COVID didn’t break Manitoba hospitals but long-term effects unclear, chief nurse tells court

Manitoba’s chief nursing officer acknowledged in court Wednesday that hospitals adapted to the increased demand of COVID-19, but cautioned the full consequences of that are still unknown.

Under cross-examination, Lanette Siragusa, who serves as co-incident commander of Manitoba’s COVID-19 response, agreed with the assessment of lawyer Jared Brown, who represents the plaintiffs in the case, that the health-care system “did not break” under the strain of the novel coronavirus.

“Yes, we were able to accommodate the people who came in, and we also made some sacrifices … the elective procedures, some people that didn’t come to the hospital that maybe should have,” Siragusa said. “There’s a trade-off.”

Siragusa testified Wednesday as part of a hearing launched by seven rural churches and three individuals who are challenging the public health restrictions imposed by the province of Manitoba in response to the COVID-19 pandemic.

Brown presented Siragusa with what he called “eye-popping numbers” from provincial statistics, which he said show alcohol-related hospitalizations spiked by 112 per cent from April to August of 2020, and opioid-related visits to an emergency department or urgent care centre increased by 240 per cent in the same time.

Brown said the number of Manitobans hospitalized with “intentional injuries” grew by 109 per cent during the same time period, according to the provincial statistics, which are part of a future witness’s affidavit.

Health-care system handled it: lawyer

“Even though the system was well-used by both COVID [patients] and the sudden increase in these non-COVID matters, the system did not break,” Brown told the court. “The system was able to accommodate the presentations that came to it.”

The group of churches and individuals he represents argue the pandemic public health orders are excessive and have violated the Charter freedoms of conscience, religion, expression and peaceful assembly

Jay Bhattacharya, a key witness for the plaintiffs who testified on Tuesday, said the various lockdowns are harming the health outcomes of non-infected individuals.

The province’s lawyers say the restrictions are reasonable measures in the face of the pandemic, which has so far led to 40,085 COVID-19 cases in Manitoba and 982 deaths from the illness.

Siragusa told the court Wednesday she isn’t responsible for creating Manitoba’s public health orders but provides feedback based on her role in assessing the health-care system’s capacity.

Siragusa said Manitoba had the beds to accommodate more COVID-19 patients in critical care, but not necessarily enough staff. (Mikaela MacKenzie/The Canadian Press)

When asked if she “broadly supports” Manitoba’s pandemic restrictions so far, she said she does.

In court Wednesday, Siragusa disputed Brown’s contention the province’s intensive care units could have supported dozens of additional patients.

He referred to last November’s announcement that Manitoba could expand ICU capacity — during the pandemic’s second wave — to 173 beds. Siragusa wrote in a March affidavit that 129 patients were in intensive care at the time.

Brown suggested the vacancies show Manitoba’s health-care system could accommodate more patients, but Siragusa disputed that argument.

“With COVID and the outbreaks, we had hundreds of staff that were off sick,” she said.

“What we put on paper as a plan was not necessarily actionable when staff were getting sick, or having to isolate.”

She added health-care staff felt like they were working at full capacity with 129 patients. Other staff were moving into critical care to support existing workers.

Manitoba had the capacity to make space for more intensive care beds last fall, but the chief nursing officer questioned whether the province had enough staff. (Trevor Brine/CBC)

“The fact that we could identify 173 spaces in ICU, and we had equipment and supplies, did not necessarily mean we have the people power to place patients in those beds,” Siragusa said.

As of April, she said 16,000 elective surgeries have been delayed due to the pandemic. The public health orders have not mandated cancellations, but medical experts decided themselves to delay surgeries based on what was happening in hospitals, she said.

Siragusa, who testified on the third day of the hearing at Manitoba Court of Queen’s Bench, is well known to many Manitobans for providing a calm presence in the face of often grim news at daily COVID-19 briefings earlier in the pandemic.

While Chief Provincial Public Health Officer Dr. Brent Roussin delivered news about case counts, Siragusa typically made an effort to convey positive news, sharing anecdotes about people helping their neighbours and occasionally showing drawings made by children for health-care workers. Her news conference appearances are now infrequent.

Court also heard testimony from microbiologist Jason Kindrachuk, a University of Manitoba associate professor and the Canada research chair in emerging viruses. 

He testified that vaccines will offer more sustained immunity from the coronavirus that causes COVID-19 than exposure or infection. 

Chief Justice Glenn Joyal is presiding over the hearing, which is expected to run for nine days. 

He began Wednesday by condemning members of the public trying to watch the hearing who have been rude to staff in the clerk’s office.

Joyal said he would not tolerate such behaviour, when the 55 members of the public allowed to watch the virtual hearing online is more people than would normally be permitted in most courtrooms.

Public access must be capped due to technological limitations, he said.

WATCH | Chief Nursing Officer Lanette Siragusa testifies at hearing on public health orders challenge:

Manitoba’s chief nursing officer acknowledged in court Wednesday that hospitals adapted to the increased demand of COVID-19, but cautioned the full consequences of that are still unknown. 1:39