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BACKGROUND: In the Canadian province of Saskatchewan, the global COVID-19 pandemic appeared amidst existing social health challenges in food insecurity, housing precarity and homelessness, poor mental health, and substance misuse. These chronic features intersected with the pandemic, producing a moment in time when the urgency of COVID-19 brought attention to underlying shortcomings in public health services. OBJECTIVE: The objectives of the program of research are (1) to identify and measure relationships between the pandemic and wider health and social impacts, namely, food insecurity, housing precarity and homelessness, and mental health and substance use in Saskatchewan, and (2) to create an oral history of the pandemic in Saskatchewan in an accessible digital public archive. METHODS: We are using a mixed methods approach to identify the impacts of the pandemic on specific equity-seeking groups and areas of social health concern by developing cross-sectional population-based surveys and producing results based on statistical analysis. We augmented the quantitative analysis by conducting qualitative interviews and oral histories to generate more granular details of people's experiences of the pandemic. We are focusing on frontline workers, other service providers, and individuals within equity-seeking groups. We are capturing digital evidence and social media posts; we are collecting and organizing key threads using a free open-source research tool, Zotero, to trace the digital evidence of the pandemic in Saskatchewan. This study is approved by the Research Ethics Board at the University of Saskatchewan (Beh-1945). RESULTS: Funding for this program of research was received in March and April 2022. Survey data were collected between July and November 2022. The collection of oral histories began in June 2022 and concluded in March 2023. In total, 30 oral histories have been collected at the time of this writing. Qualitative interviews began in April 2022 and will continue until March 2024. Survey analysis began in January 2023, and results are expected to be published in mid-2023. All data and stories collected in this work are archived for preservation and freely accessible on the Remember Rebuild Saskatchewan project's website. We will share results in academic journals and conferences, town halls and community gatherings, social and digital media reports, and through collaborative exhibitions with public library systems. CONCLUSIONS: The pandemic's ephemeral nature poses a risk of us "forgetting" this moment and the attendant social inequities. These challenges inspired a novel fusion among health researchers, historians, librarians, and service providers in the creation of the Remember Rebuild Saskatchewan project, which focuses on preserving the legacy of the pandemic and capturing data to support an equitable recovery in Saskatchewan. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46643.
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Accurate forecasting of the number of infections is an important task that can allow health care decision makers to allocate medical resources efficiently during a pandemic. Two approaches have been combined, a stochastic model by Vega et al. for modelling infectious disease and Long Short-Term Memory using COVID-19 data and government's policies. In the proposed model, LSTM functions as a nonlinear adaptive filter to modify the outputs of the SIR model for more accurate forecasts one to four weeks in the future. Our model outperforms most models among the CDC models using the United States data. We also applied the model on the Canadian data from two provinces, Saskatchewan and Ontario where it performs with a low mean absolute percentage error. © 2023 IEEE.
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Background: Saskatchewan, a Canadian Prairie province, faces a complicated HIV epidemic characterized by high rates of transmission due to injection drug use (IDU) and disproportionate representation of younger persons, women, and persons of Indigenous ethnicity. HIV incidence in Saskatchewan in 2021 was 19.7 per 100,000, 4.5 times higher than the Canadian average. Concurrently, during the COVID-19 pandemic, the recreational use of synthetic opioids such as fentanyl increased, leading to high numbers of overdose events & deaths. We characterized the difference in cascade of care outcomes & mortality amongst people with HIV (PWH) living in southern Saskatchewan during the COVID-19 pandemic. Method(s): We conducted a retrospective cohort study for all PWH cared for in the Infectious Diseases Clinic (IDC) at Regina General Hospital between December 31/19 and June 10/22. Age, sex, ethnicity & primary mode of HIV acquisition were collected from the IDC database, along with cascade of care & mortality data. Deaths, including most likely cause of death were characterized via individualized case review. Result(s): On December 31/19, IDC cared for 518 PWH. This increased to 585 by June 10/22. Amongst the current cohort, 245 (42%) were female, 163 (28%) were <= 35 years old, 306 (52%) were Indigenous, and 318 (54%) had acquired HIV through IDU. Cascade of care indicators worsened during the COVID-19 pandemic. 58.1% of the cohort were retained in care & 76.1% virally suppressed (HIV RNA <= 200 copies/mL) in December 2019, decreasing to 51.3% retained (p=0.02) & 68.8% suppressed (p=0.06) by June 2022. There were 80 deaths during the study period, representing 15.4% of the cohort from the end of 2019. Most deaths (49, 61.3%) were due to suspected or confirmed drug overdose. 10 (12.5%) additional deaths occurred due to complications from IDU (i.e., sepsis). No deaths were directly attributable to COVID-19. Most who died acquired HIV from IDU (69/80, 86%). Conclusion(s): We describe intersecting epidemics of HIV and IDU disproportionately affecting high-risk populations, leading to significant morbidity & mortality during the COVID-19 pandemic. Contributing factors may have included disruption of safe opioid supply and disrupted access to harm reduction services due to COVID-19. Comprehensive population-level harm reduction and addictions management strategies are urgently needed to reduce morbidity & mortality from drug use amongst PWH in Saskatchewan.
