AFN Alberta COVID-19 Bulletin

Thursday, January 14, 2021 AFN Alberta is summarizing updates and information we are receiving on our website. All our previous bulletins can be found on this page as well: h ttp://www.afnab.ca/News-and-Events/Coronavirus. The next bulletin will be sent Thursday, January 21, 2021.

HIGHLIGHTS January 6 January 13 Change*

Tests Completed 2,873,566 2,950,446 +76,880

Total Positive 107,501 112,743 +5,242

Active 13,450 13,220 -230

Fatalities 1,193 1,345 +152

Recoveries 92,858 98,178 +5,320

COVID-19 Regional Data for Alberta COVID-19 in Indigenous Peoples (both on and off reserve) Calgary zone - 43,140 Edmonton zone - 47,798 (As of January 06) Central zone - 7,834 Total - 8,716 On-Reserve only - 3,754 Active - 2,066 South zone - 5,300 North zone - 8,494 Current Hospital - 127 Current ICU - 33 Unidentified zone - 177 Recovered - 5,776 Deaths - 61 FN Cases by Zone (both on and off reserve) North - 2,298 Central - 2,045 South - 428 Calgary - 1,441 Edmonton - 2,485

Feedback Wanted! ● As we enter the new year, we appreciate how you have all supported your Nations in combating COVID-19. We hope that our weekly bulletin has helped to inform and guide you along the way. We’ve received some good feedback on the value of this bulletin as an informational tool, and we are looking to make it even better! ● Please send your suggestions for the kinds of information you would like to see in the bulletin or focus areas going forward to p [email protected]

New Measures ● *NEW* P rovincial restrictions on gathering and other enhanced public health restrictions remain in effect until at least January 21, 2021. ● Under new federal rules, as of Thursday, anyone older than five entering Canada will be required to show proof of a negative test - taken within 72 hours before the flight - before being allowed to board the plan.

First Nation-specific Updates ● *NEW* O n Wednesday, Indigenous Services Minister Marc Miller announced $1.2 billion in new funding to help Indigenous communities keep fighting the COVID-19 pandemic. F ull details below. ● *NEW* S toney Nakoda First Nation is seeing an increase in COVID-19 cases and enacted a state of local emergency on Monday. ● Siksika Nation received its first shipment of the Moderna COVID-19 vaccine, and began immunizing staff and residents at the Siksika Elders Lodge last Friday.

National and Regional Updates ● More than 200 doctors have signed an open letter calling on the province to prioritize the vaccination of all health-care workers caring for patients in Alberta’s dedicated COVID-19 wards. ● *Reminder* T he entirety of the province of Alberta remains under Enhanced COVID-19 status. C lick here to view the interactive map updated by Alberta Health.

*NEW* V accine Rollout Updates This new section of the highlights will cover weekly information updates on the National COVID-19 Vaccine Rollout - note - this section may repeat some information from updates in other sections of the bulletin.

Additional priority recipients added to vaccine list: ● As of January 8th, vaccine appointments are offered to health-care workers in medical, surgical and COVID-19 units. ● As of January 11th, paramedics and emergency medical technicians were also added to the vaccine priority list.

As of January 12: ● 58,144 doses of COVID-19 have been administered (1,314.9/100k population) ○ 10 adverse events following immunization have been reported to Alberta Health and AHS ● Canada currently has two approved vaccines: ○ Pfizer BionNTech, approved on Dec 9, 2020 ○ Moderna, approved Dec 23, 2020 ● Alberta will be rolling out the vaccine in phases, with timelines subject to change depending on vaccine supply ○ Phase 1A (present) is offered to key populations including ■ Respiratory Therapists ■ Health-care workers in ICUs ■ Staff in long term care and designated supportive living facilities ■ Home care workers ■ Health-care workers in emergency departments ■ All residents of long term care and designated supportive living, regardless of age

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INFORMATION AND DOCUMENTS FOR FIRST NATIONS *NEW* Additional Federal Funding to Support Indigenous Communities’ COVID-19 Response CPAC Recording of Press conference During a news conference on Parliament Hill, Indigenous Services Minister Marc Miller provides an update on the federal government’s response to the COVID-19 (coronavirus disease) pandemic, focusing on its impact on Indigenous communities in Canada and on vaccine distribution in these communities. He is joined by Valerie Gideon (Senior Assistant Deputy Minister, First Nations and Inuit Health Branch, Indigenous Services Canada) and Dr. Tom Wong (Chief Medical Officer of Public Health, Indigenous Services Canada). ● Minister Miller announces an additional $1.2 billion in funding to support the public-health response to COVID-19 in Indigenous communities. ○ As part of this, the federal government is also injecting $380 million into the Indigenous Community Support Fund. ○ $631.6 million over two years for public health response to COVID-19 in Indigenous communities for a variety of uses, PPE, Staff or other. ○ $186.8 million over two years for Supportive Care (LTC and Elder Care facilities) ● In total since March $4.2 billion in support has been announced in Indigenous support for fighting COVID-19. ● As of Jan 12, there are 4,384 active cases on-reserve for a total of 11,502 confirmed cases since March. Numbers on-reserve have now exceeded the national average.

