Provincial Respiratory Surveillance Report

COVID-19 and Seasonal Influenza

2022-2023

This weekly report provides a current epidemiological update on the intensity and severity of respiratory activity in Manitoba including laboratory confirmed activity of both COVID-19 and seasonal influenza. Surveillance data include syndromic indicators, laboratory testing, associated hospitalization and mortality, and outbreaks. Updates around immunization coverage in COVID-19 and seasonal influenza are also included.

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 Friday.

Week 48 (November 27 – December 3)

About epidemiological week

Due to an influx of influenza laboratory reports this respiratory season, Manitoba Health is experiencing delays in the documentation of laboratory results within the provincial Public Health Information Management System (PHIMS). As s result, the influenza case counts for week 48 are lower than expected. We anticipate an update to these data in next week's report.

Data extracted up to 1:00 am on December 8, 2022
Next reporting date: December 16, 2022

COVID-19 vaccination / Seasonal Influenza vaccination

COVID-19: Decreased Activity COVID-19 activity in Week 48 decreased from the previous week. COVID-19 associated hospital admissions continued to decrease in Week 48. Laboratory detection is substantively lower compared to the same time period in the previous two years. Older adults continue to be at higher risk for COVID-19 infections and associated hospital admissions and fatalities. As of December 3, in all Manitoba residents, 78.0% have received at least two doses of COVID-19 vaccines. Additionally, 20.3% have received at least one dose within the last six months. Wastewater surveillance data by December 1 indicated sustained activity of COVID-19 in Winnipeg and Brandon.		Cases About cases Cases this week: 251 Total cases: 6480 More Analyses Epi curve Age and sex Incidence by age Health region
Testing About testing This week Average daily specimens: 388 Weekly positivity rate: 14.5% Total Tested people: 32,118 Population tested: 2.3% Specimens tested: 49,278 Positivity rate: 21.2% More Analyses Provincial testing	Severity About associated severity Severe outcomes this week Hospital admissions: 76 ICU admissions3: 7 Deaths: <5 Total severe outcomes Hospital admissions: 2,045 ICU admissions: 230 Deaths: 199 More Analyses Severe outcomes Age	Outbreaks About outbreaks COVID-19 outbreaks this week In long-term care facilities: 14 In hospitals: 1 In other settings: 0 Total COVID-19 outbreaks In long-term care facilities: 168 In hospitals: 74 In other settings: 1 More Analyses Check trend
Seasonal Influenza: Similar Activity Influenza activity in Week 48 was similar to the previous week. The case counts in Week 48 were lower than expected as a result of delays in the documentation of laboratory results within PHIMS. This week, influenza A test positivity slightly decreased to 19.5% and continued to be lower than that was observed nationally. Overall, the start of increase in activity this season is earlier than would be expected for this time of year. The predominant circulating strain is influenza A (H3N2). Up to Week 48 this season, children below the age of five years are at the highest risk for influenza infection. This age group accounted for 12% of all influenza cases and 20% of associated hospital admissions. At the same time, other respiratory viruses continue to co-circulate. RSV test positivity increased to 4.0% in Week 48 from 2.2% in the previous week.		Cases Cases this week Influenza A: 120 Influenza B: 0 Total cases Influenza A: 989 Influenza B: <5 More Analyses Check trend Incidence by age Health region
Testing Influenza testing this week Average daily specimens: 289 Influenza A positivity rate: 19.5% Influenza B positivity rate: 0 Other respiratory pathogens this week RSV4 positivity rate: 4.0% RSV detections: 80 More Analyses Influenza testing Respiratory detection	Severity Severe outcomes this week Hospital admissions: <5 ICU admissions: <5 Deaths: <5 Total severe outcomes Hospital admissions: 171 ICU admissions: 6 Deaths: 12 More Analyses Severe outcomes Age	Outbreaks Influenza outbreaks this week Influenza A: 3 Influenza B: 0 Total influenza outbreaks Influenza A: 20 Influenza B: 0 More Analyses Check trend
Syndromic Indicators: Similar Activity The activity level in all syndromic indicators has increased in the last few weeks indicating an increase in respiratory activity in the community and in primary care. In Week 48, activity in two syndromic indicators continued to increase. However, the daily respiratory related visits to emergency departments/urgent care decreased in week 48 from the previous week.		FluWatchers About FluWatchers Participants reporting this week: 602 Reporting fever and cough: 4.0% More Analyses Check trend
Physician Visits About sentinel physicians Influenza Like Illness (ILI) Visits to sentinel physicians this week: 6.4% More Analyses Check Trend	Antiviral About Antiviral Units of antiviral dispensed from pharmacies this week: 29 Total influenza isolates resistant to antiviral this season in Canada Oseltamivir: 0 Zanamivir: 0 More Analyses Check Trend	ED Visits About emergency room visits Respiratory visits to emergency department (ED) this week: 2302 More Analyses Check Trend
Important Notes Data about COVID-19 and 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. Cumulative totals include all events from start of the current season to end of the reporting week. ICU admissions were included in hospital admissions, and include adult and pediatric cases. RSV - Respiratory syncytial virus.

