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 47 (November 20 – November 26)

About epidemiological week

Data extracted up to 1:00 am on December 1, 2022
Next reporting date: December 9, 2022

COVID-19 vaccination / Seasonal Influenza vaccination

COVID-19: Similar Activity COVID-19 activity in Week 47 was similar to the previous week. COVID-19 associated hospital admissions decreased from week 46. 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 26, in all Manitoba residents, 78.1% have received at least two doses of COVID-19 vaccines. Additionally, 22.6% have received at least one dose within the last six months. Wastewater surveillance data by November 23 indicated sustained activity of COVID-19 in Winnipeg and Brandon.		Cases About cases Cases this week: 281 Total cases: 6226 More Analyses Epi curve Age and sex Incidence by age Health region
Testing About testing This week Average daily specimens: 409 Weekly positivity rate: 15.4% Total Tested people: 30,372 Population tested: 2.2% Specimens tested: 46,560 Positivity rate: 21.6% More Analyses Provincial testing	Severity About associated severity Severe outcomes this week Hospital admissions: 82 ICU admissions3: 19 Deaths: <5 Total severe outcomes Hospital admissions: 1,950 ICU admissions: 222 Deaths: 191 More Analyses Severe outcomes Age	Outbreaks About outbreaks COVID-19 outbreaks this week In long-term care facilities: 4 In hospitals: 1 In other settings: 0 Total COVID-19 outbreaks In long-term care facilities: 153 In hospitals: 73 In other settings: 1 More Analyses Check trend
Seasonal Influenza: Increased Activity Influenza activity increased in the last five weeks. In Week 47, influenza A test positivity increased to 21.4%, slightly lower than 23.1% 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 47 this season, children below the age of five years are at the highest risk for influenza infection. This age group accounted for 15% of all influenza cases and 25% of associated hospital admissions. At the same time, other respiratory viruses continue to co-circulate. RSV test positivity was 2.2% in Week 47, a decrease from 5.6% in the previous week.		Cases Cases this week Influenza A: 207 Influenza B: 0 Total cases Influenza A: 586 Influenza B: <5 More Analyses Check trend Incidence by age Health region
Testing Influenza testing this week Average daily specimens: 273 Influenza A positivity rate: 21.4% Influenza B positivity rate: 0 Other respiratory pathogens this week RSV4 positivity rate: 2.2% RSV detections: 43 More Analyses Influenza testing Respirotory detection	Severity Severe outcomes this week Hospital admissions: 19 ICU admissions: <5 Deaths: <5 Total severe outcomes Hospital admissions: 105 ICU admissions: 6 Deaths: 7 More Analyses Severe outcomes Age	Outbreaks Influenza outbreaks this week Influenza A: 1 Influenza B: 0 Total influenza outbreaks Influenza A: 11 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 47. However, average daily admissions to hospitals from those respiratory patients in Winnipeg was similar to the previous week.		FluWatchers About FluWatchers Participants reporting this week: 557 Reporting fever and cough: 4.1% More Analyses Check trend
Physician Visits About sentinel physicians Influenza Like Illness (ILI) Visits to sentinel physicians this week: 15.3% More Analyses Check Trend	Antiviral About Antiviral Units of antiviral dispensed from pharmacies this week: 15 Total influenza isolates resistant to antiviral this season in Canada Oseltamivir: 0 Zanamivir: 0 More Analyses Check Trend	ED Visits About emergency room visits Respiratory visits to emergency department (ED) this week: 2613 More Analyses Check Trend
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. Weekly Cases of COVID-19 by Season, Manitoba, 2020 – 2022 (July through June)

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Figure 2. Sex and Age Distribution of COVID-19 Cases, Manitoba, July 3, 2022 – November 26, 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 26, 2022

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Figure 4. Cases of COVID-19 by Health Region and Public Health Report Date, Manitoba, August 1, 2022 – November 26, 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 26, 2022

Helath region	Total cases	Cases this week	Incidence rate this week	Age-standardized incidence rate* this week
Winnipeg RHA	3710	164	2.1	2.0
Southern Health-Santé Sud	573	28	1.3	1.4
Interlake-Eastern RHA	671	21	1.5	1.5
Prairie Mountain Health	841	46	2.6	2.4
Northern Health Region	431	22	2.8	3.6

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 26, 2022

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Severity

Figure 6. Severe Outcomes of COVID-19 by Week of Outcome Date, Manitoba, July 3, 2022 – November 26, 2022

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

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Figure 7. Age Distribution of Severe COVID-19 Cases This Week Compared to All Cases, Manitoba, July 3, 2022 – November 26, 2022

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Outbreaks

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

Note: All 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 26, 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	8.7%	3.0%	8.7%	0.0%
05-11	56.0%	42.8%	8.8%	0.1%
12-17	82.8%	78.3%	8.3%	3.9%
18-29	88.6%	85.6%	6.6%	5.3%
30-39	84.6%	82.1%	11.0%	9.5%
40-49	87.8%	86.0%	14.8%	13.1%
50-59	87.1%	85.8%	22.5%	15.9%
60-69	94.7%	93.4%	38.7%	28.2%
70-79	>=95.0%	>=95.0%	50.8%	38.8%
80+	>=95.0%	>=95.0%	50.5%	40.6%
ALL	81.4%	78.1%	19.3%	13.8%

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 Influenza by Season, Manitoba, 2019 – 2022 (July through June)

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Figure 10. Incidence Rate (/10,000 Population) of Influenza Cases by Age Group and Week of Public Health Report Date, 2018 – November 26, 2022

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Table 3. Cases of Influenza and Incidence Rate (/10,000 population) by Health Region, Manitoba, July 3, 2022 – November 26, 2022

Helath region	Total cases	Cases this week	Incidence rate this week	Age-standardized incidence rate* this week
Winnipeg RHA	341	128	1.6	1.6
Southern Health-Santé Sud	66	24	1.1	1.1
Interlake-Eastern RHA	61	18	1.3	1.3
Prairie Mountain Health	95	34	2.0	1.9
Northern Health Region	21	NA	NA	NA

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 11. Average Daily Testing Volume and Positivity (%) for Influenza by Week of Specimen Receiving Date, Manitoba, July 3, 2022 – November 26, 2022

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Figure 12. Number of Positive Respiratory Virus Tests by Week of Specimen Receiving Date, Manitoba, July 3, 2022 – November 26, 2022

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

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Severity

Figure 13. Severe Outcomes of Influenza by Week of Outcome Date, Manitoba, July 3, 2022 – November 26, 2022

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

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Figure 14. Age Distribution of Severe Influenza Cases in All Cases, Manitoba, July 3, 2022 – November 26, 2022

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Outbreaks

Figure 15. Weekly Respiratory and Influenza Outbreaks, Manitoba, 2019 – November 26, 2022

Note: All 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 26, 2022

Age group	Does	Coverage percentage
0-4	8952	10.5%
5-17	23179	10.2%
18-49	67092	11.3%
50-64	63471	24.5%
65+	123412	52.8%
All	287818	20.6%

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FluWatchers

Figure 16. Weekly FluWatchers Participants and Percentage Reporting Fever and Cough, Manitoba, 2018 – November 26, 2022

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Physician Visits

Figure 17. Weekly Percentage of ILI Related Visits to Sentinel Physicians, Manitoba, 2018 – November 26, 2022

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Antiviral

Figure 18. Weekly Units of Antiviral Dispensed from Pharmacies, Manitoba, 2018 – November 26, 2022

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ED Visits

Figure 19. Weekly Emergency Department Visits, Manitoba, 2018 – November 26, 2022

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