As regional COVID-19 rates diverge, Manitoba reflects on pros and cons of targeted restrictions

After about a month where the rate of COVID-19 infection effectively stagnated in Manitoba, the disease is now spreading fast enough to prompt some sort of public health response.

Over the past week, the seven-day average daily number of COVID-19 cases in this province has increased by about a third. On Wednesday, the moving average was 84 cases per day province-wide, down from 63 the week before.

The problem is that this increase is not happening at the same rate in the different regions of the province.

For most of September, the overall lack of growth was masked by regional variations that included a modest drop in the infection rate in most parts of the province, as COVID-19 cases began. to take off in the southern health region.

And over the past week, the spread of the disease in Manitoba’s five health regions has diverged to the point where the COVID-19 infection rate in Southern Health is 2.7 times the provincial average – and 5 , 6 times the growth rate in the Winnipeg Health Region.

This shouldn’t come as a surprise. Southern Health has the lower COVID-19 vaccination rate among parts of Manitoba and is also home to some of the most vocal oppositions to pandemic mitigation measures, including vaccination requirements to enter certain businesses and public places.

4th wave “on the back of weak vaccination”: the mayor

Ten months after the start of the provincial vaccination effort, it is no longer reasonable to expect vaccination rates to rise suddenly in low utilization health districts such as Stanley and Winkler.

Thousands of people in the region have simply not been vaccinated in time to protect themselves against the delta variant of the coronavirus.

“The fourth wave relied on low vaccination rates, resulting from misinformation, hearsay, sometimes simple aversion to authority and empty agitators,” said Brandon Burley, mayor. from Morden, a Southern Health community with a vaccination rate.

Now it is up to public health officials and politicians in Winnipeg to decide the next course of action.

It won’t be easy, as the widespread application of new pandemic restrictions would meet anger in Winnipeg, a highly vaccinated, low-infection region that is also home to most of Manitoba’s population.

The alternative would be a regional application of the restrictions. But it would be easier to announce than to execute.

“It is a tool that must be considered wisely because it is fraught with challenges and unintended consequences,” said social epidemiologist Souradet Shaw, professor of community health sciences at the University of Manitoba.

“But the data suggests a disproportionate burden of cases coming from some areas, with the increase in the number of cases starting to threaten things we all value, like keeping schools safe and receiving timely health care. “

A sign espousing opposition to vaccination warrants can be seen in the Rural Municipality of Stanley, southwest of Winnipeg. (Ian Froese / CBC)

The challenges include variation within a broad field like Southern Health.

Does highly vaccinated Morden deserve the same restrictions as neighboring low vax Winkler? Does a low-density district like Hanover deserve the same treatment as Steinbach, the agglomeration it encircles?

Shaw says public health must also ensure that the new restrictions target activities that lead to the transmission of COVID-19 and provide the public with data to support that decision.

“If it goes down this path, the province needs to be clear about why, how long it expects to do it, the parameters it chooses to base its decision-making, and be frank and open about what.” things have to look like to get out of it, ”he said.

Mixed results in the past

Prior to widespread immunizations, the application of regional restrictions in Manitoba had mixed results.

Mandatory masks in the Prairie Mountain Health Region appeared to quell a spike in cases in western Manitoba in August 2020. But the regional enforcement of store closures at Northern Health earlier this year simply resulted in residents borrowing money. Highway 6 for shopping in Winnipeg.

Martin Harder, the mayor of Winkler, said a return to regional restrictions would be “a foolish move” from public health.

“Regional closures didn’t work when Winnipeg was in the red zone and Southern Health had no cases. So why now? ” He asked. “I am disgusted at the idea.”

He would not be the only one to oppose such a plan. New restrictions on Southern Health would almost certainly inspire more civil disobedience.

Shaw and Burley said the province needs to devote more resources to the enforcement if it chooses to tighten the rules in specific areas.

“Public health has a duty to protect all Manitobans – a duty I would expect them to fulfill – even if it comes to the detriment of the many people in our region who do not want to participate in this unfortunate adventure, ”said Burley. .

The mayor of Morden said he initially advocated a regional approach to restrictions when Southern Health had few cases of COVID. But a lot has changed in the past year.

“The idea is now a lot less pleasant, because we made a rather lumpy bed to lie on,” he said.

“Some days, we have the impression [if] our region hits itself several times in the face, while being surprised to have a bloody nose. “

Unfortunately, what happens in Southern Health does not stay in Southern Health, at least when it comes to viruses.

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