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Advance care plans (ACPs) increase patient-centered care, reduce caregiver burden and healthcare costs. However, only about 25% of Canadians over 50 years of age have completed an ACP. An anonymous, cross-sectional survey was distributed to those ≥70 years attending a primary care clinic-based COVID-19 vaccination event in Regina, SK in April 2021. The survey included questions about demographics, attitudes, engagement in ACPs according to the Stage of Change model, and patient-reported influence of COVID-19 on ACP thoughts or actions. One hundred thirty-four surveys were completed (96% response rate). Twenty-seven percent of respondents were at the precontemplation stage, 21% at contemplation stage, 16% at planning stage, 26% at action stage, and 10% at maintenance stage. Thirty-three percent of respondents had thought more about ACPs during the pandemic, but few updated or created plans. Most respondents felt comfortable talking with their physician and partners. There is a need for physicians to initiate ACP conversations with patients.
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This chapter revolves around three autoethnographies that consider the impact of COVID-19 upon Indigenous schooling and related community resilience initiatives in New Zealand, the United States of America (USA) and Canada. It begins with a description of the autoethnographic methodology that underpinned our work. Next, we present the three autoethnographies. First, the autoethnographic account of Teena Henderson, a Ngāi Tahu (Māori) academic from the University of Canterbury (Christchurch, New Zealand). Teena reflects on her tribe's experiences to suggest it must remain resilient and seek to be "heard” by its Treaty partner (the Crown/New Zealand Government). Next, Dr Joseph (Joe) Martin, a Navajo academic (Northern Arizona University) will share his perspective and those of his close colleagues regarding significant challenges currently facing Navajo Nation leaders, administrators, teachers, parents and learners. Finally, Lori Whiteman (Dakota/Anishinabe;Treaty Education Alliance Executive Director) shares her concerns from rural Saskatchewan—particularly as they relate to the concepts of ambiguous loss and community resilience. We then combine as a full team of authors to relate the key recurring themes that emerge from these narratives to international literature. This highlights the unique challenges and shared experiences facing many Indigenous communities around the World—particularly those living in remote/rural areas. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2021.
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It is a mistake to conflate climate variability with climate change or, more specifically, what we have come to call climate change. Major changes in our climate are correlated very strongly with changes in the earth's orbit that occur every 100,000 years. Yet for the past 9,000 years, the earths climate has been remarkably, almost unbelievably, stable. All of which, however, has nothing to say about climate variability. Our climate, the weather we perceive in timeframes we can easily relate to, varies significantly. And in recent years, our climate appears to be getting more and more extreme, the cause of which may very well be anthropogenic warming- Or, as we have come to call it, climate change. The lack of water in Kinbasket Lake was the result of an extremely late and cold spring in British Columbia. Snow packs in the mountains flanking the Columbia River Basin were unseasonably high, and far colder than normal temperatures meant that water remained locked away as snow and ice in the mountains far into spring. Not only were these extremes affecting the Columbia River, they were also plaguing me as far east as Prince Albert, Saskatchewan.
