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.

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Week 24 (June 13 – June 19)

About epidemiological week

Data extracted up to 4:00 am on June 25, 2021
Next reporting date: July 5, 2021

COVID-19: High Activity In Week 24, there were 965 laboratory-confirmed COVID-19 cases reported in Manitoba, a decrease from 1,600 in the previous week. The volume of lab tests decreased to on average 1,862 people tested for COVID-19 per day compared to 2,287 in the previous week, and the positivity rate of lab tests was 8.3%, a decrease from 11% in the previous week. In the 965 cases reported this week, majority (48%) were reported from the Winnipeg Regional Health and 19% were reported from the Southern Health - Santé Sud Regional Health Authority. The remaining cases were reported from Northern Health Region (17%), Prairie Mountain Health Authority (8%), and Interlake-Eastern Regional Health Authority (8%). This week, 581 cases of variants of concern (VOCs) have been reported, a decrease from 1,000 in the previous week. Additionally, cases of VOCs accounted for 60.2% of new cases reported this week. As of June 19, a total of 1,133,562 doses of COVID19 vaccines have been administered and 71% of residents aged 12 years and older in Manitoba have been immunized with at least one dose.		Cases About cases New cases: 965 Total cases: 55,331 Total VOC cases: 14,750 Recovered cases: 52,817 More Analyses Epi curve Epi curve of VOCs Daily Case Counts (.csv) Age and sex Health region National update
Testing About testing This week Average daily specimens: 1,862 Weekly positivity rate: 8.3% Total Tested people: 495,351 Population tested: 36.3% Specimens tested: 814,969 Positivity rate: 7.3% More Analyses Provincial testing National testing	Severity About severity Severe outcomes associated with COVID-19: Hospitalizations: 3,761 ICU admissions3: 845 Deaths: 1,134 More Analyses Severe Outcomes Age Underlying Illness	Outbreaks About outbreaks COVID-19 outbreaks: 238 Outbreaks in long-term care facilities: 120 Outbreaks in schools: 6 More Analyses Check trend Outbreak list
Exposure About exposure Source of infection in cases (% of total) Travel: 1.2% Close contact to cases: 55.5% Unknown: 24.7% Pending: 18.5% Top five outbreak/cluster/special investigation settings4 Workplace: 36.8% Industrial setting: 17.6% Daycare: 9.0% School: 8.6% Acute care setting: 7.4% More Analyses Contacts Cases related to clusters/outbreaks	Transmission and Acquisition About transmission and acquisition Top five transmission settings in all cases5 Household: 61.4% Social gathering: 11.6% Workplace: 10.1% Transportation: 4.6% School: 3.5% Top five acquisition settings in cases with unknown source of infection6 Household: 29.3% Workplace: 17.0% Retail: 11.0% Social gathering: 6.4% School: 3.9% More Analyses Potential transmission settings Potential acquisition settings	Symptoms About symptoms Symptomatic cases: 73.3% Top symptoms (% of reports) Cough: 46.5% Headache: 38.5% Fever: 32.2% Muscle pain (myalgia): 28.7% Sore Throat: 27.7% More Analyses All symptoms Risk Factors About risk factors Pregnant cases: 640 Health care workers7: 2,520 Deceased health care workers: 4 Recovered health care workers: 2,509 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 24. As of June 19, 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: 3
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: 606 Reporting fever and cough: 0.2% Check Trend
Physician Visits About sentinal physicians Influenza Like Illness (ILI) Visits to sentinel physicians: 1.8% 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): 86 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 19, 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 19, 2021

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

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

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

Health Region	Cases	Percentage
Winnipeg RHA	32733	59.2%
Southern Health-Santé Sud	7285	13.2%
Interlake-Eastern RHA	3701	6.7%
Prairie Mountain Health	3871	7.0%
Northern Health Region	7741	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 19, 2021

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

Province	Confirmed Cases	Tests Completed	Test Rate in Population (Estimated %)	Positivity Rate (Estimated %)
Alberta	231,132	4,612,817	106.0%	5.0%
British Columbia	146,902	2,825,802	56.0%	5.2%
Manitoba	55,087	845,621	62.0%	6.5%
New Brunswick	2,311	366,688	47.4%	0.6%
Newfoundland and Labrador	1,383	292,502	55.9%	0.5%
Northwest Territories	128	24,407	54.3%	0.5%
Nova Scotia	5,784	894,557	92.5%	0.6%
Nunavut	657	17,228	44.6%	3.8%
Ontario	541,525	15,502,918	107.0%	3.5%
Prince Edward Island	206	171,173	110.0%	0.1%
Quebec	373,658	9,596,619	113.6%	3.9%
Saskatchewan	48,327	893,168	76.3%	5.4%
Yukon	145	9,129	22.5%	1.6%
Canada	1,407,258	36,052,705	96.4%	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 19, 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 19, 2021

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

Source of Infection	Cases	Percentage
Close contact of known case	1486	59%
Pending	196	7.8%
Travel	22	0.9%
Unknown	816	32.4%
All Cases	2520

Table 4. Roles of Health Care Workers with Non-missing Information, Manitoba, March 13, 2020 – June 19, 2021

Role	Cases	Percentage
Allied Health, Health Professionals, and Support Staff	1531	60.8%
Nurse/Licensed Practical Nurse	656	26%
Not identified	193	7.7%
Physician/Physician in training	84	3.3%
First Responder	56	2.2%
All Cases	2520

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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 19, 2021

Regional Health Authority	Cases	Median Contacts	Minimum Contacts	Maximum Contacts
Winnipeg Health	32733	3	0	249
Northern Health	7741	1	0	121
Southern Health - Sante Sud	7285	2	0	69
Prairie Mountain Health	3871	3	0	134
Interlake-Eastern Health	3701	1	0	76

Table 6. COVID-19 Contact Summary in New Cases Reported in Week 24, Manitoba, 2021

Regional Health Authority	Cases	Median Contacts	Minimum Contacts	Maximum Contacts
Winnipeg Health	459	3	0	49
Southern Health - Sante Sud	185	0	0	31
Northern Health	163	0	0	121
Interlake-Eastern Health	79	1	0	41
Prairie Mountain Health	79	4	0	20

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

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