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Impacts of changes to public health measures on refugee and immigrant communities

Updated: Sep 10, 2021

Hon. Jason Kenney

Premier of Alberta

307 Legislature Building

10800 - 97 Avenue NW

Edmonton, AB T5K 2B6

Cc: Hon. Tyler Shandro, Minister of Health

Hon. Muhammad Yaseen, Associate Minister of Immigration and Multiculturalism

David Shepherd, MLA Edmonton City Centre, Health Critic

Dr. Verna Yui, CEO Alberta Health Services

August 28, 2021

Re: impacts of changes to public health measures on refugee and immigrant communities

On July 28th, 2021 the Government of Alberta announced a rollback of vital public health measures and programs for COVID-19. This announcement was met by significant push back and concern from medical experts and public health leaders, including the Alberta Medical Association Section of Pediatrics and Section of Emergency Medicine, the Edmonton Zone Medical Staff Association, the United Nurses of Alberta, the Canadian Paediatric Society the Alberta College of Family Physicians, and the Federal Health Minister. A subsequent update on August 14th announced that these changes would be delayed until September 27th, due in part to a growing fourth wave. Nonetheless, the government is actively moving forward with removing many measures including eliminating contact tracing as of July 29th, terminating quarantine supports and the isolation hotel program as of August 16th, and the closure of multiple AHS mass immunization clinics at the end of July. When taken together, these changes and the other planned measures announced for the end of September, will put many Albertans at unnecessary risk.

The Refugee Health Coalition is joining the growing number of voices in opposition of these changes. We are gravely concerned about the inequitable impacts to refugee and immigrant communities here in Alberta. One in five Albertans identify as an immigrant, including 33,000 new international migrants who have arrived in 2020. Many newcomers have been essential workers throughout the pandemic, often within health care, food production and processing, and the retail and service industry, all of which can be high risk environments for COVID exposure. Studies show that Canadian immigrants and refugees are at a higher risk of severe health outcomes and death from COVID-19 infection when compared to Canadian-born populations. Furthermore, these same populations may face unique barriers to vaccine access and vaccine willingness. Accessing a vaccination can be challenging for many reasons:

  • Accessibility of telephone or online booking for those with language barriers or reduced access to computer/internet

  • Availability of language translation services throughout the vaccination appointment

  • Ease of access to vaccine clinics including transportation options, extended hours, and walk-in capacity

  • Supports for those requiring childcare assistance during vaccination appointments

  • Fears of being turned away for those who are migrant workers or who do not have an Alberta health care card

There have also been missed opportunities to improve vaccine willingness in ethnocultural communities. Hesitancy around vaccination often stems from misinformation or mistrust that is amplified by language and cultural barriers and prior negative experiences with the health care system. We feel that the Alberta Government’s efforts in mitigating these barriers have been insufficient at this point, especially as we see successes in other jurisdictions where community engagement efforts have been more robust and sustained.

The proposed changes to testing, contact tracing, masking and isolation requirements will put those who have not or could not be vaccinated at risk. We are disappointed by the Government of Alberta’s simplistic messaging that portrays the decision to be vaccinated as being up to personal choice and individual preference. This perspective fails to consider those who face practical and systemic barriers in accessing vaccination. Early data already highlights an equity gap in vaccine uptake, with visible minorities and lower-income Canadians reporting below average levels of first and second doses.4 Furthermore, the elimination of isolation supports and hotels will add an additional financial strain to lower income Albertans who may not be able to afford to stay home when sick or to isolate from other family members within their own household. Finally, premature closure of mass-vaccination clinics will disproportionately impact marginalized communities including refugee and immigrant populations. While pharmacies and some family physicians are still offering vaccines, they often lack the infrastructure, translation services, and other supports required to accommodate recent immigrants and refugees.

In summary, we, the Refugee Health Coalition, are calling on the Government of Alberta to

  1. Invest resources into community-led initiatives to address low vaccination rates among newcomer populations. This includes, but is not limited to, vaccine clinics in community settings, town halls with culturally appropriate healthcare providers, and increased access to vaccines outside of working hours.

  2. Collect and publish race-based data on key COVID metrics such as deaths, serious illness and vaccination rate. This information is pivotal in understanding and reacting to systemic inequities and health system barriers.

  3. Reinstate essential basic public health measures (mandatory masking, widespread access to testing, public health contact tracing, and mandatory isolation of positive cases). These measures help protect all Albertans and are a crucial step in protecting essential workers who may be at increased risk due to close interaction with members of the public and crowded working conditions.

  4. Ensure barrier-free access to testing for anyone with symptoms and clear isolation requirements for those who test positive. Mandated guidelines around time away from work helps protect those who fear pushback from their employer when needing time off while unwell.

We look forward to the opportunity to discuss our concerns with you further.

Sincerely,



Dr. Jessie Breton

Co-chair of the Refugee Health Coalition

Emergency Physician, Royal Alexandra Hospital and Northeast Community Health Centre

Rhianna Charchuk MSc

Co-chair of the Refugee Health Coalition


Joud Nour Eddin

Dr Valerie Krinke MD CCFP

Mom Care Docs, Family Physician New Canadians Health Center


Dr. Molly Whalen-Browne

Family Physician and Medical Director, New Canadians Health Centre


Dr. Vera Caine PhD, RN

Professor, Faculty of Nursing, University of Alberta

Board Chair, New Canadians Health Centre

President, Canadian Association of Nurses in HIV/AIDS Care

Dr. Tehseen Ladha, MD, MPH, FRCPC

Pediatrician and Director of Research and Evaluation, New Canadians Health Centre


Dr. Dunsi Strohschein PhD Public Health

Founder, HourAfrica.com and Adjunct Professor, School of Public Health


Astrid Velasquez

Manager, New Canadians Health Centre


Mergim Binakaj, MD Family Physician Resident, University of Toronto

Migrante Alberta

https://www.migrantealberta.ca


References:

1. Focus on Geography Series, 2016 Census; Statistics Canada

https://www12.statcan.gc.ca/census-recensement/2016/as-sa/fogs-spg/Facts-pr-eng.cfm?Lang=Eng&GK=PR&GC=48&TOPIC=7

2. Alberta Annual Population Report 2019-2020

https://open.alberta.ca/dataset/1050cf0a-8c1d-4875-9800-b7d2f3199e41/resource/3fadb6f0-3c40-4fe9-a835-4ae3a5d74e30/download/2019-20-population-report.pdf

3. COVID-19 deaths among immigrants; Stats Canada

https://www150.statcan.gc.ca/n1/pub/45-28-0001/2021001/article/00017-eng.htm

4. Covid-19 Vaccination Coverage Survey – Cycle 2; Statistics Canada

https://www150.statcan.gc.ca/n1/daily-quotidien/210709/dq210709b-eng.htm



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