Northwest Territories grappling with Canada’s highest COVID-19 infection rate

Alexandra Greene

The Northwest Territories (NWT) currently has the highest rate of active COVID-19 cases in Canada, with the equivalent of 740 cases per 100,000 people. This is more than one-and-a-half times the rate in Alberta, where hospitals have had to implement triage protocols, denying vitally needed care to some patients, due to an unprecedented explosion of infections and hospital admissions.

While the NWT’s 356 active infections may seem small in comparison to Alberta’s 15,295, the difference in their respective populations means that the situation in the territory, which makes up much of Canada’s far north, is dire. The Northwest Territories has a population of just 45,500, almost half of whom, some 21,400 people, reside in its capital, Yellowknife.

A nurse holds a phone while a patient affected with COVID-19 speaks with his family from the intensive care unit. (Image Credit: AP/Daniel Cole)

NWT has now recorded nine total COVID-19 deaths, all of them since August, including two that were reported on Tuesday and Wednesday of this week.

The territory had largely escaped the ravages of COVID-19 until the country’s current Delta-driven fourth wave erupted in early August. Since the pandemic began in Canada in March 2020, the Northwest Territories has had 1,537 confirmed COVID-19 cases. Of these, close to 1,400 have been reported since mid-August 2021.

This rapid increase in infections has been largely caused by an outbreak of the Delta variant in the Sahtu region, which subsequently spread to Yellowknife.

On Sunday, NWT’s chief public health officer announced that an exposure to COVID-19 had occurred last week at the territory’s legislature building. This alone has resulted in six confirmed cases and two probable cases to date. Other outbreaks declared this week include one at the Inuvik homeless shelter and another at Diamond Jenness Secondary School, both in Hay River.

Located in Yellowknife, the territory’s main hospital, Stanton Territorial Hospital, has just six ICU (intensive care) beds. By October 4, all six of these beds were occupied by patients suffering from COVID-19. The federal government sent oxygen concentrators from the national stockpile to the territory, after a public alert was issued by the NWT health authority that Stanton Territorial Hospital was struggling with oxygen supply issues.

The federal government also requested that the Red Cross send health care workers to assist in the territory. Nurses, doctors and health care staff have since been deployed to work at the temporary shelter set up at the Yellowknife Arena in September to provide services to the city’s large “underhoused” population.

The territory’s health care system is under immense pressure and was already becoming overwhelmed by mid-September. In Yellowknife as well as smaller communities throughout the NWT, health care staff have been moved out of clinics and redeployed to facilities where there are greater numbers of severely ill or at-risk patients. Non-urgent procedures and appointments have been cancelled and postponed. The health care authority announced that opioid maintenance treatment appointments and mental health and addictions counselling sessions are being triaged and moved online.

In recent weeks, there have been 36 hospitalizations due to the virus, including 13 ICU admissions. Prior to the current surge in cases, the territory had seen only four COVID-related hospitalizations during the entire pandemic.

The first six people who died from COVID-19 in the Northwest Territories ranged in their ages and the communities they came from but were all indigenous. This was confirmed by Health Minister Julie Green, who stated that some of those who died from the virus were indigenous elders, adding that important knowledge of their culture and communities died with them.

To try and counteract the spread of the virus, in-person schooling has been halted in communities across the territory and gathering restrictions are in place in the two most heavily affected communities of Yellowknife and Behchokǫ̀.

“If I were to lift the orders, it would overwhelm the health hospital system for sure,” Dr. Kami Kandola, NWT’s chief medical officer of health, told CBC News in a recent interview. Kandola also pointed out that if the health care system in the NWT were to become further taxed, the normal course of action would be to transport critically ill patients to Alberta for treatment. However, with Alberta’s own health care system overwhelmed, that option is largely if not entirely foreclosed—placing the territories’ population at still greater risk.

Kandola said that the waning immunity provide by mRNA COVID-19 vaccines is a major factor in the current surge of infections. The Northwest Territories began vaccinating elders on December 31, 2020, months ahead of the vaccine rollout in other parts of the country. “Because we were privileged to get the vaccine first, we unfortunately are going to be the first ones to experience the waning immunity, which we’re seeing in our own case numbers,” she warned in a September interview with CBC.

At the beginning of October, the territory began to supply third doses of the vaccine for people aged 75 and over in its hardest hit communities as part of a “limited roll-out.” Care home residents received a third dose in August.

While waning vaccination efficacy may well be a critical factor in the spread of the virus, the premature repeal of public health orders is ultimately what has enabled the virus to again take root in the Northwest Territories. Epidemiologists and other health experts have long warned of the consequences of relying solely on vaccinations to protect a given population.

The dismantling of many of the most basic public health protections by the territorial government was in line with policies pursued by governments across Canada. With the support and encouragement of the federal Liberal government led by Justin Trudeau, provinces from coast to coast lifted restrictions following the deadly third pandemic wave last spring. The most disastrous consequences of this “profits before life” strategy can be seen in Alberta. Overall, Canada’s official COVID-19 death toll has surpassed 28,000, but credible studies suggest the figure is actually over 50,000.

The current outbreak in Yellowknife has severely impacted the city’s large homeless population. Critics have pointed out that this could have been avoided had the territorial government not rolled back safety measures that were put in place early on in the pandemic.

Initially, the territorial government turned the downtown Aspen Apartment complex and the city’s Arnica Inn into isolation centres for those experiencing homelessness. A second day shelter was also opened downtown. Aspen Apartments had 36 rooms in which homeless people could isolate while awaiting COVID test results and remain isolated and sheltered if they did test positive for the virus. However, when case numbers declined last spring, the government closed the centre, saying it was not being used. A day shelter also closed in the spring, and now as Yellowknife struggles with the Delta variant-fueled outbreak, there are few places for the homeless population to isolate or find safe shelter. Places to access food and other essential services and escape the harsh Northern elements have also been shut.

From mid-August to September 12 alone, 19 people using shelters in Yellowknife tested positive for the virus, as did 10 health care and shelter workers. The number of shelter workers who contracted the virus or were otherwise affected by the outbreak and unable to come to work forced a further day shelter to close and, as of September 11, Yellowknife’s sobering centre close its doors indefinitely.

The Northwest Territories, and especially its indigenous population, have long been severely impacted by a chronic shortage of proper housing and rampant homelessness. (Senate of Canada)

With temperatures dropping as winter draws nearer, there is no 24-hour shelter available for those without anywhere else to go. A Quality Inn has now been converted into an isolation centre, but shelter workers and advocates for the homeless population have said that the process of setting this up has been an “intense scramble to throw things together.”

Since the start of September, numerous outbreaks at worksites have occurred across the Northwest Territories. Two workers tested positive for COVID-19 at the NWT Power Corporation’s Snare Hydro System worksite, which is located roughly 140 kilometres northwest of Yellowknife. There were also two confirmed cases among workers at the Ekati diamond mine, as well as one case at the Gahcho Kué diamond mine in Fort Smith. Cases were also recorded at the Diavik mine and the Imperial Oil facility in Norman Wells.

In all the cases at the various diamond mines and the Imperial Oil facility, the workers who tested positive had travelled into the Northwest Territories for work and do not reside there. Many workers live in Alberta and travel north to jobs in the NWT. Alberta’s skyrocketing case numbers make it all the more reckless and irresponsible to force workers to keep non-essential production facilities, such as diamond mines, operating throughout the pandemic.