COVID-19 outbreak in rural Alberta First Nation exacerbated by social inequities, doctors say

A COVID-19 outbreak in a First Nation in rural Alberta is exposing social inequities that make the spread of the virus quick, and recovery slow, according to doctors and communityleaders.

Conroy Sewepagaham is chief of the Little Red River Cree Nation, which includes Garden Creek, Fox Lake and John D'Orin northern Alberta. The nation has a population of about 6,000 people and as of Friday, there were 209 active cases of COVID-19.

About 53 per cent of residents have their first vaccine dose, and 35 per cent have their second.

Sewepagaham said there are many reasons the virus is spreading quickly, including a lack of health-care staff,boil water advisories and overcrowding of homes.

There is no hospital, ICU beds or permanent doctor. The nursing station is struggling to find staff to do testing, said Sewepagaham.

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One resident contracted COVID-19 and had to be flown four hours away to get an ICU bed.

"The standard of care with First Nations, not just ourselves, have always been atrocious," said Sewepagaham.

He added overcrowding is exacerbating the issue.

The outbreak consists of about 30 households, withan average of seven cases per home, said Sewepagaham.

He said if the outbreak were happening outside of the First Nation, where the average number of residents per household is lower, "we wouldn't have the skyrocketing numbers that we're seeing."

Sewepagaham said the community is constantly on and off boil water advisories, making it difficult for people to stay healthy.

There is currently an inter-community travel ban and the First Nation is running a social media campaign to encourage vaccinations.

Dr. James Makokis, a family physician in Kehewin First Nation, said overcrowding and boil water advisories can set up First Nations for "very disastrous situations" in the pandemic.

He said the number of positive cases is likely higher than reported, because some people have a fear of being tested or testing may not be available.

First Nations need culturally appropriate health care, said Makokis.

In the short term, Makokis said bringing in people who are trusted, like Indigenous nurses and physicians, would help reduce the barriers rooted in trauma around the health-care system.

In the long term, Makokis said young people need to be engaged and feel comfortable getting a vaccine.

"This is an emergency that necessitates an innovative and culturally appropriate, and trauma-informed approach," said Makokis.

Makokissaid in a population the size of Little Red River Cree Nation he would expect about four doctors, but there are no permanent doctors.

"We need to build health systems that are standard that every community in Alberta has," said Makokis.

The health-care system should include elders to create trust, because "if we had that, this situation would not exist. Vaccine hesitancy would not exist."

Dr. Lana Potts, medical director at the Aakom-Kiyii Health Centre, works with a virtual care clinic that does outreach to First Nations people across the province.

She said people can face significant challenges getting medical attention, for example, one individual was trying to get a COVID-19 test and had to travel 180 kilometreswithout a vehicle.

"We need equitable care. We need care that's accessible," said Potts.

In an email statement, Indigenous Services Canada (ISC) said it's meeting regularly with First Nationleadership in theregion and emergency management team to coordinate the response.

The department has also been working with the nation to make sure as many eligible people as possible have access to the vaccine, the department said.

ISC said it provides the nation with an annual housing allocation of $1.1 millionand under the 2021 budget $3 million was approved to build several housing units.

The department's COVID-19 surge team has also been sent to the nation several times to help with screening, testing and immunization, the statement said.

The department has invested $15 million for a water treatment plant in John D'or that was completed in 2019.

There is work underway to upgrade or replace the water treatment plant in Garden River. And there is ongoing work in Fox Lake to repair the water treatment plant, the department said.