COVID-19

Cases

Figure 1. Weekly Cases of COVID-19 by Season, Manitoba, 2020 – 2022 (July through June)

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Figure 2. Sex and Age Distribution of COVID-19 Cases, Manitoba, July 3, 2022 – December 3, 2022

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Figure 3. Incidence Rate (/10,000 Population) of COVID-19 Cases by Age Group and Week of Public Health Report Date, Manitoba, July 3, 2022 – December 3, 2022

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Figure 4. Cases of COVID-19 by Health Region and Public Health Report Date, Manitoba, August 1, 2022 – December 3, 2022

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Table 1. Cases of COVID-19 and Incidence Rate (/10,000 population) by Health Region, Manitoba, July 3, 2022 – December 3, 2022

Helath region	Total cases	Cases this week	Incidence rate this week	Age-standardized incidence rate* this week
Winnipeg RHA	3845	135	1.7	1.7
Southern Health-Santé Sud	621	48	2.2	2.5
Interlake-Eastern RHA	694	22	1.6	1.5
Prairie Mountain Health	871	30	1.7	1.5
Northern Health Region	447	16	2.1	2.9

Note: * Age-standardized rates are used to account for differences in the age structure in health regions. The whole Manitoba population is used as the standard population.

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Testing

Figure 5. Average Daily Testing Volume and Positivity (%) for COVID-19 by Week of Specimen Receiving Date, Manitoba, July 3, 2022 – December 3, 2022

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Severity

Figure 6. Severe Outcomes of COVID-19 by Week of Outcome Date, Manitoba, July 3, 2022 – December 3, 2022

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

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Figure 7. Age Distribution of Severe COVID-19 Cases This Week Compared to All Cases, Manitoba, July 3, 2022 – December 3, 2022

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Outbreaks

Figure 8. Weekly COVID-19 Outbreaks, Manitoba, 2020 – 2022

Note: All respiratory outbreaks include COVID-19 outbreaks, influenza outbreaks and the other respiratory outbreaks with known or unknown pathogens.

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Vaccination

Table 2. Coverage of COVID-19 Vaccinations, Manitoba, December 3, 2022

Age group (years)	At least 1 dose	At least 2 doses	At least 1 dose within the last 6 months	At least 1 dose of Bivalent
.5-04	9.0%	3.3%	8.9%	0.0%
05-11	55.9%	42.7%	9.1%	0.1%
12-17	82.8%	78.2%	8.9%	4.5%
18-29	88.5%	85.4%	7.0%	5.7%
30-39	84.5%	82.0%	11.5%	10.1%
40-49	87.8%	86.0%	15.6%	13.8%
50-59	87.1%	85.8%	23.6%	17.1%
60-69	94.7%	93.5%	40.8%	30.6%
70-79	>=95.0%	>=95.0%	53.5%	42.1%
80+	>=95.0%	>=95.0%	53.4%	44.0%
ALL	81.3%	78.0%	20.3%	14.9%

For more information, please visit COVID-19 vaccination coverage in Canada - Canada.ca

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Seasonal Influenza

Cases

Figure 9. Weekly Cases of Influenza by Season, Manitoba, 2019 – 2022 (July through June)

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Figure 10. Incidence Rate (/10,000 Population) of Influenza Cases by Age Group and Week of Public Health Report Date, 2018 – December 3, 2022

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Table 3. Cases of Influenza and Incidence Rate (/10,000 population) by Health Region, Manitoba, July 3, 2022 – December 3, 2022

Helath region	Total cases	Cases this week	Incidence rate this week	Age-standardized incidence rate* this week
Winnipeg RHA	511	58	0.7	0.7
Southern Health-Santé Sud	127	17	0.8	0.8
Interlake-Eastern RHA	153	25	1.8	2.1
Prairie Mountain Health	154	14	0.8	0.8
Northern Health Region	36	<5	0.5	0.6

Note: * Age-standardized rates are used to account for differences in the age structure in health regions. The whole Manitoba population is used as the standard population.

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Testing

Figure 11. Average Daily Testing Volume and Positivity (%) for Influenza by Week of Specimen Receiving Date, Manitoba, July 3, 2022 – December 3, 2022

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Figure 12. Number of Positive Respiratory Virus Tests by Week of Specimen Receiving Date, Manitoba, July 3, 2022 – December 3, 2022

Note. Other respiratory viruses include adenovirus, enterovirus/rhinovirus, human coronavirus (seasonal), human metapneumovirus and human parainfluenza virus.

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Severity

Figure 13. Severe Outcomes of Influenza by Week of Outcome Date, Manitoba, July 3, 2022 – December 3, 2022

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

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Figure 14. Age Distribution of Severe Influenza Cases in All Cases, Manitoba, July 3, 2022 – December 3, 2022

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Outbreaks

Figure 15. Weekly Respiratory and Influenza Outbreaks, Manitoba, 2019 – December 3, 2022

Note: All respiratory outbreaks include COVID-19 outbreaks, influenza outbreaks and the other respiratory outbreaks with known or unknown pathogens.

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Vaccinations

Table 5. Coverage of Influenza Vaccinations, Manitoba, September 1, 2022 – December 3, 2022

Age group	Does	Coverage percentage
0-4	10385	12.2%
5-17	26339	11.6%
18-49	73941	12.5%
50-64	68324	26.4%
65+	129687	55.4%
All	310750	22.2%

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FluWatchers

Figure 16. Weekly FluWatchers Participants and Percentage Reporting Fever and Cough, Manitoba, 2019 – December 3, 2022

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Physician Visits

Figure 17. Weekly Percentage of ILI Related Visits to Sentinel Physicians, Manitoba, 2018 – December 3, 2022

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Antiviral

Figure 18. Weekly Units of Antiviral Dispensed from Pharmacies, Manitoba, 2018 – December 3, 2022

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ED Visits

Figure 19. Weekly Respiratory Visits to Emergency Department, Manitoba, 2017 – December 3, 2022

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