*NEW* AFN COVID-19 National Task Force Weekly Update - Jan 11 Attached to this bulletin you will find the weekly C-19 Task Force Update dated Jan 11, 2021

Updates from ISC Alberta Region *NEW* J anuary 13 Bulletin: ISC Alberta Region is sending updates weekly to leadership on the current COVID-19 situation and response. Yesterday’s Bulletin (January 13) is attached. It includes the following information: ● Update to Protocols and Schools ● Vaccination Plans ● Ensuring safe air and surface disinfection products ● OneHealth Reminder ● AHS Vaccine Update

Also attached is the call summary for the All Chiefs calls with Dr. Hinshaw on January 5 and 11, 2021.

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*Reminder* M ental Health Telehealth Session - January 20, 2021 Helping the Helper: Resources and tools to support resilience and mental health for front end workers, o n W ednesday January 20, 10 am - 12 pm

To connect to the session: ● via , go to h ttps://fntn.zoom.us/join and enter Meeting ID: 928 4795 5576 and Passcode: 864150 ● from an audio line, dial 1-587-328-1099 and enter Meeting ID: 928 4795 5576 and Passcode: 864150 ● from a videoconference-enabled room, go to w ww.fntn.ca t o register

Questions can be submitted in advance of or during the presentation to V [email protected], or via Zoom during the presentation.

National Advisory Committee on Immunization (NACI) - Recommendations on the use of COVID-19 vaccine(s) document The document is now available online at the following link: https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-i mmunization-naci/recommendations-use-covid-19-vaccines.html This is an evergreen document which will be updated with additional information as it becomes available or relevant (e.g. information on Moderna COVID-19 post authorization from Health Canada).

CALL & MEETING SUMMARIES *NEW* A ll Chiefs call with Dr.Hinshaw | January 11, 2021 Regional Chief Poitras, along with several Chiefs from each of the three treaty areas joined with ISC Alberta Region, Alberta Health, Alberta Health Services and others to participate on a conference call regarding vaccine rollout updates in the province of Alberta. T he notes from this call are included in the attachments.

REGIONAL AND NATIONAL UPDATES Summaries and information of the following can be found in the update below. ● Government of Canada COVID Updates ● Government of Alberta COVID Updates

Government of Canada COVID Updates

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Federal Briefing on the Response to COVID-19 - January 12, 2021 In Ottawa, Dr. , Canada’s chief public health officer, and Dr. Howard Njoo, deputy chief public health officer, join federal ministers to provide an update on the ongoing COVID-19 (coronavirus disease) pandemic. K ey Highlights: ● Over 668,000 cases of COVID-19 have been confirmed including 17,086 deaths, with over 82,500 active cases across the country. Over 8,000 new cases on average are reported daily across the country. ○ 4,500 are hospitalized across the country with approximately 850 in Critical care. ● A Canada Vaccine Distribution tracker is available through the health Canada website here. ● An additional 2 million Pfizer doses are confirmed for Q2, which were originally not going to be available until the third quarter of this year. ○ The federal government remains focused on being able to provide vaccines to any Canadian that wants them prior to the end of September.

Government of Alberta COVID Updates CPAC Video: Alberta Update on COVID-19 - January 13, 2021 In Edmonton, Dr., Alberta’s chief medical officer of health, provides an update on the province’s response to COVID-19. K ey Highlights: ● Dr.Hinshaw stated 875 new cases in the last 24 hours, with 16,000 tests putting positivity at 5.3%. There are 820 in hospitals with 137 in the ICU. 23 fatalities were reported in the last 24 hours. ● Questioned on if the federal government has delivered all the doses promised in its rollout, Dr.Hinshaw stated that doses are committed for particular weeks and new shipments are still coming in. ● Asked on case spread for hair salons, personal services, and in-person dining Dr.Hinshaw stated they would not be seen in current trends as due to public health orders they have been closed for many weeks. ● Questioned on delays and transfers of appointments due to vaccine shortages and the concern, Dr.Hinshaw stated the impact is minimal for these, most cancellations were in open appointments and not ones that were currently booked. ● Dr.Hinshaw was also asked about procurement outside of the federal program and she stated it was the goal to provide the vaccines to Albertan as soon as possible using licenced and regulated products.

OTHER NEWS & LEGISLATIVE UPDATES Summaries and information of the following can be found in the update below.

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● *NEW* Some Alberta businesses defying public health order extensions ● AFN AGA 1010 Final Resolutions and Materials

*NEW* Some Alberta businesses defying public health order extensions Global News: Alberta babershow vows to stay open despite AHS ordering its closure Cochrane Now: Hinshaw speaks to businesses opening against restrictions Last week, Alberta Premier Jason Kenney announced restrictions would stay in place until Jan. 21. But some Alberta businesses are defying these orders. Dr. Hinshaw stated that “Business owners who choose to reopen despite our current restrictions are increasing the number of close contacts that are happening in their community, possibly making it harder for other business owners if that means restrictions need to stay in place for longer”.

