A weeks-long project examining pandemic and demographic data has found ongoing concerns among First Nations communities in Saskatchewan about distance from health care compounded by crowded housing, communities with a large proportion of older adults and difficulty accessing PPE amidst the COVID-19 pandemic.
The report, compiled as part of the Institute for Investigative Journalism (IIJ)’s Project Pandemic in partnership with the Prince Albert Daily Herald and Saskatoon StarPhoenix/Regina Leader-Post used a combination of data, access-to-information requests and interviews with individual coordinators to uncover several risk factors faced by the province’s First Nations communities, risks heightened by the COVID-19 pandemic. Interactive maps were created and data examined using Esri ArcGIS technology.
The data highlights the greater risks faced by residents in Indigenous communities. There are some indicators, that so far, Saskatchewan’s Indigenous communities have been disproportionally affected by COVID-19.
According to Statistics Canada data, 55 per cent of the population of the Desnethé-Missinippi-Churchill River electoral district, which covers the entire northern portion of the province, is First Nations.
Of the province’s 795 cases, 334 — or 42 per cent — are from far north, despite the region accounting for less than ten per cent of the province’s population. Many of the cases are attributed to outbreaks seen in La Loche and in Clearwater River Dene Nation.
A far north resident in their 70s was declared deceased Thursday. It was the province’s 14th COVID-19-related death.
It’s impossible to know exactly how many cases of COVID-19 in Saskatchewan have been Indigenous patients as the province doesn’t track health data by race, despite calls from advocates who say it could help identify gaps in care in at-risk communities.
— Map created using using Esri ArcGIS technology
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Distance from care
An IIJ analysis found that 28 First Nations are more than 50 km from a hospital designated for COVID-19 care. Pandemic response coordinators in Hatchet Lake and Muskeg Lake First Nations are among those who said distance from care is a concern.
“It is always a concern,” the coordinator from Hatchet Lake told IIJ reporters in May. They don’t have a hospital in the nation, but they do have a health care with primary care nurses.
Jordan Revke, the pandemic coordinator for Muskeg Lake Cree Nation, which sits about 100 km north of Saskatoon, says that so far, the community has not seen any COVID-19 cases.
Revke suspects that if anyone gets the virus they will go to Saskatoon for treatment, but he’s not sure how they’d get there. It’s not uncommon for ambulances to take 40 minutes to an hour to arrive, he said. In the meantime, the First Nation is looking to designate a space on the reserve for COVID-19 patients.
Coordinators in seven other First Nations communities also said they were concerned about their distance from a health centre, even though four were within 50 km of a hospital offering COVID-19 care.
Not all hospitals in the province are designated for COVID-19 patients. In the north, health centres accept both patients with COVID-19 and patients with other health issues. In the south, the 20 COVID-19 health centres are only for patients with COVID-19; patients with other health issues must seek help elsewhere.
A statement from the Ministry of Health said the Ministry and Saskatchewan Health Authority (SHA) are “confident that people will receive appropriate care in a timely manner” and focused on providing the support and coordinated response necessary to help residents in the north during the pandemic.”
The SHA recognized the need “to have all of its facilities in the north provide COVID care, not just those facilities designated for COVID specific treatment.”
“…we are confident residents can access COVID care at their nearest health care facility,” the statement says.
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Indigenous communities seeing overcrowding, large populations of seniors
Distance from care wasn’t the only risk factor flagged by the IIJ report. Data analysis also shows overcrowded housing, large populations of residents aged 55 or older and a lack of access to PPE.
According to the IIJ data, of the 28 First Nations more than 50 km from a hospital, four had a large proportion of population aged 55 or over and six had at least one-third of its residents living in crowded households. Crowded living situations make it harder to socially distance to prevent the spread of COVID-19.
Nearly a quarter of Muskeg Lake’s 290 band members living on reserve are 55 and older. “To try to get them (to a hospital) transportation-wise can be hard on them,” Revke said.
Older residents are much more likely to suffer COVID-19 complications, or even death. Across Canada, almost 97 per cent of all deaths have been in residents aged 60 or older. That age group also accounts for about 60 per cent of all ICU admissions.
The Ministry of Health said it understands that Indigneous communities, especially those in northern and remote locations, face greater risks (of COVID-19) and said it has been working with First Nations and Metis stakeholders throughout the pandemic.
“Our response to the outbreak situation has been to ensure that the response plan be tailored to the risks posed in the community, in the geographic area, and culturally appropriate for the local population.”
Some First Nations were also lacking PPE.
In interviews with reporters in May, four First Nations said they did not have enough protective equipment, and another two said they had concerns about running out of masks. Five first Nations, at the time, were lacking N-95 masks. Some communities were relying on the Federation of Sovereign Indigenous Nations (FSIN) and Meadow Lake Tribal Council for donations of protective equipment.
