Provincial Respiratory Surveillance Report

COVID-19 and Seasonal Influenza

This report provides a current epidemiological update on the intensity and severity of COVID-19 in Manitoba. Surveillance and administrative data include laboratory, public health case and contact tracing investigations, hospitalization and mortality data. Data are presented at the provincial and regional level; and include a focussed review on the disproportional impact of COVID-19 on various populations in the province.

Epidemiology and Surveillance also continues to monitor the activity of seasonal influenza in Manitoba during this pandemic. During the 2020–2021 influenza season, routine reporting of seasonal influenza is included in this weekly report.

In this weekly respiratory surveillance report, we provide regular updates about the current activity of COVID-19 and seasonal influenza in Manitoba with overall objectives:

To understand COVID-19 within the respiratory context;
To present a detailed overview about COVID-19 cases and contacts; and
To continue monitor and report on seasonal influenza during the pandemic.

Data are reported with a one-week delay for increased data accuracy, completeness and reliability. More analyses continue to be conducted and will be added to this report as available. It is published online at approximately 10:00am every Monday.

Week 23 (June 6 – June 12)

About epidemiological week

Data extracted up to 4:00 am on June 18, 2021
Next reporting date: June 28, 2021

COVID-19: High Activity

In Week 23, there were 1,600 laboratory-confirmed COVID-19 cases reported in Manitoba, a decrease from 1,977 in the previous week. The volume of lab tests decreased to on average 2,287 people tested for COVID-19 per day compared to 2,636 in the previous week, and the positivity rate of lab tests was 11%, a decrease from 11.7% in the previous week.

In the 1,600 cases reported this week, majority (57%) were reported from the Winnipeg Regional Health and 18% were reported from the Southern Health - Santé Sud Regional Health Authority. The remaining cases were reported from Northern Health Region (10%), Prairie Mountain Health Authority (8%), and Interlake-Eastern Regional Health Authority (7%).

This week, 1,000 cases of variants of concern (VOCs) have been reported, a decrease from 1,398 in the previous week. Additionally, cases of VOCs accounted for 62.5% of new cases reported this week.

As of June 12, a total of 1,025,184 doses of COVID19 vaccines have been administered and 71.3% of residents aged 18 years and older in Manitoba have been immunized with at least one dose.

Cases

About cases

New cases: 1,600
Total cases: 54,364
Total VOC cases: 14,092
Recovered cases: 51,242

More Analyses

Testing

About testing

This week

Average daily specimens: 2,287
Weekly positivity rate: 11%

Total

Tested people: 490,369
Population tested: 35.9%
Specimens tested: 801,935
Positivity rate: 7.3%

More Analyses

Provincial testing
National testing

Severity

About severity

Severe outcomes associated with COVID-19:

Hospitalizations: 3,693

ICU admissions³: 822

Deaths: 1,112

More Analyses

Severe Outcomes
Age
Underlying Illness

Outbreaks

About outbreaks

COVID-19 outbreaks: 237

Outbreaks in long-term care facilities: 120
Outbreaks in schools: 6

More Analyses

Exposure

About exposure

Source of infection in cases (% of total)

Travel: 1.2%
Close contact to cases: 55.5%
Unknown: 24.8%
Pending: 18.5%

Top five outbreak/cluster/special investigation settings⁴

Workplace: 36.9%
Industrial setting: 17.8%
Daycare: 9.5%
School: 8.7%
Acute care setting: 7.6%

More Analyses

Contacts
Cases related to clusters/outbreaks

Transmission and Acquisition

About transmission and acquisition

Top five transmission settings in all cases⁵

Household: 61.5%
Social gathering: 11.7%
Workplace: 10.3%
Transportation: 4.6%
School: 3.5%

Top five acquisition settings in cases with unknown source of infection⁶

Household: 29.1%
Workplace: 16.8%
Retail: 10.9%
Social gathering: 6.4%
School: 4.0%

More Analyses

Potential transmission settings
Potential acquisition settings

Symptoms

About symptoms

Symptomatic cases: 73.4%

Top symptoms (% of reports)

Cough: 46.6%
Headache: 38.6%
Fever: 32.2%
Muscle pain (myalgia): 28.8%
Sore Throat: 27.8%

More Analyses

All symptoms

Risk Factors

About risk factors

Pregnant cases: 618
Health care workers⁷: 2,491
Deceased health care workers: 4
Recovered health care workers: 2,465

More Analyses

Health care workers

Seasonal Influenza: Low Activity

A large number of respiratory specimens continued to be tested for seasonal influenza. There were no laboratory-confirmed influenza cases reported in Manitoba in Week 23.

