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 34 (August 22 – August 28)

About epidemiological week

Data extracted up to 4:00 am on September 3, 2021
Next reporting date: September 13, 2021

COVID-19: Decreased Activity In Week 34, there were 392 laboratory-confirmed COVID-19 cases reported in Manitoba, an increase from 233 in the previous week. The volume of lab tests increased to on average 1,895 people tested for COVID-19 per day compared to 1,736 in the previous week, and the positivity rate of lab tests was 3.1%, an increase from 2.2% in the previous week. In the 392 cases reported this week, 36% were reported from Southern Health - Santé Sud Regional Health Authority and 30% were reported from the Winnipeg Regional Health Authority. The remaining cases were reported from Northern Health Region (16%), Interlake-Eastern Regional Health Authority (11%), and Prairie Mountain Health Authority (7%). This week, 314 cases of variants of concern (VOCs) have been reported, an increase from 145 in the previous week. Additionally, cases of VOCs accounted for 80% of new cases reported this week. In all Manitoba residents aged 12 years and older, 82.8% of residents have been partially vaccinated and 75.7% have been fully vaccinated. This week, the majority of new cases, severe cases among them and VOC cases were unvaccinated. No fully vaccinated individuals were admitted to ICU this week.		Cases About cases New cases: 392 Total cases: 58,652 Total VOC cases: 17,468 Recovered cases: 57,157 More Analyses Epi curve Epi curve of VOCs Daily Case Counts (.csv) Age and sex Health region Vaccination status National update
Testing About testing This week Average daily specimens: 1,895 Weekly positivity rate: 3.1% Total Tested people: 536,964 Population tested: 39.4% Specimens tested: 921,942 Positivity rate: 6.8% More Analyses Provincial testing National testing	Severity About severity Severe outcomes associated with COVID-19: Hospitalizations: 4,053 ICU admissions3: 920 Deaths: 1,192 More Analyses Severe Outcomes Age Underlying Illness	Outbreaks About outbreaks COVID-19 outbreaks: 243 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: 1.4% Close contact to cases: 55.9% Unknown: 24.9% Pending: 17.7% Top five outbreak/cluster/special investigation settings4 Workplace: 36.2% Industrial setting: 17.6% Daycare: 10.3% Acute care setting: 7.8% School: 7.7% More Analyses Contacts Cases related to clusters/outbreaks	Transmission and Acquisition About transmission and acquisition Top five transmission settings in all cases5 Household: 65.6% Social gathering: 13.9% Workplace: 12.5% Transportation: 5.2% Retail: 3.7% Top five acquisition settings in cases with unknown source of infection6 Household: 50.5% Workplace: 32.6% Retail: 18.7% Social gathering: 15.0% Transportation: 6.7% More Analyses Potential transmission settings Potential acquisition settings	Symptoms About symptoms Symptomatic cases: 73.5% Top symptoms (% of reports) Cough: 46.2% Headache: 38.1% Fever: 32.0% Muscle pain (myalgia): 28.2% Sore Throat: 27.5% More Analyses All symptoms Risk Factors About risk factors Pregnant cases: 724 Health care workers7: 2,623 Deceased health care workers: 4 Recovered health care workers: 2,616 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 34. As of August 28, 31.5% 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: 547 Reporting fever and cough: 0.2% Check Trend
Physician Visits About sentinal physicians Influenza Like Illness (ILI) Visits to sentinel physicians: 0.0% 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): 100 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, August 23, 2020 – August 28, 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, August 23, 2020 – August 28, 2021

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Figure 3. Sex and Age Distribution of COVID-19 Cases, March 1, 2020 – August 28, 2021

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Figure 4. Cases of COVID-19 by Health Region and Public Health Report Date, Manitoba, September 1, 2020 – September 1, 2021

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Table 1. Cases of COVID-19 by Health Region, Manitoba, March 13, 2020 – August 28, 2021

Health Region	Cases	Percentage
Winnipeg RHA	34235	58.4%
Southern Health-Santé Sud	7930	13.5%
Interlake-Eastern RHA	4329	7.4%
Prairie Mountain Health	4068	6.9%
Northern Health Region	8090	13.8%

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Figure 5. Vaccination Status in New Cases 12+, non-ICU Hospital Admissions, ICU Admissions, Deaths, and VOCs, Manitoba, August 22, 2021 – August 28, 2021

Note. Unprotected Case: Individuals vaccinated 0–13 days following the first dose of a COVID-19 vaccine. Partially Vaccinated Case: Individuals vaccinated >=14 days following the first dose of a 2-dose series COVID-19 vaccine if only one dose was received and 0-13 days following the second dose if two doses were received. Fully Vaccinated Case: Individuals vaccinated >=14 days following the second dose of a 2-dose series or first dose of a 1-dose series of a COVID-19 vaccine.

