Ottawa doctors embrace telemedicine as Nunavut sees 1st COVID-19 case
Territory preparing to send patients in need of intensive care to the capital, if needed
- After this story was published, Nunavut's 1st COVID-19 case turned out to be a false positive.
Ottawa health-care providers who treat patients from Nunavut are changing the way they care for Inuit amid COVID-19 travel restrictions and physical distancing measures.
Face-to-face appointments are being cancelled, and doctors are doing consultations by phone or video link instead. Interpreters who translate medical advice from English to Inuktitut now do so remotely, wherever possible.
The shift to telemedicine is meant to limit unnecessary travel between the capital and the territory, which reported its first case of COVID-19 last Thursday.
"What we're doing right now is ensuring that the health and safety of our patients, their families, and their communities, are at the forefront," said Gwen Barton, manager of the Indigenous cancer program at The Ottawa Hospital.
"Limiting travel as much as possible to those that actually medically need to be here is key to helping prevent that spread."
Nunavut hospitals lack capacity
Hundreds of Inuit from the Baffin Island region travel to Ottawa each year to receive critical care, as territorial hospitals have limited capacity to treat complex illnesses and conditions.
But medical trips have decreased since the pandemic began, Barton said, to only those which are absolutely necessary.
"Each of our cases — before anybody flies down to Ottawa — are being looked at carefully to see if they could be delayed or postponed without any negative health outcomes," said Barton.
We're trying to do this in a way that is safe but also still allows this personal connection that we would normally have with families when they come in-person.- Dr. Radha Jetty, physician lead for Inuit child health at Ottawa's children's hospital, CHEO.
Inuit patients who do head south are subject to physical distancing at hospitals and must undergo a 14-day quarantine period at an Ottawa isolation centre before they can return to Nunavut.
Patients who would normally travel with an escort can do so only if it's deemed necessary — for example, to accompany a minor or for linguistic reasons.
Beneficial for some, out of reach for others
Issues such as food security, overcrowded housing and poverty would exacerbate the severity of a COVID-19 outbreak in Nunavut, according to Dr. Radha Jetty, a pediatrician who cares for young Inuit patients.
Jetty, the lead physician at the Aakuluk Clinic at Ottawa's children's hospital, CHEO, has also shifted to seeing patients online.
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She said some families have benefited from the convenience of receiving medical care while at home — especially those who have children with complex needs."We're trying t
o do this in a way that is safe but also still allows this personal connection that we would normally have with families when they come in-person," said Jetty.
Jetty acknowledged that connecting virtually can be a challenge for some Inuit families, who may not have access to a computer, smartphone or telephone.
WATCH: How a medical clinic for young Inuit patients is adapting
A lack of access to technology required for virtual services is a barrier urban Inuit face as well when accessing services in Ottawa, said Amanda Kilabuk, acting director of Tungasuvvingat Inuit, an organization that helps urban Inuit access services in Ontario.
Tungasuvvingat Inuit has shifted some of its face-to-face services online in the past few weeks.
"A lot of Inuit may not have access to a phone, to internet, to computers, to access these services," said Kilabuk.
"It's very important that after this crisis passes, that we need to address the inequalities."
Ottawa hospitals ready to care for Inuit with COVID-19
As the health care system adapts to new ways of caring for Inuit, Ottawa hospitals are also bracing for an increase in critical care patients in the event Nunavut's one COVID-19 case becomes an outbreak.
Dr. Francois de Wet, chief of staff for the Nunavut health department, said COVID-19 patients there who need intensive care will be transferred by medevac to a hospital in either Ottawa, Winnipeg, Edmonton or Yellowknife.
"We do not have the capacity to look after multiple intubated patients in the territory," said de Wet.
While the territory has increased the capacity of the Qikiqtani General Hospital in Iqaluit and has doctors ready to be deployed to isolated communities in case of an outbreak, emergency medical equipment is scarce.
The territory currently has 12 ventilators available for a population of around 38,000.
De Wet said while the territorial government is preparing for the worst, his main concern right now is trying to reduce the amount of cases of COVID-19 in Nunavut and delay any increase for as long as possible.
With files from Radio-Canada's Dominique Degré