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Repeated self-isolation periods 'mentally draining,' say NWT medical travellers

NWT residents are calling for more sensible quarantine rules for medical travellers due to the mental burdens they experience from repeated periods of self-isolation.

Allice Legat, an anthropologist who works for the Tłı̨chǫ Government, just completed a total of 14 weeks of self-isolation.

Yellowknife resident Allice Legat is urging the GNWT to introduce rapid testing for medical travellers and to reduce the self-isolation time to one week, after she just completed her 14th week of self-isolation.
photo courtesy of Jacob Shank

She has been making regular, monthly trips to Edmonton for lung cancer therapy since 2018.

But after the Covid-19 pandemic arrived in the NWT, her medical routine became more complicated.

"I go every four weeks. I go down on Monday, I come back on Thursday, and then I go into two weeks of isolation. That's because I can't do the treatment in the NWT," Legat said.

She reached a point in her immunotherapy treatment in February when she began to feel "really strong" again, was able to walk around more, have guests at her house and attend meetings.

However, two months later and after a trip to Edmonton, she began her first of seven self-isolation periods.

"What changed for me was only having one week of the month to do everything," she explained. "That includes banking, going to see the doctor, seeing anybody for work situations, jobs I need tradespeople to do in my home. It's mentally draining. For me, the first (few) weeks weren't bad. It was around the seventh week where it started becoming more difficult. This time, I'm missing Thanksgiving. And according to my schedule, I will probably miss Christmas.

"Thank goodness for friends and family that reach out. Think about what it must be like for those staying in hotels every time they go for medical travel."

Legat, who is able to self-isolate in her home, explained that as the weeks of self-isolation gradually piled up, she felt a kind of mental and physical "tightening" from the constant limitations of being in quarantine and not being able to interact with others in person.

At the same time, Legat supports all the actions the GNWT is taking in trying to keep Covid out of the territory, except when it comes to the rules that medical travellers must follow.

"I know they're doing the best that they can, I just don't agree with this one."

Legat's hope is that medical travellers can be rapid tested – even if they're asymptomatic – on arrival in the NWT and that their quarantine period be shortened to one week.

"(After that) we be like other people socially distancing, wearing masks and doing all of the things that are proper, but to give us a little more of flexibility in our lives," she said.

Some medical travellers have done their quarantine periods at the Chateau Nova Hotel in Yellowknife, an experience they said becomes mentally draining.
NNSL file photo

Legat also points at what she feels is a double standard in who receives testing before they enter the NWT.

"If they can test essential workers, if they can test miners, then they can test those of us who are seeking medical travel, even though we're not symptomatic. Give us one test and then another test, I think that's important to protecting people," she said.

Personnel arriving at the Diavik Diamond Mine have since May been tested on arrival at the site, 300 km northeast of Yellowknife. Testing is also done before staff depart the site. The non-profit health group GuardRX facilitates the testing with an on-site laboratory to conduct swabs on workers.

Legat hopes that a solution for people like her can be found soon, as the anxiety over repeated stretches of self-isolation is deterring some residents from attending their cancer treatments.

"I know that some people from the NWT aren't going down for their treatment, because they feel their quality of life would be damaged," she said. "Some are going from a targeted treatment, which you can get for cancer now, to ordinary chemo that we can get here, but it's normally not good enough."

Ted Blondin wants the GNWT to consider similar measures for medical travellers.

Since the pandemic began, he has completed two periods of self-isolation at the Chateau Nova hotel in Yellowknife after taking trips to Edmonton for preventive procedures related to cancer. Blondin, who lives in Behchoko and is chair of the Tłı̨chǫ Community Services Agency, is currently in Edmonton for another medical trip.

Although he has undergone fewer quarantine periods than Legat, he said his self-isolation experiences have affected him mentally.

"I like to be at home with my grandchildren. I worry about them all the time from down here. Other people have said that (self-isolation) reminds them of the residential school experience. I was in residential school for one year, and I can see what they're talking about.

"You're confined to a limited space, and you got to follow strict rules. And, for other people, that would traumatize them more severely than it would for me. It affects them more from a mental health point of view," Blondin said. "And there's nothing they can do because they're confined to a room, they can't get out because that's the rules."

He also has limited mobility due to a past stroke and because he uses a wheelchair. When he stays at Chateau Nova, he requests a disability-accessible room, but said that room is sometimes occupied, putting him at higher risk when he does daily tasks in a standard room.

He sides with Legat in hoping the GNWT considers testing medical travellers upon arrival, and thinks that if they test negative on the first and fourth days then their self-isolation plans could be eased so they could possibly go home.

But he thinks the value of that solution would depend on people's housing situations.

"It's difficult for some people because some people live in overcrowded housing. How do you self-isolate in a home that's overcrowded? They can't follow all the strict rules," he said. "In my house there's three generations. There are a lot of houses like that in the NWT because of the lack of housing. So that's where the hotel arrangement is probably the best way to keep us Covid-free."

Office of the Chief Public Health Officer spokesperson Mike Westwick said the office empathizes with the difficult experiences of medical travellers and those with pre-existing conditions.

"After around 21,000 self-isolation plans, we’ve heard a whole lot of stories – and tough stories like these are not lost on us," he said.

"We are absolutely looking at ways to reduce the kinds of mental and social harms which come along with responding to a pandemic, and our testing capacity and strategy will play a big role in that."