Why Manitoba understates the number of COVID patients in ICU … and wildly inflates active cases

As the pandemic lurches into its most dangerous phase, not a day goes by without one of our provincial leaders imploring Manitobans to do whatever they can to slow spread of COVID-19.

Since daily case counts started climbing in September, Premier Brian Pallister, Chief Provincial Public Health Officer Dr. Brent Roussin and Lanette Siragusa from Shared Health have all tried to get a simple message into our collective noggins.

The more we socialize, the more we spread the virus that causes COVID-19. The more we spread the virus, the more cases we get.

And the more cases we get, the more COVID patients end up in hospital.

Manitoba is now at that deadly point where hospitals are running out of capacity to treat the most serious of patients. 

On Wednesday, 105 patients — both with and without COVID-19 — were getting intensive care in regular ICU units and makeshift beds carved out of other hospitals.

Subtract the COVID patients and there would only be 55 patients in Manitoba ICUs.

Officially, the number of COVID-19 patients receiving intensive care was 50. But the actual number was 60, as the province has been understating the true number of severe COVID-19 cases since the start of the pandemic.

The reason for this 10-patient discrepancy is the ICU number published every day from the province only refers to COVID ICU patients that Shared Health considers infectious.

“What we want to identify is who’s active and where that virus is susceptible to spread. So if they’ve had COVID for over 30 days, they’re likely not infectious any more,” Siragusa explained on Monday.

“That doesn’t mean they don’t need critical care, but it poses a different risk, less of a risk for COVID spread, obviously.”

In other words, for the past eight months, Manitoba was not disclosing the number of long-term COVID patients who remained in hospital, on ventilators, for weeks at a time.

This is not because Shared Health was trying to hide anything. It’s simply because those patients didn’t pose as much of a threat to health-care workers and other patients.

“I can tell you that number is around 10 where we have patients who are in ICU who had contracted COVID-19 over 30 days ago,” Siragusa said, freely answering the question when CBC News asked about it.

Manitoba’s coronavirus-linked hospitalizations have more than doubled in the last three weeks, while the number in intensive care has nearly tripled in the same period of time. The ICU numbers don’t, however, include long-term COVID-19 cases. (Bryce Hoye/CBC)

Nonetheless, this failure to disclose the true number of COVID patients in ICU for months is a problem, for a number of reasons. 

To many Manitobans, the only thing that matters when they hear the number of COVID patients receiving intensive care is learning the actual number of severely ill people suffering from the disease. The ICU number has served as a barometer for pandemic watchers since the province first started publishing a daily COVID dashboard.

To a minority of Manitobans — public health scientists, data journalists and other useful nerds — an entire data set has been rendered suspect through the consistent under-reporting of ICU patients with COVID-19.

Finally, there is a matter of trust. Eight and a half months into the pandemic, many Manitobans are growing weary of restrictions and are more prone to the influence of online conspiracy theorists and other forms of antisocial malevolence.

On Wednesday, when CBC News again asked Siragusa how many COVID-19 patients are in ICU over and above the number stated on the dashboard, her stated answer of 10 became fodder for propagandists eager to claim the province was overstating ICU numbers rather than understating them.

With acute-care nurses, doctors and other health-care workers running ragged to treat patients, officials are losing patience for this nonsense and the people who spread it online.

“I don’t know what to say about the conspiracies and the anti-maskers,” Siragusa told CBC News on Thursday.

“All I can say is we need the public to support what needs to be done to get these numbers down. It’s not a game. It’s serious business and it’s impacting all of us.”

Dr. Brent Roussin, Manitoba’s chief public health officer, says COVID-19 deaths in the province have skyrocketed since last month. 0:42

At the same time, there is a metric Manitoba has been consistently inflating, albeit only for a matter of months.

The official number of active COVID-19 cases in Manitoba is wildly overstated, thanks to the province’s inability to clear off old cases and officially designate them as recovered.

On Thursday, the official number of active cases in Manitoba was 8,845. It is an impossible number, given that thousands of those cases date back more than a month and most COVID patients are only sick 10 days after symptoms commence.

Roussin surmised the actual active case number was 3,251, based on the number of patients who are less than 10 days past their nasopharyngeal swab and are not in hospital.

For a province of slightly fewer than 1.4 million people, 3,251 active cases of COVID-19 remains a lot.

As well, Manitoba remains the leader among Canadian provinces when it comes to new COVID-19 infections per capita. For the seven-day period that ended on Thursday, we had 210 new infections per 100,000 people.

In other words, we are doing poorly enough without the wild inflation of active cases. Ultimately, all that matters now is case counts drop quickly enough to relieve exhausted health-care workers.

ICU nurses and doctors only care about one statistic: How many people they can keep alive.