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IntroductionCanadian Paramedic services modified infection prevention and control (IPAC) practices in response to COVID-19. These changes may affect risk of exposure to infectious disease agents and can be used to inform future IPAC practices. We characterized COVID-19-related IPAC changes in the provinces of Alberta, British Columbia, Manitoba, Ontario, and Saskatchewan.Materials & MethodsQuestionnaire data (January 2021-Feb 2022) from the national COVID-19 Occupational Risks, Seroprevalence and Immunity among Paramedics (CORSIP) project was used to identify which IPAC practices were in place prior to COVID-19, and which were modified in response to COVID-19, including the timing of changes (March-May 2020;June-Aug 2020;Sept-Nov 2020;Nov 2020-present).Results2939 participants were included (146, 1249, 139, 1317, 88 from Alberta, BC, Manitoba, Ontario, and Saskatchewan, respectively), of whom 2674 (91%) reported receiving IPAC training. IPAC measures that were common prior to COVID-19 included: personal protective equipment (PPE) training, patient screening, hand hygiene, N95/P100 respirators, gowns, impermeable suits, and cleaning/disinfection. COVID-related IPAC changes included: screening staff, social distancing, restricting aerosol generating procedures, masking patients, cloth face coverings, surgical masks, face shields, and elastomeric respirators. Changes were reported for all IPAC measures. Most (71%) of these changes were made early in the COVID-19 pandemic (March-May 2020). Differences in proportions across provinces, community practice settings, and professional regulation status were reported (p < .05) for hand hygiene, PPE training, screening of patients, face shields, and various respirator types.ConclusionCanadian paramedic services were quick to modify available IPAC measures. However, these changes were variable across provinces, regulation status, and setting for specific IPAC measures. Inconsistent IPAC measures across jurisdictions may contribute to variable risk of infectious disease exposure. An evidence-informed and nationally coordinated approach may provide more equitable exposure risk mitigation for paramedic workers.
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Background: The coronavirus disease 2019 (COVID-19) pandemic has caused substantial disruption to in-person learning, often interfering with the social and educational experience of children and youth across North America, and frequently impacting the greater community by limiting the ability of parents and caregivers to work outside the home. Real-world evidence related to the risk of COVID-19 transmission in school settings can help inform decisions around initiating, continuing, or suspending in-person learning. Methods: We analyzed routinely collected case-based surveillance data from Saskatchewan's electronic integrated public health system, Panorama, from the 2020-2021 school year, spanning various phases of the pandemic (including the Alpha variant wave), to better understand the risk of in-school transmission of COVID-19 in Saskatchewan schools. Results: The majority (over 80%) of school-associated COVID-19 infections were acquired outside the school setting. This finding suggests that the non-pharmaceutical measures in place (including masking, distancing, enhanced hygiene, and cohorting) worked to limit viral spread in schools. Conclusion: Implementation of such control measures may play an essential role in allowing children and youth to safely maintain in-person learning during the pandemic.
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Background: Non-pharmaceutical interventions (NPIs) aim to reduce the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections mostly by limiting contacts between people where virus transmission can occur. However, NPIs limit social interactions and have negative impacts on economic, physical, mental and social well-being. It is, therefore, important to assess the impact of NPIs on reducing the number of coronavirus disease 2019 (COVID-19) cases and hospitalizations to justify their use. Methods: Dynamic regression models accounting for autocorrelation in time series data were used with data from six Canadian provinces (British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec) to assess (1) the effect of NPIs (measured using a stringency index) on SARS-CoV-2 transmission (measured by the effective reproduction number), and (2) the effect of the number of hospitalized COVID-19 patients on the stringency index. Results: Increasing stringency index was associated with a statistically significant decrease in the transmission of SARS-CoV-2 in Alberta, Saskatchewan, Manitoba, Ontario and Quebec. The effect of stringency on transmission was time-lagged in all of these provinces except for Ontario. In all provinces except for Saskatchewan, increasing hospitalization rates were associated with a statistically significant increase in the stringency index. The effect of hospitalization on stringency was time-lagged. Conclusion: These results suggest that NPIs have been effective in Canadian provinces, and that their implementation has been, in part, a response to increasing hospitalization rates of COVID-19 patients.
