UNA VU PA TH: moving forward during N11na?i7ut Where we are now Our map 4 Our tools 5 Scouting ahead The terrain 3 6 7 Remaining vigilant and prepared In conclusion 2 9 10 Nunavut's Path: moving forward during COVID-19 The Government of Nunavut (GN) took immediate action in response to COVID-19, by declaring a public health emergency, and introducing measures to reduce the spread of the virus. Thanks to the support of Nunavummiut, we are in a position to re-assess some of the restrictions that were put in place. It is undeniable that these measures have changed the way Nunavummiut interact and access services. The GN’s public health measures have impacted peoples’ ability to visit friends and loved ones, worship, work, travel and socialize as they would normally. Guided by three criteria that assess our ability to respond to an outbreak, the status of COVID-19 in territory and the situation in our neighbouring jurisdictions, we can now move forward with reassessing our public health measures. Starting June 1, 2020, the GN, under the guidance of the Chief Public Health Officer (CPHO) will begin modifying the current public health measures. When considering which measures to ease, we will begin with those that pose the lowest risk. All public health decisions will be guided by best available knowledge, practices, and epidemiological considerations. Every two weeks after June 1, the CPHO will decide which measures can be eased, maintained or if additional restrictions are needed. Easing restrictions also requires everyone’s commitment to continue to maintain the personal protective measures of good hygiene, hand washing, personal distance, and staying away from others when feeling sick. Nunavut's Path: moving forward during COVID-19 3 Nunavut’s Path: moving forward during COVID-19 highlights the critical public health measures that will be in place for the duration of the COVID-19 pandemic, identifies the criteria for easing public health measures, and lays out the government’s approach to ease restrictions, based on reducing risks related to the virus while minimising the impacts on Nunavummiut. 4 Nunavut's Path: moving forward during COVID-19 Public health measures are in place to ensure the health and well-being of our residents, by reducing the risk of COVID-19. As a result, when considering easing restrictions, decisions will be based on an assessment of how each measure impacts health and well-being. There are several factors that impact risk of acquisition and transmission of COVID-19. Duration of contact: the longer two people are close together, the more likely it is that a viral illness will be passed between the two; when contact is less than 10 minutes, transmission is less likely to occur.      Nature of contact: the closer two people are to each other, the easier it is for acquisition to occur. For example, two people sitting across a table are less likely to spread an illness than two people in a hairstyling session. Location: acquisition is less likely when contact occurs outdoors. Vulnerability: Elders and individuals with compromised immune systems may be more susceptible to acquiring an illness, and have higher risk of severe complications; children are less prone to severe complications and less likely to spread COVID-19. Experience, evidence and observations from within Nunavut and other jurisdictions have helped clarify how effective public health measures have been in meeting the above goals. It is prudent to alter measures that create the least risk first, as doing so has minimal chance of triggering an outbreak or spread. Nunavut's Path: moving forward during COVID-19 5 Every two weeks the current situation will be reassessed by the CPHO, with the option of continuing to ease measures, hold for an additional two weeks, or tighten measures. No matter what, Nunavummiut will need to maintain general protective measures like hand washing and staying home when they feel ill.   Knowledge about COVID-19 is still evolving and there continue to be many unknowns.  How we approach the next steps in containment are crucial. We need to examine the repercussions of each decision as measures are eased, and adapt our approach to stay one step of COVID-19 coming into the territory. Examining the situation every two weeks will allow Nunavut to maintain flexibility to adapt and respond quickly as the situation changes. As these decisions are made, they will be guided by several factors including: 1. Status of transmission of COVID-19 in territory. 2. Status of in-territory testing capacity. 3. Current health system capacity. 4. Transmission and cases levels in our most common travel destinations in Canada (Northwest Territories, Alberta, Manitoba, Québec and Ontario), and the possibility of spread to multiple locations within Nunavut. 5. Current evidence available. 6. Assessment of risk of each measure. Public health measures are and will continue to be guided by best practices, epidemiological considerations and evidence. 