Thunder Bay

Rapid COVID-19 testing helps remote First Nations cope with shortage of isolation space

A new machine that tests for COVID-19 and provides results within an hour is already making a difference in Sandy Lake First Nation, a remote community about 600 kilometres north of Thunder Bay, Ont.

Four First Nations have GeneXpert machines in place, more on the way, says health authority

Sandy Lake First Nation's COVID-19 rapid testing technicians, Sonny Meekis, Edith Kakepetum, Paisley Fiddler RN, Dorothy Kakegamic, Cheryl Knott RPN, and their trainer from the National Microbiology Laboratory with the new GeneXpert machine. (Sandy Lake Pandemic Response/Facebook)

A new machine about the size of a microwave that tests for COVID-19 and provides results within an hour is already making a difference in Sandy Lake First Nation, a remote community about 600 kilometres north of Thunder Bay, Ont.

The community reported its third active case of the virus on Wednesday after completing contact tracing on an earlier case, according to Dr. John Guilfoyle the public health physician for the Sioux Lookout First Nations Health Authority, which includes Sandy Lake.

All of the positive cases are members of the same household, and the infection is linked to travel to Winnipeg, which was caught by routine screening as part of Sandy Lake's pandemic protocols when the person returned to the community.

The rapid testing "helps us determine how fast to react, if it's an emergency or something we can handle," Sandy Lake Chief Delores Kakegamic told CBC News. 

The Public Health Agency of Canada provided machines for First Nations that have had positive cases: Sandy Lake, Pikangikum, Kasabonika Lake First Nation, and Eabametoong First Nation, Guilfoyle said. It's part of a nation-wide effort to place the machines, called GeneXpert, in all remote communities.

The Public Health Agency of Canada is making GeneXpert machines, like this one, available in remote communities across the country, but there is a world-wide shortage of cartridges to produce rapid results. (Sandy Lake Pandemic Response/Facebook)

A world-wide shortage of cartridges for the GeneXpert machine means that only the most urgent cases can be tested in the communities. Other swabs are sent to Sioux Lookout, Ont. or Thunder Bay and can take several days for results.

Rapid results are critical in First Nations because more than 40 per cent of the homes in those communities are overcrowded and there are few places to self-isolate for people awaiting tests results, Guilfoyle said.

If someone presents with COVID-19 symptoms in remote communities without a rapid testing machine, that person may need to be medevaced, i.e. taken out by air ambulance, because of the risk they could infect others in the tiny nursing stations that are the only health care facilities in most First Nations, he said.

"I consider myself lucky because we have a 10-unit isolation building," Kakegamic said. The building was built as a nurses' residence with construction completed in March, just in time for it to be repurposed for the pandemic.

"It's for our higher-risk people, people who have nowhere else to go" when they return from COVID-19 "hotspots" such as Winnipeg, she said.

Sandy Lake lifted its travel ban in August but put it back in place in September when cases started to climb. Only essential service workers and people returning from medical appointments, often in Winnipeg, are allowed in.

Urgent need for more housing

Guilfoyle said he has put in a proposal to the federal government to build temporary structures in other First Nations to accommodate people who are required to self-isolate.

"These would be good houses available for the next 20 years or so," he said. "We need isolation capacity in real time, and we need it soon."

Beyond those temporary buildings, Guilfoyle said, more permanent housing is required in every First Nation.

"We cannot consider ourselves prepared for this or any other health concern without more housing," he said. "That's just the way it is."

While provincial governments are responsible for health care across the country, the federal government provides health care to First Nations and the pandemic has highlighted, in the worst way possible, disparities in public health resources for First Nations, Guilfoyle said.

For example, the funding for pandemic response teams — people assigned and trained for specific tasks to prevent the spread of the virus — in remote communities "has been variable," he said.

"We need more resources to pay more people," Kakegamic said. "The teams we put in place right from the start in March, they've been on the go, full out, every day, and we don't want to burn out our current workers."