Extreme caseloads, a shortage of enough healthcare staff, and patients who do not want to get tested are contributing to Manitoba's current healthcare strain.
The province is speaking with the Canadian Armed Forces, North Dakota, and Saskatchewan to transport COVID-19 patients for care.
Dr. Perry Gray, Shared Health's Chief Medical Officer, says in a media briefing on Tuesday morning at least 18 patients have been transported to Ontario, with the province in conversation with other jurisdictions to care for a growing number of Manitobans needing care.
"We are the worst in North America. These numbers, while smaller and absolute, are large and my point is the importance of public health measures, and not to be fooled just by the smaller numbers," Gray says.
Gray says Manitoba has become the COVID capital of North America because of the province's strategy and overall compliance to the orders.
They are choosing to transfer patients who are in the middle of the extremes, sedated and on a ventilator, but stable enough to make the trip, to transfer to Ontario, which promises a minimum of 20 beds for Manitobans. As of Tuesday, 18 of those beds were being utilized.
Health Sciences Centre, St. Boniface Hospital, Grace Hospital, and Brandon Regional Health Centre host Manitoba's acute care beds, with other patients, potentially transferred to other care facilities.
"Capacity across all acute care sites is being viewed provincially to ensure patients are moved to the most appropriate location. When planning transfers, facilities with capacity closest to the patient's home region will be prioritized as the receiving site," a spokesperson from Shared Health says in an email Friday.
They say when patients are moved they will be lower acuity, non-COVID or COVID-recovered patients. Patients would ideally be treated in their home communities.
Chief Nursing Officer Lanette Siragusa says approximately four patients per day have been moved to Ontario since they first started doing the interprovincial moves.
She says staff continues to be the issue, noting that they have asked retired nurses to return and are continuing to recruit people who traditionally wouldn't be working in these settings but have the medical skills to help.
Calling others in need of care "invisible patients," Gray says they are not the patients who refuse to be tested, but the ones who need medical care but are avoiding it or in a care limbo.
The doctor says he does not know how many Manitobans have died waiting for care but knows it is a very real possibility and reality. Gray is hoping to reach Manitobans who do not believe in COVID or the severity of it, asking them to follow the health orders to protect the patients on medical waiting lists because of the pandemic's pressures.
"It is not just COVID when it comes to Public Health Orders. We need to get our people back to non-COVID care as well," Gray says.
He says invisible patients are patients who need care and are waiting for medical tests. Most non-essential surgeries have been put on pause in Manitoba due to COVID-19 needs.
"When people are scared of COVID they actually stay away," Gray says. This is a patient we cannot see but that does not mean there is not something wrong with them."
Gray is anticipating increased severity in emergency visits due to the wait in care.
"Patients are using the 911 system more."
He says hesitancy to ask for care and a slowdown of testing create congestion of people needing more serious care, something he is anticipating to come in the future.
No testing, lack of vaccines
Gray says most COVID-19 patients are not vaccinated, closer to 70 per cent. Younger Manitobans aged 30-50s are also being admitted and needing longer hospital stays. As of Tuesday morning, 761,132 doses of vaccine have been administered with eligibility for first doses open to all aged 12 and older. Second-dose appointments opened for some, including Indigenous people, within the past four days.
The doctor says the vaccine will shorten the need for COVID healthcare, noting that a 75 per cent uptake will make a difference.
Another issue doctors are seeing is testing. On Friday, 129 of the 296 patients being treated for COVID-19 allowed staff to test them for COVID. The remaining 167 did not get tests but are being treated for the virus, as they present with the symptoms.
"I don't know why some people are resiting things but we are being informed people are resisting testing."
As of Sunday, there were 461 new COVID-19 cases, but Shared Health says they anticipate far more positive cases are present in the province in people not getting tested.
People are refusing to test for COVID, even in hospitals. Gray says they are still being treated and isolated if it is believed they have COVID.
Impact of health orders
In March of 2020, Gray estimated three thousand hospital beds would have been needed in Manitoba if there were no health restrictions.
The doctor says health care is a "backstop" to public health measures when they are not followed.
"There is not a public health system that can cope without a public health strategy."
He says in March, Manitobans were much more proactive about the orders.
"I am not getting the same sense right now."
Gray says compliance with the orders will help get the province back on track and lighten the healthcare load, saying "this is not forever but we really need it now."