Overwhelmed by the Omicron wave and unable to keep up with testing, local health authorities will no longer track or report the number of COVID-19 cases in Kahnawake.
Throughout the pandemic, these numbers have been a key metric in evaluating an appropriate balance between personal liberty and community safety. The stats have also been a valuable resource for community members trying to assess their personal risk tolerance.
“It’s certainly not throwing in the towel, but it’s definitely a change in strategy,” said public safety commissioner Lloyd Phillips. “People need to really ensure they’re taking their own responsibility.”
The system had been inundated by potential cases, leading to a decision last week to end PCR testing for the general population.
In recent weeks, the positivity rate – meaning the number of people who test positive against the total number of tests administered – ranged from 30 per cent to nearly 80 per cent, indicating a massive level of COVID-19 in Kahnawake. Five per cent was once considered high.
It has been known for weeks that the case numbers being reported were no longer accurate, according to Phillips, due to the testing landscape.
Locally, other measures of the prevalence of COVID-19 will take the place of case numbers. These include metrics such as hospitalizations, the level of impact on staffing, and how many people are reaching out to seek advice. These are less definitive but also reflect a shift in priorities.
“It was never 100 per cent just about the number of cases,” said Phillips, who acknowledged assumptions will have to be made.
There were zero hospitalizations as of Tuesday morning, but this could change quickly. There is no doubt still a high level of COVID-19 in the community.
“We know we had several community members who were recently in the hospital, including some youngsters,” said Phillips. “By having an overall sense of what’s happening, it helps guide us, but there is not an exact formula.”
Phillips conceded that the colour-coded alert system to which the community has become accustomed may no longer make sense without case numbers.
It is expected that the State of Emergency will be extended to February 20, according to Phillips, who is tasked with making a recommendation to the Mohawk Council of Kahnawake.
“I’m equally sick of it, but we’re hoping we can move through it much quicker in the weeks and months to come in terms of ending the State of Emergency, having the State of Recovery, and then have a declaration of a state of normalcy,” he said.
A new State of Recovery would last 120 days before needing to be renewed.
Despite the State of Emergency, there is already a softening of measures underway; gyms and personal care businesses that had been forced to close last month have been allowed to reopen with restrictions.
Phillips said the community is looking toward the endemic phase, in which Kahnawake – and the world – learns to live with the virus.
“It’s going to be largely based upon our ability to maintain the essential services in the community,” he said. “It’s going to be about rolling out the vaccinations.”
The fewer people who become severely ill from the virus, the more the focus can shift to protecting the vulnerable.
“At some point, there’s only so much that can be done,” said Phillips. “Nobody wants to see ongoing measures forever.”
Public Health, stretched thin by its management of community spread, had long been planning for a transfer of responsibility to residents. However, the Omicron wave has expedited the process.
“It sped up hugely with this change in the testing procedures,” said Lisa Westaway, executive director of Kateri Memorial Hospital Centre and Task Force member. “Every individual now has the obligation to self-manage, either as a case themselves or as a contact.”
She urged those who have even mild symptoms to take the situation seriously.
“You’ve got a little cough and you’ve got a runny nose and a headache, but it’s not really that big a deal,” she said. “In the past you would go to work. Well, that could be COVID.”
It’s an uncertain transition from what are now well-established social norms around testing and isolation, she said.
“We’re just in a really weird phase right now,” she said. “This is new for everybody. Nobody really knows how we’re going from where we were before through this transition phase and what it’s going to look like on the other side.”
Westaway acknowledged it will be difficult to assess the situation without knowing how many cases there are, but the emphasis remains on protecting essential services.
“We judge the pandemic situation by hospitalizations and deaths in Quebec and in the hospitals around us,” she said.
The best way to avoid hospitalization is to follow vaccine recommendations, and Public Health has responded to the latest wave by moving clinics to the Bingo Hall, which has more space to vaccinate more people safely.
Boosters for those 18 and older and first and second doses for those 12 and older are currently being administered.
“It’s about protecting you from ending up in the hospital,” said Westaway. “That’s very clear, that the vaccines are working in that sense.”
An anticipated rise in hospitalizations and deaths in Quebec in the coming weeks will be predominantly among the unvaccinated, Westaway emphasized.
As Kahnawake’s strategy pivots, many core institutions are still deeply impacted by the current wave, but these, too, are looking ahead.
The Kahnawake Education Center has released a plan for reopening schools this month.
Step By Step Child and Family Center – which saw 22 of its staff have to isolate since December 23 – is planning to reopen to all children and families in need of services on Monday. It is strongly recommended that parents continue to keep their kids at home if possible, however.
“I think that after 22 months, people are tired,” said Natalie Beauvais, executive director of Step By Step. “It’s so difficult to be at this point again. I really truly believe in the next couple weeks and months that we’re going to find a happy medium.”
The centre is working to adapt.
“It’s day-by-day right now,” said Beauvais.