In some ways, British Columbia has led the country with sharing information about COVID-19, which has helped build trust in public-health decisions on managing the pandemic. Missing, however, are details of how COVID rates vary depending on ethnicity, socioeconomic status or vocation.
Some of those answers will come as early as this week when the First Nations Health Authority releases data on COVID transmission among the province’s Indigenous peoples.
The data are likely to offer good news.
The odds seemed to be stacked against remote and rural communities where medical services are scarce. And many Indigenous communities endure economic inequality that has, in other jurisdictions, allowed the pandemic to run deeper.
But First Nations in B.C. have been deeply involved in keeping the pandemic at bay. Dozens of communities have shut their doors to visitors, and the First Nations Health Authority (FNHA) has been part of the province’s emergency response team, helping shape B.C.'s pandemic strategy. The agency, which is unique in Canada, has provided access to clinical nursing support and testing equipment, and it has delivered more than 715,000 pieces of personal protective equipment to front-line health-care workers.
On Vancouver Island, in the Nuu-chah-nulth territories span 300 kilometres of the Pacific coast, and their 14 First Nations represent 10,000 members. “There have been no COVID cases in our communities,” Tribal Council President Judith Sayers said in an interview.
Starting in March, some of the Nuu-chah-nulth communities blocked traffic to all but essential travellers. Remote villages brought in bulk groceries so that residents did not have to travel. One island community set up tents for COVID testing, while another installed temporary quarantine housing, supplied with food, to ensure new arrivals were not carrying the virus.
Even as the province has started to reopen the economy, and neighbouring communities have begun welcoming tourists again, Coastal First Nations including the Nuu-chah-nulth say they are not ready to let up their guard.
“We just never want to get to the point where our population is at risk," Ms. Sayers said. That has meant discouraging cultural practices when they involve gatherings. “The hardest thing of course has been funerals,” she said. “Not being able to go into the family’s home when someone dies, it has been really, really hard. But people have been living up to it.”
According to figures gathered by Indigenous Services Canada, which is responsible for on-reserve health care, First Nations have been largely successful in preventing the spread of COVID-19. While Indigenous peoples make up about 6 per cent of B.C.'s population, there have been 43 cases of COVID on reserve in B.C. – about 1.5 per cent of all the cases in the province. That doesn’t include the many Indigenous people living off reserve, so the figures from the FNHA will be higher, but they are not expected to be disproportionately so.
Ms. Sayers said having a First Nations-led voice in pandemic response planning has been helpful, but tensions with the public-health system remain. One is around COVID data.
The Nuu-chah-nulth say they won’t reopen their territories – which encompass a large swath of Vancouver Island – to non-residents until they can be sure visitors are not carrying the virus. One thing they want is an agreement that health authorities will promptly report to them – with confidentiality protections – all relevant information relating to suspected and confirmed cases of COVID-19 in Vancouver Island communities.
Dr. Bonnie Henry, Provincial Health Officer, said information about how COVID affects different parts of the population is important to have. “We are collecting some very important disaggregated information by race, by ethnicity, by community, by socioeconomic status, because that does help us understand the impacts that it has had on various different communities across the province,” she told reporters during a briefing on June 9.
But that information will not be publicly released any time soon. Dr. Henry worries that too much detail could reveal individuals who have had COVID.
Premier John Horgan, who wants British Columbians to spend their travel dollars in the province this summer, acknowledges the conflict. “If we’re going to talk about tourism on one hand and isolation and closing communities on the other, we’re going to have an impasse,” he said last week. He wants to find a balance between restarting the economy and protecting Indigenous communities.
Finding that balance will not be easy. This is not the first time these communities have faced the threat of a virus or bacteria for which they have no immunity. First contact with Europeans brought smallpox and tuberculosis to coastal tribes, decimating their populations. And these are not forgotten traumas: There are still Nuu-chah-nulth elders who spent part of their childhoods warehoused in tuberculosis wards.
“We’ve learned things from those viruses,” Ms. Sayers said. “We’re protecting our people because the chiefs have said over and over again, people before economics.”
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