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 26 (June 27 – July 3)

About epidemiological week

Data extracted up to 4:00 am on July 9, 2021
Next reporting date: July 19, 2021

COVID-19: Decreased Activity In Week 26, there were 437 laboratory-confirmed COVID-19 cases reported in Manitoba, a decrease from 648 in the previous week. The volume of lab tests decreased to on average 1,317 people tested for COVID-19 per day compared to 1,671 in the previous week, and the positivity rate of lab tests was 5.7%, a decrease from 6.4% in the previous week. In the 437 cases reported this week, 48% were reported from the Winnipeg Regional Health and 18% were reported from the Northern Health Region. The remaining cases were reported from Interlake-Eastern Regional Health Authority (13%), Southern Health - Santé Sud Regional Health Authority (13%), and Prairie Mountain Health Authority (8%). This week, 283 cases of variants of concern (VOCs) have been reported, a decrease from 370 in the previous week. Additionally, cases of VOCs accounted for 64.8% of new cases reported this week. As of July 3, a total of 1,565,178 doses of COVID19 vaccines have been administered and 75.9% of residents aged 12 years and older in Manitoba have been immunized with at least one dose.		Cases About cases New cases: 437 Total cases: 56,418 Total VOC cases: 15,804 Recovered cases: 54,480 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: 1,317 Weekly positivity rate: 5.7% Total Tested people: 502,960 Population tested: 36.9% Specimens tested: 835,879 Positivity rate: 7.2% More Analyses Provincial testing National testing	Severity About severity Severe outcomes associated with COVID-19: Hospitalizations: 3,844 ICU admissions3: 871 Deaths: 1,157 More Analyses Severe Outcomes Age Underlying Illness	Outbreaks About outbreaks COVID-19 outbreaks: 239 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: 55.6% Unknown: 24.7% Pending: 18.4% Top five outbreak/cluster/special investigation settings4 Workplace: 36.6% Industrial setting: 17.4% Daycare: 8.9% School: 8.3% Acute care setting: 7.6% 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: 10.0% Transportation: 4.5% School: 3.4% Top five acquisition settings in cases with unknown source of infection6 Household: 29.6% Workplace: 16.9% Retail: 11.1% Social gathering: 6.5% 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: 38.4% Fever: 32.2% Muscle pain (myalgia): 28.6% Sore Throat: 27.7% More Analyses All symptoms Risk Factors About risk factors Pregnant cases: 665 Health care workers7: 2,531 Deceased health care workers: 4 Recovered health care workers: 2,527 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 26. As of July 3, 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: 597 Reporting fever and cough: 0% Check Trend
Physician Visits About sentinal physicians Influenza Like Illness (ILI) Visits to sentinel physicians: 3.1% 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): 99 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, July 19, 2020 – July 3, 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, July 19, 2020 – July 3, 2021

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

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Figure 4. Cases of COVID-19 by Health Region and Public Health Report Date, Manitoba, July 5, 2020 – July 3, 2021

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Table 1. Cases of COVID-19 by Health Region, Manitoba, March 13, 2020 – July 3, 2021

Health Region	Cases	Percentage
Winnipeg RHA	33298	59.0%
Southern Health-Santé Sud	7446	13.2%
Interlake-Eastern RHA	3824	6.8%
Prairie Mountain Health	3936	7.0%
Northern Health Region	7914	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, July 19, 2020 – July 3, 2021

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

Province	Confirmed Cases	Tests Completed	Test Rate in Population (Estimated %)	Positivity Rate (Estimated %)
Alberta	232,097	4,685,485	107.7%	5.0%
British Columbia	147,705	2,895,634	57.4%	5.1%
Manitoba	56,306	871,873	63.9%	6.5%
New Brunswick	2,336	375,196	48.5%	0.6%
Newfoundland and Labrador	1,387	302,943	57.9%	0.5%
Northwest Territories	128	24,872	55.4%	0.5%
Nova Scotia	5,842	945,789	97.8%	0.6%
Nunavut	657	18,029	46.6%	3.6%
Ontario	545,381	15,830,086	109.3%	3.4%
Prince Edward Island	207	174,863	112.3%	0.1%
Quebec	375,019	9,848,214	116.6%	3.8%
Saskatchewan	48,882	915,385	78.2%	5.3%
Yukon	357	9,129	22.5%	3.9%
Canada	1,416,317	36,897,574	98.6%	3.8%

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, July 19, 2020 – July 3, 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 – July 3, 2021

Figure 8. Percentage of COVID-19 Cases With Underlying Illnesses, Manitoba, March 13, 2020 – July 3, 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 – July 3, 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 – July 3, 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 – July 3, 2021

Regional Health Authority	Cases	Median Contacts	Minimum Contacts	Maximum Contacts
Winnipeg Health	33298	3	0	249
Northern Health	7914	1	0	121
Southern Health - Sante Sud	7446	2	0	69
Prairie Mountain Health	3936	3	0	134
Interlake-Eastern Health	3824	1	0	76

Table 6. COVID-19 Contact Summary in New Cases Reported in Week 26, Manitoba, 2021

Regional Health Authority	Cases	Median Contacts	Minimum Contacts	Maximum Contacts
Winnipeg Health	210	3	0	29
Northern Health	78	0	0	32
Interlake-Eastern Health	58	0	0	34
Southern Health - Sante Sud	56	2	0	14
Prairie Mountain Health	35	2	0	19

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Figure 10. Percentage of COVID-19 Cases Linked to Top-five Cluster/Outbreak/Special Investigation Settings, Manitoba, January 24, 2021 – July 3, 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 – July 3, 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 – July 3, 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 – July 3, 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