Manitoba had additional ICU beds available during second wave but not necessarily the staff to open them up, chief nursing officer tells court
WINNIPEG -- Shared Health’s Chief Nursing Officer Lanette Siragusa took the witness stand Wednesday morning in a constitutional challenge of Manitoba’s public health orders.
Seven churches and three individuals have taken the province to court, arguing the measures infringe on people’s charter rights to hold religious and public gatherings and to gather at people’s private homes.
The province’s lawyers have argued legislation gives the chief public health officer the power to implement emergency orders during a pandemic.
Under cross-examination by Jared Brown, a lawyer for the applicants, Siragusa testified her role is focused on the health system’s response to COVID-19 in Manitoba.
“I’m not responsible for the public health orders, my responsibility is the health system,” Siragusa told the court.
Siragusa told the court she is supportive of the province’s response to COVID-19.
Brown questioned Siragusa about the impact of the pandemic on the health care system as a whole, including cancelled surgeries.
“You confirmed that there was a backlog of 16,000 cases during COVID, is that accurate?” Brown asked.
“Yes, that was accurate,” Siragusa testified.
Brown suggested the number seems significant. Siragusa told the court it is unique.
“That is a comparison of numbers from last year compared to this year – it’s the difference of surgical procedures performed,” Siragusa testified. She later noted emergent and urgent procedures, such as surgeries related to cancer, were prioritized.
“That was at the discretion of the surgeons based on an individual assessment of the patients. If they told us it had to happen, we made sure it happened.”
Brown showed the court a document from December 2020 which indicated Manitoba increased total ICU-bed capacity from a pre-COVID number of 72 general ICU beds to 173 ICU beds last fall. Court heard Siragusa said in an affidavit that the province had 129 total ICU patients, including both COVID and non-COVID patients, in December 2020 during the second wave.
Brown argued the numbers show Manitoba had additional ICU capacity available.
“If we had space for 173 critical care (patients), I would say at 129 patients, we were feeling at our full capacity,” Siragusa testified. “The nurses – we had different team members coming into critical care to help support those patients, new nurses who had never worked in critical care.”
“We added additional support in terms of PPE teams, turning teams and I would say at 129 – the staff, the physicians felt exhausted physically, mentally, and spiritually.”
Siragusa said the fact officials were able to identify 173 spaces only takes into account the equipment and supplies needed but did not necessarily mean the province had “the people power” to place patients in those beds.
“Had we needed more, we would’ve looked at all options available to us,” Siragusa testified. “It was pretty tough at that time in mid-December.”
Siragusa testified other health services were impacted to staff those 129 beds and that adding any more would’ve required reducing services in other areas.
“It’s not to say we couldn’t have done it but those are really hard decisions we had to make as a health system and it wasn’t comfortable for anyone. Could we have done it? Maybe. And maybe we could’ve asked for more help, but it certainly wasn’t, ‘We had them sitting around waiting and staffed for 173 beds.’ We would’ve had to mobilize our teams and make decisions to do that.”
Siragusa told the court officials in Manitoba had conversations with acute care colleagues in Wuhan, China early on in the pandemic about the clinical response to COVID-19.
“We had a conference call with them early on,” Siragusa told the court. “Our conversation wasn’t really about their public health orders.”
Brown asked Siragusa if she was aware of lockdown measures implemented in Wuhan.
Siragusa told the court she only heard of measures through news reports.
“That wasn’t part of our conversation,” Siragusa testified. “It was the clinical impacts of the patients who had COVID.”
Earlier this week Jay Bhattacharya, an expert witness for the churches, was called for cross-examination by the province. He’s a Stanford University medical professor who has argued for focused protection of vulnerable people while allowing COVID-19 to spread until herd immunity is reached, with help from vaccines.
Jason Kindrachuk, a virologist and assistant professor in medical microbiology and infectious diseases at University of Manitoba, challenged that view during his testimony in the court case.
“Herd immunity for vaccinated individuals has been proven but so far not for sustained immunity from natural infection,” Kindrachuk told the court.
Brown also questioned Kindrachuk about government decisions to implement public health interventions in response to the pandemic.
“You say that governments were thus forced, you’ll agree that the governments did have a choice on the policy prescription?” Brown asked.
“I think they were forced in the sense that they had a public health crisis and either allowed the extreme fatalities that we saw in different regions of the world or they acted quickly,” Kindrachuk told the court. “I don’t believe that the government had other options to be able to curtail COVID-19 transmission and spread.”
Dr. Brent Roussin, Manitoba’s chief public health officer, is tentatively scheduled for cross-examination on Friday.
Nine days have been set aside for the case.