First Nations Health Authority grappling with complex issues in B.C. COVID-19 surge

British Columbia’s First Nations are being disproportionately affected by the pandemic, most acutely during a fourth wave that has seeing infections surging as vaccinations stagnate below the provincial average.

At the start of August, the First Nations Health Authority was recording just 10 to 15 infections per day at a time the provincial rolling average was around 200; they are now seeing 80 as the provincial rolling average hovers around 750. 

Dr. Shannon McDonald, the acting chief medical officer of the agency, described a variety of reasons why First Nations communities can be particularly susceptible to the coronavirus.

She pointed out that large families often live together under the same roof, so it’s hard to isolate one sick person; cultural gatherings are “the lifeblood of the community,” but are high risk for viral spread; many Indigenous people work in group settings; the communities tend to have more children; and many live in the north and Interior where infections have been rising the fastest the longest during the fourth wave. 

“Just like every other part of the province, we have a population of vaccine-hesitant people and that varies,” McDonald said. “We have some communities where vaccination rates are well over 90 per cent, especially in elders, and we have other communities where those vaccination rates are much much lower."

Canada’s history also plays a role in vaccine hesitancy among Indigenous people, McDonald said.

"We live in a context where the relationship between government processes, health-care service delivery organizations and the relationship with First Nations people has not always been a kind, gentle relationship," she said. “We have a proportion of the population that just cannot and will not trust.”

Systemic racism continues to be a significant issue for First Nations seeking medical care in British Columbia, documented in a damning report published last fall. 


McDonald is a member of the Tsawout First Nation and spoke to CTV News from her community on Vancouver Island. Many of her health-care worker and administration colleagues in the First Nations Health Authority are Indigenous as well.

The health authority’s social media pages include videos, pictures and messages from Aboriginal health-care workers addressing issues ranging from how to quit vaping to vaccine hesitancy among men in particular, all addressed through the lenses of the cultural and geographical factors that are impacting care, physical health and overall well-being. 

B.C.’s First Nations Health Authority was established 13 years ago and was the first of its kind in Canada. Since then, it’s been a model for other Indigenous-led and -staffed health authorities in the country, but remains the only one that’s province-wide. It serves more than 200 communities, as well as First Nations people living off-reserve.

“I've seen the exponential growth of Indigenous people who've succeeded in university and medical school and gone onto careers in medicine and that is changing, but it's still a very, very minute proportion of the population," said McDonald. “I'm trained in Western medicine. That's what I learned and that's where my authority comes from, but at the same time as a member of the community I can speak in a very different way and it sometimes is a challenge to wear both of those hats." 

While the health authority has been recruiting local elders and community leaders of various stripes to encourage more people to be vaccinated, it is also in the process of approaching young Aboriginal social media influencers to reach younger members of the community and convince them the shots are safe and a good idea.


In the spring, Prince Rupert experienced a massive surge in COVID-19 cases and health officials prioritized the entire adult community for vaccination.

The area – which has a large Indigenous population – jumped at the opportunity, with 78 per cent getting their first dose quickly and cases plummeting as a result, making it a perfect example of the efficacy and safety of mass vaccinations. 

While every First Nations community, as well as individuals living off-reserve, was given priority ahead of the general population in the age-based rollout, vaccination numbers are well below the provincial average.

While 88 per cent of eligible British Columbians have had at least a first dose of the COVID-19 vaccine, only 77 per cent of First Nations people living in community had had their first dose, and only 72 per cent of those living off-reserve had.

While the FNHA is counting on community members to help spread the word that vaccines are safer than COVID-19 and can save lives, it is also taking steps to make it even easier to get protected against the Delta variant contuing to spread throughout the province.

“We're trying to move so the vaccine is available in the community all the time,” said McDonald, saying officials are undeterred by the geographical challenges of even the most remote communities.

“Those vaccines were on airplanes, they were on boats, they were in the back of someone's SUV, but they got to community.”