Thanks to Bob Rae, leader of the Liberal Party of Canada, for tweeting the link to this Winnipeg Free Press report: Bad days for St. Theresa Point. Apart from being a useful account of an outbreak often reported here, this story reflects very badly on the Conservative government of Canada and its policy of suppressing unwelcome scientific news. Excerpt:
In the span of just 22 days during the H1N1 pandemic, at least 40 per cent of all babies on the remote St. Theresa Point reserve were sick with the flu.
That's according to a Health Canada study published recently in the Canadian Journal of Public Health detailing the spread of H1N1 through the First Nations community in 2009, an outbreak made worse by the reserve's lack of proper sewer-and-water services.
Must-read sidebar: REPORT RUNAROUND
The Free Press first asked Health Canada for the St. Theresa Point H1N1 study in April 2010.
Back then, Health Canada said the Public Health Agency of Canada had the report. The public health agency said Manitoba Health had the report. Manitoba Health said Health Canada had the report.
Eventually, the Free Press filed a formal access-to-information request for the study. Health Canada denied that request, saying the report was due to be published within 90 days, so the public would have to wait. Ninety days went by and no report was published.
Health Canada then said the study was submitted to the Canadian Journal of Public Health. If the government released the study to the media, the journal wouldn't publish it.
A year went by. No report was published in the journal.
By then, the Free Press had filed a formal complaint to the information commissioner's office -- another process plagued by delays but one that eventually secured the document's release, 20 months after the original call to Health Canada.
The study cited the lack of running water and proper sanitation as a key reason for St. Theresa Point's dramatic H1N1 outbreak.
One hitch: The government censored much of the critical data. Citing privacy concerns, Health Canada blacked out the number of people who died from H1N1 in St. Theresa Point, the number medevaced to Winnipeg for emergency treatment, the number admitted to the ICU and the ages of the victims. The government also blacked out the number of homes without running water, even though that figure has been reported dozens of times by the Free Press and other local and national media.
Health Canada even blacked out the name of the First Nation, but sources confirmed long ago the research was done at St. Theresa Point.
This spring, a shorter version of the report was finally published in the Canadian Journal of Public Health. It was a much shorter study and many of the original data tables were not included. But some of the figures originally blacked out by government censors, such as the ages of victims, were published.
Resume main story:
According to researchers, the first wave of the flu outbreak hit St. Theresa Point early and hard, resulting in 180 confirmed or suspected cases.
St. Theresa Point's babies had an alarmingly high "attack rate." Forty per cent of all children under the age of one got infected with the flu.
The researchers said the chief and council, community and government did almost everything right when it came to battling the epidemic. Extra nurses and doctors were rapidly mobilized. Infection-control measures such as masks, cough hygiene and handwashing protocols were emphasized in the community with an extensive awareness campaign. Schools were closed and social gatherings were cancelled.
Those measures usually help, but not in St. Theresa Point, partly because the H1N1 virus was already widespread.
"Limited access to water in homes and overcrowded households may also have contributed to the rapid and extensive transmission of (H1N1) in this community," wrote the researchers.
Preparing for the next big pandemic outbreak needs to include attention to fundamental health determinants such as overcrowded housing, access to clean water and proper sanitation, said the researchers.
In addition to reviewing every chart and the nursing station's daybooks, researchers interviewed 23 flu sufferers. Of those, 70 per cent did not have indoor plumbing. They hauled their water in containers from a community pipe.