Developing strategies to support First Nation communities' decision-making during COVID-19 outbreaks

Although Manitoba First Nation (FN) reserve communities have yet to experience a positive COVID-19 case, communities are preparing for disproportionate severe outbreaks, based on the experience of H1N1. The COVID-19 pandemic highlighted the importance of modeling in estimating the course of the infection over time, the potential impact of public health measures and the resources required to meet response needs. We developed this proposal at the request and in full partnership with the First Nations Health and Social Secretariat of Manitoba (FNHSSM). We are a seasoned team of FN organization-based and university-based researchers with a long history of collaborating. We are already working together on a number of projects, and many of us worked together on the H1N1 pandemic. For this project, we plan to, 1.Construct/update detailed community profiles of Acute Respiratory Infections, community size, remoteness, access to health care, risk factors associated with severe COVID-19 infection, and local infrastructure limitations impacting communities' ability to respond (safe drinking water, crowding, existing facility to be used for isolation), to support FN-centric model developments; 2.Develop a FNHSSM-based agile platform, for modeling community pandemics, to be updated with live data. Models will be developed with data from community profiles, evidence of transmission and severity derived from the literature and approaches co-created through knowledge exchange via a series of monthly meeting; and 3.Estimate the potential financial and social burden on FN communities, in view of ensuring adequate resourcing to support local responses; We have mobilized FN leadership, modeling, health services research and health economic expertise to support FN planning and decision-making on COVID-19 management in their communities and at the provincial level. Our unique project will strengthen an existing platform and make scalable to other Indigenous contexts.