AFN Annual General Assembly 2020 Final Resolutions and Materials The dropbox link below can be accessed to view AFN AGA materials https://www.dropbox.com/sh/f3tb50lkfp4vv7u/AACssaIpKz2z1DV61E0H0IzJa?dl=0

IMPORTANT/USEFUL LINKS AND ADDITIONAL INFORMATION ● Canadians can now apply through the Canada Revenue Agency for a new sick leave benefit and a new caregiver benefit for those forced to take time off work to care for a dependent because of the pandemic. Details on this and other Employment Insurance changes are available through the G overnment of Canada ● The Alberta First Nation Governance Information Centre is publishing a weekly COVID-19 update with First Nations case count and epidemiological data. Click here to access the latest and previous reports (on the left sidebar of the webpage). ● Alberta Health is available on request to support First Nations in developing guidelines around ceremonies. Contact a [email protected] for support. ● Canada created a web portal to help businesses find a wide range of COVID-19 support and other programs and services. C lick here to access it. ● Canada created a web hub for buying and supplying PPE. C lick here t o access it. ● A COVID-19 Indigenous Business Task Force released their findings from a survey meant to analyze the impact of the pandemic on Indigenous businesses. Click here to read the report. Their work was funded by Indigenous Services Canada. ● The National Aboriginal Council of Midwives (NACM) has created a series of 5 posters with sexual and reproductive health information for Indigenous communities The posters have been translated into 4 languages (French, Plains Cree, Inuktitut, Mohawk) and are hosted on the N ACM website ● The A lberta Indigenous Virtual Care Clinic (at the link provided) provides video or phone care with a family doctor in Alberta to rural and urban Indigenous communities. All physicians are either Indigenous or have experience working with Indigenous communities.

6 AFN C-19 National Task Force Weekly Update for: January 11, 2021

Health Sector https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html Areas in Canada with cases of COVID-19, as of 2021-01-10 19:00PM EDT

Province Confirmed Active Hospitalizations Deaths Recovered Cases Cases (ICU)* BC 56,632 7,438 358 (75) 988 48,205 AB 111,452 14,116 827 (132) 1,282 96,052 SK 18,110 3,493 187 (31) 191 14,462 MB 26,316 4,728 332 (36) 738 20,850 ON 215,782 30,079 1,483 (388) 4,983 180,720 QC 228,821 24,472 1,380 (203) 8,686 195,663 NFLD/Lab 393 8 - 4 381 NB 779 185 - 9 585 NS 1,528 28 - 65 1,435 PEI 102 8 - - 94 Yukon 70 10 - 1 59 NWT 24 - - - 24 Nunavut 266 - - 1 265 Total 660,289 84,567 4,522 (865) 16,950 558,772 *These are numbers of current hospitalizations and ICU admissions. Some sources report the total cumulative number of hospitalizations and ICU admissions. Also, hospitalization data are amalgamated as they are reported by various hospitals; they are therefore updated sporadically, intermittently, and are likely to be less accurate and current that other data points.

Cases Deaths Recovered Global 90,367,346 1,936,436 50,080,157 Data is as of January 11,2021 at 6:22AM from Johns Hopkins University: https://coronavirus.jhu.edu/map.html Canada’s COVID-19 Totals: ESRI Canada COVID-19 Database (as of 6:27AM EDT January 11, 2021)

Total Cases Recovered Deaths Tests Completed Total Vaccinations 660,289 557,652 16,938 19,610,332 313,918

First Nations: Per FNIHB, below is a summary of First Nations COVID-19 test positive cases, reported through communities, FNIHB Regional Medical Officers, and media as of Jan 8, 2021.

Jurisdiction BC AB SK MB ON QC ATL YK/NWT*

Confirmed 817 3,261 2,605 2,895 304 333 5 69/24 (+210) (+60) (+153) (+654) (+349) (+97) (+2)

*note – these cases reflect all cases reported in Yukon and NWT, including non-Indigenous.2 Exposure Summary https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html As of January 10, 2021, the majority (95.9%) of COVID-19 cases are related to domestic acquisition. Domestic acquisition is defined as any exposure that occurred within Canada. This includes acquisition through contact with a COVID-19 case (58.2%); through contact with a traveller (1.0%); and from an unknown source (36.8%). Only 1.5% of cases are attributed to travel outside of Canada. The exposure setting for the remaining 2.5% of Canadian cases is unknown (information pending). As of Jan 10, 2021, Canada has an overall case fatality rate of 2.6%. As of Jan 10, 2021, 84.6% of all Canadian COVID-19 cases are reported to have recovered. Risk to Canadians COVID-19 is a serious health threat, and the situation is evolving daily. The risk will vary between and within communities, but given the increasing number of cases in Canada, the risk to Canadians is considered high. There is an increased risk of more severe outcomes for Canadians:

