Pangnirtung, a small town on Baffin Island, has been battling the largest tuberculosis outbreak in Nunavut since 2017, according to data released by the territorial government on Thursday after refusing for months to reveal the extent of the spread of the disease.
The Nunavut Department of Health said on Thursday that 139 cases of tuberculosis had been identified in Pangnirtung in the past 18 months, 31 of which were active, meaning patients were ill and infectious. The rest were cases of latent or “dormant” tuberculosis, an asymptomatic version of the bacterial infection that is not contagious, but which puts patients at risk of developing active tuberculosis in the future.
The Globe and Mail traveled to Pangnirtung earlier this month as part of an ongoing investigation into health care in Canada’s youngest territory. In interviews, community leaders have expressed frustration at the lack of official information about the TB outbreak, which Michael Patterson, the country’s public health official, first stated on Nov. 25 without providing a case count. .
The size of the outbreak surprised Pangnirtung Mayor Eric Lawlor, who, along with the rest of the village’s elected council, was unaware of official statistics on the health problem in his own community.
“The information should have been provided to us regularly to begin with,” Mr. Lawlor Thursday. “This is more worrying than COVID, really. With such high numbers, it’s a little worrying and annoying that we haven’t taken it more seriously from the government.”
The Nunavut Department of Health released the figures in a press release a week after receiving a list of questions from The Globe about the ongoing TB outbreak in Pangnirtung, a community of about 1,600 people within an hour’s flight of north of Iqaluit, the territorial capital.
“I don’t know why they are so secretive,” said Madeleine Qumuatuq, Pangnirtung community welfare coordinator. “It simply came to our notice then. I mean, they have to be honest with us. “
Ms. Qumuatuq was one of the many Pangnirtung residents who expressed concern about the pace of the government’s response to the TB outbreak. He noted that the health department rented the community room, one of the few public spaces in Pangnirtung, from March 1 for a satellite tuberculosis clinic that is not yet operational.
“We’re losing a lot of age groups that would normally come here to play checkers, billiards, whatever. And teens spend time here,” he said. “All this is taken away because they have rented the space. But they’re not even here. “
Nunavut Health Department spokeswoman Danarae Sommerville said in an email that the delay was caused by a shortage of “skilled workers” needed to ensure the Hamlet building has the right wiring and network to set up workstations. for staff “. Those workers were hit in response to the aftermath of a fire that consumed a government building in another village, he added.
In response to previous questions about the outbreak, he noted that the Department of Health sent additional nurses and other front-line staff to Pangnirtung to help manage the outbreak, an easy feat during a pandemic-aggravated national nursing shortage.
Active tuberculosis infections, which are caused by bacteria that spread through the air and usually stay in the lungs, can cause fever, weight loss, night sweats, fatigue, and chronic cough, sometimes with blood. Antibiotics can cure active TB and prevent latent cases from becoming serious illnesses. The infection can be fatal if left untreated.
Tuberculosis is a disease that most Canadians consider a scourge of the past. But it is still a scourge of the present in indigenous communities, especially Inuit communities, where deep poverty, overcrowding and limited access to health care make residents especially vulnerable.
The federal liberal government, along with Inuit Tapiriit Kanatami, a national Inuit organization, pledged in 2018 to eliminate tuberculosis in Inuit communities by 2030.
The latest data from the Public Health Agency of Canada shows that there were 72.2 active cases of tuberculosis per 100,000 population among the Inuit population in 2020, compared to a national case rate of 4.7 per 100,000 .
Despite being 15 times higher than the national average, the rate of tuberculosis among Inuit in 2020 dropped significantly, from 188.7 cases per 100,000 in 2019 and an annual 10-year average of 184.14 per 100,000 between 2010 and 2019. The likely decline in cases. that tuberculosis is not diagnosed during the first year of the pandemic, disease experts have said.
Nunavut, which hosts the majority of Inuit in Canada, had 34 active cases across the country in 2020, or 86.40 per 100,000, below an average of 66 active cases per year across the country over the past four years. previous.
In February, Nunavut’s privacy commissioner ruled in favor of The Globe after the newspaper appealed the the refusal of the territorial government to release the count of cases of tuberculosis by community, age and gender.
But the decisions of the privacy commissioners are not binding on Nunavut. Health Minister John Main rejected the call to publish data at the community level, saying at the time that doing so could risk identifying patients and stigmatizing entire communities.
Not even Mr. Main nor Dr. Patterson was available for interviews Thursday.
Chris Puglia, another Nunavut Department of Health spokesman, said in an email that the department has no plans to release TB data per village, except during outbreaks. “Community-wide data outside of an outbreak does not provide additional protection to public health and could further stigmatize the disease and create hesitation in people asking for tests,” he wrote.
He added that Dr. Patterson’s office decided to commit to the Pangnirtung case and post updates every three months that “could help manage outbreaks.” The Department of Health released data at the community level during the last major outbreak of tuberculosis in Nunavut, Qikiqtarjuaq in 2017-2018. A 15-year-old girl died in this outbreak.
Nunavut Privacy Commissioner Graham Steele said the government should go further and follow its decision on TB data.
“I continue to believe that the law requires numbers at the community level to be published, and not just at a time and place selected by the government,” he said Thursday. “It’s hard to hold the government accountable for the TB policy when it keeps all the numbers a secret.”
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