NAN COVID-19 Bulletin- October 15, 2020

Nishnawbe Aski Nation (NAN) COVID-19 Update                                                                                                                                           

Thunder Bay District Health UnitTotal Number: 109
Active Cases: 0 (Last case reported on October 10)
Recovered: 108
Deceased: 1
Porcupine Health UnitNumber of cases: 8
Active Cases: 3 (last case reported on October 14)
Recovered: 77
Deceased: 9
Northwestern Health UnitTotal Number: 71 ( 69 positive test results, 2 probable cases)
Active: 3 (last new case reported on October 14 in the Rainy River region)
Recovered: 68
Deaths: 0
Public Health Sudbury & DistrictsTotal Number: 111
Active: 2 (last case reported on October 13)
Recovered: 107
Deaths: 2
Timiskaming Health UnitTotal Number: 17 (no change since last week)
Active: 0
Recovered: 17
Deaths: 0

NAN Grand Chief Update                                                              

  • A moment of silence was observed to honour the life of Jennifer Landry, a member of Matachewan First Nation. Jennifer was a constable with the Ontario Provincial Police and former officer with the Nishnawbe Aski Police Service (NAPS). We are thankful for her years of service with NAPS, keeping our families and our communities safe. Her family and the Matachewan community are in our thoughts and our prayers.
  • Condolences were offered to the family and leadership of Wunnumin Lake First Nation after the tragic loss of two young men in Thunder Bay over the weekend. This is a painful reminder of the importance of the work NAN is doing on many fronts, such as mental health and addictions.
  • Grand Chief also acknowledged our Mi’kmaq brothers and sisters on the East Coast who are facing racist attacks while exercising their inherent and Treaty right to fish and provide for their families. The lack of action by the RCMP to ensure their safety and wellbeing is very

discouraging. We are monitoring this situation and stand in solidarity with the Mi’kmaq. We are hopeful for peaceful resolution soon.

Public Health Update from Grand Chief Fiddler

  • Grand Chief received his flu shot and reminded everyone that protecting your health is especially important this year. A video will be posted on NAN’s social media platforms Friday.
  • We continue to advocate for an additional 50 public health nurses to be provided to NAN First Nations to increase capacity at the community level.
  • Grand Chief will participate on a call with federal Ministers regarding systemic racism in the Canadian health care system on Friday.
    • We are hopeful that there is a commitment to meaningful action, and will continue to advocate for Health Transformation across NAN territory.

NAN Chiefs Fall Assembly

  • REMINDER: NAN Chiefs Virtual Fall Assembly – October 20 & 21.
  • Chiefs are urged to register as soon as possible as it is only a few days away!
  • As of October 15, there are 34 Chiefs and 2 proxies registered.
  • To register online for the assembly please visit http://www.123formbuilder.com/form- 5648522/nan-chiefs-virtual-fall-assembly
  • The Chiefs Kit and Annual Report have been sent to leadership for review.

NAN COVID-19 Task Team 

  • First Nations in Manitoba are experiencing a surge in COVID-19 cases.
    • As of October 9, 2020, there were 143 active cases among First Nations people.
    • Nine different communities have reported COVID-19 cases in recent weeks.
    • Largest outbreak is in Little Grand Rapids First Nation, where 38 members have tested positive.
    • Vulnerable community members with COVID-19 are being evacuated to Winnipeg to be closer to medical services. BlueMed tents and emergency workers with the Red Cross have been dispatched to the community.
  • These cases show how much a threat COVID-19 remains to First Nations and highlights the importance of remaining vigilant during this pandemic.
  • The NAN Task Team recommends caution for non-essential travel in order to keep health risks low for people who need to travel for medical appointments.

Medical Travel

  • The NAN Task Team continues to determine how NAN community members can safely access medical care during this pandemic.
  • The NAN Critical Preparedness Readiness & Response Actions are being revised to include more specific guidance on medical travel and updated information about rapid testing. This will be shared with leadership when the amendments are finalized.
  • SLFNHA has provided its communities with public health guidance on Safe Pathways to and from communities for care.

o   SLFNHA currently considers both Kenora and Winnipeg to be high-risk areas and recommends community members returning from these locations to be tested, self-isolate for a full 14 days and be tested again 7-10 days after they return to their community.