• Aged 65 and over • With compromised immune systems • With underlying medical conditions Data Sources: British Columbia: https://experience.arcgis.com/experience/a6f23959a8b14bfa989e3cda29297ded Alberta: https://covid19stats.alberta.ca/#cases Saskatchewan: https://www.saskatchewan.ca/government/health-care-administration-and- provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019- novel-coronavirus/cases-and-risk-of-covid-19-in-saskatchewan Manitoba: https://www.gov.mb.ca/covid19/updates/index.html#cases Ontario: https://www.ontario.ca/page/2019-novel-coronavirus#section-0 : https://www.inspq.qc.ca/covid-19/donnees : https://www2.gnb.ca/content/gnb/en/departments/ocmoh/cdc/content/respiratory_diseases/ coronavirus/case-map.html : https://novascotia.ca/coronavirus/data/ : https://www.princeedwardisland.ca/en/information/health-and- wellness/pei-covid-19-testing-data Newfoundland and Labrador: https://www.gov.nl.ca/covid-19/ Yukon: https://yukon.ca/covid-19 Northwest Territories: https://www.hss.gov.nt.ca/en/services/coronavirus-disease-covid-19 Additional source (national): https://www.ctvnews.ca/health/coronavirus/tracking-every-case- of-covid-19-in-canada-1.4852102#alberta Housing, Infrastructure, Water & Emergency Management Sector Local States of Emergencies:

First Nation States of Emergency - As per ISC report January 05, 2021 Region BC AB SK MB ON QC ATL Territories Total Confirmed 80 26 0 23 68 2 6 1 206

WILDFIRE: - As Per ISC EMD 2020 FN Flood / Wildland Fire Report as of January 11, 2021, - **Please note that given the decrease in significant incidents, this report will now be issued on a bi-weekly basis** - Updates in Bold FLOODS: As Per ISC EMD 2020 FN Flood / Wildland Fire Report as of January 11, 2021, - **Please note that given the decrease in significant incidents, this report will now be issued on a bi-weekly basis** - Updates in Bold

➢ Cowichan First Nation (642) Chief William Seymour - Population: 2,861 • 07JAN2020: Six community members remain evacuated. • 05JAN2021: Evacuation order rescinded. One house remains evacuated due to flood risk. • 04JAN2021: Number of evacuees revised to 40. • 03JAN2021: 10 homes evacuated to local hotels due to flooding. Evacuees maintaining family bubbles with up-to two people per room.

➢ Halalt First Nation (645) Chief James Thomas - Population: 97 • 07JAN2021: Community continues to monitor river. • 05JAN2021: Sandbags deployed. Flood risk active. • 03JAN2021: Homes under threat of flooding from nearby Chemainus River.

➢ Snuneymuxw First Nation (648) Chief Mike Wyse - Population: 713 • 03JAN2021: Flood watch, evacuation alert issued.

➢ Pacheedaht First Nation (658) Chief Jeff Jones - Population: 126 • 03JAN2021: Under threat of flooding from nearby San Juan River.

➢ Ditidaht First Nation (662) Chief Councillor Brian Tate - Population: 235 • 05JAN2021: One family evacuated due to flooded roads. • 03JAN2021: Flooding reported.

➢ Tseshaht First Nation (665) Councillor Debra Foxcroft - Population: 482 • 03JAN2021: Flooding affecting yards, basements, roads in community.

➢ Tsartlip First Nation (653) Chief Don Tom - Population: 659 • 05JAN2021: Flooding causing raw sewage backup in basements.

Communication Sector Top COVID Headlines Mom of St. Amant resident who died of COVID puts aside longtime vaccine fears, urges others to get the shot CBC – Jan 11 https://www.cbc.ca/news/canada/manitoba/manitoba-woman-refused-vaccines-covid-shot- 1.5866205

First Nations across Canada begin receiving COVID-19 vaccine CP24 – Jan 10 https://www.cp24.com/news/first-nations-across-canada-begin-receiving-covid-19-vaccine- 1.5260812

Moose Cree First Nation elders receive COVID vaccine CTV News – Jan 8 https://northernontario.ctvnews.ca/moose-cree-first-nation-elders-receive-covid-vaccine- 1.5259901

Almost 300 new COVID 19 cases on Manitoba First Nations this week, as vaccine rolls out CBC – Jan 8 https://www.cbc.ca/news/canada/manitoba/first-nations-covid-19-update-vaccine-1.5866604 First COVID-19 shots administered in Sioux Lookout YorkRegion.com – Jan 7 https://www.yorkregion.com/news-story/10303500-first-covid-19-shots-administered-in-sioux- lookout/

Sarnia, Ont., awaiting COVID-19 vaccines, mayor frustrated by communication issues Global News – Jan 7 https://globalnews.ca/news/7560970/sarnia-ont-awaiting-covid-19-vaccines-mayor-frustrated- by-communication-issues/

Stay-at-home order issued by Cowichan Tribes to curb COVID-19 spread CBC – Jan 7 https://www.cbc.ca/news/canada/british-columbia/stay-home-order-cowichan-tribes-covid- 19-1.5865160

First doses of Moderna COVID-19 vaccine head to Manitoba First Nations CBC – Jan 7 https://www.cbc.ca/news/canada/manitoba/moderna-vaccine-manitoba-first-nations- 1.5864392

Canada’s Plan To Vaccinate 600 Inmates Met With Fierce Resistance Huffpost – Jan 6 https://www.huffingtonpost.ca/entry/canada-vaccinate-inmates- resistance_ca_5ff62603c5b64e568bf3a220?guccounter=1

Hundreds of Alberta doctors pen letter asking why COVID-19 unit staff aren’t priority for vaccine Global News – Jan 6 https://globalnews.ca/news/7558190/alberta-letter-physicians-covid-19-unit-vaccinations/