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In the community of La Loche in Northern Saskatchewan, we experienced the highest COVID outbreak per capita. We were dealing with a complex problem where the answer is not clear, and we had to act as 7% of the population, tested positive for COVID-19. Due to the cases in La Loche and a transient population and little to no cell phone service, traditional test, trace isolate methods were not successful. We established a partnership with SHA, Metis Nation, Clear Water Dene Nation, and the Village of La Loche through engaging others. Together we performed 3 core activities: * Door to Door testing: We tested every individual in the community, bringing 37 staff from around Saskatchewan to support us. * Managed Alcohol Program: overnight establishment when alcohol sales ceased due to municipal bylaw * Community awareness: Daily communication translated into dene on the radio. The combined efforts and results led to us in a matter of 3 months to having 0 cases of COVID-19 in La Loche with a culture change away from health service delivery to community health improvement. In conclusion, no one organization can do it all;we need everyone advocating for health.
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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.
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This paper aims to understand the impact of COVID-19 on three mental health outcomes-anxiety, depression, and mental health service use. Specifically, whether the associations between social and economic variables and these outcomes are exacerbated or buffered among equity-seeking groups in Saskatchewan. We analyzed secondary datasets of Saskatchewan adults from population-based national surveys conducted by Mental Health Research Canada (MHRC) on three occasions: cycle 2 (August 2020), cycle 5 (February 2021), and cycle 7 (June 2021). We examined temporal changes in the prevalence of anxiety, depression, and service utilization. Using the responses from 577 respondents in cycle 5 dataset (as it coincides with the peak of 2nd wave), we performed multinomial logistic regression. The policy implications of the findings were explored empirically through a World Café approach with 30 service providers, service users and policy makers in the province. The prevalence of anxiety and depression remained steady but high. Mental health services were not accessed by many who need it. Participants reporting moderate or severe anxiety were more likely to be 30-49 years old, women, and immigrants who earned less than $20,000 annually. Immigrants with either college or technical education presented with a lesser risk of severe anxiety. Factors associated with moderate or severe depression were younger age (<50 years), low household income, as well as immigrants with lower levels of education. Racialized groups had a lower risk of severe depression if they were under 30 years. Students and retirees also had a lower risk of severe depression. Canadian-born residents were more likely to require mental health supports but were not accessing them, compared to immigrants. Our analysis suggests mental health outcomes and service utilization remain a problem in Saskatchewan, especially among equity-seeking groups. This study should help drive mental health service redesign towards a client-centred, integrated, and equity-driven system in Saskatchewan.
Subject(s)
COVID-19 , Adult , Female , Humans , Middle Aged , COVID-19/epidemiology , Pandemics , Cross-Sectional Studies , Saskatchewan/epidemiology , Anxiety/epidemiology , Outcome Assessment, Health Care , Depression/epidemiologyABSTRACT
SESSION TITLE: What Lessons Will We Take From the Pandemic? SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: COVID-19 surges due to variants continue to intermittently strain healthcare resources, highlighting the need to refine crisis standards of care (CSC) guidelines and study how they may perform in actuality. Studies to date, focusing on excess deaths or exacerbations of existing health disparities, simulate retrospective patient cohorts that synchronize patient presentation to a single point in time, rather than the reality where patients present continually throughout time. This artificial static model may not be an accurate reflection of patient throughput and dynamic resource strain, which occurs in reality, and might distort patient cohorts and mislead CSC simulated outcomes. METHODS: All intubated COVID-19 patients in a single healthcare system in New York City during the first surge (1/1/20 to 6/30/20) were included. A crisis period requiring CSC activation was defined as occurring once 95% of pre-pandemic ventilators were utilized and lasted 2 weeks in duration, consistent with prior simulated length of CSC for this cohort under the New York State Ventilator Allocation Guidelines (NY). NY, Maryland (MD), Pittsburgh (PA), Saskatchewan Canada (SAC), and California (CA) CSC policies were reviewed for exclusionary and other criteria that would affect patient triage (admission diagnosis, comorbidities, occupation, or other patient circumstances). NY, MD, SAC, and CA all use exclusionary criteria. Subsequently NY and SAC only use a SOFA score for triage whereas MD, PA, and CA all integrate tiered comorbidities in addition to a SOFA score to generate an overall triage