Update on Rapid Testing

  • Rapid testing technologies currently approved by Health Canada for use outside of a certified laboratory are the GeneXpert, the ID NOW, and the PanBio.
    • Except for the GeneXpert, these tests have only recently been approved and are not widely available yet.
    • The National Microbiology Laboratory (NML) has been running a program to bring rapid COVID-19 testing to northern, remote, and isolated communities.
      • NML started by offering the GeneXpert. They are also planning to offer the ID NOW instrument to communities within the coming weeks. The PanBio uses a different testing method than the others, and it is unknown when it will be widely available in Canada.

·       If your community is interested in receiving a rapid testing instrument, please reach out to your local health authority or emergency@nan.ca to be connected with the NML.

  • NAN continues to advocate at both levels of government to ensure that rapid testing is available to any community who wishes to employ it.

Flu Shots

  • Supplies of the annual flu vaccine are now available. The Task Team recommends that everyone get their flu shot.
  • Getting the flu shot will make it less likely that you will need to use health care resources that are needed to respond to COVID-19.
  • Even if you believe you will not get sick from the flu, getting the vaccine may help prevent you from passing the flu on to vulnerable people in your community.
  • Check with your nursing station, health centre or health clinic to see if the flu shot is available in your community.
  • Demand is high for the flu shot this year. It is recommended that you call ahead or check online to see if your local drugstore has the vaccine in stock before you go.

NAN Hope

  • NAN Hope offers:
    • 24/7 toll-free rapid access to confidential crisis services.
    • Rapid access to clinical and mental health counselling.
    • Navigators who provide connection to existing mental health and addictions support services in home communities and the region.
  • This service is for all NAN members from youth to Elders, living on or off-reserve.

·       Please continue to share NAN Hope with anyone who might need help.

  • There are language speakers available through this program.

o   NAN Hope can be accessed through 1-844-NAN-HOPE (1-844-626-4673) and www.nanhope.ca

Hand Sanitizer Alert

  • This week, the Thunder Bay District Health Unit issued a Public Health Alert warning that some hand sanitizer products in Thunder Bay may be contaminated with methanol. Anyone who consumes these products are at risk of methanol poisoning.
    • The Task Team is trying to determine the specific brands or manufacturers.
  • Symptoms of methanol poisoning include confusion, drowsiness, seizure, trouble breathing, fast heart rate, nausea and/or vomiting, and can lead to organ damage, blindness & death.
  • Call 911 or seek immediate medical care if you, or someone you know, is showing symptoms of methanol poisoning.

Update on Justice 

  • A landmark decision was delivered in the Ontario Court of Justice in Kenora on the R v. Turtle case by Justice David M. Gibson on October 2, 2020.
    • Six people from Pikangikum were charged with drinking and driving, and the case was based on them being unable to serve their intermittent sentences.
      • Justice Gibson ruled that Section 255 of the Criminal Code violated Section 15 of the Charter.
      • The people of Pikangikum were not being treated as equals to those in urban centers.
      • It was a major decision for the people of Pikangikum and across NAN.
      • The case has revealed violations of the Charter, and how the government has failed to honour the Treaty.
  • Northern courts are still not open and are classified as Stage 3.
    • It has yet to be determined when courts will re-open in drive-in communities.
      • Nishnawbe-Aski Legal Services has been asked to connect with leadership on these matters. The decisions of leadership will be honoured.
  • Justice Jana-Rae Dewson has been appointed to the Ontario Court of Justice and will be assigned to Sioux Lookout. There is potential for satellite courts to be utilized in the region.
  • There are concerns around institutional barriers to the release of those in custody. The government must focus on proper releases in addition to upgrades to jails.
  • NAN Legal continues to provide services remotely. A list of services is available at www.nanlegal.on.ca.

Nishnawbe Aski Police Services (NAPS) 

  • Each region is operating under COVID-19 protocols and NAPS has acquired a lot of PPE.
  • In-person meetings are permitted while following provincial guidelines.
  • There have been 24 incidents reported in the last week, several of which have been major occurrences.
  • There have been more NAPS employees getting tested for COVID-19 now that cold and flu season has arrive to ensure the safety of all.
  • There is a lack of resources for responding to cases involving mental health issues.
    • NAN will continue its advocacy in this regard recognizing the importance of these supports.

