Inuit Nunangat and COVID-19

26 May 2020, 11 a.m.

(Disponible en français : L’Inuit Nunangat et la COVID 19)

Key factors that influence health and wellbeing may make Inuit more susceptible to COVID-19 and more likely to experience severe forms of the illness. This HillNote provides information about access to health care, recent federal funding, and Indigenous communities’ responses to COVID-19 in the Canadian Arctic.

Background

Inuit Nunangat (the Inuit homeland) comprises the land, water and ice of the Inuvialuit Settlement Region, Nunavut, Nunavik (northern Quebec) and Nunatsiavut (northern Labrador). Here, 52% of homes are crowded and people are more likely to live in poverty, lack consistent access to enough healthy food, and have underlying chronic diseases.

These determinants of health are exacerbated by historic trauma related to colonization such as the introduction of diseases like tuberculosis (TB) or the Spanish flu to Inuit by Europeans. Today, Inuit face a high incidence of TB, a disease that has been largely eradicated in southern Canada but has been a persistent challenge for Inuit for decades. Across Canada, Indigenous populations, including those in the territories, experience significant health disparities compared to other Canadians.

Health Care Access

Inuit, and northerners in general, have significantly lower access to health care compared to the rest of Canada. Compared to the Canadian average (84%), only 24% of people in Nunavut and 44% in the Northwest Territories have a regular health care provider. Health care systems in the Arctic are hampered by limited services  in communities, infrastructure gaps, the high cost of medical travel and the challenge of retaining health professionals.

Nurses provide primary health care in remote Inuit Nunangat communities. People may need to travel from their remote communities to regional centres by air to access health services. If specialized service is required, they may need to fly south to access primary, specialized and acute care services, potentially exposing themselves to COVID-19.

Medical transportation makes up a large proportion of health care spending in the Arctic. For example, in 2015-16, Nunavut’s medical transportation costs represented 16% ($70 million) of the Department of Health’s overall spending.

Measures Related to COVID-19 in Inuit Nunangat

Inuit Nunangat community members are at risk of contracting COVID-19 from individuals arriving from southern Canada. At the onset of the pandemic, restrictions on non-essential travel limited the movement of people in and out of Nunavut, Nunavik and the Northwest Territories. The Nunatsiavut Government also recommended that non-essential travel be avoided.

Containing the spread of the virus requires the rapid identification of COVID-19 cases. Although there were regular flights from northern communities to southern Canada prior to the pandemic, travel restrictions resulted in delays in test samples and shipments of essential supplies. In Nunavut, delivery of test results can take up to a week. This delay could lead to increased community transmission as infected persons may not be identified soon enough.

Arctic leaders flagged air transportation as a major challenge related to the COVID-19 response. The Government of Nunavut is spending $2.25 million per week to ensure regular flights continue. There have been calls for the federal government to increase subsidies for northern airlines and recognize them as an essential service during the pandemic.

Quarantine orders and physical distancing are more difficult to undertake in the Arctic. Across Inuit Nunangat, multiple families may reside in a single residence, making it nearly impossible to practice physical distancing and self-isolation.

Due to the difficulty of containing the virus in a fragile health system, Inuit have called for reforms, including the establishment of health care management systems so that communities can rely on regular visits from physicians and nurses. They have also called for increased federal support for health infrastructure such as isolation and medical tents, along with ventilators and personal protective equipment.

Recent Federal Funding

In addition to the federal COVID-19 support programs available to all Canadians, Inuit received funding from the $305 million Indigenous Community Support Fund. The Inuit land claims organizations allocated the $45 million of the fund as follows:

  • $5.8 million to the Inuvialuit Regional Corporation;
  • $22.5 million to Nunavut Tunngavik Incorporated;
  • $11.2 million to the Makivik Corporation; and
  • $5.3 million to the Nunatsiavut Government.