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Testing

Figure 6. Average Daily Testing Volume and Positivity (%) for COVID-19 by Week of Specimen Receiving Date, Manitoba, August 23, 2020 – August 28, 2021

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Table 2. Cumulative National Testing Volume and Positivity (%) for COVID-19 by Province/Territory, Canada, March 13, 2020 – August 28, 2021

Province	Confirmed Cases	Tests Completed	Test Rate in Population (Estimated %)	Positivity Rate (Estimated %)
Alberta	248,954	5,051,290	116.1%	4.9%
British Columbia	163,560	3,374,186	66.9%	4.8%
Manitoba	58,506	964,490	70.7%	6.1%
New Brunswick	2,721	416,745	53.9%	0.7%
Newfoundland and Labrador	1,469	319,698	61.1%	0.5%
Northwest Territories	395	27,598	61.5%	1.4%
Nova Scotia	5,999	1,104,250	114.2%	0.5%
Nunavut	657	18,960	49.0%	3.5%
Ontario	562,756	16,975,727	117.2%	3.3%
Prince Edward Island	230	184,348	118.4%	0.1%
Quebec	387,230	10,780,102	127.6%	3.6%
Saskatchewan	53,262	1,008,934	86.2%	5.3%
Yukon	684	9,129	22.5%	7.5%
Canada	1,486,436	40,235,533	107.6%	3.7%

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

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Severity

Figure 7. Severe Outcomes of COVID-19 by Week of Public Health Report Date, Manitoba, August 23, 2020 – August 28, 2021

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

Figure 8. Age Distribution of Severe COVID-19 Cases Compared to All Cases, Manitoba, March 13, 2020 – August 28, 2021

Figure 9. Percentage of COVID-19 Cases With Underlying Illnesses, Manitoba, March 13, 2020 – August 28, 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 – August 28, 2021

Source of Infection	Cases	Percentage
Close contact of known case	1528	58.3%
Pending	201	7.7%
Travel	29	1.1%
Unknown	865	33%
All Cases	2623

Table 4. Roles of Health Care Workers with Non-missing Information, Manitoba, March 13, 2020 – August 28, 2021

Role	Cases	Percentage
Allied Health, Health Professionals, and Support Staff	1603	61.1%
Nurse/Licensed Practical Nurse	671	25.6%
Not identified	204	7.8%
Physician/Physician in training	89	3.4%
First Responder	56	2.1%
All Cases	2623

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Outbreaks

Figure 10. 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 – August 28, 2021

Regional Health Authority	Cases	Median Contacts	Minimum Contacts	Maximum Contacts
Winnipeg Health	34235	3	0	249
Northern Health	8090	1	0	121
Southern Health - Sante Sud	7930	2	0	69
Interlake-Eastern Health	4329	2	0	76
Prairie Mountain Health	4068	3	0	134

Table 6. COVID-19 Contact Summary in New Cases Reported in Week 34, Manitoba, 2021

Regional Health Authority	Cases	Median Contacts	Minimum Contacts	Maximum Contacts
Southern Health - Sante Sud	141	3.0	0	17
Winnipeg Health	117	3.0	0	28
Northern Health	62	0.0	0	20
Interlake-Eastern Health	42	0.5	0	14
Prairie Mountain Health	30	4.5	0	48

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Figure 11. Percentage of COVID-19 Cases Linked to Top-five Cluster/Outbreak/Special Investigation Settings, Manitoba, January 24, 2021 – August 28, 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), PH order #10 (effective June 26, 2021), PH order #11: (effective July 17, 2021). Content of Public Health Orders

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Figure 12. Percentage of Total COVID-19 Cases Exposed to Top-five Transmission Settings, Manitoba, January 24, 2021 – August 28, 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), PH order #10 (effective June 26, 2021), PH order #11: (effective July 17, 2021). Content of Public Health Orders

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Figure 13. Percentage of Community-transmitted COVID-19 Cases Exposed to Top-five Acquisition Settings, Manitoba, January 24, 2021 – August 28, 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), PH order #10 (effective June 26, 2021), PH order #11: (effective July 17, 2021). Content of Public Health Orders

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Symptoms

Figure 14. Percentage of Symptoms Reported by COVID-19 Cases, Manitoba, March 13, 2020 – August 28, 2021

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

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FluWatchers

Figure 15. Weekly FluWatchers Participants and Percentage Reporting Fever and Cough, Manitoba, 2020 – 2021

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Physician Visits

Figure 16. Weekly Percentage of ILI Related Visits to Sentinel Physicians, Manitoba, 2021

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ED Visits

Figure 17. 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