Provincial Respiratory Surveillance Report

COVID-19

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.

In this weekly respiratory surveillance report, we provide regular updates about the current activity of COVID-19 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

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.

Reporting for seasonal influenza in 2021-2022 season will start on October 15, 2021 for Week 40 (October 3–9, 2021).

Week 39 (September 26 – October 2)

About epidemiological week

Data extracted up to 4:00 am on October 8, 2021
Next reporting date: October 18, 2021

COVID-19: Increased Activity In Week 39, there were 642 laboratory-confirmed COVID-19 cases reported in Manitoba, an increase from 504 in the previous week. The volume of lab tests decreased to on average 3,058 people tested for COVID-19 per day compared to 3,215 in the previous week, and the positivity rate of lab tests was 3.3%, an increase from 2.5% in the previous week. In the 642 cases reported this week, 37% were reported from the Southern Health - Santé Sud Regional Health Authority and 25% were reported from the Winnipeg Regional Health Authority. The remaining cases were reported from Northern Health Region (17%), Prairie Mountain Health Authority (14%), and Interlake-Eastern Regional Health Authority (7%). This week, 472 cases of variants of concern (VOCs) have been reported, an increase from 367 in the previous week. Additionally, cases of VOCs accounted for 74% of new cases reported this week. In all Manitoba residents aged 12 years and older, 86.2% of residents have been partially vaccinated and 80.8% 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: 642 Total cases: 60,872 Total VOC cases: 19,123 Recovered cases: 59,150 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: 3,058 Weekly positivity rate: 3.3% Total Tested people: 573,576 Population tested: 42% Specimens tested: 1,012,082 Positivity rate: 6.5% More Analyses Provincial testing National testing	Severity About severity Severe outcomes associated with COVID-19: Hospitalizations: 4,271 ICU admissions3: 921 Deaths: 1,215 More Analyses Severe Outcomes Age Underlying Illness	Outbreaks About outbreaks COVID-19 outbreaks: 245 Outbreaks in long-term care facilities: 121 Outbreaks in schools: 7 More Analyses Check trend Outbreak list
Exposure About exposure Source of infection in cases (% of total) Travel: 1.5% Close contact to cases: 55.8% Unknown: 25.4% Pending: 17.3% Top five outbreak/cluster/special investigation settings4 Workplace: 35.1% Industrial setting: 16.8% Daycare: 9.8% School: 8.5% Acute care setting: 7.2% More Analyses Contacts Cases related to clusters/outbreaks	Transmission and Acquisition About transmission and acquisition Top five transmission settings in all cases5 Household: 65.7% Social gathering: 14.4% Workplace: 12.7% Transportation: 5.1% School: 4.0% Top five acquisition settings in cases with unknown source of infection6 Household: 49.4% Workplace: 31.8% Retail: 17.8% Social gathering: 15.4% School: 6.7% More Analyses Potential transmission settings Potential acquisition settings	Symptoms About symptoms Symptomatic cases: 73.9% Top symptoms (% of reports) Cough: 46.5% Headache: 38.2% Fever: 32.1% Muscle pain (myalgia): 28.2% Sore Throat: 27.6% More Analyses All symptoms Risk Factors About risk factors Pregnant cases: 774 Health care workers7: 2,729 Deceased health care workers: 4 Recovered health care workers: 2,710 More Analyses Health care workers
Important Notes Data about COVID-19 cases and contacts 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 – October 2, 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 – October 2, 2021

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Figure 3. Sex and Age Distribution of COVID-19 Cases, March 1, 2020 – October 2, 2021

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Figure 4. Cases of COVID-19 by Health Region and Public Health Report Date, Manitoba, November 1, 2020 – October 2, 2021

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Table 1. Cases of COVID-19 by Health Region, Manitoba, March 13, 2020 – October 2, 2021

Health Region	Cases	Percentage
Winnipeg RHA	34882	57.3%
Southern Health-Santé Sud	8758	14.4%
Interlake-Eastern RHA	4531	7.4%
Prairie Mountain Health	4352	7.1%
Northern Health Region	8349	13.7%

