It would be devastating if COVID-19 started moving through the northern First Nations community, an Ontario expert said. David Fisman is a professor in the Epidemiology Division at the Dalla Lana School of Public Health at the University of Toronto. After making a comment on Twitter about the outbreak, he responded to questions from CTV Saskatoon via email.
While the province
only one new case of the virus in the far north on Thursday, 50 of 88 active cases of the province are concentrated in the region and two long-term residents of La Loche
There are outbreaks throughout the country. What’s wrong with the La Loche outbreak that caught your attention?
The La Loche epidemic was the first I realized in the isolated First North Nations community. These communities may be partially protected by their remoteness, but COVID-19 that spreads through such communities has the potential to cause disaster. Many do not have strong health systems and resources at the best of times; COVID-19 causes severe lung disease which often requires intensive care. It is very difficult to evacuate large numbers of people to the south for ICU care. If this begins to cause epidemics in isolated northern communities, many people will die in the north or die on their way south to be treated.
Crowded housing has become a problem in many northern communities as well; which makes it very difficult for people to isolate or distance, which has proven effective in limiting the spread of COVID-19 elsewhere in Canada.
We saw this game during the 2009 H1N1 pandemic, especially in the northern Manitoba community. I am worried that La Loche suggests that we begin to see dynamics similar to COVID-19.
The Saskatchewan government announced plans last week for a gradual reopening of the provincial economy. Given the La Loche outbreak, as well as other cases in the north, should the reopening be delayed?
I think the Saskatchewan government must make its own decisions. There are many geographies in Saskatchewan and the population is relatively scattered. Different approaches may be appropriate in different parts of the province; but I would think that you want to limit travel within the province to prevent hotspots from igniting other regions, especially in the north. We have seen what “linked” populations are vulnerable to our nursing home epidemic here in Ontario. That has caused many deaths.
You have to try very hard to protect the north by ensuring a lot of testing for situational awareness (eg testing people who fly into northern communities before they leave), limiting movement between communities, doing whatever you can to prevent disease. Because once you enter a remote community, it will be very difficult to control, and you will lose people who cannot be cared for.
How does the Saskatchewan government fight COVID-19? Are there particular strengths / special areas that stand out?
I don’t know the details of the Saskatchewan response but we do cross-Canadian forecasts every morning. Until this last week Saskatchewan has been prominent for the speed and effectiveness of COVID-19 control so this is clearly a setback.
What have we learned about coronavirus / COVID-19 since it appeared in Canada?
Expect the unexpected and declare victory prematurely at your own risk.
What we must see before life returns to normal, that is. end the physical distance? Or does this look like a new normal?
This is it. We will go one step forward, one step back for a while. We will find this out, but vaccines are a long way away (keep your fingers … promising results from some initial vaccine work). Distance has proven to be very effective, but it certainly has a large economic cost, so we will be walking on a rope for a while.