As of June 12, 31.7% of residents in Manitoba have been immunized with seasonal influenza vaccines.

Influenza Cases

About cases

New cases this week

Influenza A: 0
Influenza B: 0

Total cases from September 1, 2020

Influenza A: 4
Influenza B: 2

Syndromic Indicators: Low Activity

The respiratory activity levels in the community, primary care and emergency rooms continued to be low for this time of a year. The number of respiratory outbreaks reported that were not due to COVID-19 remains low.

FluWatchers

About FluWatchers

Participants reporting: 602

Reporting fever and cough: 0%

Check Trend

Physician Visits

About sentinal physicians

Influenza Like Illness (ILI) Visits to sentinel physicians: 0.6%

Check Trend

Antiviral

About Antiviral

Units of antiviral dispensed from pharmacies: 0

ED Visits

About emergency room visits

Average daily respiratory visits to emergency department (ED): 96

Check Trend

Important Notes

Data about COVID-19 cases and contacts aswell as influenza cases are extracted from PHIMS.
Numbers are subject to change. Missed events in the current report due to reporting delays will be included in later reports when data become available.
ICU admissions were also included in hospitalizations.
The top five settings where cases are found to be linked with an outbreak or cluster or special investigation.
Transmission settings include those settings exposed during a case’s communicability period, i.e., 48 hours prior to the development of overt symptoms in the case until the case is classified as no longer infectious. Percentages are calculated using total cases counts as a denominator. Categories are NOT mutually exclusive.
Acquisition settings include those settings exposed during a case’s incubation period, i.e., 14 days before symptom onset date. Percentages are calculated using community-transmitted case counts as a denominator for acquisition settings. Categories are NOT mutually exclusive.
Health care workers include personnels in hospitals, long-term care settings, community health clinics and services (including agency staff), and diagnostic/laboratory services.

Cases

Figure 1. Cases of COVID-19 by Week of Public Health Report Date, Manitoba, June 28, 2020 – June 12, 2021

Note. Deaths due to COVID-19 were aligned by week of death date.
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Figure 2. COVID-19 Cases of Variants of Concern (VOC) by Type and Percentage of VOC Cases in All Cases by Week of Public Health Report Date, Manitoba, June 28, 2020 – June 12, 2021

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Figure 3. Sex and Age Distribution of COVID-19 Cases, March 1, 2020 – June 12, 2021

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Figure 4. Cases of COVID-19 by Health Region and Public Health Report Date, Manitoba, March 13, 2020 – June 12, 2021

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Table 1. Cases of COVID-19 by Health Region, Manitoba, March 13, 2020 – June 12, 2021

Health Region	Cases	Percentage
Winnipeg RHA	32274	59.4%
Southern Health-Santé Sud	7093	13.0%
Interlake-Eastern RHA	3622	6.7%
Prairie Mountain Health	3791	7.0%
Northern Health Region	7584	14.0%

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Testing

Figure 5. Average Daily Testing Volume and Positivity (%) for COVID-19 by Week of Specimen Receiving Date, Manitoba, June 28, 2020 – June 12, 2021

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Table 2. Cumulative National Testing Volume and Positivity (%) for COVID-19 by Province/Territory, Canada, March 13, 2020 – June 12, 2021

Province	Confirmed Cases	Tests Completed	Test Rate in Population (Estimated %)	Positivity Rate (Estimated %)
Alberta	230,119	4,574,316	105.1%	5.0%
British Columbia	146,176	2,786,458	55.2%	5.2%
Manitoba	53,869	828,543	60.7%	6.5%
New Brunswick	2,284	357,677	46.2%	0.6%
Newfoundland and Labrador	1,368	285,133	54.5%	0.5%
Northwest Territories	128	24,036	53.5%	0.5%
Nova Scotia	5,726	860,773	89.0%	0.7%
Nunavut	654	16,384	42.4%	4.0%
Ontario	538,651	15,335,173	105.9%	3.5%
Prince Edward Island	206	167,657	107.7%	0.1%
Quebec	372,656	9,457,176	112.0%	3.9%
Saskatchewan	47,769	879,385	75.1%	5.4%
Yukon	98	9,129	22.5%	1.1%
Canada	1,399,717	35,581,916	95.1%	3.9%

Note. National testing data are collected daily from the national Coronavirus disease (COVID-19) Outbreak update webpage.