Newfoundland and Labrador extends restrictions on Atlantic bubble to early February CTV News- Jan 6 https://atlantic.ctvnews.ca/newfoundland-and-labrador-extends-restrictions-on-atlantic- bubble-to-early-february-1.5256174

Quebec issues province-wide curfew starting Saturday in effort to combat surging COVID-19 cases CTV News – Jan 6 https://montreal.ctvnews.ca/quebec-issues-province-wide-curfew-starting-saturday-in- effort-to-combat-surging-covid-19-cases-1.5256257

Ontario Says Long-Term Care Residents, Workers in Hot Spots To Get Vaccine by Jan. 21 To Do Canada – Jan 5 https://www.todocanada.ca/ontario-says-long-term-care-residents-workers-in-hot-spots-to- get-vaccine-by-jan-21/

Ethical framework provides clarity regarding COVID-19 vaccine distribution Star – Jan 5 https://www.thestar.com/news/canada/2021/01/05/ethical-framework-provides-clarity- regarding-covid-19-vaccine-distribution.html

Alberta’s COVID-19 vaccine rollout rate and the plan to ramp it up Global News – Jan 5 https://globalnews.ca/news/7557488/alberta-covid-19-vaccine-rollout-pace/

Trudeau says he too is frustrated by holiday travellers, pace of vaccine rollout Winnipeg Free Press – Jan 5 https://www.winnipegfreepress.com/special/coronavirus/wire/trudeau-says-he-too-is- frustrated-by-holiday-travellers-pace-of-vaccine-rollout-573533082.html

Ontario has been slow to give COVID-19 vaccinations. Doug Ford says that’s about to change Toronto Star – Jan 4 https://www.thestar.com/politics/provincial/2021/01/04/ontario-has-been-slow-to-give-covid- 19-vaccinations-doug-ford-says-thats-about-to-change.html

First Nations in Quebec implement stricter public health measures as COVID-19 cases climb CBC – Jan 4 https://www.cbc.ca/news/indigenous/first-nations-quebec-covid-19-1.5860919

5 more COVID-19 cases added to B.C. First Nation cluster CTV News – Jan 4 https://vancouverisland.ctvnews.ca/5-more-covid-19-cases-added-to-b-c-first-nation-cluster- 1.5253108

Northern Sask. Medical Health Officer concerned about elevated COVID-19 cases CBC – Jan 4 https://www.cbc.ca/news/canada/saskatoon/northern-sask-medical-health-officer-concerned- about-elevated-covid-19-cases- 1.5860814#:~:text=The%20Northern%20Inter%2DTribal%20Health%20Authority%20(NITHA)%2 0is%20worried,in%20some%20northern%20Saskatchewan%20communities.&text=%22We've% 20had%20a%20number,Health%20Officer%20Dr.%20Nnamdi%20Ndbuka.

ISC - Alberta Region COVID-19 Update for Chiefs: January 13, 2021

Updates Question of the Day Update to Protocols and Schools: Q: How can we ensure we are using safe On January 7th, the Province announced that the current public health measures will remain air and surface disinfection products? in places until at least January 21, 2021. Health officials actively continue to evaluate the situation and will adjust measures if required. Businesses, organizations and service A: In Canada, surface disinfectants are providers will be given at least 1 week notice prior to changes to the current health regulated and evaluated by Health Canada. measures that may affect them. One change, however, is that as of this past Monday, Applications for the approval of disinfectant schools have returned to in-person classes across Alberta. For schools on First Nations, products must provide evidence that the your Nation’s governance and education teams will decide what protocols make sense for product is effective against microorganisms it your community, be it in-person, online or a combination. As a reminder, The Public Health claims to kill. Additionally, disinfectant labels Agency of Canada (PHAC) has developed COVID-19 back-to-school guidance directed to must present clear instructions for use to administrators of both public and private schools from Kindergarten to Grade 12 and local prevent acute health hazards, and should public health authorities. Also, Environmental Public Health Officers (EPHOs) are available provide information on compatibility with to support your return-to-school plans. EPHOs are certified public health inspectors, who surfaces, as relevant. Health Canada approved have undergone specialized training in public health and are therefore able to provide public disinfectants are assigned a Drug health guidance, education, risk assessments, inspections, and recommendations to First Identification Number (DIN). A list of products Nations. Please contact your community EPHO to assist in the relaunch planning and approved for use against COVID-19 is guidance for your return-to-school planning. Additionally, Our Education team will remain in available here. Companies have approached contact with your Nations to answer questions on funding, protocols or other education First Nations communities and other potential related issues. buyers making false claims of their approval status. There are products imported and sold Vaccination Plans: under Interim Measures which have not been As you’ve likely heard, vaccinations have begun in Alberta mostly targeting those in home evaluated by Health Canada. A list of products care (on and off reserve) and residents and staff of Long Term Care homes, including authorized for sale in Canada under the several on First Nations. The next priority group will be on-reserve members over the age of Interim Measure is available here. Please 65. In order to rollout delivery of these vaccinations as soon as possible, Alberta Health is connect with your local Environmental Public requesting a vaccine plan from every First Nation in Alberta. FNIHB will work with Health Officer if you have any questions. communities to validate the population over 65 as well as your capacity for storing and administering the vaccines. These plans are critical for determining timelines for when vaccines can be expected in communities. Through a coordinated approach, communities National Info will receive the vaccine at approximately the same time. The plans, as well as any questions CPHO Issue Statement Series on COVID-19: you may have, can be submitted to your FNIHB contacts. Please ensure these plans are mRNA Vaccines finalized and submitted as soon as possible so that the coordination and logistics of vaccine delivery can be accomplished as quickly and smoothly as possible. Should you have any Vaccines can protect you and those around questions or require support, please contact the CD inbox at sac.cdemergenciesab- you [email protected] Alberta Cases: Regional Snapshot as of January 12th, 3:30 p.m. MST

