RT Journal Article
SR Electronic
T1 COVID-19 in a remote First Nations community in British Columbia, Canada: an outbreak report
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E1073
OP E1079
DO 10.9778/cmajo.20210054
VO 9
IS 4
A1 Courtney R. Smith
A1 Charmaine Enns
A1 Dan Cutfeet
A1 Shannon Alfred
A1 Nicole James
A1 Jennifer Lindbeck
A1 Shannon Russell
YR 2021
UL http://www.cmajopen.ca/content/9/4/E1073.abstract
AB Background: In April 2020, British Columbia experienced its first outbreak of COVID-19 in a remote First Nations community. The objective of this paper was to describe the outbreak, including epidemiological and laboratory findings, and the public health response.Methods: This report summarizes an outbreak of COVID-19 on Cormorant Island, British Columbia, in March and April 2020. Confirmed cases underwent investigation and contact tracing. Supports were provided to ensure successful isolation and quarantine for cases and contacts. Messaging to the community was circulated by trusted community members. Descriptive and social network analyses were conducted to describe the outbreak as it evolved. All case specimens underwent whole-genome sequencing.Results: Thirty cases of SARS-CoV-2 infection were identified. Those infected had a median age of 34 years (range 15–77), and the majority identified as female (19, 63%) and as First Nations (27, 90%). The most common symptoms included chills, cough, diarrhea, headache and fever. Five people were hospitalized (17%) and 1 died (3%). Percent positivity in the community was 18%. Transmission occurred primarily during evening social gatherings and within households. Two weeks after control measures were initiated, no further cases were identified. All cases were genetically related by 2 single nucleotide polymorphisms or fewer, and they belonged to the most dominant SARS-CoV-2 lineage present in British Columbia in April 2020.Interpretation: A community-led response was essential for the effective containment of this outbreak that included 30 cases, preventing onward transmission of the virus. Lessons learned from the management of this outbreak can inform response to other similar outbreaks in First Nations communities across Canada.