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Severity

Figure 6. Severe Outcomes of COVID-19 by Week of Public Health Report Date, Manitoba, June 28, 2020 – June 12, 2021

Note. ICU admissions are not included in the hospital admissions.

Figure 7. Age Distribution of Severe COVID-19 Cases Compared to All Cases, Manitoba, March 13, 2020 – June 12, 2021

Figure 8. Percentage of COVID-19 Cases With Underlying Illnesses, Manitoba, March 13, 2020 – June 12, 2021

Note. Musculoskeletal illnesses include: osteoporosis, osteoarthritis, juvenile idiopathic arthritis, gout and crystal Arthropathies; COPD-chronic obstructive pulmonary disease; CVD-cardiovascular disease; Other CVDs include: ischemic heart disease, heart failure, acute myocardial infarction, and stroke; Other chronic conditions include: parkinson’s disease, multiple sclerosis, alzheimer’s disease and epilepsy. About definitions of chronic conditions

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Risk Factors

Table 3. Source of Infection in Health Care Workers with Non-missing Information, Manitoba, March 13, 2020 – June 12, 2021

Source of Infection	Cases	Percentage
Close contact of known case	1469	59%
Pending	196	7.9%
Travel	22	0.9%
Unknown	804	32.3%
All Cases	2491

Table 4. Roles of Health Care Workers with Non-missing Information, Manitoba, March 13, 2020 – June 12, 2021

Role	Cases	Percentage
Allied Health, Health Professionals, and Support Staff	1512	60.7%
Nurse/Licensed Practical Nurse	651	26.1%
Not identified	189	7.6%
Physician/Physician in training	84	3.4%
First Responder	55	2.2%
All Cases	2491

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Outbreaks

Figure 9. Weekly Respiratory and COVID-19 Outbreaks, Manitoba, 2018 – 2021

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Contacts

Table 5. COVID-19 Contact Summary in All Cases, Manitoba, March 13, 2020 – June 12, 2021

Regional Health Authority	Cases	Median Contacts	Maximum Contacts
Winnipeg Health	32274	3	249
Northern Health	7584	1	66
Southern Health - Sante Sud	7093	2	69
Prairie Mountain Health	3791	3	134
Interlake-Eastern Health	3622	1	76

Table 6. COVID-19 Contact Summary in New Cases Reported in Week 23, Manitoba, 2021

Regional Health Authority	Cases	Median Contacts	Maximum Contacts
Winnipeg Health	917	3	58
Southern Health - Sante Sud	284	1	31
Northern Health	165	1	34
Prairie Mountain Health	118	4	16
Interlake-Eastern Health	116	1	31

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Figure 10. Percentage of COVID-19 Cases Linked to Top-five Cluster/Outbreak/Special Investigation Settings, Manitoba, January 24, 2021 – June 12, 2021

Note: COVID-19 public health orders in Manitoba since January 23, 2021: PH order #1 (effective January 23, 2021), PH order #2 (effective March 5, 2021), PH order #3 (effective March 26, 2021), PH order #4 (effective April 19, 2021), PH order #5 (effective April 28, 2021), PH order #6 (effective May 9, 2021), PH order #7 (effective May 22, 2021), PH order #8 (effective May 29, 2021), PH order #9 (effective June 12, 2021). Content of Public Health Orders

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Figure 11. Percentage of Total COVID-19 Cases Exposed to Top-five Transmission Settings, Manitoba, January 24, 2021 – June 12, 2021

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Figure 12. Percentage of Community-transmitted COVID-19 Cases Exposed to Top-five Acquisition Settings, Manitoba, January 24, 2021 – June 12, 2021

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Symptoms

Figure 13. Percentage of Symptoms Reported by COVID-19 Cases, Manitoba, March 13, 2020 – June 12, 2021

Note: Other symptoms include those less common symptoms such as sweating, runny eyes, itchy throat, etc.

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FluWatchers

Figure 14. Weekly FluWatchers Participants and Percentage Reporting Fever and Cough, Manitoba, 2020 – 2021

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Physician Visits

Figure 15. Weekly Percentage of ILI Related Visits to Sentinel Physicians, Manitoba, 2021

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ED Visits

Figure 16. Weekly Respiratory Visits to Emergency Department, Winnipeg Regional Health Authority, Manitoba, 2018 – 2021

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Epidemiology and Surveillance

epiCOVID@gov.mb.ca

Other Epidemiology and Surveillance reports

https://www.gov.mb.ca/health/publichealth/surveillance/index.html