White Coat, Black Art

Amid Manitoba's COVID-19 surge, First Nations response team leads fight in hard-hit Indigenous communities

Manitoba's Indigenous community is bearing the brunt of an alarming surge in COVID-19 cases.

Indigenous communities bearing brunt of alarming spike in COVID-19 cases

Melanie MacKinnon, head of the Indigenous Institute of Health and Healing in the Rady Faculty of Health Sciences at the University of Manitoba, is part of the Indigenous Pandemic Response Team. (Austin Grabish/CBC)

Leslie Williams caught COVID-19 through his wife's carpool.

She's a teacher who makes the trek from Winnipeg to a First Nation school every day with a colleague.

And though they were wearing masks in the car, both she and her colleague fell sick with the virus, followed by Williams, his father-in-law and his daughter-in-law, who all live together in a household of six.

That includes his son and daughter, who were yet to be tested when Williams spoke to White Coat, Black Art host Brian Goldman Wednesday.

Hollow Water councillor Leslie Williams contracted COVID-19 through his wife's carpool. (Submitted by Leslie Maurice Williams)

"I had the runny nose, the headache. I didn't feel like a fever, but I had chills. I had to constantly warm myself up. Loss of taste, loss of smell and appetite," said Williams, who is a band councillor for the Hollow Water First Nation, in charge of the community's health portfolio.

He lives in Winnipeg, but makes the 180-kilometre trip home by car regularly. 

After keeping the coronavirus at bay during the spring and summer, Manitoba is now at the centre of an alarming surge of COVID-19 cases.

The number of COVID-19 patients in hospital has spiked over the last few weeks, from 28 on Oct. 19, to 140 as of Nov. 4. (Bryce Hoye/CBC)

The number of people hospitalized with the illness has climbed every day since Oct. 19, and ICU numbers are at their highest point in the pandemic, pushing the health-care system to its limits. As of Nov. 5, there were 16 patients in ICU in the province, down from a high of 21 the day before.

Manitoba's Indigenous community is bearing the brunt of that surge. At one point this week, 69 per cent of COVID-19 patients in the ICU were Indigenous, as were 26 per cent of those hospitalized, according to data compiled by the Manitoba First Nations COVID-19 Pandemic Response Coordination Team.

"As soon as I developed a little cough in my First Nation, I left the community and came to the city right away to isolate," said Williams.

But he worries that most Indigenous people in the province won't be able to do so, given it's common to have several people sharing a home, often in multigenerational households that include elders and others in high-risk groups.

"That's still one of the biggest struggles for our First Nation — how do we isolate one person away from their family?"

Response team prepared for 2nd wave

Though there are no known cases of the virus in Hollow Water, Williams said he isn't confident the community is COVID free.

"It's hard to say because no one's going to get tested because you have to drive 45 minutes away to get tested."

He said a lot of members of the Hollow Water First Nation don't have access to vehicles, so when they do venture to neighbouring towns, or even to Winnipeg, it's often in a full car.

"It's not just one person jumping into their vehicle and saying, 'OK, I'm going to get tested.' It's like, 'I'm going shopping today, but I'm going to take my auntie who needs a ride; I'm going to take my cousin who needs a ride to go and shop for food. So you have one person that wants to go get tested, but you have three other people in the vehicle with them." 

Those conditions are the reason why First Nation leaders, health providers and academics formed an Indigenous Pandemic Response Team in the early days of the pandemic. 

Melanie MacKinnon, head of the Indigenous Institute of Health and Healing in the Rady Faculty of Health Sciences at the University of Manitoba, is part of the team.

Manitoba First Nations COVID-19 Pandemic Response Team is reporting a surge in COVID-19 cases among First Nations People in the province. (Evan Mitsui/CBC)

While some communities have been able to isolate people in hotels, the response team also set up alternative accommodation in larger centres like Winnipeg and Thompson, where people can be close to hospitals if their condition worsens, she said.

"We find when we can get people out of their home, the transmission rate is much, much lower," said MacKinnon, a nurse and member of the Misipawistik Cree Nation.

She noted that there are "several historical and contemporary inequities" that make Indigenous people disproportionately vulnerable to infectious disease — all related to the social determinants of health. Those include overcrowded housing, income insecurity and access to clean drinking water, to name a few. 

But MacKinnon added that the surge in cases in Indigenous communities came about in similar fashion to second waves elsewhere.

