The COVID-19 pandemic has reached a remote First Nation in northwestern Ontario, a local health authority said Monday as it cautioned the virus would soon place additional strain on a social and health-care system poorly equipped to handle it. A statement from the Sioux Lookout First Nations Health Authority said a positive case of the disease caused by the novel coronavirus has surfaced in Eabametoong First Nation. The community, about 300 kilometres north of Thunder Bay, Ont., is one of 49 remote areas comprising the Nishnawbe Aski Nation. NAN Grand Chief Alvin Fiddler said the patient recently returned to Eabametoong from Thunder Bay, where COVID-19 cases have already been confirmed. He said the man is self-isolating at home, but said the emergence of the virus in Eabametoong is sounding alarms across NAN territory.

Carlos Osorio/Toronto Star via Getty Images Nishnawbe Aski Nation Deputy Grand Chief Alvin Fiddler stands for a photograph in Toronto on Feb. 14, 2013.

“This makes it even more real for all of us,” Fiddler said in a telephone interview from Thunder Bay. “The urgency of it all, and the importance of our communities to continue practising what we’ve been told by public health experts.” But Fiddler said heeding that advice is more difficult in Indigenous communities than elsewhere in Canada. The time-honoured advice to wash hands regularly, he said, will be difficult to follow in Eabametoong, which has been under a boil-water advisory since 2001. Self-isolation, too, poses a problem in communities plagued by housing shortages and chronic overcrowding.

This makes it even more real for all of us. Alvin Fiddler

Fiddler said numerous NAN communities are looking into converting empty classrooms and vacant community centres into spaces where prospective patients could be kept isolated if needed. But public health officials warned that even with preventative measures in place, the medical system serving northern communities does not have the capacity to deal with the crushing load COVID-19 has placed on other parts of Canada’s health-care apparatus. Dr. Natalie Bocking, a physician with the Sioux Lookout First Nations Health Authority, said most Indigenous communities wrestle with a shortage of personnel and equipment at the best of times. During a pandemic, she said, those shortages will be exacerbated and an already vulnerable population will face a heightened threat. “Communities like Eabametoong experience a disproportionate burden of other chronic health conditions that put them at higher risk of becoming more sick with the virus,” she said. “The worst-case scenario we are concerned about where there are multiple people getting quite sick without the care that they need.” Bocking and Fiddler both said talks are underway with various levels of government to secure key supplies, including the personal protective equipment that’s currently scarce across the province. Ontario running low on some equipment Premier Doug Ford said Monday that Ontario is at risk of depleting its stock of masks, gowns, gloves and other gear within a week without a renewal of supplies. The Ministry of Health did not immediately respond to request for comment. Canada’s top doctor, meanwhile, acknowledged that the public health advice guiding the rest of the country can’t be applied in the same way across Canada’s Indigenous communities. “We’ve issued guidance for public health actions in more remote and rural settings as well, and those do have to be adapted to the realities of what’s on the ground,” Dr. Theresa Tam told a Monday news conference without providing specific details of how guidelines have been revised. Bocking said health authorities have received acknowledgment that self-isolation is not possible in many homes in remote communities, such as three-bedroom houses with as many as 20 people living in them. Such messages, she said, have shaped conversations about how to create additional spaces for self-isolation.

Fiddler said remote communities are increasingly concerned about the potential spread of COVID-19, which has surfaced in a number of cities that serve as key gateways to more remote First Nations. He said those include northern urban centres such as Timmins, Sioux Lookout and Dryden. The sorts of physical distancing measures that have transformed daily life across much of the country, he said, have taken hold in more remote areas over the past week-and-a-half. “There’s a growing sense that this is a real threat to our communities,” he said. “We have to do everything we can to try and prevent it.” This report by The Canadian Press was first published April 6, 2020.