TO: First Nation Leadership, Leadership Council
FROM: Chiefs of Ontario Health and Social Sector
DATE: May 14, 2020
RE: COVID-19 Weekly Update
As COVID-19 continues to evolve, Chiefs of Ontario Health and Social Sectors will be providing updates concerning technical highlights and vital priority areas.
HEALTH RESEARCH
Establishing a regional picture of COVID-19 in First Nations in Ontario
The COO Health Research department is working to support First Nations by providing a regional picture of COVID-19 in First Nations in Ontario.
Reliable, consistent COVID-19 data
COO’s Health Research department is releasing weekly COVID-19 test result data. These data come from the Ontario Laboratory Information System and are used by COO and the Ministry of Health of Ontario to monitor progress with COVID-19 across the province. These data may not agree perfectly with other COVID-19 reports such as those from Indigenous Services Canada or grassroots efforts based on social media etc. This is because each reporting system has its own definitions, data capture processes and timing of reporting. The COVID-19 test result data are being used by COO because they are readily available in a consistent way across all First Nations and the province. This makes the data more useful and valuable for regional decision-making and advocacy.
Regional guidance and advocacy
In addition to the weekly reports of testing results, COO is analyzing these data to increase our understanding of how COVID-19 is affecting First Nations people, particularly those with chronic conditions across different age groups. The intent is to guide regional advocacy for support of First Nations in their management of COVID-19 and point to lessons learned on pandemic efforts to protect First Nation communities. These regional efforts could guide and inform but do not replace the work by First Nation communities or public health units to do tracing and monitoring of individuals with COVID-19.
Partnership with ICES
COO is partnering with ICES again in its work with COVID-19 data. ICES holds health care (including COVID-19 test results) and other administrative data in Ontario to help inform population health and system Improvement. Through resolutions, COO worked with ICES to link federal Indian Register data to ICES data for approved use by First Nations. To that end, a Data Governance Agreement between COO and ICES was established in 2012 regarding data from the Indian Registry System. In this agreement, First Nations have governance over First Nations data held at ICES. The agreement allows for presentation of aggregate, de-identified data to support regional decision-making while respecting the sovereignty of First Nations. Through partnership with ICES, the Ontario Strategy for Patient-Oriented Research (SPOR), and First Nations Information Governance Centre, COO is working to develop an Ontario First Nation Research and Data Management Centre that would provide First Nations even better access to their data. In the meantime, COO continues to enjoy a productive partnership with ICES, a partnership that has already resulted in several important projects on aging, diabetes, cancer, chronic disease, mental health and other topics.
Questions asked and answered
Collaboration with ICES in analysis of COVID-19 data is helping answer several important questions for First Nations.
- How many First Nations people have tested positive for COVID-19?
Figure 1 shows there were 75 COVID-19 positive test results as of May 4, 2020. This is much lower than for Ontario as a whole (for which there were over 16000). However, the First Nations total appears to be growing faster than the Ontario total. This means that while Ontario may be ready to start opening up again, the same might not yet be true for First Nations.
- How is testing going?
Figure 2 shows that testing rate among First Nations is increasing. As of May 4, 2020, 2.1% of First Nations people had been tested, slightly more than the 1.7% of Ontarians who had been tested in the same time period. This pattern suggests that regional and local advocacy for more testing among First Nations might be working.
- What is the positive rate for COVID-19 test results in First Nations people?
As of May 4, 2020, the percent of First Nations people tested who were positive for COVID-19 was 2.4%. This is about the same as the previous week and quite a bit lower than the rate of 6.2% among others in Ontario. However, the Ontario numbers include testing during outbreaks in Long Term Care homes, for which the positive rate is quite high. Nevertheless, the lower rate among First Nations suggests that the efforts being made to reduce the spread of COVID-19 are working. That is good news!
- How are things on First Nation communities/on reserve?
As of May 4, 2020, 3.2% of the people on reserve who were tested were positive for COVID-19, compared to 2.0% of people living off reserve who were tested. These rates might not truly reflect what is happening on or off reserve as they depend on whether people are keeping the postal code on their health card up to date when they move into or out of First Nations communities on reserves.
Unanswered question
One question that the data have not yet been able to answer is “When is it safe for First Nations to open up?”. This question is top of mind for many First Nation communities. It is a big question that has to consider much more than just COVID-19 test results.
Keep the circle strong
In the meantime, the data show that closing borders and other measures seem to have kept the number of cases of COVID-19 in First Nation communities low. However, the number of positive COVID-19 test results is still increasing and the testing rate is low in First Nations and across Ontario. All of this suggests that it may still be too early for First Nations to open up. Keep encouraging social distancing, washing hands, advocacy for testing and self-isolating when necessary.
Figure 1: Total COVID-19 positive test results
Figure 2: Percent of people tested for COVID-19
We remain committed to working together with all of you in keeping our nations protected, supported and embraced. While not possible physically, then with our spirit, as we do everything possible to combat COVID-19 and its impacts.
Be Well.