PHIMS is a secure, integrated electronic public health record designed to assist public health practitioners in Manitoba with management of:
PHIMS provides authorized health-care professionals in Manitoba with the ability to collect, share and analyze a wide range of health information at the regional and provincial levels. Data from PHIMS are used in a range of public reports.
The PHIMS database is refreshed daily at 1:00am.
Cases include both confirmed and probable cases. Surveillance case definitions are provided for the purpose of standardizing case classification and reporting. They are based on evidence, public health response goals, and are subject to change as new information becomes available. Please visit https://manitoba.ca/asset_library/en/coronavirus/interim_guidance.pdf for the most current case definition.
Probable case – A person who:
Confirmed case – A person with a laboratory confirmation of infection with the virus that causes COVID-19 performed at a community, hospital or reference laboratory (NML or a provincial public health laboratory) running a validated assay. This consists of detection of at least one specific gene target by a NAAT assay (e.g. real-time PCR or nucleic acid sequencing).
Close contact – A person who provided care for the patient, including healthcare workers, family members or other caregivers, or who had other similar close physical contact or who lived with or otherwise had close prolonged contact with a probable or confirmed case while the case was ill.
Viruses like the ones that cause COVID-19 are constantly changing through mutation. New variants occur over time; sometimes the new variants emerge and disappear while others last. It is not unexpected to see cases of COVID-19 linked to VOCs in Manitoba. Current VOCs identified globally include:
Please visit https://manitoba.ca/asset_library/en/coronavirus/interim_guidance.pdf for more information.
Cumulative data includes updates to previous weeks; due to reporting delays or amendments, the sum of weekly report totals may not add up to cumulative totals.
The date the laboratory specimen was collected is used to assign cases to the epidemiological week in this report. Occasionally, if the specimen collection date is not available, the laboratory report date is used. If both dates are not available, the earliest date a case was reported to Public Health is be used.
Incidence rate measures the frequency that COVID-19 occurs in a population. It is calculated as the total number of new cases multiplied by 100,000 and divided by the total count in a population based on the provincial mid-year population file in 2019.
ILI is defined as acute onset of respiratory illness with fever and cough and with one or more of the following - sore throat, arthralgia, myalgia, or prostration.
Hospitalizations and ICU submissions in COVID-19 cases are extracted from the provincial data system, Admission, Discharge and Transmission. Due to a need for timely reporting, hospitalizations and ICU submissions do not need to be directly attributed to COVID-19. Instead an association to a positive COVID-19 laboratory result is sufficient. Duplicate submissions for the same patient within the same illness episode are excluded. In this report, only Manitoba residents are included. ICU admissions are also included in hospitalizations.
Death due to COVID-19Source: Adapted from WHO International Guidelines for Certification and Classification (coding) of COVID-19 as a cause of death
A death resulting from a clinically compatible illness, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). There should be no period of complete recovery* from COVID-19 between illness and death.
*Recovery in this context means no residual effects or complications from COVID-19, and does not refer to the status of "recovered", which refers to clients who are off isolation or precautions and are no longer considered infectious
Provincial data about COVID-19 related tests are collected daily from Cadham Provincial Laboratory, Shared Health, and Dynacare.
National testing data are collected daily from the national Coronavirus disease (COVID-19) Outbreak update webpage.
Outbreaks are reported to the Epidemiology and Surveillance (E&S) unit via phone call or email from regional public health staff, or by Cadham Provincial Laboratory (CPL) advising the assignment of an outbreak code. CPL submits both positive and negative laboratory results related to outbreaks to E&S. Details related to outbreak investigations are reported from Regional Health Authorities (RHAs) to E&S by completing an outbreak summary report.
COVID-19 OutbreakIn the context of the COVID-19 pandemic, two or more cases of COVID-19 diagnosed within a 14-day period in a setting, with evidence of transmission occurring within the setting defines an outbreak. In a highly vulnerable setting, a single laboratory-confirmed case of COVID-19 in a staff member, volunteer, or resident may define an outbreak at the discretion of the Medical Officer of Health.