6 Nunavut's Path: moving forward during COVID-19 Measures generally fall into in three groups - lower risk measures, medium risk measures and higher risk measures. Based on the current evidence on risk and impacts of measures, the below is a current assessment of some of these measures.  The risk level of activities can change over time. Examples of low risk measures • Opening daycares. • Opening parks and playgrounds. • Increasing the number of people participating in outdoor events/gatherings. • Opening work places. • Opening gyms (solo workouts and swims). • Opening outdoor day camps. • In-territory travel between communities. • Visiting museums and art galleries (without group tours). • Opening retail outlets. • Resume in-person health care services. Examples of medium risk measures • Dining in restaurants (half capacity or other space separation requirements). • Visits to long-term care facilities. • Holding faith and critical cultural ceremonies, based meetings (indoor; must maintain distancing and separation). • Resuming personal services such as hairdressers and nail salons (one-on-one session(s), while wearing gloves and masks and maintaining distancing when feasible. • Resuming indoor group meetings (gym classes, indoor sports). • Opening public sauna & hot tubs. • Opening youth centres. • Opening the theater. • Resuming Courts. • Opening schools and Nunavut Arctic College campuses. Examples of high risk measures • Allowing community feasts (indoor). • Allowing indoor concerts. • Lifting household visitor restrictions. • Opening drinking establishments, bars and pubs. Nunavut's Path: moving forward during COVID-19 7 Travel restrictions are expected to continue in some form until we have more information about effective therapies and/or a vaccine for COVID-19, since travel is Nunavut’s highest risk. It is important to remember that as the threat of COVID changes, it will affect these measures. Even though an activity may be assessed as low risk, it may not be appropriate for a measure to be eased immediately. Removing a Public Health Order barring an institution/facility from opening does not force or guarantee that the facility will open on that specific date. These are decisions for the owner(s) and operators. For employers and retailers seeking detailed information, please refer to the Workers’ Safety and Compensation Commission (WSCC). For individuals wishing to understand their personal risk of acquisition of COVID-19 there are many resources available at https://nu.thrive.health/covid19/en, https://gov.nu.ca/health/information/covid-19-novelcoronavirus, or at 1-888-975-8601. As more information becomes available and data on the current situation is analyzed, some measures may need to be re-introduced or new measures implemented to reduce the risk of spreading COVID-19. Everyone still has a role in Nunavut’s response to COVID-19. As there are currently no targeted treatments or vaccine available, public health measures are critical to slow the spread of COVID-19 and protect our family, friends and communities. 8 Nunavut's Path: moving forward during COVID-19 We are asking Nunavummiut to continue to respect these personal public health practices: Stay informed, be prepared and follow public health advice. Continue to practise good hygiene (hand hygiene, avoid touching face, respiratory etiquette, disinfect frequently touched surfaces). Maintain physical distancing as much as possible when outside of the home (i.e. from non-household members). Continue to increase environmental cleaning and ventilation of public spaces and worksites. Stay at home and away from others if symptomatic/feeling ill. Stay at home if you have pre-existing conditions. Wear a mask when social distancing cannot be maintained Limit non-essential travel out of the territory. Assess and be aware of the risk with non-essential social gatherings. Following these practices are critical to reduce the spread of COVID-19 and will support easing the various restrictions. Nunavut's Path: moving forward during COVID-19 9 Today, there is no timeline for when the COVID-19 pandemic may end. Until a vaccine or another form of treatment is developed, COVID-19 is something that the world will have to live with. We all want to return to what our lives were like before the pandemic, but this is not possible right now. We cannot go back to what we considered normal. Instead, we need to work towards something new. We need to decide how to re-introduce the activities we love and the programs we depend on, in a way that is safe and sustainable. Our sacrifices and our actions have allowed us to keep COVID-19 out of Nunavut for now. We have also all shown that we can respond quickly and decisively. Our efforts as a territory will need to continue, even as we begin to ease public health measures. Nunavut’s collective responsibility will keep us safe and healthy, and each day that passes gives us more information and better tools to help manage the threat of COVID-19. 10 Nunavut's Path: moving forward during COVID-19 Nu?i?ut