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Figure 5. Vaccination Status in New Cases 12+, non-ICU Hospital Admissions, ICU Admissions, Deaths, and VOCs, Manitoba, September 26, 2021 – October 2, 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 – October 2, 2021

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Table 3. Cumulative National Testing Volume and Positivity (%) for COVID-19 by Province/Territory, Canada, March 13, 2020 – October 2, 2021

Province	Confirmed Cases	Tests Completed	Test Rate in Population (Estimated %)	Positivity Rate (Estimated %)
Alberta	299,802	5,516,308	126.8%	5.4%
British Columbia	187,694	3,829,152	75.9%	4.9%
Manitoba	60,628	1,053,942	77.2%	5.8%
New Brunswick	4,272	473,239	61.2%	0.9%
Newfoundland and Labrador	1,788	355,643	68.0%	0.5%
Northwest Territories	1,059	32,546	72.5%	3.3%
Nova Scotia	6,715	1,218,574	126.1%	0.6%
Nunavut	664	20,622	53.3%	3.2%
Ontario	586,817	17,942,990	123.9%	3.3%
Prince Edward Island	302	202,200	129.9%	0.1%
Quebec	410,823	11,668,807	138.1%	3.5%
Saskatchewan	67,810	1,133,038	96.8%	6.0%
Yukon	755	9,129	22.5%	8.3%
Canada	1,629,142	43,456,266	116.2%	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 – October 2, 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 – October 2, 2021

Figure 9. Percentage of COVID-19 Cases With Underlying Illnesses, Manitoba, March 13, 2020 – October 2, 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 4. Source of Infection in Health Care Workers with Non-missing Information, Manitoba, March 13, 2020 – October 2, 2021

Source of Infection	Cases	Percentage
Close contact of known case	1569	57.5%
Pending	207	7.6%
Travel	36	1.3%
Unknown	917	33.6%
All Cases	2729

Table 5. Roles of Health Care Workers with Non-missing Information, Manitoba, March 13, 2020 – October 2, 2021

Role	Cases	Percentage
Allied Health, Health Professionals, and Support Staff	1670	61.2%
Nurse/Licensed Practical Nurse	692	25.4%
Not identified	217	8%
Physician/Physician in training	92	3.4%
First Responder	58	2.1%
All Cases	2729

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Outbreaks

Figure 10. Weekly COVID-19 Outbreaks, Manitoba, 2018 – 2021

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Contacts

Table 6. COVID-19 Contact Summary in All Cases, Manitoba, March 13, 2020 – October 2, 2021

Regional Health Authority	Cases	Median Contacts	Minimum Contacts	Maximum Contacts
Winnipeg Health	34882	3	0	249
Southern Health - Sante Sud	8758	2	0	69
Northern Health	8349	1	0	121
Interlake-Eastern Health	4531	2	0	76
Prairie Mountain Health	4352	3	0	134

Table 7. COVID-19 Contact Summary in New Cases Reported in Week 39, Manitoba, 2021

Regional Health Authority	Cases	Median Contacts	Minimum Contacts	Maximum Contacts
Southern Health - Sante Sud	241	3.0	0	37
Winnipeg Health	163	3.0	0	26
Northern Health	107	0.0	0	23
Prairie Mountain Health	88	4.5	0	38
Interlake-Eastern Health	43	2.0	0	31

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Figure 11. Percentage of COVID-19 Cases Linked to Top-five Cluster/Outbreak/Special Investigation Settings, Manitoba, January 24, 2021 – October 2, 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), PH order #12: (effective August 7, 2021), PH order #13: (effective August 28, 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 – October 2, 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), PH order #12: (effective August 7, 2021), PH order #13: (effective August 28, 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 – October 2, 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), PH order #12: (effective August 7, 2021), PH order #13: (effective August 28, 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 – October 2, 2021

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

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