Communications 

  • Members of the NAN Executive Council will continue to provide updates on Wawatay Radio on Tuesday at 12 pm EST and on Friday at 1:05 pm EST.
  • COVID-19 Tools and Resources are being translated into Oji-Cree, Ojibway, and Cree to assist the communities in spreading awareness and public health messaging on COVID-19. They are posted on the NAN website under COVID-19 Tools and Resources.
  • Please send all new and updated community memos, statements, By-Laws, BCR’s and relevant community restriction information to emergency@nan.ca so that NAN and applicable partners can remain aware and respectful of your communities wishes.

Urban Communities 

  • NAN has posted specific information on the NAN website for members living off-reserve in urban centres across northwestern and northeastern Ontario.
    • This includes how to find shelters, food banks, social and mental health services, as well as Indigenous organizations that can provide assistance.
  • Please visit www.nancovid19.ca. It is updated daily with the most current information.

NEXT CALL: Thursday, October 29, 2020 | 1p.m. EST | 12p.m. CST

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NAN COVID-19 Bulletin- October 8, 2020

Nishnawbe Aski Nation (NAN) COVID-19 Update                                                                                                                                           

Thunder Bay District Health UnitTotal Number: 107
Active Cases: 0 (Last case reported on October 6)
Recovered: 106
Deceased: 1
Porcupine Health UnitNumber of cases: 85
Active Cases: 3 (last case reported on October 6)
Recovered: 73
Deceased: 9
Northwestern Health UnitTotal Number: 67 ( 66 positive test results, 1 probable case)
Active: 13 (last case reported on October 3)
Recovered: 54
Deaths: 0
Public Health Sudbury & DistrictsTotal Number: 109
Active: 1 (last case reported on October 6)
Recovered: 100
Deaths: 2
Timiskaming Health UnitTotal Number: 17*
Active: 0
Recovered: 17
Deaths: 0
*On October 5, THU announced that two of its most recent cases were being re-assigned to other Health Units, while another resolved case would be considered at THU case. These changes were due to ONtario’s Case Content Managing guidelines being updated so that home address was no longer the sole reason to attribute a case to a health unit.

NAN Grand Chief Update

  • NAN Executive acknowledges Muskrat Dam Chief Gordon Beardy on his election this week. NAN also congratulates Missanabie Cree First Nation on the historic claim settlement with the federal government as well as Chief Gauthier and Council and all the past leaders, elders, youth and ancestors who have helped reach this settlement.

COVID-19 Update from Grand Chief Fiddler

  • Flu season is approaching, and we encourage all community members to get a flu shot as soon as they are available. A flu shot prevents you from getting very sick and will not give you the flu.
  • Canada is working to provide a COVID-19 vaccine. NAN is working to ensure there will be capacity at the community level to deliver both of these vaccinations as soon as possible.
  • We recognize there is increased anxiety about in NAN territory and across the province.
  • When the pandemic began there was very little structure for public health, and we have been trying to strengthen this.
  • NAN continues to advocate for public health nurse capacity at the community level by working with the province on the request for an additional 50 public health nurses.
    • Letter to Canada’s Chief Public Health Officer Dr. Tam has been written on this request.
  • We spoke with the Premier this week to ensure that all identified NAN priorities (Treaty relationship & respecting First Nations) are addressed as they move toward development in our territory.
  • NAN also spoke with Minister Yakabuski and Minister Rickford about the Far North Act this week. A report is being developed and will be presented at the upcoming Chiefs Assembly.

CAO Travis Boissoneau Update

NAN Office Logistics

  • The re-opening of the NAN office has been postponed until November 9, 2020. This comes after recommendations from our Task Team and the TBDHU. This decision was made with the health and safety of all employees and communities in mind.
    • Will continue to monitor and consider all public health recommendations and revisit the status on the office on a monthly basis.
  • NAN staff are under a continued travel restriction including travel to communities and urban areas. Vendor travel has also been suspended until further notice.
  • All staff will continue to work in a virtual environment to ensure that the priorities of NAN First Nations continue to be addressed.

NAN Chiefs Fall Assembly

NAN Website

  • The new NAN website (www.nan.ca) was launched this week.
  • It is designed to be more informative, easier to navigate, and has been organized to make it easier to find up-to-date information.
  • New features include mobile and tablet friendly, multimedia compatibility, events calendar and social media integration.
  • The NAN COVID-19 website (www.nancovid19.ca) is still live and will continue to be updated with public health information.
  • We encourage Chiefs and community members to visit the new NAN website. Please send any or suggestions or questions to NANComms@nan.ca.

