Provincial Respiratory Surveillance Report

COVID-19 and Seasonal Influenza

2022-2023

This weekly report provides a current epidemiological update on the intensity and severity of respiratory activity in Manitoba including laboratory confirmed activity of both COVID-19 and seasonal influenza. Surveillance data include syndromic indicators, laboratory testing, associated hospitalization and mortality, and outbreaks. Updates around immunization coverage in COVID-19 and seasonal influenza are also included.

Data are reported with a one-week delay for increased data accuracy, completeness and reliability. More analyses continue to be conducted and will be added to this report as available. It is published online at approximately 10:00am every Friday.

Week 46 (November 13 – November 19)

About epidemiological week

Data extracted up to 1:00 am on November 24, 2022
Next reporting date: December 2, 2022

COVID-19 vaccination / Seasonal Influenza vaccination

COVID-19: Similar Activity COVID-19 activity in Week 46 was similar to the previous week. COVID-19 associated hospital admissions decreased from week 45. Laboratory detections were substantively lower compared to the same time period in the previous two years. Older adults continue to be at higher risk for COVID-19 infections and associated hospital admissions and fatalities. As of November 19, in all Manitoba residents, 78.1% have received at least two doses of COVID-19 vaccines. Additionally, 21.9% have received at least one dose within the last six months. Wastewater surveillance data for the city of Winnipeg by November 17 indicated sustained activity of COVID-19.		Cases About cases Cases this week: 314 Total cases: 5632 More Analyses Epi curve Age and sex Incidence by age Health region
Testing About testing This week Average daily specimens: 388 Weekly positivity rate: 18.2% Total Tested people: 28,632 Population tested: 2% Specimens tested: 43,691 Positivity rate: 22.0% More Analyses Provincial testing	Severity About associated severity Severe outcomes this week Hospital admissions: 82 ICU admissions3: 12 Deaths: <5 Total severe outcomes Hospital admissions: 1,836 ICU admissions: 201 Deaths: 175 More Analyses Severe outcomes Age	Outbreaks About outbreaks COVID-19 outbreaks this week In long-term care facilities: 4 In hospitals: 4 In other settings: 0 Total COVID-19 outbreaks In long-term care facilities: 149 In hospitals: 72 In other settings: 1 More Analyses Check trend
Seasonal Influenza: Increased Activity Influenza activity increased in the last three weeks. In Week 46, influenza A test positivity increased to 15.6%, lower than 19.2% that was observed nationally. This increase in activity is earlier than would be expected for this time of year. The predominant circulating strain is influenza A (H3N2). Up to Week 46 this season, approximately 40% of those influenza cases and influenza associated hospital admissions are among children below the age of 18. Additionally, children below the age of five years accounted for 15% of all influenza cases and 20% of associated hospital admissions. At the same time, there are other co-circulating respiratory viruses whose detections have also increased. RSV test positivity was 5.6% in Week 46, similar to 5.5% in the previous week.		Cases Cases this week Influenza A: 154 Influenza B: 0 Total cases Influenza A: 310 Influenza B: <5 More Analyses Check trend Health region
Testing Influenza testing this week Average daily specimens: 160 Influenza A positivity rate: 15.6% Influenza B positivity rate: 0 Other respiratory pathogens RSV4 positivity rate: 5.6% RSV detections: 62 More Analyses Influenza testing Respirotory detection	Severity Severe outcomes this week Hospital admissions: 14 ICU admissions: <5 Deaths: <5 Total severe outcomes Hospital admissions: 52 ICU admissions: <5 Deaths: <5 More Analyses Check trend	Outbreaks Influenza outbreaks this week Influenza A: 4 Influenza B: 0 Total influenza outbreaks Influenza A: 9 Influenza B: 0 More Analyses Check trend
Syndromic Indicators: Increased Activity The activity level in all syndromic indicators has increased in the last few weeks indicating an increase in respiratory activity in the community and in primary care. In addition, the daily respiratory related visits to emergency departments/urgent care continued to increase in week 46. Additionally, average daily admissions to hospitals from those respiratory patients in Winnipeg also continued to increase.		FluWatchers About FluWatchers Participants reporting: 610 Reporting fever and cough: 2.3% More Analyses Check trend
Physician Visits About sentinel physicians Influenza Like Illness (ILI) Visits to sentinel physicians this week: 3.8% More Analyses Check Trend	Antiviral About Antiviral Units of antiviral dispensed from pharmacies: 13 Total influenza isolates resistant to antiviral this season in Canada Oseltamivir: 0 Zanamivir: 0 More Analyses Check Trend	ED Visits About emergency room visits Total respiratory visits to emergency department (ED): 2389
Important Notes Data about COVID-19 and influenza cases are extracted from PHIMS. Numbers are subject to change. Missed events in the current report due to reporting delays will be included in later reports when data become available. Cumulative totals include all events from start of the current season to end of the reporting week. ICU admissions were included in hospital admissions, and include adult and pediatric cases. RSV - Respiratory syncytial virus.