score. Partial triage priority is provided by PA, SAC, and CA for certain occupations and by PA for those socially disadvantaged. Patient charts were reviewed to determine if they would satisfy triage criteria from any of these guidelines and if they would be relevant during the specific crisis period. RESULTS: 936 patients were included in the total cohort, of which 573 were involved during the crisis period. Those not involved during the crisis period required a ventilator when less than 95% of all ventilators were utilized and would not be relevant during a CSC simulation. NY, MD, PA, SAC, and CA would have excluded 1, 3, 0, 79, and 4 patients respectively for the entire cohort, but 0, 0, 0, 29 (36.7%), and 2 (50%) during the specific crisis period. MD, PA, & CA would have modified 49, 88, & 102 individual’s triage score due to comorbidities in the entire cohort but only 17 (34.7%), 40 (45.5%), and 41 (40.2%) during the crisis period respectively. CONCLUSIONS: CSC simulations that include patients outside the crisis period will include patients that may not be relevant to understanding how CSC might perform. CLINICAL IMPLICATIONS: Understanding CSC performance, particularly when studying excess deaths or exacerbating social disparities, requires incorporating patient throughput for an accurate real-world understanding. DISCLOSURES: No relevant relationships by Deepak Pradhan No relevant relationships by Brandon Walsh
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Sound and effective solid waste management practices are important to mitigate health risks and protect the surrounding environment. Proper Municipal Solid Waste (MSW) management practices are especially important during the COVID pandemic. Since the beginning of the COVID pandemic different waste disposal and recycling behaviors are observed in Regina, the capital city of Saskatchewan. It is believed the changes of waste disposal rate at Regina landfill is related to the new hygienic guidelines, more opportunities for work from home, distinct consumer behaviors, and COVID related regulations and recommendations. Waste generation and recycling behaviors are complex and multi-dimensional. The objective of this study is to model waste disposal rate at the City of Regina landfill using a System Dynamics (SD) model. The proposed SD model will help us better manage the City of Regina’s human resources during the pandemic and estimate the demand of additional personal protective equipment required for the waste management workers. In the present work, a total of 7.5 years of waste disposal data is collected, consolidated, and verified. Socio-economical parameters such as GDPs and population at Regina were also collected during the study period from 2013 to 2020. The model is built using stock-flow diagram to illustrate the effects of various inter-related variables on the waste generation behaviors. Construction and demolition (C&D), Grit, Asphalt Shingles Only, Asphalt Shingles Mixed and Treated Biomedical wastes data are used in the SD model. Results show that waste generation has affected by the pandemic and there is a general increase in amount of waste generation. The modeling results are important because it helps us predict the amount of MSW during and after the pandemic. © 2023, Canadian Society for Civil Engineering.
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Introduction: Evaluating a learning health system (LHS) encourages continuous system improvement and collaboration within the healthcare system. Although LHS is a widely accepted concept, there is little knowledge about evaluating an LHS. To explore the outputs and outcomes of an LHS model, we evaluated the COVID-19 Evidence Support Team (CEST) in Saskatchewan, Canada, an initiative to rapidly review scientific evidence about COVID-19 for decision-making. By evaluating this program during its formation, we explored how and to what extent the CEST initiative was used by stakeholders. An additional study aim was to understand how CEST could be applied as a functional LHS and the value of similar knowledge-to-action cycles. Methods: Using a formative evaluation design, we conducted qualitative interviews with key informants (KIs) who were involved with COVID-19 response strategies in Saskatchewan. Transcripts were analyzed using reflexive thematic analysis to identify key themes. A program logic model was created to represent the inputs, activities, outputs, and outcomes of the CEST initiative. Results: Interview data from 11 KIs were collated under three overarching categories: (1) outputs, (2) short-term outcomes, and (3) long-term outcomes from the CEST initiative. Overall, participants found the CEST initiative improved speed and access to reliable information, supported and influenced decision-making and public health strategies, leveraged partnerships, increased confidence and reassurance, and challenged misinformation. Themes relating to the long-term outcomes of the initiative included improving coordination, awareness, and using good judgment and planning to integrate CEST sustainably into the health system. Conclusion: This formative evaluation demonstrated that CEST was a valued program and a promising LHS model for Saskatchewan. The future direction involves addressing program recommendations to implement this model as a functional LHS in Saskatchewan.