AB Total Confirmed (Jan. 11th – 652 new cases) 112,743 112,743 38% 50% AB Recovered Cases 98,178 cases Calgary Zone males Confirmed First Nations On-reserve Cases 3,750

On-reserve Recovered Cases 2,594 4754 766 1,345

On-Reserve Active Cases 1,132 Hospitalized ever ICU ever deaths More Alberta case data can be found here Calgary Zone Confirmed 43,140 Useful Links Central Zone Confirmed 7,834

Edmonton Zone Confirmed 47,798 Vaccine Telehealth Session TOMORROW: North Zone Confirmed 8,494 On January 14th, from 1:30-3pm a telehealth detailing vaccinations and other COVID-19 updates will be held. South Zone Confirmed 5,300 • To connect to the session:via Zoom, go to https://fntn.zoom.us/join and enter Meeting ID: 970 Unknown Confirmed 177 1352 4309 and Passcode: 963703 Deaths due to COVID-19 1,345 • from an audio line, dial 1-587-328-1099 and enter Meeting ID: 970 1352 4309 and Passcode: 963703 On-reserve Deaths due to COVID-19 24 • from a videoconference-enabled room, go to OneHealth Reminder www.fntn.ca to register. Questions can be submitted A friendly reminder that the Alberta OneHealth website in advance of or during the presentation to [email protected], or via Zoom during the (https://www.onehealth.ca/ab/ABCovid-19) has a presentation. This session will be recorded and section specific to the COVID-19 vaccine. This posted to www.fntn.ca. information contains information specific to the vaccines as well as a communications tool kit and other resources that communities can use. This area will be kept up to AHS Vaccine Update: date as new resources and information as it becomes AHS has developed this FAQ site which also includes available. Please distribute the link and information with further resources and an online form is you have questions that are not answered online. your Nations administration and community. Alberta First Nation Chiefs, Alberta Health Chief Medical Officer of Health & Indigenous Services Canada, Alberta Region Update Call January 5 & 11, 2021

Introductory Remarks Opening remarks

Rhonda Laboucan & Jamie Brown, Indigenous Services Canada, Alberta Region

 Thank you to everyone for the ongoing participation in a number of recent teleconferences. These sessions provide opportunity for information sharing and dialogue  To support Nations with vaccine planning, FNIHB-AB brought back experienced veteran communicable disease control nurses and established a COVID-19 vaccine planning team. This team is engaging directly with First Nations Health Directors, Directors of Emergency Management and Health Centre teams to support on-reserve vaccine planning and information sharing with provincial partners.  Please do not hesitate to contact the ISC-AB Communicable Disease Emergency Inbox with any questions or concerns at [email protected].

Dr. Deena Hinshaw, Chief Medical Officer of Health, Alberta Heath Trish Merrithew-Mercredi, Assistant Deputy Minister, Public Health and Compliance, Alberta Health

January 5, 20201 Update

 Two COVID-19 vaccines are currently approved by Health Canada, Pfizer and Moderna, both of which have an approximate protection rate from symptomatic infection of 95% after two doses have been administered. A third vaccine, by AstraZeneca is currently in the review process and is not anticipated to receive approval until spring/summer 2021.  Canada receives the Pfizer vaccine from Germany which requires extreme cold storage needs while the Moderna vaccine is produced in the United States and is easier to transport and store.  Vaccine supply is currently very limited, with the Moderna vaccine delivered once every three weeks and the Pfizer vaccine delivered on a more regular basis.  While other provinces have announced the delay of the second vaccine dosage, Alberta is currently examining options and a final decision has not been determined regarding the timing of administration of second dose-vaccines at this time.  Provinces and territories have utilized the National Advisory Committee on Immunization guidelines to determine vaccine eligibility sequencing and rollout. Current National priority guideline include: o Residents and staff of congregate living settings that provide care for seniors; o Adults 70 years of age and older, beginning with adults 80 years of age and older, then decreasing the age limit by 5-year increments to age 70 years as supply becomes available; o Health care workers (including all those who work in health care settings and personal support workers whose work involves direct contact with patients); and,

