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Canada: In Nunavut, medical staff saw signs of a devastating TB outbreak. The government didn’t

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  • Canada: In Nunavut, medical staff saw signs of a devastating TB outbreak. The government didn’t

    PUBLISHED JUNE 29, 2022

    KELLY GRANT

    ... As the only public health nurse working in the fly-in community last summer, she found there weren’t enough hours in the day to trace all the contacts of patients with contagious TB. She estimated there were, “at minimum,” 100 contacts of newly diagnosed patients who needed assessments. She didn’t have time to start everyone who needed it on preventative treatment or to chase down all those sick with active cases of TB to give them their daily pills.

    “The TB program needed manpower a month ago,” Ms. MacNab wrote in an e-mail to territorial health officials on Sept. 9.“The program is failing every single day. TB continues to spread. It needs help immediately. I have been utterly clear in my repeated requests. I am at a loss where to go to have my words heard.”

    Six weeks earlier, on July 29, Yves Panneton, the nurse in charge of Pangnirtung’s health centre, wrote to some of the same officials to say the community was in the midst of a tuberculosis outbreak. But Government of Nunavut health officials disagreed and held off on publicly declaring an outbreak until late November.

    They also refused, until May of this year, to divulge the number of TB cases in Pangnirtung, despite the territory’s top Inuit organization and its information and privacy commissioner pressing the government to report TB cases in all 25 Nunavut communities, just as it had for COVID-19.

    ... Thirty-one active cases and 108 latent cases of tuberculosis were identified in Pangnirtung between January 2021 and May 2022, making the outbreak the largest to be publicly disclosed in Nunavut since 2017, when 15-year-old Ileen Kooneeliusie died of TB during an outbreak in Qikiqtarjuaq.

    Given its population of only about 1,500 people, Pangnirtung’s TB incidence rate in 2021 ranks among the highest in the world, exceeding rates regularly seen in the least developed countries in Africa.

    ... Although the federal government made the elimination pledge, Nunavut, like all provinces and territories, is responsible for providing health care, and that includes responding to infectious disease outbreaks. In 2018, the federal government allocated $13-million in funding for TB countermeasures to Nunavut, but much of that money went unspent as TB spread in Pangnirtung because the territorial government has yet to agree on a regional TB action plan with Nunavut Tunngavik Inc., the territory’s lead Inuit organization and the recipient of the federal funds.

    A Globe investigation found nurses at Pangnirtung’s understaffed health centre were begging for help from the territorial government in the summer of 2021 as TB spread and officials held off on publicly declaring a crisis



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