NAN COVID-19 Task Team

  • New daily case counts in Ontario continue to be high, with over 500-600 new cases per day for the past 5 days and a record high today of 797 confirmed COVID-19 cases.
    • Ontario is moving away from the concept of social circles. Residents are urged to only have close contact with those in their immediate household.
  • Winnipeg has over 600 active cases.
  • New cases in the NWHU, including those identified at Valleyview Public School in Kenora on October 1, have been classified as an outbreak.
  • Both NWHU and TBHU have issued recommendations that residents are to avoid non-essential travel outside of northern Ontario.
  • TBRHSC and St. Joseph’s Care Group have reinstated travel restrictions. Anyone who does not require urgent care and/or has travelled outside northern Ontario within the past 7 days will not be allowed on-site.
  • The Task Team continues to meet on a weekly basis to advise on, and respond to, issues relating to the pandemic. They can be reached at emergency@nan.ca if you have any questions.

Importance of Seeking Medical Care – Dr. Anna Banerji

  • Although there are risks with travelling, this should not stop people from accessing medical care including necessary treatments, diagnostic tests, mental health care and surgeries.
  • Serious health complications can arise if people do not, or cannot, access necessary medical care.
    • People with cancer usually have better outcomes the sooner the cancer can be diagnosed and treated.
    • Untreated infections can lead to sepsis.
    • Having to wait for a pacemaker may increase the risk of adverse events such as  heart failure.
  • Healthcare providers can determine what care is urgent and what can safely be delayed.
  • .

Update on Rapid Testing

  • Last week, Health Canada approved the Abbott Laboratories (USA) ID Now test for COVID-19. The Government of Canada has signed an agreement to purchase up to 7.9 million of these tests.
    • The NML received its first ID NOW instruments and will be preforming tests.
    • NML is hoping to deploy these units to communities in late October.
  • This week, Health Canada approved the Abbott Laboratories (Germany) PanBio test.
    • Unlike the ID Now test, this is an antigen test instead of a molecular test.
    • Antigen tests are quick and easy to use.
    • These types of tests are less sensitives than molecular tests like the GeneXpert or the ID Now.
  • Both tests need to go through a validation process. The total number of tests that the federal government has agreed to purchase is not the number of tests that are currently available in Canada. The supply will become available in the coming months.
  • As rapid testing becomes available, we are advocating for NAN communities to be prioritized for safe, reliable and accurate point-of-care tests.

NAN Hope

  • NAN Hope offers:
    • 24/7 toll-free rapid access to confidential crisis services. 
    • Rapid access to clinical and mental health counselling.  
    • Navigators who provide connection to existing mental health and addictions support services in home communities and the region.
  • Last week, the three most common presenting issues were substance use, suicidal ideation, and trauma.
    • Other reasons included family concerns, grief and loss, domestic violence, and sexual abuse/assault.
  • Please continue to share NAN Hope with anyone who might need help, from youth to Elders.
    • There are language speakers available through this program.
    • NAN Hope can be accessed through 1-844-NAN-HOPE (1-844-626-4673) and www.nanhope.ca

Nishnawbe Aski Police Services (NAPS)

  • Each region is operating under COVID-19 protocols.
  • Last week there were 8 major occurrences (assaults, domestic, weapons) across all regions.
    • During hunting season, people are out on the land, therefore a decline is seen in occurrences at this time.
  • NAPS is entering into the final six months of its current funding agreement and is waiting on a response from the federal government to start negotiations.
  • There is a vacancy in the Professional Standards Office. The position will be filled in the near future and NAPS will work with partners until then.
  • NAPS will transition from Wasaya Airlines to North Star Air Effective November 1.
  • Communities are asked to provide communities any updates on their protocols.

Communications

  • Members of the NAN Executive Council will continue to appear on Wawatay Radio on Tuesday at 12 pm EST and on Friday at 1:05 pm EST.
  • COVID-19 Tools and Resources are being translated into Oji-Cree, Ojibway, and Cree to assist the communities in spreading awareness and public health messaging on COVID-19. They are posted on the NAN website under COVID-19 Tools and Resources.
  • Please send all new and updated community memos, statements, By-Laws, BCR’s and relevant community restriction information to emergency@nan.ca so that NAN and applicable partners can remain aware and respectful of your communities wishes.