The Northern Inter-Tribal Health Authority (NITHA) said in April that about 40 per cent of its health sites did not have the PPE to support an outbreak. The agency said much of its PPE had expired. According to MBC radio, in late May, they repeated their concerns to a House of Commons Committee. Afterwards, several companies reached out to see if they needed ore PPE. NITHA is responsible for health care in the province’s far north and is a partnership between First Nations, the province and the federal government.
Beardy’s and Okemasis’ First Nation is not served by NITHA. Emergency response manager Brenda Seeseequasis said in May that the community had a “minimal” amount of safety equipment, such as masks, faces shields, gloves and monitors. They were looking into getting supplies through FSIN and other partners.
Seeseequasis said the concern surrounding COVID-19 was high. The community, at that time, was turning its daycare into a self-isolating/self-monitoring facility so workers from Alberta didn’t have to isolate at home with their families. She said the community didn’t have enough masks to hand out, so community members stepped up to sew non-medical fabric masks for those without.
Seeseequasis was unavailable for comment when reporters attempted to check in this week. The other First Nations that said they were lacking PPE in May were also unavailable for comment.
Belanger says government acted too slow
The concerns surrounding distance from care, crowding and lack of PPE are no surprise for NDP MLA Buckley Belanger, who spent 10 weeks in lockdown in the province’s northwest during the initial outbreak in La Loche.
Last Monday, during a committee meeting, Belanger and fellow northern MLA Doyle Vermette grilled Municipal Relations and Northern Affairs Minister Lori Carr over the government’s initial response to northern COVID-19 concerns.
Belanger said northern leaders understood their communities were at risk.
“When we sat there with them, the leadership said … we live in the remote part of the province. We live a long ways away. We live in close quarters with teach other. There’s overcrowding in these homes,” he said. “
Northern communities, including First Nations, had asked for $10 million to support response efforts.
What they got instead was about $370,000, of which $20,000 went to La Loche to help them fight a COVID-19 outbreak.
Carr, though, disputed that account. She said after negotiations the northern MLAs agreed to accept $5 million in support, something Vermette and Belanger denied.
While $350,000 has gone towards checkstops, a further $4.3 million in support was delivered in the form of self-isolation trailers sent to La Loche, type one and two firefighters manning checkstops, education programs in multiple language broadcast over the radio, cleaning supplies and cots delivered to Buffalo Narrows and La Loche and food security programs. That doesn’t include additional staff sent by SHA.
“The resources were extensive,” Carr said.
“We extended millions of dollars of resources to the north for trying to bend the curve … trying to ensure the spread didn’t grow more than it did. Just because we didn’t write a cheque doesn’t mean we’re not contributing.”
In a statement, the SHA said it is working on building a task force with First Nations and northern stakeholders to further mitigate COVID-19.
Since more aid came in May, Belanger acknowledged some things have gotten better. However, he suggested that if it had come sooner, before an outbreak was declared, COVID-19 illnesses and deaths could have been prevented.
“We tried our darnedest (to keep out COVID-19) … and with no resources or help, we lost that battle,” he said.
Belanger wants the province to acknowledge its mistakes in order to avoid a similar situation should a second wave occur, as some experts have indicated.
“We want to make sure there are lessons so it doesn’t happen again.”
Other communities have also seen an improvement. Reached by phone, coordinators at both Lac La Ronge Indian Band and at Cumberland House Cree Nation said this week there are fewer concerns than in the pandemic’s earlier days. Lac La Ronge, which described its concern as “high” in May, now says that concern is “medium.”
Kevin Roberts is part of the pandemic response team in Lac La Ronge. He said the virus hasn’t hit there yet, but they’re ready if it does.
Early concerns such as a lack of health professionals and equipment in many communities have been resolved. Now, it’s a matter of keeping people safe.
“Some of it boils down to just not respecting the rules and guidelines that have been set forth by Sask. Health,” he said.
He said a recent northern outbreak linked to a funeral highlighted the risks if people aren’t careful about physical distancing.
“People go out and they come back to their communities, spread to each other and it’s just unfortunate,” he said.
“I don’t understand the province opening up,” he said.
Roberts said the focus is on keeping the message out there and encouraging people to follow SHA guidelines.
“We’re just continuing to be vigilant on our end.”
— With files from Jayda Taylor, Prince Albert Daily Herald; Amanda Short, Saskatoon StarPhoenix; emerging reporter Declan Keogh and IIJ reporters Angela Amato, Jaida Beaudin-Herney and Karina Zapata
Project Pandemic: Canada Reports on COVID-19 is coordinated by Concordia University’s Institute for Investigative Journalism, with the support of the Canadian Association of Journalists. For more information, please visit projectpandemic.concordia.ca.