Canada’s far north Nunavut Territory faces major COVID-19 outbreak

Until early November, Canada’s sparsely populated Nunavut territory was among the few inhabited places on the planet that had not seen a single case of COVID-19. Located in Canada’s remote far north, the territory was able to remain COVID-free for eight months after the virus took hold in North America, by implementing strict travel controls and social distancing in grocery stores and other places.

However, as a second wave of the pandemic developed in Canada’s south this fall as a result of the reckless back-to-work and back-to-school policies pursued by the federal and provincial governments, the virus inevitably found its way into the territory. After the first COVID-19 case was reported last month, the virus quickly spread, forcing small and isolated Nunavut communities to cope with major outbreaks in the midst of harsh winter conditions.

Only residents and essential workers were permitted to enter the territory as of March 24. Those coming from elsewhere who were approved to enter the territory had to undergo a mandatory 14-day period of self-isolation beforehand in either Ottawa, Winnipeg, Edmonton or Yellowknife.

Health officials and community leaders in the territory knew that if the pandemic were to begin spreading in the isolated region, the consequences would be dire. The population of Nunavut, standing at just over 39,000—85 percent of whom are Inuit—has been burdened with simultaneous crises for many years. A chronic housing shortage, a food insecurity crisis and a decades-long struggle with tuberculosis are the main hardships already faced by those living there.

In 2018, the federal government committed to ending TB among Inuit by 2030. But after just two years of effort, progress was officially stalled in January 2020 due to a lack of funding. Rates of tuberculosis among the Inuit are 300 times higher than those observed in non-Indigenous, Canadian-born citizens.

Advocates for tackling the TB crisis in Nunavut acknowledge that the problem is inextricably bound up with a housing crisis, food insecurity and high levels of unemployment.

Varied stressors of poor living conditions oftentimes allow for the disease to become active in a carrier, and this fact combined with the affected population living in overcrowded housing and suffering from malnourishment mean the likelihood of transmission is very high.

Tuberculosis is a disease caused by bacteria that most commonly affect the lungs, causing chest pain, coughing and a host of other symptoms. A 2011 Globe and Mail article labelled Nunavut as “one of the world’s worst places for respiratory health” (see: “ Tuberculosis: Canadian Arctic tragedy, growing global threat “).

Based on these factors and many others, COVID-19 reaching the territory was a grim prospect, with the potential to cause mass suffering and death.

On November 6, Nunavut’s chief public health officer announced the first official case within the territory. The infected individual was in the small Hudson Bay community of Sanikiluaq, where only about 850 people live. All residents of the community were instructed to remain at home and limit contact with others as contact tracing and exposure tracking measures were put into place. Two days later, a second infection in Nunavut was announced out of the same town.

Just 12 days after the first case was announced, Nunavut had a total of 70 confirmed COVID-19 infections. As of November 28, the territory was into the triple-digits of case numbers, with 131 active cases.

On December 2, lockdown restrictions imposed two weeks earlier were lifted for all areas except the hamlet of Arviat. Although the number of active cases has eased somewhat, there were still 49 active cases in Nunavut as of yesterday. The community of Arviat is especially affected, reporting nine new cases yesterday.

Over 640 people who have potentially been exposed to the virus are being “followed” by the Government of Nunavut. The official Nunavut Department of Health website page recording COVID-19 information states that “persons followed includes individuals with specific symptoms and exposures as well as others who are self-monitoring or self-isolated,” but this statement is followed by a disclaimer noting that not all of these individuals have symptoms or require testing.

Arviat, a community of approximately 2,550 people, is now seeing families confined to their homes as winter arrives. The problems of overcrowded and inadequate housing are thus compounded.

Families are speaking out about the difficult living conditions that they are struggling to cope with. Cecilia Akammak, an Arviat resident, spoke to CBC News about how her household of 11 people has gone without hot water throughout the duration of the outbreak. The family’s boiler is broken, and at a time when hygiene and sanitation to limit the spread of the virus is of the utmost importance, Cecilia has had to boil water to disinfect surfaces and to provide her family with water to simply wash their hands.

Cecilia lives with her husband, children and grandchildren in a three-bedroom public housing unit. The Nunavut Housing Corporation says only emergency repairs are possible, as maintenance staff with the local housing authority are self-isolating. Consequently, Cecilia’s boiler cannot be fixed at this time.

Another Arviat resident, Jennifer Aulatut, told CBC News that the water in her household is yellow and makes her children sick. As a result, Jennifer buys fresh water at the store, yet due to financial constraints that is not always possible. Usually, when a situation like this occurs or the 60-year-old dilapidated home her family resides in needs repairs, she will stay with other family members in a different house. However, currently that is not possible due to lockdown measures.

These terrible conditions are faced by many other households in Nunavut, where 54 percent of Inuit peoples live in “hidden homelessness.” This means that they have no home of their own but are not visibly living on the street. Approximately one half of the 39,000 people living in the territory do so in overcrowded housing. As of 2016, 36.5 percent of the population were in “core housing need,” more than double the rate in any other province or territory.

The desperate housing crisis and rampant poverty confronting wide sections of Nunavut’s population are exacerbated by the longstanding problem of exorbitant food prices. Major retail chains offload the cost of shipping food to the far north by charging exorbitant prices that make it impossible for most people to eat a healthy diet. A kilogram of asparagus costs over C$32 in Iqaluit in January, while an apple averages around C$1.50. According to Food Banks Canada, it costs a staggering C$1,846 per month to feed a family of four in the community of Taloyoak, compared to C$868 in the national capital, Ottawa.

Government policies have actively contributed to the worsening food crisis. In 2011, the federal government implemented the Nutrition North Canada (NNC) program, which provides subsidies to retailers, supposedly to reduce prices for customers. However, this hardly ever occurs, both because the government does not enforce price controls and because the retailer receiving the subsidies is often the only store one can shop at in the entire community. According to a 2019 study published in the Canadian Medical Association Journal, food insecurity in Nunavut’s 10 largest communities increased 13.5 percent following the introduction of the NNC, which replaced a scheme known as Food Mail, which subsidized food shipments via Canada Post.