The disproportionate impact of COVID-19 among Indigenous Peoples on Vancouver Island – British Columbia, Canada, March 2020-March 2021

  • Vaccine preventable diseases
  • Public health surveillance
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Background:
Indigenous Peoples globally have experienced increased morbidity and mortality in past pandemics relative to the non-Indigenous population. The COVID-19 pandemic is another example of this health inequity. To characterize the burden of COVID-19 among Indigenous people, and to inform public health action, a surveillance system was developed on Vancouver Island with a focus on the Indigenous population.

Methods:
Surveillance data were analyzed from March 2020-2021. Incidence and disease severity indicators were compared between Indigenous and non-Indigenous populations. Indigenous identity was based on self-report by those testing positive for SARS-CoV-2. A cluster was defined as any Indigenous community with two or more households with active cases of COVID-19. The surveillance system, and corresponding cluster response, were supported by a multi-disciplinary team of Indigenous and non-Indigenous public health professionals. Each cluster response was directed by community leadership. Cultural safety and collaboration served as cornerstones of this partnership.

Results:
Despite representing only 7.6% of the population of Vancouver Island, the Indigenous population represented 34.9% of COVID-19 cases. The incidence for the Indigenous population was 1,323 per 100,000 compared to 202 per 100,000 for the non-Indigenous population. Compared to the non-Indigenous population, those who self-identified as Indigenous experienced three times the rate of hospitalizations and four times the rate of deaths. The average age of hospitalization and death for Indigenous individuals was 17 and 22 years younger than their non-Indigenous counterparts, respectively. Over the surveillance period, 17 clusters were identified.

Conclusions:
The data presented here were used to inform vaccine prioritization, resulting in expedited delivery to this population, and a significant decrease in new cases. It remains essential to be able to characterize the burden of COVID-19 on the Indigenous population to inform and advocate for public health actions and respond to clusters in a collaborative and community-led manner.

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