Last October the small northern community of Kitimat became the first in B.C. to vaccinate 100 per cent of its population. Journalist Robin Rowland asked around to find out why...
In mid-March 2020, Kitimat family physician Dr. Howard Mills called an urgent meeting.
It was about the time the World Health Organization declared Covid-19 a pandemic, and Mills, who had worked in Kitimat since 1981, was gathering together the district’s health care professionals and other stakeholders for a briefing on how Covid-19 could impact the community.
At a lodge owned by Mills and his wife, Ruth, located on the shores of Kitimat’s Minette Bay, doctors, nurses, paramedics, and local officials got a stark warning from visiting physician Dr. Michael Kenyon, the director of the intensive care unit at Nanaimo Regional General Hospital. Kenyon, who also has an internal medicine practice at Mills Memorial Hospital in Terrace, was one of the first doctors in Canada to publicly raise the alarm about Covid-19.
In a March 19, 2020 interview with Gary Mason in the Globe and Mail, Kenyon warned that hospitals in Canada would soon be overwhelmed by Covid-19 cases, leading to health-care rationing and patients being triaged. Kenyon also proved prescient in predicting Canada would very soon face a shortage of ventilators.
Kenyon knew what he was talking about. Educated in South Africa before immigrating to Canada, he had 40-years experience in internal and emergency medicine. He’d worked in the South African Army Medical Corps, and as a specialist in Soweto, a township near Johannesburg. He’d also run the main intensive care unit at Kandahar three times for the Canadian Forces in Afghanistan. As well, Kenyon trained University of B.C. Fellows for rural and community care, and had, throughout his career, dealt with HIV/AIDS, Ebola, and H1N1 influenza.
Ellis Ross, Liberal MLA for Skeena and former chief counsellor of the Haisla Nation, attended that initial Kitimat meeting. He described what he heard as “shocking,” when Kenyon recounted how a surge in Covid-19 cases had overwhelmed hospitals in Italy.
About the same time as the meeting with Mills and Kenyon, the District of Kitimat fire chief and emergency program coordinator, Trent Bossence, activated the district’s Emergency Operations Centre to level 1, the lowest alert level, anticipating Covid-19 would soon strike the community.
Then his team reached out to Northern Health. “They’re the experts and the lead on this,” Bossence said. “We were trying to wrap our heads around what could this mean, what was it going to look like down the road, so we could do some advance planning.”
After a couple of weeks, Bossence raised the alert to level 2, which brought in more people to help with logistics and planning, and he began weekly virtual meetings with concerned people and organizations across the Kitimat community.
The warning from Kenyon rallied the multicultural Kitimat community to create a strategy for what was to come with Covid-19.
“The physicians brought it on themselves to bring us all together. That was the biggest, most progressive stance that was taken,” said Lucille Harms, director of health for the Haisla Nation, the majority of whose members live in Kitimaat Village, about 12 kilometres south of the Kitimat district municipality.
Kitimat Mayor Phil Germuth said there was a really coordinated response to the pandemic right from the outset.
“Pretty much every stakeholder was involved in these meetings,” Germuth said. “It was really an extraordinary effort by everybody. I really have to give compliments to our fire chief, and to industry, and to the Haisla, who really worked together to keep our community as safe as it could be.”
“Whole of community” strategy
Leaders of the Kitimat and Haisla communities were among the first to create what Dr. Jong Kim, chief medical health officer for Northern Health, called “a whole of community approach” to the pandemic; a strategy that would soon be happening in other parts of the province.
“Clearly the overwhelming majority of Kitimat residents see the benefits of getting vaccinated, and not only protecting themselves and their loved ones, but not putting an unnecessary strain on our health care system,” said Germuth. “A lot of credit goes to everybody being open and honest with each other.”
Fire chief Bossence said even in the early stages of the pandemic, they knew it wasn’t something that would end quickly. “We tried to understand logistically what we needed,” he said. There was a shortage of personal protective equipment and cleaning supplies. Did they have enough masks or even the ability to find them?
“We were hearing from the community and other groups that they were short of that sort of stuff, so it was really up to us to see if we could step in and find these supplies,” Bossence recalled. “We distributed to the community based on need and severity, and what’s the risk, and what do they need to have.”
The Haisla Nation donated $300,000 to the Kitimat Hospital Foundation “to purchase some testing equipment, because there weren’t enough services here in Kitimat and Terrace,” Harms said.
Previously, all swabs and tests went to Vancouver. With the donation, Northern Health created regional testing sites, first in Terrace, and later in Kitimat, although some more specialized tests still had to be sent to Vancouver, Harms said.
The Haisla Nation also set up a checkpoint at the entrance to Kitamaat Village, restricting entry to village residents and essential visitors; a check point that remained for almost a full year. “My family, they live in town, so I could not come over here unless I was coming here to work,” Harms said. “That was another good way of protecting the nation.”
Meanwhile, at Kitimat’s Emergency Operation Centre, officials started looking at what other communities were doing and how best to share information.
“Communications is often the Achilles heel on most issues like this,” Bossence said. “We didn’t want miscommunication, say, with what LNG Canada is doing versus what Haisla are doing, what the District of Kitimat’s doing, and what Northern Health is saying.” The weekly virtual conferences kept “everyone aligned and follow(ing) best practices,” he said.
A key industrial player in Kitimat is the Rio Tinto BC Works aluminum smelter. Built in the early 1950s by Alcan, the Aluminum Company of Canada, and owned by Anglo-Australian multinational Rio Tinto since 2007, the smelter has been the main industry supporting Kitimat for six decades. Many of the smelter’s employees live in Kitimat, while others commute daily from Terrace, and some contractors travel from outside the region to work at the smelter or its powerhouse at Kemano.
