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Siksika First Nation reserve located southeast of Calgary is seeing a rise in COVID-19 cases this past week, July 7, 2020.

Todd Korol/The Globe and Mail

The chief of an Alberta First Nation that went under lockdown in the face of a recent COVID-19 scare says the pandemic has laid bare inequities that continue to persist in Indigenous communities.

Chief Ouray Crowfoot of Siksika Nation, which successfully contained a coronavirus outbreak last month, says the pandemic should be a wake-up call that drives long-term change.

Siksika Nation, located east of Calgary, imposed a curfew and other restrictions last month amid concern that COVID-19 was spreading in the community. The First Nation’s health department said dozens of households were in isolation as it conducted widespread testing.

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In the end, infections did not spike as feared. Siksika Health Services has identified 29 cases, involving members both on and off the reserve, since its first confirmed case in June. There haven’t been any new infections on the reserve in weeks and there are currently no active cases in the community. One person has died.

Siksika Health added a new case to its totals on Monday but said it was not a member of the First Nation and that the person does not live on the reserve. The agency did not elaborate.

The Chief said even a relatively small number of cases requires a significant response because First Nations communities such as his are at particular risk from conditions that have persisted since long before the pandemic.

“The fact of the matter is that on the reserve, because we have inadequate housing, inadequate security, inadequate policing, inadequate basic needs – that’s why any kind of outbreak can go from 0 to 100 overnight,” Mr. Crowfoot said in an interview.

“I think it has shown the rest of Canada the conditions that we live under every day at Siksika.”

Mr. Crowfoot pointed to federal funding that has not kept up with population growth and leaves people in Indigenous communities unable to meet their basic needs.

The community declared a state of emergency in March as it prepared for possible COVID-19 cases. Its health department set to work preparing a pandemic plan and building up its contact tracing and testing capacity.

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Siksika Health has conducted nearly 3,300 COVID-19 tests. Siksika Nation has about 7,500 members, including more than 4,000 people living in the community.

The curfew remains in place and masks have been mandatory since the beginning of the month.

Mr. Crowfoot said Siksika, like most places in Canada, is beginning to reopen from its lockdown as businesses and services resume operations. Still, he said the community’s approach will need to be more cautious as it seeks to prevent any more flare-ups.

“Even though now the number is at zero, we don’t just pull away. Because of our demographics, we want to be more on the precaution side than the rest of the province or the rest of Canada.”

Mr. Crowfoot said overall the community has received the pandemic support it needs from the federal government.

First Nations communities have been identified as particularly at risk during the COVID-19 pandemic and the federal government announced $285-million to support public-health efforts in Indigenous communities earlier this year.

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Chief Ouray Crowfoot says even a relatively small number of cases requires a significant response because First Nations communities such as his are at particular risk from conditions that have persisted since long before the pandemic.

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Federal Indigenous Services Minister Marc Miller acknowledged the federal government has more work to do to address conditions on First Nations reserves that have made the pandemic more dangerous, particularly overcrowded housing. He said the current Liberal government has made infrastructure in Indigenous communities a priority and that work needs to continue.

“Knowing the historical disadvantages and the social determinants of health [in Indigenous communities], I think this is really top of mind in pretty much every indigenous community,” he said in an interview.

Mr. Miller said the federal government has worked to ensure Indigenous communities and their respective health departments, whose work he praised, have the resources they need to track and treat infections.

“Because COVID isn’t limited to off or on reserve, it’s quickly becoming a challenge as to how you provide a wraparound health solution to a historic epidemic,” he said.

As of last Thursday, based on the most recent data available, there have been a total of 422 cases of COVID-19 on First Nations reserves across the country, according to Indigenous Services Canada.

Of those, 34 have been hospitalized and six have died.

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Marlene Poitras, the Alberta Regional Chief for the Assembly of First Nations, said the federal government has been responsive during the pandemic, but she agreed with Mr. Crowfoot that the risks posed to First Nations are rooted in long-standing problems.

“The pandemic brought the issues to light, in terms of the housing situations, the boil-water advisories, overall poor health conditions of our people,” she said.

“There are a lot of those underlying conditions that if COVID were to spread, it would put more of our people at risk to get seriously ill.”

Ms. Poitras said she’s concerned that Indigenous communities will face an increased risk as provinces around them open up, including as children return to school.

“I see a huge potential for spread of the virus,” she said.

Anna Banerji, an infectious-disease expert at the University of Toronto whose work has focused on Indigenous health care, agreed that pre-existing conditions on First Nations reserves such as overcrowded housing, a lack of clean drinking water and high rates of health conditions such as diabetes have made COVID-19 far more dangerous.

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She said lockdowns have been effective in keeping cases relatively low in First Nations communities, but she said that cannot be a long-term solution.

Dr. Banerji said Indigenous communities are looking for a comprehensive plan to manage a pandemic that is expected to continue for some time.

“They really can’t be in lockdown for that long because it’s taking a toll,” she said.

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