On June 3, Kashechewan First Nation, on James Bay, had a single case of COVID-19. The next day, it had nine. By mid-June, the community of around 2,000 people had 232 cases — nearly a quarter of the active cases in all Indigenous communities in Canada and 69 per cent of the active cases in the Porcupine Health Unit at the time.
The Alpha variant raged through the community, mainly in unvaccinated or partially vaccinated children. On June 13, 144 of the 222 cases in the community were in people under 17.
As of July 2, there were 52 cases in the James and Hudson bay region, 39 of them in Kashechewan.
While leadership in Kashechewan has expressed appreciation for the assistance the federal government has provided the community, they say that the response came too late and that underlying issues contributed to spread and must be addressed.
The exact cause of transmission in the James Bay and Kashechewan area is still unknown. However, Lianne Catton, PHU’s medical officer of health, has noted that travel to the south is a likely factor. "The unfortunate reality of the north is people often have to travel, and sometimes that's where we end up seeing spread," she said at a May 28 press conference, when there were 338 active cases in the region of about 82,000 people. “Individuals are travelling — often for very essential reasons.”
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Those essential reasons include health care, says Elaine Innes, chief of staff for the Weeneebayko Area Health Authority, which oversees the local hospitals and staffs doctors in the region. “We do not provide all the services that are necessary for some of our patients. They have to travel to southern cities to access those services,” she told TVO.org in mid-May. At the time, there were nine cases in the region, and Innes cautioned that the health authority had limited capacity to deal with a significant outbreak: “We certainly don't have the infrastructure or capacity to be able to handle very sick patients here at our hospitals.”
By May 26, the town of Moosonee, about 220 kilometres southeast of Kashechewan, had 45 active cases. A larger cluster of cases emerged in Fort Albany First Nation, peaking at 65 on June 5. On June 15, Kashechewan would see its highest number of active cases: 232.
In a press conference on that day, Catton stressed the interdependency of the coast and the area around Timmins to the south. “Our communities are interconnected across the Highway 11 border all the way up to the James and Hudson bay region,” she said. “The communities are connected; the linkages and support that are required are connected.”
Catton said remaining diligent about vaccines and COVID-19 protocols in the south of the health unit would help mitigate risk of further spread in the north. "This is where we need that collective unified voice and work and partnership," she said. "We all need to protect all of our communities, no matter how far or close we may be."
In the second week of June, ISC began offering additional supports.
An ISC spokesperson tells TVO.org via email that “the standard complement of ISC-employed human health resources in Kashechewan includes eight nurses and two paramedics” and that on June 8, 2021, “ISC deployed seven additional nurses and one additional paramedic to Kashechewan, for a total of 15 nurses and three paramedics in the community.” On June 16, one additional nurse and one additional paramedic were sent to Kashechewan; a week later, another nurse joined them. “As of June 24, 2021,” they write, “these additions bring the total number of nurses providing support in Kashechewan to 17 and the total number of paramedics in community to four.”
In June 2021, the spokesperson says, ISC approved more than $1.1 million in funding for Kashechewan, “for supports including: food supplies and transport, cleaning supplies, personal protective equipment, a pandemic response coordinator, quarantine officers, COVID-19 screeners and testing personnel, security, public health communications, active case response, and additional physicians and mental health workers in community.”
And the end of that month saw the arrival of the military: on June 17, Armed Forces members started delivering food and supplies and installing structures for isolation, including six medical isolation domes. WAHA has sent three nurses, two physicians, and two mental-health workers..
Friday acknowledges that various departments are undertaking significant work in the community but says the response wasn’t fast enough: “I’m still worried about the people that are positive cases, that they [will] get worse.”
According to Friday, stay-in-place directives were not effective in his community: “We have a lot of people in houses that are overcrowded,” Friday says, adding that there can be up to 20 people in the community living in a single home. Timmins–James Bay MP Charlie Angus, whose riding includes Kashechewan, also stresses the housing situation: “When we keep someone with COVID in a home with 15 or 20 people, what do you think's going to happen?”
Miller says separating positive cases from the community was a challenge because many were children: “You can't just separate children from their family if they're very young, and that’s what complicated the issue. We at no point in time said simply, ‘Stay home, folks, and hope all goes for the best.’ I would have to get to the bottom of that if that was the indication.”
Friday believes a persistent housing shortage contributed to spread in the community. “From the beginning, we've been crying for houses,” Friday says. “We couldn't get any loans from the bank because we have to insure the units. The insurance companies are saying that they cannot insure anything in the flood zone.” (Kashechewan is located in an area under yearly threat of flooding from the Albany River and has waited for 16 years to be relocated.)
Miller agrees that the housing shortage and annual flooding were likely aggravating factors in the outbreak. “It is an important point to reflect on as to their current housing situation, their current location,” he says, adding that there need to be “serious discussions about relocation.”
ISC says it has allocated $4.3 million to Kashechewan to address housing for 2020 and 2021; that will in part go toward a 20-unit housing project. Additionally, ISC says, $49 million was provided between 2015 and 2017 for 52 duplexes built on raised pilings to replace flood-damaged homes.
When asked about his conversations with Miller regarding housing and relocation, Friday, who referenced previous promises he’s heard about relocation, says, “I think he's trying to help, but I’m not sure or positive about the things I spoke to him about.”
Miller acknowledges that the community has waited a long time to be moved off a flood zone and adds that Friday’s comments were “reflective of broken relationships that the federal government's been responsible for over time.” The worst thing you can do as a minister or public official, he says, “is to make promises you can't keep. This is a portfolio where you do have foremost a duty to speak truth. And the truth isn’t good sometimes.”
But, Miller says, “We’re there to continue the response. It's a scary situation for the community. I do remain in contact with Chief Friday, and his long-term ask is a very valid one.”
Although Friday continues to push for long-term solutions, his current focus is on getting the through this latest emergency. “We try hard to help the community,” he says.
This is one in a series of stories about issues affecting northeastern Ontario. It's brought to you with the assistance of Laurentian University.
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