​A Message from FNHA’s Office of the Chief Medical Officer

In BC, and across Canada, some First Nations communities are taking the step of establishing checkpoints or closing the borders of their communities. Many BC First Nations are looking for ways to restrict movement in and out of our communities to contain the spread of COVID-19. Our Elders are very precious to us – especially their roles in holding language, knowledge and culture – and therefore need increased protection from COVID-19.

Decisions to “close" a First Nations community or reserve, and the assessment of related security needs, rest solely with the authorities of each BC First Nation. First Nations benefit from informing these decisions through collaborative conversations with their local Health Director, FNHA's Office of the Chief Medical Officer, BC's Provincial Health Officer, and/or the Chief Medical Health Officer or Medical Health Officers of their RHA.

 Like any public health intervention, we must consider the benefits and risks of checkpoints and community closures. Those benefits and risks vary depending on whether the community is using checkpoints to provide public health education and other relevant information, or whether the community is using the checkpoint to try and force compliance, or some combination of both.

The Province of BC has developed an Ethical Decision-Making Framework to guide them in their response decisions. This Framework includes a checklist and decision-making tool that communities may find useful to use to work through this important decision to run a checkpoint or not. Security measures/check-points are just one of the many possible ways to promote public health during a pandemic.

For those communities who have already decided to implement community closures or checkpoints, there are ways to maximize the public health benefits and maintain everyone's safety:

• Create a plan to ensure that the flow of essential services and supplies/goods into the community is not limited.

• ​Form relationships and consult with local/neighboring essential services like the police and ambulance services to support the checkpoints/closures.

• ​Ensure that checkpoint staff are clear on their roles and responsibilities:

o ​​They do not have the authority to search people/vehicles or seize property;

o ​If it is felt that someone is failing to obey the law, staff are to call the appropriate authorities.

o ​Checkpoint staff are there to educate members and visitors about the expectations of a community; it is not their role to enforce them.

• ​To ensure staff safety, checkpoints should be equipped with reduced speed signs, informative signs and trained flag people if possible.

• ​Checkpoint staff should receive appropriate training/education to be able to provide important public health information (ge​neral​ and specific to the community) to those who visit the checkpoint.

• ​Those staffing the checkpoint require management and support. Ensure that plans are in place to reduce burnout, ensure safety and support cultural/mental health needs of checkpoint staff/volunteers.

• ​Ensure adequate shelter for staff (a place to keep warm or out of the sun).

• ​Homemade facemasks and alcohol-based or hydrogen peroxide-based hand sanitizers should be distributed to staff.

• ​Ensure physical distancing is maintained at checkpoints (2 meters).

• ​Some people in the community may be using alcohol or other substances as a coping mechanism during this crisis, or may have an alcohol use disorder or addiction. An abrupt loss of access to alcohol and other substances can lead to a state of acute withdrawal or, in severe cases, a life-threatening medical emergency. We encourage you to devise compassionate ways to care for everyone in your community.

Please continue to hold eac​h other up and practice lateral kindness in these challenging times.

Any general inquiries about COVID-19 can be sent to COVID19@fnha.ca​.

In wellness,​

Shannon McDonald, MD
Deputy Chief Medical Officer
First Nations Health Authority