Community and Public Health Responses to a COVID-19 Outbreak in North-west Saskatchewan: Challenges, Successes, and Lessons Learned

In Spring 2020, Indigenous communities in northwest Saskatchewan, Canada, experienced the first significant outbreak of COVID-19. Through the collective efforts of public health measures by local, provincial, federal, and community partners, COVID-19 impacts were mitigated, and the severity of the outbreak in northwest Saskatchewan was limited. This article outlines the epidemiological profile of COVID-19 in the area during this period and the concomitant narrative of the public health control measures. The narrative connects specific culturally grounded approaches that were taken by community leaders and public health officials to moderate the pandemic's impacts and contain the outbreak. Among the lessons learned from these multi-jurisdictional efforts were the need to customize interventions to individual community characteristics and the benefits of continuous consultation and communication with community leadership. These findings suggest that long-term monetary investment in the strengths, assets, and capacity of communities can contribute toward sustainable solutions for existing structural inequities that have been amplified by the pandemic. The collaboration that resulted from local, provincial, and federal partnerships informed other pandemic response measures for subsequent outbreaks that have affected the region during the evolution of the COVID-19 pandemic.

Multijurisdictional outbreak of COVID-19 associated with a wake/funeral event in a northern Saskatchewan First Nations community.

Background: Sixty-eight laboratory-confirmed cases of the coronavirus disease 2019 (COVID-19) (12 in Alberta [AB], 56 in Saskatchewan [SK]) were linked to a gathering at a hospital in Alberta on June 1-4, 2020, and a wake/funeral in a First Nations community in northern Saskatchewan on June 9-11, 2020. Objective: The objectives were to provide a comprehensive description of the epidemiology of the outbreak and describe the chains of transmission to inform the hypothesis that there were multiple introductions of COVID-19 at the wake/funeral. Methods: Case investigation and contact tracing was conducted by local public health in AB and SK. The Public Health Agency of Canada conducted a centralized case analysis. An epidemic curve and a Gantt chart for period of communicability were created to support or refute whether there had been multiple introductions of COVID-19 at the wake/funeral. Results: Illness onset dates ranged from May 31 to July 1, 2020. Ages ranged from 2 to 80 years (median age=43 years). Five cases were hospitalized; there were no deaths. The available case exposure information supports the hypothesis that there had been multiple introductions of COVID-19 at the wake/funeral. Public health authorities in AB and SK declared the outbreak over on July 20, 2020; based on two incubation periods (i.e. 28 days) following the illness onset of the last primary case. Conclusion: During multijurisdictional outbreaks, data sharing, coordination across health authorities and centralized analysis is essential to understanding the events that lead to the outbreak and possible hypotheses around chains of transmission.