Third-wave ICU crisis continues to serve as Heather Stefanson’s Achilles heel

Third-wave ICU crisis continues to serve as Heather Stefanson’s Achilles heel

by Sue Jones
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Heather Stefanson says she heeded public advice when she was health minister. Questions remain about the quality of that advice, whether it ever got to her — and if it did, whether she heeded it.

Heather Stefanson

In an interview in September, now-premier Heather Stefanson said she relied on public health and Shared Health for her information when she was health minister. (Jeff Stapleton/CBC)

When Heather Stefanson became Manitoba’s premier, the Tuxedo MLA’s performance as health minister during the pandemic’s third wave was always going to be an Achilles’ heel.

Stefanson was responsible for health during the spring of 2021, when Manitoba hospitals were so overwhelmed by severe COVID-19 cases, Shared Health had to transfer 57 intensive-care patients to other provinces.

Stefanson was forced to address her record during the PC leadership race, which she eventually won by a narrow and disputed margin.

Asked why she didn’t push for tougher third-wave restrictions earlier — especially after Manitoba’s disastrous experience during the second wave — she said she was listening to advice from public health.

“You know what? Coulda, shoulda, woulda,” Stefanson said during an interview in September.

“That’s what we can think of after the fact. But you know, when you’re thrown in the middle of this, there is no playbook for this and you just make your decisions based on the advice that you get from the professionals.”

Six months later, questions remain about the quality of that advice, whether it ever got to the health minister who would become premier — and if it did, whether Stefanson heeded it.

On Monday, documents obtained by the official opposition revealed Manitoba Shared Health was working on transferring ICU patients to Ontario five days before the premier stated the province could still expand ICU capacity.

On May 13, Shared Health CEO Adam Topp had a meeting about Thunder Bay Regional Health Sciences Centre and ICU capacity, according to a copy of Topp’s calendar obtained by the NDP through a freedom-of-information request. 

Five days later, Stefanson told reporters ICU capacity could be expanded by another 50 patients.

“As the ICU numbers continue to grow, as we expect them to over the course of the next couple of weeks,” she told reporters on May 18, “we will continue to ensure that we are staffing to be able to handle that capacity.”

That very same day, Manitoba transferred the first ICU patient to Thunder Bay because hospitals had run out of capacity.

Thunder Bay Regional Health Sciences Centre

Stefanson said on May 18 Manitoba could expand ICU capacity to handle the continuing surge of COVID patients. The same day, the province started transferring patients to Thunder Bay Regional Health Sciences Centre. (Thunder Bay Regional Health Sciences Centre)

This is not quite the smoking gun NDP Leader Wab Kinew made it out to be on Monday, when he suggested Stefanson intentionally misled Manitobans about ICU capacity.

For starters, there is no evidence Topp briefed Stefanson about the transfers to Thunder Bay, though it is reasonable to suggest he could have done so.

More significantly, there is no need for a smoking gun. At this point in May, Shared Health had already said Manitoba could not expand ICU capacity.

During a technical briefing with reporters on May 7, former Shared Health official Lanette Siragusa — then Manitoba’s chief nursing officer and the provincial lead for health systems integration and quality — warned the province was coming close to running out of ICU capacity.

During the telephone briefing, Siragusa said on the record the province was fast approaching the second-wave ICU peak of 129 patients and could not handle any more.

“That’s been our line-in-the-sand working number and we are getting close to that now,” Siragusa said.

This prompted questions from reporters about previous Shared Health targets about expanding ICU capacity to 173 patients.

That number, she explained, was put together in 2020, when the pandemic was still new and officials had yet to learn how infections among hospital workers and staff burnout could affect the ability to find enough staff to keep ICUs running well over their pre-pandemic capacity of 72 patients.

“The 173 number was the number that we planned for really early on in the spring of last year, while we were learning more about the virus and the situation was evolving and changing,” Siragusa said. “The estimate of 173 beds was a paper exercise, literally at the beginning.”

Siragusa went on to explain that while vaccinations made hospital staff far less susceptible to infections, vaccinations among older Manitobans and the severity of the Delta variant had changed the demographics of COVID patients who required intensive care.

Covid Mb Lanette Siragusa Covid 19 Winnipeg Manitoba Legislature

Lanette Siragusa, former chief nursing officer and systems integration lead for Shared Health, said on May 7 that 129 ICU patients was a “line-in-the-sand working number.” Eleven days later, the health minister said ICU capacity could be expanded by 50 patients. (John Woods/The Canadian Press)

Simply put, Manitoba ICUs were now caring for younger patients who stayed in hospital longer, demanding more hospital resources. Whatever planning had occurred in 2020 did not prepare Manitoba for the spring of 2021.

Manitoba had 131 patients in ICU on May 18, when the transfers began to other provinces.

Yet for reasons that are not clear, Stefanson was claiming that very same day ICU capacity could be expanded to closer to 180 patients.

Even if one accepts the possibility Shared Health left Stefanson in the dark about the imminent patient transfers, the question remains why the future premier was touting the ability to expand ICU capacity 11 days after Siragusa told reporters that wasn’t possible.

One possibility is Stefanson was not briefed. A second possibility is she was briefed, but received six-month-old information. 

The third possibility is Stefanson was doing what Kinew alleged. Stefanson insists she did no such thing.

“Under no circumstances did I mislead Manitobans about ICU capacity during the COVID-19 surge last spring,” the premier said in a statement on Monday.

“I understood Manitoba needed additional ICU capacity and as such was having daily briefings and incident command meetings with Shared Health and public health officials to be briefed on contingency plans.”

In September, during the PC leadership race, the future premier was asked specifically why she claimed ICU capacity could be expanded by roughly 50 patients 11 days after Shared Health publicly stated that was not the case.

“I was taking the advice of our professionals in the system and as I understood at the time, we were up to capacity in the 150s,” Stefanson said in September.

“Often people are moved around province. It just was unfortunate we had to for safety reasons move some individuals out of province.”

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