The Government of Canada announced funding in March and April 2020 for Inuit and/or Inuit Nunangat including:

  • $25 million in additional funding for Nutrition North Canada, which provides subsidies for some food and hygiene products;
  • $1.6 million for health care for the territories (out of a $500 million fund);
  • $18.4 million to Yukon, $23.4 million to the Northwest Territories, and $30.8 million for Nunavut for health and social services preparations and response to COVID-19;
  • up to $3.6 million to Yukon, $8.7 million to the Northwest Territories, and $5 million to Nunavut for northern air carriers over a three-month period; and
  • $15 million for businesses in the territories impacted by COVID-19.

Given the small population dispersed across the Arctic and the per capita nature of the Canada Health Transfer, which provides funding for health care, territorial governments have limited budgets to deliver services. The Premier of Nunavut welcomed the recent funding but stated that “Nunavut needs more, and we need it now.” Inuit land claims organizations also raised concerns about the adequacy of federal funding to respond to COVID-19.

Makivik Corporation stated that funding from the Indigenous Community Support Fund took over a month to reach Nunavik. It expressed concerns about funding conditions, specifically, the $5,000 limit on spending for capital assets, unless approved by the Minister of Indigenous Services. This prevents funding from being used quickly to purchase tents or small buildings for people who must self-isolate but cannot do so in a crowded household.

Responses to COVID-19 in Inuit Nunangat

Inuit governments and land claims organizations have been responding to community needs during the pandemic. In Nunavut, water is often delivered by truck and must be conserved due to limited municipal infrastructure and overcrowded housing where water tanks may be too small to meet household needs. To ensure water is available for hand washing and cleaning, Nunavut Tunngavik Incorporated funded daily water and sewer deliveries.

Many Inuit experience hunger due to the high costs of store-bought food and costs associated with fuel, equipment and vehicles to practice hunting and fishing. All regions have developed programs to provide food to specific groups like Inuit Elders, children, and low-income families, or financial support to purchase food. In some cases, financial support is being provided for Inuit to go out on the land and harvest country food.

In Nunatsiavut, poor quality housing and the impact of climate change on their structural integrity have resulted in high home heating costs, which are being subsidized during the pandemic.

Provincial government responses to the pandemic may impact Inuit communities. On 13 April 2020, the Government of Quebec announced the resumption of mining activities, despite Makivik Corporation’s concerns about the lack of consultation and the potential spread of COVID-19 in Nunavik when flights resume to the mines.

Inuit are taking steps to ensure coordinated communication and decision making during the pandemic response. The Nunavik Leaders Group was created to address issues faced by Inuit and make decisions in relation to COVID-19. To address community needs, Inuit are working  with governments and public health officials through the Inuit Public Health Task Group. Inuit are also using social media to cope with social isolation and connect with their culture by hosting drum dancing and singing.

Additional Resources

Elis Quinn, et al., “Roundup of COVID-19 Responses Around the Arctic,” Eye on the Arctic, Radio-Canada International.

Inuit Tapiriit Kanatami, Inuit Tuberculosis Elimination Framework, November 2018.

Inuit Circumpolar Council, Ongoing Coronavirus Pandemic Highlights Infrastructure Gaps Across Circumpolar Regions Related to Inuit Health – Demonstrates Strength of Inuit Culture, 21 April 2020.

National Collaborating Centre for Aboriginal Health report, Social Determinants of Health: Housing as a Social Determinant of First Nations, Inuit and Métis Health, 2017.

Jessica Penney, “COVID-19 and Inuit Nunangat: Research, Responsibility & Infrastructure Inequality,” Yellowhead Institute, 31 March 2020.

Rachel Kiddell-Monroe, et al., “Inuit communities can beat COVID-19 and tuberculosis,” The Lancet, 24 April 2020.

Statistics Canada, First Nations people Métis and Inuit and COVID-19: Health and social characteristics, 17 April 2020.

Authors: Sara Fryer and Brittany Collier, Library of Parliament