Early in the pandemic, Northern Health asked large industrial companies – especially those posing high risk for transmission with employees working in close proximity or living in work camps – to support the vaccination effort through their own medical clinics.
Rio Tinto helps vaccinate local community
Rio Tinto representatives were already participating in the weekly virtual conferences organized by the Kitimat fire chief. The company agreed to support local vaccination, with a parallel campaign specific to industry.
“For us, that was a really great opportunity to partner with Northern Health,” said Alyssa Dalton, health and hygiene team lead at Rio Tinto BC Works.
Rio Tinto brought additional immunizers to Kitimat for the campaign. “Within two weeks we were starting to give out Covid-19 doses at our on-site clinic,” Dalton said. Set up in the company cafeteria, the central hub of the Rio Tinto complex, the clinic was easily accessible for workers and visitors from outside the plant.
The first-dose campaign immunized 1,120 people, representing over 60 per cent of employees, including local contractors; then 56 per cent got their second dose as well, Dalton said. Others were immunized at the regular Northern Health clinics, while some Haisla Nation employees of the smelter were vaccinated in Kitamaat Village.
Vaccination posed a unique logistical challenge for Rio Tinto.
The electricity for the aluminum plant comes from the remote mountain powerhouse in Kemano, which is inaccessible by road, and about 75 kilometres by air or 98 kilometres by boat from Kitimat. Construction is ongoing in Kemano as Rio Tinto bores a second tunnel through a mountain to bring water to the turbines of the power plant that provides electricity for the smelter.
“A lot of workers are coming from outside the area to take part in the tunnel project.” Dalton said. “So we did have some people coming to our onsite clinic, either before they would get on the boat to Kemano, or after they came out and went to the airport to fly out of the region.”
Later in the campaign, the company flew an immunizer by helicopter to Kemano to facilitate onsite vaccination.
Kitimat campaign became company model
The Kitimat vaccination campaign served as a model for similar efforts by the company.
“We had vaccination clinics all across Canada, the Northwest Territories, Labrador, Quebec, but B.C. was really the first one that we had on-site that was administered by Rio Tinto,” said company spokesperson Simon Letendre.
Over at LNG Canada, the company maintained mandatory rapid Covid-19 testing for all workers traveling to and from Kitimat, and introduced mandatory vaccination for employees and visitors to the LNG project site last October. Workers can isolate onsite or in work camp lodges with 24-hour access to medical resources, a spokesperson for LNG Canada wrote in an emailed response to questions about the company’s immunization policies.
Northern Health’s Dr. Kim points to the health region’s “whole of community” approach which, whenever possible, tailored the promotion of vaccination to the needs of a particular smaller, northern or rural community.
“The major test of the approach was Prince Rupert,” Kim said. In March 2021, as transmission rates escalated in Prince Rupert, Northern Health decided to forgo B.C.’s general policy of prioritizing vaccination by age groups and instead spent three weeks immunizing the entire community.
“It was quite helpful because the whole of a community approach means that for that particular community, it’s not sector-by-sector, or group-by-group, so everyone in the community, in a week or given point, can be immunized,” Kim said. “With that community we did a full campaign and promotion of immunization around it.”
That success, coupled with the mass-immunization approach in other communities “helped boost the overall immunization rate in the Northwest,” he said.
The strategy considered multiple factors like population size, remoteness, and accessibility, Kim said. It also took into account the logistics of obtaining vaccines and arranging immunizations.
“It was by the local leaders, and by the local health-care providers, and the local health-care team that can do promotion and awareness to let the community know that immunization is accessible, and to encourage people,” he said.
Haisla welcomed vaccines
The Haisla, like other First Nations, welcomed the early eligibility for the vaccines, said Harms. “I think we’re more consciously aware that there are these other visitors here and we should be diligent in ensuring we get our vaccine coverage.”
Together, with the community health nurse and the nation’s communication officer, the Haisla created live streams to educate community members on the benefits of vaccines, urging people to take advantage of the vaccine roll out in Kitamaat Village, as well as at clinics in Kitimat and elsewhere. (Many Haisla members live in the Lower Mainland).
For both Harms and Skeena MLA Ross, the initial briefing with Kenyon reminded them of when Haisla Nation Elders recalled their own memories of being told as youths about the devastation of the 1918 Spanish flu epidemic at the then-isolated First Nation.
Years ago, Harms remembered a Haisla Elder recalling his experience during the Spanish flu pandemic. “He was only eight when he was helping dig mass graves because there weren’t enough men standing. They weren’t put in coffins,” she said. Another Elder told her about her brother: “They were just young boys being sent out to help, and even a woman, because women don’t do the burials… even young women had to go. And so these stories are still alive and known today.”
Other pre-Covid pandemics triggered similar memories, Harms said, including the 2003 SARS epidemic in Toronto, the 2009 H1N1 flu pandemic, and, later, the threat of Ebola. “I was a manager in the hospital here,” Harms said. “Ebola, even though we didn’t get it, we prepared. Within days, we had all the equipment and supplies. But this one (Covid-19) just hit us like a ton of bricks.”
At the outset of the Covid-19 pandemic, there weren’t enough supplies, gowns, masks, or hand sanitizer, Harms said. “The physicians, I really commend those guys because everyone was saying what do we do? They just took it on themselves, and they just got everyone together and that’s how we first started,” she said.
“It’s hard to believe that it’s almost two years ago,” said Harms.
Both as an MLA and a member of the Haisla Nation, Ross is keeping a wary eye on Covid-19 as Omicron cases surge. He said Kitimat and British Columbia still have to heed the warnings he first heard back in March 2020 at that shocking meeting with Drs. Mills and Kenyon.