Northern Health is moving into a new phase of planning to meet the evolving healthcare needs of northern residents during the COVID-19 pandemic.
The health authority was finalizing its strategy Friday in anticipation of receiving more critical and acute care patients over the next several weeks.
“It’s been a very busy time, and I want to emphasize how proud I am of staff, management and physicians in the way they have contributed to ensuring we are prepared for this unprecedented situation,” Cathy Ulrich, Northern Health CEO said. “The support from the community has been very heartening in the way people have been attending to the provincial health officer’s directives. We all have examples of where that hasn’t occurred, but we have many, many, many examples of where people have taken this seriously.”
Ulrich and Northern Health’s acting chief medical officer, Dr. Raina Fumerton, spoke to press by teleconference April 3.
The strategy is being modelled on projections last week by provincial health officer Dr. Bonnie Henry, which looked at best- and worst-case scenarios for acute and critical care in B.C. during the pandemic.
As part of the new phase of planning, Emergency Operations Committees at every Northern Health facility are preparing the sites to receive, treat and transfer patients to hospitals designated as primary COVID-19 treatment centres for the most critically ill patients.
Mills Memorial in Terrace is designated for the Northwest.
Northern Health has been working with B.C. Emergency Health Services on plans for transporting patients and critical-care staff across the region.
As of mid-March there were 116 ventilators available within Northern Health. Ulrich did not express concern about securing more if needed, saying the devices are in the province’s inventory.
“We’ve had discussions with the Ministry of Health regarding the gap between ventilators we might have now versus what we will need, and we’ve been assured that there will be a supply handed to us,” Ulrich said.
“I’m not prepared to give numbers today…but it’s a gap that can be met.”
For remote communities, working teams have identified protocols for responding to COVID-19 scenarios, based on factors such as geography, housing and health services. Those details are also expected next week.
“This is something that’s top of mind for us, that people in isolated and remote locations have clarity on the kind of care they will receive,” Ulrich said.
As of April 3 there have been 21 confirmed cases of COVID-19 in the Northern Health region, resulting from 850 tests throughout the north. Five people have recovered fully and five remain in acute care. There have been no deaths. Most cases are connected to travel, but community transmission is occurring.
The four new cases reported Friday include the transmission to a worker at LNG Canada’s construction site near Kitimat.
The company informed their employees of the positive case on March 28.
In a statement LNG Canada said the individual self-isolated immediately upon the onset of symptoms, and Northern Health was contacted to track down all the people at risk of potential transition.
On Friday Northern Health would not say how many people are now in self-isolation, or where the contact may have occurred.
“I can tell you that Public Health follows up on every lab-confirmed case. We do all the contact follow up too,” Fumerton said. “If a public notice was warranted [for Kitimat] we would have issued one.”
LNG Canda reduced their work force by 65 per cent March 27 to just under 600 people to allow for social distancing at the work site, in addition to implementing a variety of other preventive measures, according to an April 2 statement by LNG Canada CEO Peter Zebedee.
The province declared major industrial projects essential services, but work camps such as that at LNG Canada and mining sites across the north are under increased scrutiny as potential hotbeds for COVID-19 transmission.
Ulrich defended the province’s possition, saying prior to COVID-19 a significant amount of work has gone into developing guidelines for work camps to protect against communicable disease. Since the pandemic was declared those guidelines have been enhanced with the input of the provincial health ministry and the B.C. Centres for Disease Control.
“Medical health officers have been working with the industry around the implementation of those guidelines —they are very much aligned with the directives the provincial health officer has put in place, and indicates how those directives can be implemented in the industrial camp environment.”
Ulrich added the spread of COVID-19 is imminent, and the only goal now from a public health perspective is to “flatten the curve” to avoid overloading the healthcare system.
Last week Northern Health’s retired chief medical health officer, Dr. David Bowering, issued a public letter to provincial health officer Dr. Bonnie Henry calling for transparency on naming northern communities with confirmed cases of COVID-19.
“This is dangerous, especially in light of the prolonged delays we often experience just getting test results to Vancouver for processing. Those positive tests are like flashing lights to remind us that the virus was already in this location or that one, 10 days to two weeks ago.”
Bowering also called for for the immediate closure of industrial work camps, referring to them as “land-locked cruise ships.”
Fumerton said Northern Health will maintain its position of patient confidentiality, saying the health authority is legally prohibited from divulging the home community of COVID-19 patients. Exceptions arise with outbreak and high-risk scenarios in places such as acute and long-term care facilities.
“These cases [in Northern Health] haven’t been concentrated in any one area,” she said. “They’ve been diagnosed in large and small communities across the entire region.”
Fumerton added there is consensus among all B.C.’s medical health officers that case counts for each community is not necessary for local response planning. The majority of COVID-19 cases that are mild and unconfirmed by lab resultsas people self-isolate and treat the symptoms at home.
“If we have zero confirmed cases in a community, that is absolutely not a guarantee that the virus is absent. So that type of announcement can very well produce a false sense of security.”
She added Health authorities are also worried about acts of vigilantism against people known to carry the disease.
“I appreciate this is frustrating for some people,” Fumerton said. “Appropriate prevention strategy and mitigation planning can and should be taken by all communities across the north.”
Despite the vastness of the Northern Health region, Fumerton is assuring residents the health authority is equipped to handle the challenge.
“We’ve put together highly-skilled public health management teams in each of the health service delivery areas,” she said. “A lot of what we do can be done remotely — and a lot of our communication with the laboratories is done electronically. So we are able to do the same work they do in the Lower Mainland and just as efficiently… we’ve managed thus far to not have any scenarios where we feel we haven’t been able to track down the close contacts [of infected persons] and provide them with public health advice, as well as active daily monitoring during their isolation period.”