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Alberta First Nation Chiefs, Alberta Health Chief Medical Officer of Health & Indigenous Services Canada, Alberta Region Update Call January 5 & 11, 2021

o Adults in Indigenous communities where infection can have disproportionate consequence, with specific reference to remote and isolated communities.  The following vaccine Phase 1 rollout in Alberta First Nations communities was developed under significant time constraints. o Phase 1A (December – February) . Staff in the six seniors’ congregate facilities on reserve; . Residents of the six seniors’ congregate facilities on reserve; and, . Home care workers on reserve. o Phase 1B (February – March) . Persons 65 years of age and over living on a First Nations reserve; . All Adults in remote or isolated First Nations reserves (Fort Chip and Fox Lake); . Based on this framework, 10,000 doses have been allocated to First Nations on reserve for use in February – March; and, . Each First Nation can determine how they wish to use their allocated dose, in order to ensure vulnerable and at risk community members are prioritized.  Moving forward, Alberta Health is committed to engaging more comprehensively with First Nation partners and organizations on vaccine planning and rollout for Phase 2 and onward.  Recent COVID-19 data collected by the Alberta First Nations Information Governance Centre and the Government of Alberta: o While the First Nation population initially saw low incidence rates, since September the incidence rate of COVID-19 in the First Nation population in Alberta has significantly surpassed the incidence rate of non-First Nation Albertans. Further, the average age of diagnosis in the First Nation population is 29 years compared to an average age of 36 years in non-First Nations. o First Nation individuals have a higher rate of death (median age of death 69 years) than non-First Nation Albertans (median age of death 86 years). o First Nations individuals are three times more likely to be admitted to hospital with COVID-19 than non-First Nation Albertans.

January 11, 2021 Update

 Covid-19 vaccine rollout has begun on-reserve in five of the six on-reserve long-term care homes and for homecare service delivery teams.  Alberta Health is working with First Nations and Inuit Health Branch, Alberta Health Services and community technicians to support the development of detailed vaccine plans including information on vaccine storage, administration and population estimates for individuals ages 65 years of age and older.  In order to support Phase 1B of vaccine rollout, the goal is to have each Nation’s plans no later than January 15, 2021.  The province will work to ensure Phase 1B of vaccine delivery rolls out in Nations across the province as closely as possible to avoid any inequities in vaccine delivery.

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Alberta First Nation Chiefs, Alberta Health Chief Medical Officer of Health & Indigenous Services Canada, Alberta Region Update Call January 5 & 11, 2021

 The federal government anticipates having enough vaccines to be offering every Canadian the opportunity to be immunized by the fall 2021.

Key Meeting Themes Chair: Allen Willier, Special Leadership Liaison All participants

Vaccine Planning Questions  Who are the representatives on the provincial vaccine planning working group?  Which type of vaccine will First Nations on-reserve likely receive?  Given data has indicated significant outcomes in First Nation communities are taking place at a younger age compared to the general population, should First Nations not have lower age-markers for vaccine priority?  Will the COVID-19 vaccine be administered only in health centres?  How is the vaccine currently being procured and can First Nations procure vaccines directly from the suppliers?  How will urban Indigenous peoples receive the vaccine?  Where should completed vaccine planning documents be sent?  If there is a surplus of vaccine in a community can the Nation utilize the excess vaccine or will it have to be returned?

Answers  The regional COVID-19 Vaccine Planning Working Group is currently composed of representatives from the relevant Health Co-Management subcommittees, non-HCoM signatories in addition to representatives from Alberta Health, Alberta Health Services and Public Health Agency of Canada. The group includes representatives from each Treaty area.  ISC-AB has also started a weekly COVID-19 Vaccine Information Session for community technicians. This weekly meeting provides an opportunity for information sharing and support communities in developing vaccine rollout plans.  Vaccine planning and supply will determine which type of vaccine is received on-reserve. Most First Nations will likely receive the Moderna vaccine due to transportation and storage requirements.  Pfizer has confirmed that its vaccine can be moved short distances from the initial delivery location, however the vaccine is delivered in package of 975 doses which cannot be separated. In light of this information, planning is underway to determine if the Pfizer vaccine can be utilized to support vaccine rollout in larger First Nations.  Recognizing that age is the most impactful indicator of severe outcomes, the younger Phase 1B age of 65 years and older has been identified to support initial vaccine allocation on-reserve. Phase 1B rollout in the general Alberta population will include seniors ages 75 years of age and older.

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Alberta First Nation Chiefs, Alberta Health Chief Medical Officer of Health & Indigenous Services Canada, Alberta Region Update Call January 5 & 11, 2021

 Additionally, Nations will have the flexibility to determine community priority populations within the available vaccine supply. This will ensure First Nations are able to immediately prioritize vulnerable and at-risk community members.  To enhance buying power and secure a larger amount of vaccine supply, provinces and territories are working with the federal government on vaccine procurement. The federal government engages directly with the manufacturers to purchase on behalf of Canada and works with each province and territory to determine vaccine allocation. At this time, direct purchase from the vaccine suppliers is not available given the global demand on vaccine supply.  Nations completed Phase 1B vaccine plans can be sent to the ISC-AB Communicable Disease Emergency Inbox ([email protected]) no later than January 15, 2021. ISC-AB COVID-19 vaccine planning teams are engaging directly with First Nations throughout the week of January 11 – 15, 2021 to support vaccine planning efforts.  The province will be making the vaccine available to all individuals ages 75 years and over in February, 2021 in alignment with Phase 1B. Urban Indigenous peoples ages 75 years and older will be eligible to receive the vaccine at this time through provincial service delivery. Alberta Health is working closely with Indigenous urban organizations to support vaccine planning and ensure the urban Indigenous community is well informed of vaccine rollout.  If a Nation has excess vaccine after immunizing initial priority populations identified in the community’s vaccine plan, the additional vaccines may be allocated as the Nation sees fit. No vaccine will need to be returned.