Respiratory OutbreakFluWatch is an important part of Canada's national influenza surveillance program. It relies on an online health surveillance system that helps track the spread of influenza and influenza-like illness in the community across Canada. FluWatchers are volunteers from all over Canada. Each week, FluWatchers get an e-mail asking if they had a cough or fever in the previous week. Additional questions may be asked if participants reported ILI symptoms. Answers are anonymous.
Manitoba data are included in this report.
FluWatch typically tracks information related to influenza, but due to the COVID-19 pandemic, the focus is shifting to tracking COVID-19 over the spring and summer months.
More volunteers are needed across Canada to help track the spread of influenza and COVID-19. Please consider signing up to be a FluWatcher.
Manitoba participates in FluWatch, Canada's national surveillance system coordinated by the Public Health Agency of Canada (PHAC), which monitors the spread of influenza and ILI on a year-round basis. FluWatch consists of a network of laboratories, hospitals, physician clinics and provincial and territorial ministries of health. In 2019-2020, there were 19 sentinel physicians recruited throughout Manitoba reporting to FluWatch weekly. The Epidemiology and Surveillance Unit receives weekly reports from FluWatch, which describe the ILI rate for Manitoba and for each participating sentinel physician. The reporting sentinel physicians vary by week, and their reports may not be representative of ILI activity across the province.
Daily statistics of visits to Emergency Departments (ED) in the Winnipeg Regional Health Authority (WRHA) including all visits and those related to respiratory illness are submitted to the Epidemiology and Surveillance Unit weekly. Respiratory visits are defined as patients whose triage chief complaints contain one or more of these symptoms: weakness, shortness of breath, cough, headache, fever, cardiac/respiratory arrest, sore throat, and upper respiratory tract infection complaints.
Exposure to COVID-19, indicated by acquisition events (how someone acquired the infection within 14 days prior to symptom onset) and transmission events (where a case may have transmitted the infection to others from 48 hours prior to symptom onset until the case is no longer infectious), is assessed to determine the most likely source of infection in cases and contacts. Acquisition and transmission event details are retrieved from public health follow-up investigation reports of both cases and contacts and entered into PHIMS. In certain scenarios, determining the source of infection is straightforward and obvious. For example, categories like Travel and Close Contact to Known Cases are easier to determine. However, there are times when more information is required to finalize a category and then “pending” is used, or a category can simply not be identified. In those cases, the category “unknown” is applied. This is also a way to describe Community Acquired cases.
To better understand Community Acquired cases, we can look at the places that people were during both their periods of acquisition and transmission. This allows us to trend data more effectively but should not be considered as the source of infection or transmission.
We base our categories on those provided by the Public Health Agency of Canada, with the short description of each below.
Risk factors for cases are retrieved from public health follow-up investigation reports of cases and entered into PHIMS. Risk factors indicate if a case is at higher risk for COVID-19 infection or potentially more severe outcomes as a result of COVID-19 infection. Common risk factors include:
Symptoms of COVID-19 cases are retrieved from public health follow-up investigation reports of cases and entered into PHIMS. Symptoms range from no symptoms, mild or moderate symptoms to severe illness. Common symptoms have included cough, fever, difficulty breathing, and pneumonia in both lungs. In severe cases, infection can lead to death. COVID-19 can be transmitted to others from asymptomatic cases and those who have not yet developed symptoms (pre-symptomatic). Pre-symptomatic cases can transmit COVID-19 up to two days prior to developing symptoms.
Symptoms take an average of 5-6 days to appear after exposure to COVID-19. However, symptoms may take up to 14 days to appear.
Validated algorithms developed by the Canadian Chronic Disease Surveillance System (CCDSS) are used to define the common chronic conditions of COVID-19 cases using administrative health records maintained by Manitoba Health, Seniors and Active Living. (MHSAL).