Manitoba could have acted quicker to prevent COVID-19 from spreading in Hutterite colonies, especially given the "intense threat" the virus has demonstrated to Hutterites west of the province, an epidemiologist says.
The latest numbers show nearly 600 confirmed cases on Saskatchewan Hutterite colonies, which account for one-third of the provincial total and an infection rate of roughly 10 per cent of the Hutterite population there.
"Had there been more willingness, openness, to identify the first few cases, and then had there been a very quick, almost instantaneous response to that case … the case number could have been fewer than we ended up having," said Saskatchewan-based epidemiologist Nazeem Muhajarine, who studies community health.
If Manitoba wants to avoid something similar, aggressive testing needs to happen from the outset, local doctors familiar with communities need to be used and culturally-sensitive relationships need to be built before the crisis, he said.
Manitoba's chief public health officer Dr. Brent Roussin said on Monday that one-third of all active cases in the province are connected to tight-knit communities, which includes Hutterite colonies.
Lessons learned out west
While health officials in Saskatchewan have been able to track the cases, their ability was sometimes hampered by cultural differences.
The province also had time to build better relationships before the pandemic hit the colonies, he said.
"It helps a great deal if you are building on a cultural understanding and a relationship between non-Hutterites and Hutterites communities," he said.
"A pandemic situation is not a good time to be building that relationship."
One successful step Saskatchewan health officials took early on was to communicate the gravity of a colony infection, Muhajarine said.
"The premier of the province was very clear … in saying that Hutterites' communities have to really do whatever they can, in order to actually get ahead of this virus, in order to minimize the spread and so on," he said.
I would have expected that all Hutterite communities in Manitoba would not have COVID. - David Tschetter, Hutterian Safety Council
Once COVID-19 did start appearing in Saskatchewan colonies, Hutterite leadership and health officials also openly discussed the potential for more restrictions if cases weren't kept under control, he said.
Hutterian Safety Council chair David Tschetter said he had hoped Hutterites in Manitoba could have learned from the experiences of colonies further west.
"I would have expected that all Hutterite communities in Manitoba would not have COVID, because of the delay, and the lessons learned here in Alberta and in Saskatchewan," he said.
"I had expected, in a perfect world, that this would make an absolutely huge difference," he said.
Use established connections with doctors
One of the helpful things public health officials did in Alberta and Saskatchewan was to use local doctors and health-care providers that colonies already had a rapport with, Tschetter said.
That's key to getting Hutterite communities in Manitoba on board with testing right now, along with fighting the stigma colonies face from the broader public, according to Muhajarine.
"We have to also communicate that there isn't anything ... culturally [or] morally wrong about actually having an outbreak in a community," he said.
"Getting the virus is not a moral failing."
Depends on 'what communities are agreeable': Manitoba's top doctor
A spokesperson for the Government of Manitoba said Thursday local public health officials involved in helping Hutterite communities tackle COVID-19 already had relationships with Hutterite communities in their regions.
"Public information has been shared, and questions and answers specific to Hutterite communities has been developed," a spokesperson wrote.
The province pointed to its use of mobile testing sites, which as of Thursday had been used in two colonies.
But with an estimated 125 colonies in Manitoba, Muhajarine said that level of testing isn't going to be enough to stop the virus from spreading.
"It seems to me, just the math of it, there will need to be more than two mobile testing clinics. The testing has to happen very quickly and very extensively."
Roussin defended the province's response to outbreaks on Hutterite colonies.
"A lot of the plans that come out, are worked out with the region and communities. And so it all just depends on what they're seeing in the [epidemiology] there and what communities are agreeable," he said.
Roussin said he wasn't aware of health officials being turned away from any colonies.
"There's certainly a gradient where we see some communities that are going above and beyond looking at public health advice, while others may not be quite on board."
Breaking through the barriers
Hutterite colonies' relative isolation and self-sufficiency provided some initial protection from COVID-19, according to Muhajarine.
But once the virus infiltrated a colony, it was able to quickly spread, he said.
"Because of the intense lifestyle of communal living there, they are put under intense threat of this virus. Their health, their well-being, is put in jeopardy to a greater extent," Muhajarine said.
One of the keys to the Hutterite belief system is communal living— meaning colony members share everything from possessions to food.
Meanwhile, Tschetter — who is based in Alberta — said early on they struggled to get Hutterite colonies to take COVID-19 seriously.
"Initially, it was extremely tough because we were dealing with the illusion that because our communities are self-isolated to an extent, geographically, and secluded, that that equates to COVID-resistance status. And breaking through that was extremely hard," said Tschetter.
"Then of course the conspiracy theories started setting in. That just made our challenge even more difficult," he said.
Things changed when colony members started getting sick, he said.
"Over time as the cases start to mount, and some of our people are getting really sick and some of them are dying, that reality set in really quick and helped break through some of the barriers in getting people to embrace the public health orders," he said.