In late 2019 a novel coronavirus started spreading from Wuhan, China, and by early 2020 the SARS-CoV-2 virus we now call Covid-19 had begun its spread across the world.
The headlines and outbreaks were seen with increasing concern "for about two-and-a-half months" by public health officials all over Canada, including Nunavut's chief public health officer Dr. Michael Patterson, who watched it unfold.
"There was increasing concern from early in January, although we still felt it was relatively low-risk getting into remote communities (at the time), until after a few events that happened like northern Italy and other large outbreaks outside of China and evidence of spread in southern Canada," he said.
At this time there were still a lot of open questions about how to deal with the virus and how transmissible it was among other questions.
"There was initially significant debate about how important asymptomatic or pre-symptomatic transmission was – a number of things we didn't know how much they were contributing to (the) spread of the virus in the early days," Patterson said.
"There was a lot of information for everybody to pick up in a short amount of time."
At the end of April of 2020 there was a false positive in Pond Inlet, which led to a brief lockdown in that community over the following week.
"Even though it was a false positive," Patterson said, "it was the first time we did the deployment of our Rapid Response Team, the staff in the Operations department did a lot of work putting that together."
The experience they got from this helped prepare Patterson and the Department of Health to deal with future outbreaks, including improvements in public communication that came after as well.
Come summertime, there was an easing of public health measures in the territory once Health developed testing capacity in Rankin Inlet and Iqaluit.
There were also two travel bubbles that had opened up during this time, one with the NWT and another with Churchill, Manitoba.
"We called that approach Nunavut's Path, every couple of weeks we moved along in the Path in easing measures to a certain point and we held steady for a while."
However there was a sense of complacency, he adds, when it came to the isolation hubs in southern Canada, where anyone going to Nunavut has to stay for two weeks prior to arriving in the territory.
"By fall time I think there was a little too much faith in the isolation hubs, we even said early on that the hubs weren't perfect," said Patterson.
"I think many people started getting the idea that Covid couldn't get through the hubs. Then November started and at least in Arviat it spread very fast once it got in there."
"In June or July at one of the press conferences I told one of the reporters that I was surprised that Covid hadn't gotten here already."
The bubble bursts
In the latter half of 2020 the first cases of Covid-19 started to appear in Nunavut, first in Sanikiluaq where it was successfully contained to just one household.
"Sanikiluaq was definitely the first time Covid was introduced into Nunavut, but there was no transmission outside of the house," said Patterson, "The first time we had actual transmission outside of the house in the community itself was Arviat."
Active cases appeared in Sanikiluaq, Whale Cove, Rankin Inlet and Arviat, the last of which saw community transmission. Dealing with the various communities, often at the same time started to push Health's resources to respond.
"We had extra staff available within 24 hours of the positive results coming back, at that point (with cases) in four communities there was a stretch on everything, a stretch on all of our resources," said Patterson.
Getting more health workers to respond and help remotely was one element that helped the Rapid Response Teams going to the affected communities to deal with active cases.
Three of the four affected communities – Rankin Inlet, Whale Cove and Sanikiluaq – successfully contained the virus with help from the Department of Health.
"In three communities we were able to keep it from transmitting much and were able to get control of it very quickly," he said, "obviously in Arviat it (has taken) a lot more work and a lot longer time to get it under control."
With the Government of Canada first approving the Pfizer Covid-19 vaccine, and subsequently the Moderna vaccine, the Government of Nunavut started its vaccination rollout first focusing on Kivalliq which had been particularly impacted by Covid.
By mid-March the majority of Nunavut communities had held a mass vaccination clinic to cover whole communities at once, with priority age group clinics taking place in the capital of Iqaluit and Baker Lake.
"Over the next two weeks every community will have had at least one mass vaccination clinic except for Iqaluit where we've now opened up to everyone over 18," said Patterson.
Compared to back in the fall the territory now sits in a much better position to deal with Covid-19.
"That puts us in a good situation, it's been a lot of hard work by the staff who have been doing the vaccinations and supporting it, hats off to them for what they have accomplished."
Not like 'flipping a switch'
It's not over yet, he wanted to add.
"It's certainly encouraging but we'll want to get as many people vaccinated as possible over the next little while."
"I think the vaccines and the progress we're seeing is cause for optimism but I don't think it's going to be what (a lot of people) think like flipping a switch. I think it'll be a more gradual return to normal, kind of like what happened in June or July where we eased away from restrictions. We may see something like that once the mass vaccination clinics are complete."
When looking back at the past year, it's been a difficult one for many Patterson said, "it's been a busy and trying year for a lot of people, not just in Nunavut but all over the country and all over the globe."
According to the Pan-Canadian Public Health Network, Dr. Patterson completed his family practice residency in 2001 and worked in the Kivalliq and northern Manitoba with the JH Hildes Northern Medical Unit.
In 2005 he entered a private practice in Nova Scotia before returning to Nunavut in 2012.
By December of 2018 he became the chief public health officer of Nunavut, while also working occasional weekends in the emergency room in Iqaluit.