Delta took Manitoba ICUs to the brink this fall. Omicron is poised to make another push

After a miserable 2020 holiday season marred by deadly COVID outbreaks in personal care homes, the last thing anyone in Manitoba wanted was another dark December.

This is, however, what we're getting, albeit with fewer fatalities and more uncertainty.

A number of depressing pandemic indicators over the past few weeks has forced Premier Heather Stefanson and her cabinet to approve the first set of broad-spectrum pandemic restrictions in six months.

The main metric is a spike in COVID-19 cases, likely because of the continuing spread of the Delta variant but also possibly due to the arrival of Omicron.

On Dec. 13, Manitoba was reporting an average of 164 new COVID cases a day. As of Monday, that running average had risen to 234 cases per day, a rise of 43 per cent in one week.

On its own, one week of rapid growth would not be a cause for concern. But the prospect of continuing rapid spread as the more-transmissable Omicron variant supplants the Delta strain suggests Manitoba should not expect only one week of rapidly climbing case counts.

Even then, climbing case counts would not be an overwhelming concern, if Manitoba hospitals had the same capacity to handle severe COVID cases as they did during the second and third waves of the pandemic.

Unfortunately, that is not the case, either. At the most desperate point of the second wave, nurses and doctors in  Manitoba intensive care wards somehow treated 129 intensive care patients. At the most desperate point of the third wave, they managed to  treat 131.

Over the past few weeks, Manitoba ICUs have struggled to treat between 87 and 104 patients. The health-care system simply doesn't have the critical-care capacity it cobbled together months ago.

The reasons for this are numerous and well-documented. More than 21 months into the pandemic, some nurses have retired or quit. Their replacements are eager but don't possess the same skills and experience, at least not yet. They also have to spend more time treating individual patients, since more tend to be young and able to endure more time in ICUs without succumbing to COVID.

The bottom line is Manitoba is entering the Omicron phase of the pandemic with hospitals already tapped out.

When you think back to the start of the pandemic, this was the ultimate worst-case scenario: a health-care system so ravaged by the pandemic, it was unable to deliver basic services to people who need them.

But this is where we are, and where we have been for many weeks now.

Yet only on Friday did the chief provincial public health officer announce new restrictions he hopes will slow the rise in COVID cases that will translate into more people in ICUs a few weeks down the road.

"We're not going to stop Omicron," Dr. Brent Roussin said during a late-afternoon news briefing. 

"Omicron's going to be here and it's going to climb rapidly, but if we can significantly reduce the amount of contacts we have outside of our household, we can buy more time to get many more Manitobans vaccinated."

Public health is now trying to get as many Manitobans triple-vaxxed as soon as possible to reduce the potential for more ICU cases, buoyed by data that suggest booster shots prevent most cases of serious illness due to COVID infection.

The rules that came into effect this morning, however, seem mild compared to the lockdowns of the second or third waves. People are still allowed to gather in other people's households, whether they are vaccinated or not.

Roussin said Manitobans would likely disobey tougher restrictions.

"We have the holiday season approaching," he said. "Do we feel if we tell people they're not able to gather with anyone, whether that's a realistic expectation?"

He may very well be correct. But the real question is why the Stefanson government did not make a move earlier this fall, when daily COVID cases were still hovering around the 150 mark.

If the ultimate goal of public-health measures is to protect the health-care system, then that would have made sense in mid-November, when COVID hospitalizations started mounting and ICUs began to strain.

But that did not happen. As recently as two weeks ago, the health minister was insisting the province could expand ICU capacity even as Shared Health conceded it could not meet the ICU targets it had set in mid-November.

Instead, the province announced new measures that took effect four days before Christmas, surprising a hospitality industry that expected Manitoba to ride out the holiday season.

"Have a decision made, and not just fly by the seat of your pants," said Cam Loeppky, co-owner of Good Will Social Club, a Winnipeg live music venue that just cancelled six sold-out holiday-season events and laid off 14 workers.  

"Like, it's happening all over the world. It's not new to Manitoba. All of a sudden, Manitobans realize that the Omicron is coming?"

When you look back at the second wave during the fall of 2020, Manitoba did not enact new public health measures early enough to prevent case counts from getting out of control and ultimately killing hundreds of seniors. 

When you look back at the third wave during the spring of 2021, Manitoba did not enact new public health measures early enough to prevent ICUs from getting overwhelmed to the point where dozens of patients had to be flown out of province.

During the fourth wave, something new has happened. ICUs wound up on the brink before new restrictions were put in place.

Officials may blame the current situation on Omicron, but Delta took us to this cliff. This is where we are now perched, with the full force of the new variant yet to arrive.