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 25 (June 20 – June 26)

About epidemiological week

Data extracted up to 4:00 am on July 2, 2021
Next reporting date: July 12, 2021

COVID-19: Decreased Activity

In Week 25, there were 648 laboratory-confirmed COVID-19 cases reported in Manitoba, a decrease from 965 in the previous week. The volume of lab tests decreased to on average 1,671 people tested for COVID-19 per day compared to 1,862 in the previous week, and the positivity rate of lab tests was 6.4%, a decrease from 8.3% in the previous week.

In the 648 cases reported this week, majority (55%) were reported from the Winnipeg Regional Health and 16% were reported from the Southern Health - Santé Sud Regional Health Authority. The remaining cases were reported from Northern Health Region (15%), Interlake-Eastern Regional Health Authority (10%), and Prairie Mountain Health Authority (4%).

This week, 370 cases of variants of concern (VOCs) have been reported, a decrease from 581 in the previous week. Additionally, cases of VOCs accounted for 57% of new cases reported this week.

As of June 26, a total of 1,304,270 doses of COVID19 vaccines have been administered and 72.7% of residents aged 12 years and older in Manitoba have been immunized with at least one dose.

Cases

About cases

New cases: 648
Total cases: 55,981
Total VOC cases: 15,193
Recovered cases: 53,622

More Analyses

Testing

About testing

This week

Average daily specimens: 1,671
Weekly positivity rate: 6.4%

Total

Tested people: 499,569
Population tested: 36.6%
Specimens tested: 826,663
Positivity rate: 7.3%

More Analyses

Provincial testing
National testing

Severity

About severity

Severe outcomes associated with COVID-19:

Hospitalizations: 3,804

ICU admissions³: 858

Deaths: 1,141

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

Exposure

About exposure

Source of infection in cases (% of total)

Travel: 1.2%
Close contact to cases: 55.6%
Unknown: 24.7%
Pending: 18.5%

Top five outbreak/cluster/special investigation settings⁴

Workplace: 36.8%
Industrial setting: 17.6%
Daycare: 8.9%
School: 8.4%
Acute care setting: 7.5%

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: 4.5%
School: 3.4%

Top five acquisition settings in cases with unknown source of infection⁶

Household: 29.3%
Workplace: 17.0%
Retail: 10.9%
Social gathering: 6.4%
School: 3.8%

More Analyses

Potential transmission settings
Potential acquisition settings

Symptoms

About symptoms

Symptomatic cases: 73.2%

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: 653
Health care workers⁷: 2,531
Deceased health care workers: 4
Recovered health care workers: 2,521

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 25.

As of June 26, 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: 594

Reporting fever and cough: 0%

Check Trend

Physician Visits

About sentinal physicians

Influenza Like Illness (ILI) Visits to sentinel physicians: 4.2%

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): 91

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 26, 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 26, 2021

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Figure 3. Sex and Age Distribution of COVID-19 Cases, March 1, 2020 – June 26, 2021

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Figure 4. Cases of COVID-19 by Health Region and Public Health Report Date, Manitoba, March 13, 2020 – June 26, 2021

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Table 1. Cases of COVID-19 by Health Region, Manitoba, March 13, 2020 – June 26, 2021

Health Region	Cases	Percentage
Winnipeg RHA	33092	59.1%
Southern Health-Santé Sud	7393	13.2%
Interlake-Eastern RHA	3764	6.7%
Prairie Mountain Health	3898	7.0%
Northern Health Region	7834	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 26, 2021

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Table 2. Cumulative National Testing Volume and Positivity (%) for COVID-19 by Province/Territory, Canada, March 13, 2020 – June 26, 2021

Province	Confirmed Cases	Tests Completed	Test Rate in Population (Estimated %)	Positivity Rate (Estimated %)
Alberta	231,722	4,648,225	106.8%	5.0%
British Columbia	147,418	2,863,403	56.7%	5.1%
Manitoba	55,773	860,326	63.1%	6.5%
New Brunswick	2,323	371,310	48.0%	0.6%
Newfoundland and Labrador	1,384	298,083	57.0%	0.5%
Northwest Territories	128	24,665	54.9%	0.5%
Nova Scotia	5,814	921,534	95.3%	0.6%
Nunavut	657	17,611	45.5%	3.7%
Ontario	543,571	15,663,482	108.1%	3.5%
Prince Edward Island	206	173,311	111.3%	0.1%
Quebec	374,406	9,728,913	115.2%	3.8%
Saskatchewan	48,644	904,595	77.2%	5.4%
Yukon	242	9,129	22.5%	2.7%
Canada	1,412,301	36,484,663	97.5%	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 26, 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 26, 2021

Figure 8. Percentage of COVID-19 Cases With Underlying Illnesses, Manitoba, March 13, 2020 – June 26, 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 26, 2021

Source of Infection	Cases	Percentage
Close contact of known case	1493	59%
Pending	196	7.7%
Travel	22	0.9%
Unknown	820	32.4%
All Cases	2531

Table 4. Roles of Health Care Workers with Non-missing Information, Manitoba, March 13, 2020 – June 26, 2021

Role	Cases	Percentage
Allied Health, Health Professionals, and Support Staff	1542	60.9%
Nurse/Licensed Practical Nurse	656	25.9%
Not identified	193	7.6%
Physician/Physician in training	84	3.3%
First Responder	56	2.2%
All Cases	2531

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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 26, 2021

Regional Health Authority	Cases	Median Contacts	Maximum Contacts
Winnipeg Health	33092	3	249
Northern Health	7834	1	121
Southern Health - Sante Sud	7393	2	69
Prairie Mountain Health	3898	3	134
Interlake-Eastern Health	3764	1	76

Table 6. COVID-19 Contact Summary in New Cases Reported in Week 25, Manitoba, 2021

Regional Health Authority	Cases	Median Contacts	Maximum Contacts
Winnipeg Health	355	3	22
Southern Health - Sante Sud	104	0	14
Northern Health	98	0	24
Interlake-Eastern Health	62	1	12
Prairie Mountain Health	29	2	9

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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 26, 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 26, 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 26, 2021

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Symptoms

Figure 13. Percentage of Symptoms Reported by COVID-19 Cases, Manitoba, March 13, 2020 – June 26, 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