Why two weeks of promising COVID-19 signs doesn't mean Manitoba can return to normal

Thanks to geography, determination and maybe a little bit of luck, Manitoba has been spared the worst of the COVID-19 pandemicso far.

The placement of this province in the snowy centre of the continent means Manitoba is the last to receivealmost anything, whether it's the latestfashion trend or ahorrible disease.

The relatively early introduction of physical distancing measures in Manitoba and the public's general willingness to adhere to publichealth orders appears to have played an even larger role in keeping COVID-19 caseloads down to a manageable level in this province.

Manitoba has also been lucky, so far, that the disease has failed to take a foothold within personal care homes, where vulnerable residentshave fallen victim to the disease in horrificnumbers in Ontario and Quebec.

As a result, every measure of the disease's spread is on a middling to positive trajectory in Manitoba at the moment.

For starters, few new cases of COVID-19 are being discovered. It's been two weeks since Manitoba announced a significant number of new cases 35 were reported on April 1 and the province has averaged just under six new cases per dayever since.

• No new cases of COVID-19 in Manitoba, top doctor says

The growth rate for the disease in Manitoba, where the total caseloadwasdoubling every four days during the latter half of March, hasalmost flattenedout entirely in April.

Thenumber of active cases of the disease that is,Manitobanssuffering from COVID-19 symptoms at any given moment is roughly the same today as it was at the beginning of the month.

As well, the sickest among those active cases are not growing more numerous. The number of people hospitalized from the diseaseisthe same right now as it was on April 3.

Together, these sunny statisticshaveManitoba's chief provincial public health officer musing about how this province could start relaxing restrictions on business and public gatherings the physical distancing measures that have thus far proven so successful at slowing the growth of the disease.

"It's certainly nice to see a number of days like this," Dr. Brent Roussin said on Tuesday, when Manitoba announced no new cases of COVID-19.

As he has every day since Manitoba's COVID-19 growth rate started slowing, Roussin said he's not ready to start relaxingpublic health orders.

When the conditions are right

He did, however, identify two conditions that must occur before any rules are loosened up.

For starters, the growth of the disease has to plateau entirely, as it almost has right now. Then the number of active cases that crucial indicatorof the potential demandon the health-care system has to drop over time, instead of sitting at a plateau.

"We want to see thatdownward trend of active cases," he said, adding he'd like to see that trend take place for more than a week.

"That's going to make us think of what sort of things could we do to ease some of the restrictions, without compromising our gains."

The first public health ordersthat could be loosened up would be restrictions on businesses, saidRoussin, adding he's trying to determine what sectors of the economy would be the safest to free up.

Relax, then observe

Further relaxations of public health rules would arrive in stages. Each time the province loosens up its rules, it will sit back and see how that affects the spread of COVID-19, Roussin suggested.

Roussinhas said it's reasonable to expect public health orders to relax somewhat by the start of the summer. But he also said to expect some measures in place until the fall.

That's why there won't be a summer festival season this year in Manitoba. Large gatherings of people will be among the last facets of society to return, especially before a vaccine is developed for COVID-19.

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Manitobans can also expect to wait a while before interprovincialtravel returns to normal. At this moment, COVID-19 continues to spreadmore rapidly in neighbouring provinces than it does here at home. International travel for the purpose of tourismlikely won't resume for even longer.

It's also unclear how schooland university classes, eating at restaurants and moviescan returnbefore Manitoba devises a way to test more of its population for COVID-19, isolate new cases and keep track of all their potential contacts.

Simply put, people can't start rubbing shoulders again before public health authorities figure out how to more efficiently track thedisease.

Manitobans are all too aware of the limitations of existing testing. The tests for the disease can only identify symptomatic patients with any reliability and even then in relatively limited numbers.

The province is only beginning to conduct research on antibody testing that couldhelp determine who has already been exposed to the disease, Roussin said on Tuesday.

While this sort of testing is not very effective at diagnosing new cases, it could be veryuseful duringthe latter phases of the pandemic. Some public health experts believe antibody testinghas to be available on a wide scale before society can return to normal.

In other words, it's not a safe bet to assume there will be a return to normalcy this calendar year, as the prime minister and others have warned. But it's safe to assume society won't be as constricted this fall as it is now.

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And lest anyone be tempted to declare social distancing was pointless: All you need to do is compare Manitoba's experience thus far with other jurisdictions.

Complaining about social distancing after two solid weeks of slow disease growth is like complaining about the use of an umbrella after your head stays dryin a downpour.

Some Manitobans may be temptedto ditch the umbrella now. Roussin would be more inclined to check the forecast.