"We were acting like everybody else in this province, where over the summer, we had a bit of a reprieve. And we were able to see our families again, and go to other centres for our own essential services, or groceries or supplies, you know, have a bit of a holiday or even go to other provinces," she told Goldman.

Outbreak in Little Grand Rapids

Edna Nabess, 63, caught COVID-19 at one of those gatherings while officiating a wedding held in her fly-in community Little Grand Rapids, located 280 kilometres northeast of Winnipeg, at the end of September.

Edna Nabess contracted COVID-19 in her fly-in community Little Grand Rapids at the end of September. (Submitted by Edna Nabess)

"I went to Winnipeg for an appointment, and when I was on my way to the airport, the health authority here phoned me and said I need to go get tested for COVID because I had been exposed," said Nabess.

"It was like something I couldn't believe … you hear it on the news, but you just don't think that it's going to happen to you."

She self-isolated at her son's home in Winnipeg and returned to Little Grand Rapids last week.

"We only had one bathroom in their house, so whenever I went to the bathroom — which was like in a daze — I had to sanitize the bathroom and then go back into my room."

On Oct. 4, an outbreak of COVID-19 was declared in Little Grand Rapids. With a population of 1,300 people, roughly a fifth of the population — approximately 263 people — were either known cases or their close contacts, said Arlen Dumas, grand chief of the Assembly of Manitoba Chiefs, in an interview with CBC Manitoba's Up to Speed last month.

An outbreak of COVID-19 was declared in Little Grand Rapids Oct. 4. (Submitted by Harrison Bushie)

To help deal with the outbreak, the federal government set up special isolation tents on the First Nation. The Canadian Red Cross is also assisting, while Manitoba's Red Cross was deployed to help with COVID-19 testing and PPE support. 

Leslie Williams cautioned that separating family members during this crisis may be especially painful given the history of residential schools. 

"Because it's like, 'OK, we're going and we're coming into your community; we're going to take you out of your house, so we're going to put you in a tent and tell you you can't see your family….'  People don't want to get tested because they're scared that that's going to happen to them." 

Manitoba's Indigenous communities experiencing COVID-19

CBC News Manitoba

3 months agoVideo
Almost a third of all Manitoba First Nations have had cases of COVID-19, officials working with the Assembly of Manitoba Chiefs said Friday, including 15 communities that currently have active cases. 2:35

Infectious disease expert Jason Kindrachuk, an assistant professor at the University of Manitoba's department of medical microbiology, said the outsized impact of COVID-19 on the province's Indigenous communities shouldn't come as a surprise.

"Those of us that have worked in vulnerable communities in different areas of the globe, we've seen the toll firsthand that these types of viruses can take," said Kindrachuk, who has a PhD in biochemistry and has been involved in the fight against other outbreaks, including Ebola and Zika virus. "We need to be much more proactive in our preparedness for these communities."

MacKinnon said the response team took advantage of the low numbers in the first wave to prepare for a surge they knew was "inevitable" and drew on lessons from the H1N1 epidemic that hit Indigenous communities hard in 2009. 

They were driven by the fact that no one wants to see a repeat of an incident from that period where Health Canada sent body bags to reserves, along with hand sanitizer and masks, she said.

COVID-19 cases a concern in remote Manitoba First Nations

The National

4 months agoVideo
Manitoba has seen higher numbers of COVID-19 cases in recent weeks and though most of the cases are around Winnipeg, there is also concern about remote First Nations communities that lack critical resources. 1:54

A key early step was developing an ethnic and racial identifier for those who have COVID-19, which MacKinnon said has been "tremendously helpful" in allowing them to respond to outbreaks quickly and to advocate for more resources. Health-care workers from other areas like chronic care were reassigned to COVID response teams. Setting up alternate isolation accommodations in hotels was also a priority.

"As First Nations in Manitoba, we knew that we were not wanting that same experience this time around, and we knew that we needed to work together to build a bridge [to other levels of government]," she said, adding that kind of collaboration will be critical to controlling the virus in the coming weeks. 

"I think our shared and collaborative leadership efforts are demonstrating to our provincial and federal partners that we know what we're doing. And so let us do it."

Written by Brandie Weikle. Produced by Sujata Berry, Dawna Dingwall and Jeff Goodes. 

Clarification: This story initially indicated that Melanie MacKInnon is a Registered Nurse. (RN). She currently holds the designation Bachelor of Nursing. The story has been edited to clarify this.