice from public health.

"You know what? Coulda, shoulda, woulda," Stefanson said during an interview in September.

"That's what we can think of after the fact. Butyou know, when you're thrown in the middle of this, there is no playbook for this and you just make your decisions based on the advice that you get from the professionals."

Six months later, questions remain about the quality of that advice, whether it ever got to the health minister who would become premier and if it did, whether Stefanson heeded it.

On Monday, documents obtained by the official opposition revealed Manitoba Shared Health was working on transferring ICU patients to Ontario five days before the premier stated the province could still expand ICU capacity.

On May 13,Shared Health CEO Adam Topphad a meeting about Thunder Bay Regional Health Sciences Centreand ICU capacity, according to a copy of Topp's calendar obtained by the NDPthrough a freedom-of-information request.

Five days later, Stefanson told reporters ICU capacity could be expanded by another 50 patients.

"As the ICU numbers continue to grow, as we expect them to over the course of the next couple of weeks," she told reporters on May 18,"we will continue to ensure that we are staffing to be able to handle that capacity."

That very same day, Manitoba transferred the first ICU patientto Thunder Bay because hospitals had run out of capacity.

This is not quite the smoking gun NDP Leader Wab Kinew made it out to be on Monday, when he suggested Stefanson intentionally misled Manitobans about ICU capacity.

For starters, there is no evidence Topp briefed Stefanson about the transfers to Thunder Bay, though it is reasonable to suggest he could have done so.

More significantly, there is no need for a smoking gun. At this point in May,Shared Health had already said Manitoba could not expand ICU capacity.

During a technical briefing with reporters on May 7, former Shared Health official Lanette Siragusa then Manitoba's chief nursing officer and the provincial lead for health systems integration and quality warned the province was coming close to running out of ICU capacity.

During the telephonebriefing, Siragusa said on the record the province was fast approaching the second-wave ICUpeak of 129 patients and could not handle any more.

"That's been ourline-in-the-sandworking number and we are getting close to that now," Siragusa said.

This prompted questions from reporters about previous Shared Health targets about expanding ICU capacity to 173 patients.

That number, she explained, was put together in 2020, when the pandemic was still new and officials had yet to learn how infections among hospital workers and staff burnout could affect the ability to find enough staff to keep ICUs running well over their pre-pandemic capacity of 72 patients.

"The 173 number was the number that we planned for really early on in the spring of last year, while we were learning more about the virus and the situation was evolving and changing," Siragusa said. "Theestimate of 173beds was a paper exercise, literally at the beginning."

Siragusa went on to explain that while vaccinations made hospital staff far less susceptible to infections, vaccinations among older Manitobans had changed the demographics of COVID patients who required intensive care.

Simply put, Manitoba ICUs were now caring for younger patients who stayed in hospital longer, demanding more hospital resources. Whatever planning had occurredin 2020 did not prepare Manitoba for the spring of 2021.

Manitoba had 131 patients in ICU on May 18, when the transfers began to other provinces.

Yet for reasons that are not clear, Stefanson wasclaiming that very same day ICU capacity could be expanded to closer to 180 patients.

Even if one accepts the possibility Shared Health leftStefansonin the dark about the imminent patient transfers, the question remains why the future premier was touting the ability to expand ICU capacity 11 days after Siragusa told reporters that wasn't possible.

One possibility is Stefanson was not briefed. A second possibility is she was briefed, but received six-month-old information.

The third possibility is Stefanson was doing what Kinew alleged.Stefansoninsists she did no such thing.

"Under no circumstances did I mislead Manitobans about ICU capacity during the COVID-19 surge last spring," the premier said in a statement on Monday.

"I understood Manitoba needed additional ICU capacity and as such was having daily briefings and incident command meetings with Shared Health and public health officials to be briefed on contingency plans."

In September, during the PC leadership race, the future premier was asked specificallywhy she claimed ICU capacity could be expanded by roughly 50 patients11 days after Shared Health publicly stated that was not the case.

"I was taking the advice of our professionals in the system and as I understood at the time, we were up to capacity in the 150s," Stefanson said in September.

"Often people are moved around province. Itjust was unfortunate we had to for safety reasons move some individuals out of province."