WINNIPEG -- With COVID-19 variant cases popping up in Manitoba, an intensive care specialist is warning it is likely a third wave of the pandemic could hit the province in the coming months, but it is not inevitable.

On Monday, Dr. Brent Roussin, Manitoba's chief public health officer, reported 18 new cases of the B.1.1.7. variant—the highest daily spike of variant cases yet. Along with the new cases came a slew of exposures on Winnipeg Transit linked to variant cases.

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Of Manitoba's 41 total variant of concern cases (30 B.1.1.7. cases and 11 B.1.351 cases), Roussin said eight are linked to travel, 24 are close contacts, and nine are unknown.

"We are seeing the test positivity creep up. We're now seeing increasing variants of concern, which are much more infectious. So we need to be quite cautious moving forward especially with our reopening plans," Roussin said, adding no hospitalizations or deaths have been linked to variant cases in Manitoba.

"It's certainly a concern."

That concern is shared by Dr. Anand Kumar, an intensive care specialist at the Health Sciences Centre and a professor of medicine and microbiology at the University of Manitoba.

Kumar—who is also trained in infectious diseases—said Manitoba could be facing a third wave of COVID-19—this one exacerbated by the more infectious variants of concern.

"I certainly don't rule out the possibility of another significant wave sometime around May. If I had to guess myself, I'd think it is quite likely. What is uncertain is how big it might be," Kumar said.

"It’s a race between how fast we can get people vaccinated and how fast these variants and the standard strain increase in the context of loosening restrictions at the same time."

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This comes days after the province eased restrictions—allowing groups up to six people to dine together at outdoor patios, and relaxing mask rules in churches.

The latter of which worries Epidemiologist Cynthia Carr, founder of EPI Research.

"We know that the virus—whether it is the variant or not—will transmit the more opportunity we give it—which is in enclosed spaces and closer together and without masks."

Roussin said the eased mask rules in churches don't add a lot of risk—as they are still required to follow the capacity limits and physical distancing.

Carr said with only about two per cent of the population vaccinated, the province needs to keep the reopening slow.

"What we want to be very cautious about is not moving forward too quickly when we are still getting our vaccine rollout underway."

Roussin said the province is still weeks away from having the populations most vulnerable to COVID-19 vaccinated. Even after that is completed, Roussin said it will take a couple weeks for the protection to take effect.

Still, Roussin said Manitoba is in an "optimistic place" compared to the daily COVID-19 case numbers and deaths seen in November and December.

While Kumar said a third wave is not inevitable—Manitobans should be on the look out.

"I think we should be cautious and cognizant that we are not out of the woods," he said.

"I worry that everybody thinks that we are kind of at the beginning of the end, and I'm not sure the situation is quite that optimistic."

Kumar and Carr said just because restrictions are eased, doesn't mean Manitobans need to take advantage of them.

"Reflect on your individual and your family situation," Carr said. "If you still feel that you want to wear a mask in church or not participate in some of these activities, certainly continue to do so."