Urban Communities

  • NAN has posted specific information on the NAN website for members living off-reserve in urban centres across northwestern and northeastern Ontario.
    • This includes how to find shelters, food banks, social and mental health services, as well as Indigenous organizations that can provide assistance.
  • Please visit www.nancovid19.ca. It is updated daily with the most current information.

NEXT CALL: Thursday, October 15, 2020 | 1p.m. EST | 12p.m. CST

Download PDF

Sweating, Hallucinations, Orientation, Tremor (SHOT) Scale for Assessing Alcohol Withdrawal

This scale accompanies the Alcohol Withdrawal Management Nursing Resource This scale helps to assess the severity of alcohol withdrawal. It is shared to support Nurses who are working with a Physician to minimize the effects of alcohol withdrawal in NAN community members during the COVID-19 pandemic. Nurses also have the option of using the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale if they are more familiar with that scale.

THIS RESOURCE IS ONLY INTENDED TO BE REFERENCED BY TRAINED, REGISTERED NURSES. The information in this document is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Nishnawbe Aski Nation (NAN) makes no representation and assumes no responsibility for the accuracy of information contained on or available through this resource, and such information is subject to change without notice. Nurses, NAN community members, and the general public are encouraged to confirm any information obtained from or through this resource with other sources, and to review all information regarding any medical condition or treatment with a community physician or other medical professional. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEBSITE.

Sweating, Hallucinations, Orientation, Tremor (SHOT) Scale for Assessing Alcohol Withdrawal

Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) Scale

This scale accompanies the Alcohol Withdrawal Management Nursing Resource This scale helps to assess the severity of alcohol withdrawal. It is shared to support Nurses who are working with a Physician to minimize the effects of alcohol withdrawal in NAN community members during the COVID-19 pandemic. Nurses also have the option of using the SHOT scale if they are more familiar with that scale.

THIS RESOURCE IS ONLY INTENDED TO BE REFERENCED BY TRAINED, REGISTERED NURSES. The information in this document is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Nishnawbe Aski Nation (NAN) makes no representation and assumes no responsibility for the accuracy of information contained on or available through this resource, and such information is subject to change without notice. Nurses, NAN community members, and the general public are encouraged to confirm any information obtained from or through this resource with other sources, and to review all information regarding any medical condition or treatment with a community physician or other medical professional. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEBSITE.

Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) Scale

Clinical Opioid Withdrawal Scale (COWS)

This scale accompanies the Opioid Withdrawal Management Nursing Resource This scale helps to measure the severity of opioid withdrawal. It is shared to support Nurses who are working with a Physician to minimize the effects of opioid withdrawal in NAN community members during the COVID-19 pandemic.

THIS RESOURCE IS ONLY INTENDED TO BE REFERENCED BY TRAINED, REGISTERED NURSES. The information in this document is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Nishnawbe Aski Nation (NAN) makes no representation and assumes no responsibility for the accuracy of information contained on or available through this resource, and such information is subject to change without notice. Nurses, NAN community members, and the general public are encouraged to confirm any information obtained from or through this resource with other sources, and to review all information regarding any medical condition or treatment with a community physician or other medical professional. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEBSITE.

Clinical Opioid Withdrawal Scale (COWS)

Stimulant Withdrawal Management Nursing Resource

This document outlines clinical measures to be taken if a community member or a family member calls the Nursing Station because someone is experiencing the symptoms of stimulant withdrawal related to substances such as cocaine, crack cocaine, methamphetamine and prescription stimulants like Ritalin. This resource is intended for a Nurse and is specific to the COVID-19 pandemic. It guides the care between a Nurse who is in a NAN community, and the Physician who is providing medication orders to the nurses to minimize the effects of stimulant withdrawal. The Physicians who produced this document are Drs Lindsay Hancock and Sharon Cirone, who both work in remote First Nations. NAN thanks them for their efforts.

THIS RESOURCE IS ONLY INTENDED TO BE REFERENCED BY TRAINED, REGISTERED NURSES. The information in this document is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Nishnawbe Aski Nation (NAN) makes no representation and assumes no responsibility for the accuracy of information contained on or available through this resource, and such information is subject to change without notice. Nurses, NAN community members, and the general public are encouraged to confirm any information obtained from or through this resource with other sources, and to review all information regarding any medical condition or treatment with a community physician or other medical professional. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEBSITE.

Stimulant Withdrawal Management Nursing Resource