Public Health Guidance & Scientific Outcomes Questions  If an individual has been previously diagnosed with COVID-19 can they contract the virus again and will the vaccine be withheld from individuals who have previously contracted COVID-19?  What types of vaccine side-effects are being seen specifically in individuals with allergies or auto-immune diseases?  Are individuals who receive the vaccine at higher risk of developing Bell’s palsy?  Are the vaccines currently available safe for children and pregnant women?  Have there been reports of individuals contracting COVID-19 after receiving the vaccine?  How long did it take to develop the COVID-19 vaccine?  How effective are the current vaccines against the COVID-19 variants recently reported?  What is the effectiveness of one-vaccine dose vs. the two doses?  Will public health measures still be required after individuals receive the COVD-19 vaccine?

Answers  The current best available scientific evidence indicates that individuals previously infected with COVID-19 develop some type of short-term immunity to the virus. Reports however

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Alberta First Nation Chiefs, Alberta Health Chief Medical Officer of Health & Indigenous Services Canada, Alberta Region Update Call January 5 & 11, 2021

have also confirmed individuals can be re-infected a second time. As such, vaccines will not be withheld from individuals who have been previously infected.  The Moderna and Pfizer trials did not exclude individuals with auto-immune diseases and allergies; however, there was not significant representation of these populations to determine specific outcomes. An individual with an auto-immune disease or allergies should talk to their doctor before receiving the vaccine.  The National Advisory Committee on Immunization has recommended that if an individual is allergic to one of the components, they should not receive the vaccine.  Bell’s palsy is a condition that impacts approximately 1 in 10,000 individuals. During the vaccine trials, the condition was noted in approximately 1 in 10,000 individuals. As this prevalence is not above the average number seen in the general population, there is no evidence to support a clear connection between the vaccines and the condition at this time.  Common vaccine side effects that have been documented include fatigue, headache, red and soreness at the site of immunization, chills, joint pain and fever (especially after the second dose). These are fairly common vaccine side effects.  At this time, the Pfizer vaccine is only licensed for individuals ages 16 years and older while the Moderna vaccine is licenced for individuals ages 18 years and older. Vaccine trials are currently underway to test vaccine efficacy and safety in children and youth.  Pregnant woman were excluded from the vaccine trials and while some participants became pregnant during the trial, there is insufficient evidence at this time. Pregnant woman should speak to their doctor to determine if the personal benefit of the vaccine is greater than the risk of COVID-19.  There have been reports of individuals diagnosed with COVID-19 after receiving the vaccine, however, it has been confirmed that these individuals were exposed to the virus prior to immunization or within the first two-weeks after vaccine administration. Research has indicated that both vaccines are 95% effective after both doses are administered.  Research on mRNA technologies has been underway for many years; however, the specific COVID-19 vaccine development has been underway since mid-2020. Vaccine trials are first tested in animals, followed by smaller trials in humans prior to transitioning to larger clinical trials to determine efficacy and safety.  There are no reports at this time indicating that the available vaccines are not effective in protecting against the COVID-19 variants. On-going testing of these new variants is underway across the world with new scientific information available on a daily basis. Alberta Health is continually monitoring this growing body of evidence.  Based on the initial vaccine trials and limited analysis of evidence, a single dose of either COVID-19 vaccines is approximately 92% effective 14 days after the first dose versus the 95% efficacy of a second dose. At this time, the period of effectiveness of a single vaccine dose is unknown and a second dose is required.  Scientific evidence has not currently determined if the vaccine protects against asymptomatic transmission of the COVID-19 virus. Additionally, current evidence indicates approximately 70% of a population must receive the COVID-19 vaccine in order to reach herd immunity. Due to limited global vaccine supply, current provincial planning indicates

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Alberta First Nation Chiefs, Alberta Health Chief Medical Officer of Health & Indigenous Services Canada, Alberta Region Update Call January 5 & 11, 2021

only 10% of the province will be immunized by March 2021 and only 30% by summer 2021. As such, public health measures are likely to remain in place for some time and individuals who receive the vaccine must continue to adhere to all public health measures including wearing a mask. Public Health Measures & Testing Questions  What rapid testing devices are available in First Nations?  Will First Nations be notified if a variant is confirmed in community?

Answers  Two different types of rapid testing devices are currently available across the province. ISC-AB in collaboration with First Nation partners has supported the distribution of 15 GenXpert rapid testing devices on-reserve. The region has also received the AbbotID rapid testing device and is working with the National Microbiology Lab to train technicians and support rollout of the units in community.  At this time, the provincial lab is working to improve variant testing capacity. The current case of a COVID-19 variant in Alberta was confirmed in an individual returning from travel from the United Kingdom. Contact tracing efforts have confirmed no onward transmission associated with this case

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