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Background: Appropriate management of inflammatory bowel disease (IBD) often requires multiple specialist appointments per year. Living in rural locations may pose a barrier to regular specialist care. Saskatchewan (SK) has a large rural population. Prior to COVID-19, telehealth (TH) in SK was not routinely used for either patient assessment or follow up. Furthermore, TH was exclusively between hospitals and specific TH sites without direct contact using patient's personal phones. Aims: The objective of this study was to assess the differences in demographics, disease characteristics, outcomes, and health care utilization between patients from rural SK with IBD who used TH and those who did not. Methods: A retrospective chart review was completed on all rural patients (postal code S0∗) with IBD in SK who were followed at the Multidisciplinary IBD Clinic in Saskatoon between January 2018 and February 2020. Patients were classified as using TH if they had ever used it. Information on demographics, disease characteristics, and access to IBD-related health care in the year prior to their last IBD clinic visit or endoscopy was collected. Data was not collected for clinic visits after March 1, 2020 as all outpatient care became remote secondary to the COVID-19 pandemic. Mean, standard deviations, median and interquartile ranges (IQR) were reported. Mann-Witney U and Chi-Square tests were used to determine differences between the groups. Results: In total, 288 rural SK IBD patients were included, 30 (10.4%) used TH and 258 (89.6%) did not. Patient demographics were not significantly different between the two groups;although, there was a statistically significant difference in the proportion of ulcerative colitis patients (17% TH vs. 38% non-TH, p=0.02). The percentage of patients with clinical remission was 87% for TH patients and 74% for non-TH patients (p=0.13). There were no significant differences in health care utilization patterns and biochemical markers of disease, including c-reactive protein (CRP) and fecal calprotectin (FCP) (p>0.05). Conclusions: Prior to the pandemic, a small percentage of patients with IBD in rural SK ever used TH. A small proportion of UC patients used TH. No significant differences in disease characteristics, outcomes, or health care utilization were identified. Further study is warranted to identify barriers to use of this technology to tailor care to this patient group and improve access to care, especially now as the COVID-19 pandemic has drastically changed the use of virtual care.
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Background: Public health measures during the COVID-19 pandemic resulted in many multiple sclerosis (MS) patients being assessed virtually. Expanded Disability Status Scale (EDSS) scores, which are routinely obtained during MS consults, cannot be reliably calculated during virtual assessments. The Patient Determined Disease Steps (PDDS) is a validated patient-reported outcome measure of disability in MS. This study aimed to find real world evidence for the validity of PDDS as a surrogate of EDSS. Methods: Chart review of all MS patients from the MS Clinic in Saskatoon, Saskatchewan who completed PDDS forms emailed to them prior to their virtual visit (N = 277) was performed. 97 (35%) had documented EDSS scores prior to and following their self-reported PDDS. Correlational analysis between PDDS scores and pre and post EDSS scores was performed. Results: PDDS scores were highly correlated with EDSS scores before (r(95) = .79, p < .001) and after (r(95) = .84, p < .001) clinic closure occurred. Conclusions: This study provides real-world evidence that PDDS can accurately assess disability in MS when in-person assessments are not possible. Further investigation into patient demographics that increase the likelihood of completing PDDS assessments prior to appointments at our centre is ongoing.
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This project is a community-led collaboration between an interdisciplinary research team (including Indigenous and visible minority academics, health professionals and students working in health, and community disaster researchers) and First Nation leadership and community members. The project addresses two critical issues that affect Indigenous, visible minorities, and refugee communities: negatively impact their health and poor access to healthcare. We will examine how ethnic and cultural identity, protective factors, and psycho-social stresses impact this pandemic. Given the growing ethnically diverse population of Alberta and Saskatchewan, Canada, it is essential to understand how these communities view, use, and experience health services to build their health resiliency. The findings will provide a high reward policy and programming recommendations to improve health services and deliver equitable, quality and ethnically conscious care during the COVID-19 disaster. Following relational, Indigenous, and antiracist theoretical frameworks, we will use a mixed-method approach of self-reported surveys, focus groups, individual interviews, and Indigenous story-sharing to collect data from the Indigenous, visible minorities, and refugee communities' overall health, factors that negatively impact their health, how they cope with adversity, and their usage of health services.
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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.