Residents of Indigenous communities in Manitoba are testing positive for COVID-19 at rates nearly five times the national level, and some of the spread has been linked to essential trips to access health care.
It's unclear exactly how public health officials keep track of the number of cases that have been linked to medical travel. Neither the federal nor provincial government responded to a Free Press request for data Wednesday.
The Manitoba First Nations Pandemic Response Coordination Team has been tracking COVID-19 case counts, test positivity rates and hospitalizations among on- and off-reserve First Nations people, but a spokeswoman said Wednesday the team doesn't look at medical travel.
Residents of northern and remote communities in Manitoba must travel to larger cities, usually Winnipeg and Thompson, for many non-COVID-related medical appointments. Some of that travel has allowed the novel coronavirus to spread in their home communities, the same way some patients returning from essential medical trips brought home H1N1 in 2009.
But people typically aren't contracting COVID-19 at their doctor's office, said Dr. Mike Isaac, medical health officer for the Northern Health region.
"We don't think that people are acquiring COVID at their medical appointments. I think it's likely more related to what's going on before and after the appointment, so people perhaps visiting with other family members or having contact with other people while they're staying at a hotel, or that kind of thing. I think that's likely what's driving acquisition of those cases outside of their home community," Isaac said in an interview.
He said large outbreaks in small, far-apart communities drive up the test positivity rate in northern Manitoba, and lately, as soon as one outbreak calms down, another pops up. The region is currently seeing the effects of an outbreak in Thompson's Mystery Lake district.
"Thompson has seen another resurgence of COVID, so when people leave the community for reasons (of) medical travel or for essential purposes, sometimes they'll acquire it and bring it back to the community. And for sure, overcrowded housing is a big risk factor."
Community transmission is a reality in many communities, though strict lockdown measures set by First Nations leadership are still helping to control the spread, Isaac said.
He said new cases are primarily from household gatherings, including holiday get-togethers, but the North isn't logging large outbreaks at workplaces, schools or health centres.
Earlier this week, three chiefs of northern First Nations drew attention to the oft-repeated need for improved health facilities and enough doctors and nurses working locally. At an MKO news conference Tuesday, Pimicikamak Cree Nation Chief David Monias said pre-pandemic, 50-60 residents had to go to Winnipeg for medical reasons each month, from the community of roughly 7,000.
"We need to be in charge of our own health system, our own facilities. We need to make sure that we have the appropriate funding for it," he said when asked what the community needs to cope with and move forward from the pandemic.
"We need the expertise to be here, so they will know our realities. Because a lot of people think they know our realities, but they don't."
Katie May reports on courts, crime and justice for the Free Press.