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North American COVID-19 Policy Response Monitor: Nunavut

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North American COVID-19 Policy Response Monitor: Nunavut North American COVID-19 Policy Response Monitor: Nunavut September 4, 2020 What is the North American COVID-19 Policy Response Monitor? The North American COVID-19 policy monitor has been designed to collect and organize up-to-date information on how jurisdictions are responding to the crisis. It summarizes responses of health systems as well as wider public health initiatives. The North American policy monitor is an offshoot of the international COVID-19 Health System Response Monitor (HSRM), a joint undertaking of the WHO Regional Office for Europe, the European Commission and the European Observatory on Health Systems and Policies. Canadian content to HSRM is contributed by the North American Observatory on Health Systems and Policies (NAO). Contents List of Acronyms and Abbreviations ............................................................................................................. 2 1. Preventing transmission ........................................................................................................................... 3 2. Ensuring sufficient physical infrastructure and workforce capacity ....................................................... 15 3. Providing health services effectively....................................................................................................... 19 4. Paying for services .................................................................................................................................. 22 5. Governance ............................................................................................................................................. 25 6. Measures in other sectors ...................................................................................................................... 28 References .................................................................................................................................................. 38 Appendix A: Key Resources ......................................................................................................................... 46 List of Acronyms and Abbreviations ALTS Adult Learning and Training Supports CSSW Community Social Service Workers CHARS Canadian High Arctic Research Station CPHO Chief Public Health Officer EHB Extended Health Benefits FANS Financial Assistance for Nunavut Students FNIHB First Nations and Inuit Health Branch ITK Inuit Tapariit Kanatami NHCP Nunavut Health Care Plan NIHB Non-Insured Health Benefits NML National Microbiology Laboratory NRI Nunavut Research Institute NTI Nunavut Tunngavik Incorported PPE Personal protective equipment PUI Person under investigation QEC Qulliq Energy Corporation QGH Qikiqtani General Hospital RCDC Regional Communicable Disease Coordinator RCMP Royal Canadian Mounted Police RNANT/NU Registered Nurses Association of the Northwest Territories and Nunavut TCDS Territorial Communicable Disease Specialist WSCC Workers’ Safety and Compensation Commission 2 1. Preventing transmission This section includes information on key public health measures that aim to prevent the further spread of the disease. It details how jurisdictions are advising the general public and people who (might) have the disease to prevent further spread, as well as measures in place to test and identify cases, trace contacts, and monitor the scale of the outbreak. 1.1 Health communication Health authorities in Nunavut first addressed the public regarding the novel coronavirus on January 31, 2020 (Government of Nunavut, 2020p). While there were no confirmed or suspected cases of COVID-19 in Nunavut at this time, the Department of Health notified the public that they were in close contact with the Public Health Agency of Canada (PHAC) and their partners from other provincial and territorial (PT), specifically PT Chief Medical Officers of Health, to share information and support vigilance in Nunavut’s response to the emerging COVID-19 situation. At this time, the Nunavut government recommended that residents of Nunavut, referred to as Nunavummiut, were encouraged to consult the Government of Canada’s travel notices before traveling abroad; at this time, Canada’s travel notices were limited to regions of China affected by COVID-19 (ibid). On March 11, Nunavut’s Chief Public Health Officer (CPHO), Dr. Michael Patterson, updated the public with assurance that the Government of Nunavut was monitoring the COVID-19 situation closely and, although the territory still had no cases of COVID-19, the territory remained on high alert (Government of Nunavut, 2020r). Further, the CPHO informed Nunavummiut that the territory has extensive pandemic management and response plans already in place to protect their health and safety and ensure the continued delivery of services (ibid). The CPHO advised that prevention and awareness are important and asked all Nunavummiut to practice good hand hygiene, respiratory etiquette, avoid touching their faces, stay home if feeling sick and monitor for COVID-19 symptoms. Two days later, the CPHO outlined additional measures the Government of Nunavut was taking in preparation for its response to COVID-19 and reassured residents that the territories’ community health centers had all necessary supplies and were ready to respond to “uncertain, evolving” situation. He reassured Nunavummiut by saying, “It is normal to be concerned, but we are prepared. The best course of action is to stay aware and use preventive measures: if you are sick, stay home; observe travel restrictions and listen to the advice of health professionals” (ibid). Between March 17 and May 13, 2020, the Government of Nunavut provided daily COVID-19 media updates, broadcast live Monday to Friday on various local television channels, the CBC Nunavut Facebook page, the Government of Nunavut’s Facebook pages and Premier Joe Savikataaq’s Facebook page, in both English and Inuktitut, the territory’s official Indigenous language (Government of Nunavut, 2020ac). In addition, CBC radio broadcasts recordings of the daily media provided updates three times per day with recordings available through the official Facebook and YouTube pages. Media updates featuree CPHO (Dr. Michael Patterson), Nunavut’s Premier (Joe Savikataaq) and Minister of Health (George Hickes). Since May 14, 2020, these updates have occurred with less frequency, occurring twice per week (ibid) until June 25, 2020, when they were provided once a week, on Mondays (Government of Nunavut, 2020ap). 3 On June 1, the Government of Nunavut has also released bi-weekly announcements on the assessment and potential easing of their public health measures (Government of Nunavut, 2020am); notably, this is the basis for informing their re-opening plan (see Section 5.2 for further details). The territory also operates a COVID-19 Hotline (975-8601 or 1-888-975-8601) and launched a dedicated COVID-19 website (https://www.gov.nu.ca/health/information/covid-19-novel-coronavirus) containing detailed information on the territory’s responses to the pandemic, summaries of the media updates, and pages dedicated to documenting the policy and other responses taken by each governmental department in response to the pandemic (Government of Nunavut, 2020k). Notably, the Government of Nunavut’s COVID-19 website is user friendly, easy to navigate, and includes many infographics with clear, plain language messages. Resources are available in Inuktitut, Inuinnaqtun (the territory’s other most common Indigenous language), English and French; Nunavut has three official languages and most residents’ first language is Inuktitut (Government of Canada, 2017b). Further, many resources include culturally relevant messaging, including land-based activities and tips for protecting elders (ibid). Several territory officials are also active on social media, e.g. Facebook and Twitter, including official pages for the Government of Nunavut, where governmental updates are regularly shared (Government of Nunavut, n.d.-b). On March 19, Premier Savikataaq's press secretary, Cate Macleod, stated that she would be personally monitoring the premier's social media feed for questions about COVID-19 and the team would do their best to respond to all questions and concerns (Deuling, 2020). Many of the messages Nunavut’s leaders have sent to the public focus on the activities that they can engage in to protect themselves and others. Minister of Health, George Hickes, consistently ends his messages with some variation of the following sentiment: “be patient and kind, and take care of each other” (Government of Nunavut, 2020h). At the time of writing (September 4, 2020), Nunavut is the only PT in Canada, and one of a few regions globally, without any confirmed cases of COVID-19 (Public Health Agency of Canada, 2020; Vandinther, 2020). The territory’s strict travel restrictions (see Sections 1.3 and 6.1) are widely viewed at the major contributor to their successful prevention of COVID-19 importation (Vandinther, 2020). Most of Nunavut’s 25 communities are only accessible by air or water. Most of the other international regions without any cases of COVID-19 confirmed to date are similar geographically isolated; many are islands (ibid). Although the territory encountered its first suspected case, this was reported to be a false positive by May 4 (Government of Nunavut, 2020h). Similarly, on July 2, a presumptive case of COVID-19 was identified at the territory’s Mary River Mine (Government of Nunavut, 2020aq) and two additional suspected cases were soon identified at the
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