As many jurisdictions across Canada move forward in their Covid recovery stages, the NWT remains in phase two, with the next phase still a ways off.
While the substance of other jurisdictions’ relaxation of measures are similar in some respects to the NWT’s, they stand out for their loosening of restrictions as they still have community spread of Covid, unlike the NWT.
Recovery across Canada
Ontario, despite having the country’s second highest number of Covid infections and deaths, has made headlines over the last two weeks for the entry of the province into stage three, including the densely populated Toronto region.
Even Quebec, the hardest-hit jurisdiction in Canada announced on Aug. 5 that festival promoters can resume their events if the appropriate health measures are in place and attendance is capped at 250 people. The province has no isolation measures for Canadians entering from elsewhere in the country.
In the West, B.C. entered phase three of its recovery plan on June 24, though the substance of its relaxation measures closely resemble those of the NWT in its phase two. Canadians travelling to B.C. do not have to self-isolate.
Yukon also entered its third phase, on Aug. 1, with the new measures allowing for seated outdoor events of 100 people and sport activities to return in the fall.
Alberta is in Stage Two of its Relaunch Strategy. Most of its measures resemble those of the NWT, with some differences namely that outdoor gatherings with up to 200 people are permitted at audience-type community outdoor events and no caps on the number of people in indoor establishments like bars and worship gatherings. Our southern neighbour has no restrictions on Canadians entering the province.
“It’s important we be very honest with folks: this is a really tough challenge,” said Mike Westwick, spokesperson for the Office of the Chief Public Health Officer (OCPHO).
“But we aren’t in the business of simply changing course based on what others do – our decisions are based in rigorous public health risk assessments taking into account the NWT health system’s capacity and remote communities.”
Rules on moving forward
Westwick pointed to the requirements listed in Emerging Wisely to explain how the NWT can advance to phase three:
All phase two steps must be successfully implemented; a “robust, rapid-testing strategy” has been implemented; community spread remains limited; a strong system of contact tracing must remain in-place and all active Covid cases can have their contacts traced; and a second surge of infections in Canada and the United States has passed, with new cases falling over time.
It has been forecast that the second wave could occur between August and October.
Judging by the progress of two of most relevant of those five those requirements, NWT residents shouldn’t hold their breath that phase three can begin soon.
Cases in B.C, Alberta and Saskatchewan have recently begin to rise again and the U.S. is facing a rise in cases as well, before its second wave has officially begun.
NNSL Media has asked the OCPHO why the territory’s progression into Phase 3 is tied to a second wave passing in both countries, and didn’t receive a response by press time.
Speeding up testing
However, the appropriate rapid-testing capabilities could be closer in reach.
The OCPHO defines a “robust” testing strategy as the ability to do widespread surveillance, catching Covid cases in asymptomatic individuals, having sufficient testing supplies to test all high-priority cases rapidly and confidently respond to outbreaks, explained Westwick.
“The supply is really the biggest challenge in getting there,” he said. The testing capacity of GeneXpert devices in the NWT bears that out.
Since May, Stanton Territorial Hospital has been using two GeneXpert rapid Covid testing kits that can process results in about an hour.
The hospital has prioritized testing for those deemed most at need due to a national shortage of cartridges for the kits and testing capacity remains unchanged.
“GeneXpert cartridges are the items in short supply,” said David Maguire, spokesperson for the Northwest Territories Health and Social Services Authority (NTHSSA). “The supply is not regular or consistent and varies between the 10 to 40 kits per week, however some weeks we do not receive shipments due to availability.”
If a GeneXpert device confirms a positive result, it would be regarded as “presumptive positive” and urgently sent to Alberta Precision Labs, said Westwick.
“That said, we would immediately treat it, epidemiologically, as a positive right away and investigate contacts and get folks isolated who needed to be pending the results of the confirmation,” he added.
The majority of conventional Covid nasal test swabs are still sent to a laboratory in Alberta, which takes up to one week to process results.
The NWT’s testing capacity contrasts with that of Diavik Diamond Mine, where the non-profit GuardRX has set up a laboratory that can process results in a few hours, depending on the amount of tests, said a Diavik spokesperson.
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The lab can process 100 to 150 samples per day and processes 600 to 700 swabs during each 14-day rotation, including test samples from the Gahcho Kué and Snap Lake mines operated by De Beers.
Presumptive positive cases are affirmed at the Precision Labs in Alberta.
Speedier results in the NWT could be on the horizon with the arrival of BioFire devices.
Manufactured by the Utah-based BioFire Diagnostics, the devices can identify a range of viral and bacterial diseases including Covid, pneumonia and meningitis, according to the company website.
The GNWT aims to have one BioFire Base and four torch modules operational at Stanton in September, said Westwick. One module can process a test in about one hour or less.
“Diversifying our rapid testing infrastructure is an important step – it is our hope it will help reduce the burden on the GeneXpert supply and standard (nasal swab) tests as we move forward,” he said.
A GeneXpert device will also be installed in Inuvik and the targeted operational start time is September.
Nunavut, which has had no confirmed cases of Covid inside the territory, has one operational BioFire unit in Iqaluit that can process 48 tests in one day, said Chris Puglia, spokesperson for the Government of Nunavut’s Department of Health.
Another BioFire unit arrived in Rankin Inlet on Aug. 6 and health staff are currently setting it up for use.
RELATED REPORTING: Sights set on BioFire devices for Covid-19 testing in Nunavut
But even after the NWT acquires BioFire devices, their effectiveness will hinge on supply.
“We’ll need to see how supply procurement goes with the BioFire testing machine before we can make big pronouncements on how we’ll be able to deploy it,” Westwick said.
“The bottom line: we need good rapid testing availability here, and we’re working incredibly hard to get it. It could open a lot of opportunities for us as a territory.”
Resuming activities earlier
While it’s difficult to estimate when phase three will formally start, Chief Public Health Officer Dr. Kami Kandola has indicated that Emerging Wisely has some flexibility.
Kandola said on May 13, just two days before phase one began that if a second wave doesn’t occur across Canada and if community spread has been significantly decreased then travel restrictions could be eased before a vaccine is developed.
RELATED REPORTING: Early opening of patio dining, outdoor sport events possible, GNWT says
“Public health has worked with several organizations on prudent, risk-mitigating plans for altering their activities to resume in earlier phases,” said Westwick. “All are invited to submit proposals with solid mitigation measures – like physical distancing, infection prevention and control measures, personal protective equipment use, and administrative and population controls – like age-based cohorting, crowd and person limits, or physical barriers, for example.”
Some sports have been permitted to resume their activities earlier than scheduled.
Gymnastics was supposed to restart in phase three, according to Emerging Wisely, but was given an exemption to come back in phase two. The Yellowknife Gymnastics Club held its first meet for competitive athletes on Aug. 4 in the Multiplex.
Hockey, which is slated to return in phase four after a vaccine is found, was also given an exemption to resume, and the Yellowknife Sporting Club is due to launch its summer hockey program on Aug. 13. Only skills and drills will be permitted for now. Games will have to wait.