COVID-19

Cases

Figure 1. Cases of COVID-19 by Week of Public Health Report Date, Manitoba, July 3, 2022 – November 19, 2022

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Figure 2. Sex and Age Distribution of COVID-19 Cases, Manitoba, July 3, 2022 – November 19, 2022

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Figure 3. Incidence Rate (/10,000 Population) of COVID-19 Cases by Age Group and Week of Public Health Report Date, Manitoba, July 3, 2022 – November 19, 2022

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Figure 4. Cases of COVID-19 by Health Region and Public Health Report Date, Manitoba, August 1, 2022 – November 19, 2022

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Table 1. Cases of COVID-19 and Incidence Rate (/10,000 population) by Health Region, Manitoba, July 3, 2022 – November 19, 2022

Helath region	Total cases	Cases this week	Incidence rate this week	Age-standardized incidence rate* this week
Winnipeg RHA	3546	181	2.3	2.2
Southern Health-Santé Sud	545	28	1.3	1.5
Interlake-Eastern RHA	650	22	1.6	1.5
Prairie Mountain Health	795	57	3.3	2.9
Northern Health Region	408	26	3.4	3.9

Note: * Age-standardized rates are used to account for differences in the age structure in health regions. The whole Manitoba population is used as the standard population.

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Testing

Figure 5. Average Daily Testing Volume and Positivity (%) for COVID-19 by Week of Specimen Receiving Date, Manitoba, July 3, 2022 – November 19, 2022

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Severity

Figure 6. Severe Outcomes of COVID-19 by Week of Outcome Date, Manitoba, July 3, 2022 – November 19, 2022

Note. ICU admissions are not included in the hospital admissions.

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Figure 7. Age Distribution of Severe COVID-19 Cases Compared to All Cases, Manitoba, July 3, 2022 – November 19, 2022

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Outbreaks

Figure 8. Weekly COVID-19 Outbreaks, Manitoba, 2020 – 2022

Note: Respiratory outbreaks include COVID-19 outbreaks, influenza outbreaks and the other respiratory outbreaks with known or unknown pathogens.

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Vaccination

Table 2. Coverage of COVID-19 Vaccinations, Manitoba, November 19, 2022

Age group (years)	At least 1 dose	At least 2 doses	At least 1 dose within the last 6 months	At least 1 dose of Bivalent
.5-04	8.5%	2.7%	8.5%	0.0%
05-11	56.1%	42.8%	9.1%	0.1%
12-17	82.9%	78.4%	9.0%	3.3%
18-29	88.7%	85.7%	6.7%	4.9%
30-39	84.6%	82.1%	10.9%	8.8%
40-49	87.9%	86.1%	14.7%	12.1%
50-59	87.1%	85.8%	25.5%	14.4%
60-69	94.7%	93.5%	45.5%	25.6%
70-79	>=95%	>=95%	62.6%	35.3%
80+	>=95%	>=95%	62.9%	36.8%
ALL	81.4%	78.1%	21.9%	12.6%

For more information, please visit COVID-19 vaccination coverage in Canada - Canada.ca

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Seasonal Influenza

Cases

Figure 9. Weekly Cases of Laboratory-Confirmed Influenza, Manitoba, 2018 – November 19, 2022

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Table 3. Cases of Influenza and Incidence Rate (/10,000 population) by Health Region, Manitoba, July 3, 2022 – November 19, 2022

Helath region	Total cases	Cases this week	Incidence rate this week	Age-standardized incidence rate* this week
Winnipeg RHA	189	82	1.0	1.1
Southern Health-Santé Sud	31	16	0.7	0.7
Interlake-Eastern RHA	26	16	1.2	1.2
Prairie Mountain Health	48	33	1.9	1.8
Northern Health Region	17	7	0.9	1.1

Note: * Age-standardized rates are used to account for differences in the age structure in health regions. The whole Manitoba population is used as the standard population.

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Testing

Figure 10. Average Daily Testing Volume and Positivity (%) for Influenza by Week of Specimen Receiving Date, Manitoba, July 3, 2022 – November 19, 2022

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Figure 11. Number of Positive Respiratory Virus Tests by Week of Specimen Receiving Date, Manitoba, July 3, 2022 – November 19, 2022

Note. Other respiratory viruses include adenovirus, enterovirus/rhinovirus, human coronavirus (seasonal), human metapneumovirus and human parainfluenza virus.

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Figure 12. Age Distribution of Severe Influenza Cases Compared to All Cases, Manitoba, July 3, 2022 – November 19, 2022

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Outbreaks

Figure 13. Weekly Respiratory and Influenza Outbreaks, Manitoba, 2018 – November 19, 2022

Note: Respiratory outbreaks include COVID-19 outbreaks, influenza outbreaks and the other respiratory outbreaks with known or unknown pathogens.

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Vaccinations

Table 5. Coverage of Influenza Vaccinations, Manitoba, September 1, 2022 – November 19, 2022

Age group	Does	Coverage percentage
0-4	7357	8.7%
5-17	19401	8.5%
18-49	59829	10.1%
50-64	58044	22.4%
65+	115823	49.5%
All	261866	18.7%

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FluWatchers

Figure 14. Weekly FluWatchers Participants and Percentage Reporting Fever and Cough, Manitoba, 2018 – November 19, 2022

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Physician Visits

Figure 15. Weekly Percentage of ILI Related Visits to Sentinel Physicians, Manitoba, 2018 – November 19, 2022

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Antiviral

Figure 16. Weekly Units of Antiviral Dispensed from Pharmacies, Manitoba, 2018 – November 19, 2022

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