The province is focusing on four needs to increase hospital care capacity during the pandemic.

The province is identifying three areas of need for Manitoba's healthcare. Critical care space, family medicine, and low acuity patients are what the province is identifying as the greatest need for Manitobans.

"The plan is based on principles," Chief Nursing Officer Lanette Siragusa says. She says they are "learning as they go" and says plans can change.

Over three phases, the province says they can be capable of caring for 1,014 patients in acute care. The plan is a living document that will adapt as needed.

In the spring, the province planned for more COVID-19 patients than they saw, but now they are implementing the plan.

Space

The province is planning for the possibility to take low-acuity patients out of the hospital. 

Its plans involve potentially tripling the amount of ICU space. Its total plans include having 1,014 total acute surge medical care spaces. 

The province says non-healthcare environments could be used to house 180 patients at four locations in Brandon and Winnipeg in open-concept spaces. The province says they have also considered adding 400 beds. The open-concept space would allow for a smaller amount of staff to be able to monitor the patients. 

Currently, the province is looking at repurposing surgery beds and expanding critical care into spaces. This would include using decommissioned operating rooms or ICUs.

The province says they have created models to provide more acute care than they anticipate needing. 

Equipment

The province has purchased new equipment to handle the potential for new patients.

"We have nearly doubled our available ventilators," Siragusa says.

The province currently has 215 ventilators is waiting for 71 more to arrive. They have over 800 new basic hospital beds and 150 new critical care beds.

There are 1,794 new divider panels for hospital rooms that include 390 for the potential off-site bed spaces.

Oxygen concentrators, vital sign monitors, infusion pumps, and glucometers have been newly purchased. 

All of the equipment has been purchased due to an anticipated surge in hospital demand. 

Siragusa says the province will order more as needed. She adds supply chain and vendors issues from earlier in the year have mostly been resolved. 

Supplies

Part of the plan was based on the province's H1N1 experience 10 years ago. They say they are not using the same treatments used in the H1N1 outbreak but did look at the patterns of what was needed to purchase supplies and medicines that could be needed.

The province says its goal is to have a 90-day reserve of its supplies. They are prioritizing PPE for staff.

The province has a shortage of small N95 masks.

Staffing

Staff in the medical system, such as doctors, nurses, and other allied health professionals may b shifting their duties. The province will be looking at the skills of the staff to find what areas they would be best suited for. Critical care nurses, for example, have specific skills other nurses do not.

"I have complete confidence that you have the skills and the competency to do what you need," Siragusa.

The Chief Nursing Officer says healthcare workers are "very valuable."

Siragusa says there will be conversations with staff about their comfort levels.

"You are all human beings, you are parents or caregivers, you are individuals."

Paramedics and physiotherapists could be used to aid in the healthcare system. Physiotherapists, for example, could perform a chest assessment, assess vital signs, and interpret laboratory results. Respiratory therapists could take vitals, read EKG machines, and monitor vent signs. All would be overseen by nurses.

The province says doctors and other health professionals have offered to help with increased COVID-19 demands.

The province is keeping an eye on the 6,000 Manitobans healthcare students that could be utilized in the future after they graduate. Students may also be given placements in the healthcare system based on skill, need, and comfort levels. 

Looking at nurse duties, the province may be delegating other duties to different staff, such as cleaning, to free up nurses for nurse-specific duties. 

The province is also looking at staff support roles, such as social work and spiritual care.

Siragusa says healthcare workers are natural leaders and changemakers and would like them to voice their opinion if they have ideas or solutions so the province can work with them.