Top doctor defends ‘crisis’ restrictions

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This article was published 07/05/2021 (1330 days ago), so information in it may no longer be current.

“Eye-popping” increases in medical interventions for drug overdoses, mental health crises, and intentional acts of self-harm can’t be blamed entirely on public health orders issued to help curb the spread of COVID-19, Manitoba’s chief public health officer testified Friday.

“Certainly these harms were increasing pre-pandemic and… many of these vulnerable communities are also disproportionately affected by this pandemic itself,” Dr. Brent Roussin said. “We have to balance their vulnerability to public health measures, but for sure they are vulnerable to the pandemic itself.”

Roussin was testifying at a court challenge launched by seven Manitoba churches that argue pandemic restrictions violate their charter rights.

The churches, along with three individuals, are represented by the Justice Centre for Constitutional Freedoms, a Calgary-based advocacy group which has launched similar court challenges in Alberta and B.C.

Justice centre lawyer Jared Brown pointed to a Nov. 1 health department report that said dramatic post-pandemic increases in several medical and health complaints, including a 240 per cent increase in opioid-related hospitalizations and a 109 per cent increase in intentional injuries. He alleged Roussin and his team made no attempt to assess the risk of the “downstream harms” before instituting public health orders.

“We don’t see any indication of a risk assessment,” Brown said. “There is no indication of a harm/benefit analysis.”

Roussin said he “engaged widely” with local health-care providers, and national and international health experts before issuing public health orders.

“This is a crisis, a 100-year pandemic, and we are required to make decisions during levels of crisis when our hospital capacity was strained, and so we’re certainly aware of the potential harm,” he said. “We’re aware of the importance of these activities to Manitobans. We’ve never taken these (restrictions) lightly.”

Much of Friday’s testimony focused on the effectiveness of testing and contact-tracing protocols.

Roussin said seven per cent positive test cases result in hospitalizations within 10 to 14 days and 1.4 per cent will be admitted to intensive care.

When the province reports positive case counts, it doesn’t include how many of the cases were infectious at the time of diagnosis, Brown said.

“So the public is not told in any of these positive cases that they may not be able to infect anybody?” Brown said.

“We don’t know that. There really isn’t any way of discerning that,” Roussin said. “In the amount of time that we need to be reporting these… it isn’t a factor. We know that we have a stable amount of severe outcomes based on that test positive number.”

Brown argued the province could reduce its contact-tracing load and better assess infection risk by examining each positive case’s cycle threshold value.

Cycle threshold value refers to the estimate of how much virus is present in a sample. Brown said several recent studies suggest the higher the cycle threshold value, the less infectious a person will be.

“It is very difficult to know if they have a low probability of infectiousness because if we are just relying on a high CT value, we don’t know if they are early on in their infection and are just about to be more infectious, or if they are late in their infection,” Roussin said.

“Even if they have a low probability of infectiousness, it’s very difficult to know when that low period of probability began. Their contacts could be cases right now. So there is a lot of benefit to doing that contact tracing.”

Then there is the question of just how low a risk of infection is acceptable, Roussin said.

“If we had a case where somehow we knew they had a low probability of being infectious, how low would that probability have to be before we had that person go work at a personal care home?” he said. “How low would it have to be before we didn’t do a contact-tracing investigation looking for vulnerable contacts?”

There would be severe economic and societal effects if COVID-19 were allowed to spread unchecked, Roussin said. Hospitals fill up and more health-care workers are out sick when there’s significant community infection. It can mean serious consequences, even for people who don’t have the virus and need health services.

“When we risk overwhelming our health-care system, which in November and December it was, we now start affecting morbidity and mortality for people who’ve never had COVID-19,” he said.

Age, as well as other health issues, is one of the main factors leading to severe outcomes from COVID-19, Roussin said, but even if younger people don’t get as sick with the virus, infections in that population can have a significant effect on society, including on health-care workers, first responders and people who work with critical infrastructure.

— with files from The Canadian Press

dean.pritchard@freepress.mb.ca