WINNIPEG -- As Manitoba grapples with the third wave of the COVID-19 pandemic, the chief public health officer found himself in a courtroom Friday defending the province’s public health measures.

Dr. Brent Roussin was cross-examined by Jared Brown, a lawyer representing a group of seven churches and three individuals fighting the restrictions on the grounds they infringe on charter rights to hold religious and public gatherings.

Roussin testified the goal of the province’s public health measures from early on in the pandemic has been to “minimize morbidity and mortality while minimizing social disruption.”

“We know these interventions are very intrusive to Manitobans,” Roussin told the court. “I’m bound by using the least restrictive means.”

Allowing the virus to spread unchecked would have severe economic and societal impacts, he testified. While the health care system didn’t collapse under the weight of COVID-19 during the second wave, Roussin told the court the system was clearly overwhelmed.

“We were at a critical stage,” Roussin testified. “I was in touch with hospitals daily who were telling me they were on the brink. They couldn’t sustain this and we needed to bring down these numbers.”

Brown asked Roussin whether a decision to reverse a restriction banning drive-up worship service was due to court action. Roussin testified while there was a court challenge, it was a risk to benefit analysis that paved the way for the change.

“We were at such a critical stage,” Roussin told the court. “We just could not get this wrong. We could not be wrong in November. We had to put very strict non-pharmaceutical interventions in place and that included at that time limiting the drive-up (worship) services.”

“Over time we felt the risk benefit shifted to the benefit of these.”

Roussin told Brown many of his colleagues in clinical care had been pushing for even stricter measures sooner.

“And so they’ve been very vocally against the incremental approach we’ve taken but I’m bound to use that least restrictive means,” Roussin testified.

Roussin agreed with Brown when he suggested the primary mode of transmission for the virus appears to be from infectious droplets or aerosols discharged from an infectious person by exhaling, coughing or talking loudly.

Brown questioned Roussin about PCR (polymerase chain reaction) tests — the ones used to identify laboratory-confirmed cases of the SARS-CoV-2 virus that causes COVID-19.

Roussin testified the tests accurately determine laboratory-confirmed cases, which are valuable on a population level to identify the burden of the disease.

“I know that seven per cent of those test positive cases are probably going to be in hospital 10 days from now,” Roussin told the court. “1.4 per cent require intensive care.”

“If we had a day of 400 test positive, PCR test positives, I knew in 10 days about 28 people would be admitted that day and it was very accurate throughout the entire second wave.”

Brown showed the court a document which he argued highlights that Manitoba had additional hospital bed and ICU bed capacity available during the worst of the second wave.

Brown pointed to a December 2020 update which showed Manitoba expanded ICU bed capacity to 173 beds when the number of patients topped out at 129.

Roussin testified the equipment was available but not the staff.

“We certainly didn’t create more staff,” Roussin told the court. “The staff comes from somewhere. These expansions come at the cost of non-COVID care.”

Roussin testified public health is aware there are unintended consequences from the measures but the full scope hasn’t yet been determined.

“We certainly don’t have a full picture of all the effects of the public health measures,” Roussin told the court. “It’s very difficult to measure.”

Brown suggested to Roussin the province hasn’t done a good enough weighing the benefit of the measures against the adverse effects.

Roussin testified the province has been dealing with a crisis and has had to make difficult decisions to protect people and the health care system.

Roussin testified when hospitals are flooded with COVID-19 patients, non-COVID care is impacted which can have an effect on the morbidity and mortality of people who don’t have COVID-19.

He told the court uncontrolled spread can result in health and critical care workers getting sick, which can have severe societal and economic impacts.