Sask. doctor's prescription to government: Follow the Manitoba model

Saskatchewan should look to Manitoba for how to blunt the fourth wave of COVID-19 and increase vaccinations, says a Regina infectious disease physician as Saskatchewan officials prepared to update the province on the COVID-19 situation.

The update from Premier Scott Moe and Chief Medical Health Officer Dr. Saqib Shahab at 2 p.m. CT Thursday also comes less than 24 hours after Alberta announced widespread health policies to deal with surging COVID-19 cases and increased hospitalizations.

But Dr. Alex Wong said Manitoba has given Saskatchewan a roadmap on how to protect the public and increase vaccine uptake. 

Over the summer, Manitoba began requiring proof of vaccination for some events and introduced a number of measures designed to slow the spread of COVID-19 and respond to the fourth wave, including expanding places where proof of vaccination was required, mandatory vaccination for health-care workers, teachers and child-care workers and an indoor mask mandate. 

"We don't even have a mask mandate in our province," Wong said, adding he thinks the Saskatchewan public would comply with a mask mandate. "Our system is on the brink right now. Literally no ICU beds in the entire province."

"If you look at Manitoba just right next to us, the dynamics are very similar politically, geographically, all the rest of it. You don't hear a peep from anybody there."

Comparing the numbers

At the time when Manitoba introduced those measures, 75 per cent of those eligible in that province were fully immunized. As of Wednesday, Saskatchewan has fully vaccinated 71 per cent of those eligible.

"We're in a serious situation. We're taking preemptive action because we want to avoid the magnitude of what we saw in the second and third wave," said then-Manitoba Premier Brian Pallister at the time.

On Aug. 24, Manitoba reported 40 new cases, a test positivity rate just over two per cent and 362 known active cases.

On Wednesday, Saskatchewan reported 475 new cases, a test positivity rate of 12 per cent and 4,116 known active cases.

On Tuesday and Wednesday combined, Saskatchewan reported 205 new COVID-19 cases in children 11 and under. Manitoba's total number of cases in all ages over the same two-day period was 105.

Manitoba had 584 known active cases as of Wednesday. Saskatchewan had 4,016, more than seven times as many as its neighbour to the east.

The provinces also differ when it comes to hospitalizations and ICU patients. Manitoba has 69 people in hospital and 15 in ICU. Saskatchewan has 184 people in hospital and 40 in ICU.

"[Manitoba is] killing it right now," Wong said. "We can see very clearly the effective policy. When you have good policy in place, it works. And when you don't, we struggle." 

He said a proof-of-vaccine requirement is needed in Saskatchewan to boost its vaccination rates, which are among the worst in Canada, along with rates in Alberta.

As of Wednesday, Manitoba had fully vaccinated 79 per cent of those eligible, and 84 per cent had at least one dose.

"Manitoba has got vaccine rates eight to 10 per cent higher than ours. And the only fundamental difference between Manitoba and Saskatchewan is that mandate that was put in place."

Delta has changed the battle

Wong said the delta variant has changed the battle against COVID-19 and vaccinations alone are not enough to slow the surge.

"Delta was and is a different beast, just so much more contagious, so much more transmissible. It became very clear that just trying to rely on vaccine only in order to decouple hospitalizations and deaths from cases was not going to be sufficient."

Saskatchewan and Alberta have flip-flopped leading the country in per-capita cases in recent weeks. Both are at the bottom of the national ranking in vaccination rates. Alberta introduced a mask mandate for indoor spaces two weeks ago.

On Wednesday night, Alberta also introduced a proof of vaccination policy, leaving Saskatchewan as the largest province without a policy.

"Unfortunately, now we're in a situation where both jurisdictions, both Alberta and Saskatchewan, aren't dialling it back for basically political reasons," Wong said.

He said that Alberta and Saskatchewan removing restrictions in early July, and using modelling from the United Kingdom that showed vaccination rates causing hospitalizations to fall, was not sufficient.

The U.K. had vaccinated more of its adult population and was not a fair comparison to the two Prairie provinces, Wong said. He called the modelling "extremely optimistic" and said it ignored "what was going to take place in the United States and elsewhere."

"We knew this was coming."

Moe, like Alberta Premier Jason Kenney in Alberta, has referred to the fourth wave as the pandemic "of the unvaccinated."

Wong said that shifts blame away from government policy and onto individuals.

"This narrative that everybody is an anti-vaxxer is not the case. The majority of people who are eligible but not vaccinated remain individuals who are dealing with structural and social barriers," he said.

"To shift the blame to individuals and to try to shift away from our policymakers, I think is not a responsible narrative."

Wong said the "best-case scenario" is doubling cases in the next two weeks, which would see daily cases hover around 800 to 1,000.

"The hope from there, from the models and what's happened in the U.S. is that maybe our curve will peak, but we can't wait for that to happen. We need to do something."

CBC requested an interview with Saskatchewan's chief medical health officer on Wednesday, but the Ministry of Health said it was "unable to accommodate" an interview. Premier Moe and Saskatchewan's chief medical health officer Dr. Saqib Shahab will provide a COVID-19 update today at 2 p.m. CST.

Province, public proactive: Manitoba virologist

Jason Kindrachuk has a unique perspective on the COVID-19 comparison between the two provinces.

He is an assistant professor and Canada research chair of emerging viruses at the University of Manitoba, and also lived in Saskatoon for parts of 2020 and 2021. He was working with VIDO-Intervac at the University of Saskatchewan and returned to Winnipeg in June.

Kindrachuk said that if the government did intervene, it would take at least "three to four weeks" for the impact to be felt.

"We know, unfortunately, things are probably going to get worse before they get better."

Kindrachuk said Manitoba legislators recognized the seriousness of the delta variant and acted early.

He said vaccine mandates "make sense" because education and community outreach "take time," which is not a luxury the government has when cases are spreading quickly.

He said one major difference between the two provinces is that two-thirds of the Manitoba population is centred in Winnipeg, making vaccination efforts easier.

Another distinction is Manitoba's death toll from COVID-19, which is nearly double Saskatchewan's. As of Wednesday, Manitoba had reported a total of 1,203 deaths compared to 629 in Saskatchewan.

Kindrachuk said Manitoba's difficult second and third wave and subsequent widespread lockdown may have had an impact on the public.

"I think people look at this now and say 'Let's be proactive rather than reactive.' "

Kindrachuk said "natural immunity" through infection adds immunity in the population, but comes with a significant cost. He also said not enough research is available to show the protection an individual has after being infected.

"We have to think about the consequences on the individual, on the families, and on the health-care system."

He said getting vaccinated provides benefits to the individual and community.

"We will get through it. It will take some time and we're not there yet."