Editor’s note: This is a two-part story chronicling the journey of mobile vaccine teams to the fly-in community of Old Crow. It was funded with support from the National Geographic Society. Part one was published May 5.
The Yukon government has chartered a plane on Air North to travel from Whitehorse to Old Crow. But when the team begins to arrive in the darkened airport at 4:30 a.m. the flight is grounded due to low clouds.
Logistics lead John Coyne has planned for months to control all the details of deployment, but he can’t control arctic winter weather.
As his team dozes on benches and tracks down coffee in the empty waiting area, Coyne traverses between the gate and the air-side flight crew, trying to determine their best plan of action.
By Jan. 22, Team Balto has already visited a number of communities around the territory. But communities like Haines Junction and Carmacks are reachable by road. The teams can bring all the supplies — including chairs and tables — that they conducted their training exercises with.
Team Balto’s schedule is booked a month solid. A cancelled flight would mean major rearranging, but Coyne doesn’t want the pilot to feel influenced by the presence of the vaccine. Flying in unpredictable winter weather could have even bigger consequences.
At 12:05 p.m., just minutes before the final cut-off time, the flight crew makes the call.
When the plane finally touches down in Old Crow, Team Balto breaks into applause.
“After sitting for, man, at that point, it had been probably nine or 10 hours into our workday already and we hadn’t even started. It’s like, okay, now the work can get done,” recalled nurse Laura McDonald.
With a limited supply available and procurement complications, the higher-per-capita doses going to the northern territories meant some Southern Canadians would wait longer for their doses. With that in mind, the goal is to not waste a single dose of the Moderna vaccine.
The job is harder than it sounds.
Moderna must be kept chilled to -25 C. When it is ready to use, doses must be removed from the cold box and transferred into a second box, which thaws it to the working temperature of -15 C.
Each box of Moderna contains ten vials. Each vial contains 10 doses – maybe 11, if you have a team member as skilled as nurse Laura McDonald extracting them.
Once a vial is thawed the team has 12 hours to use it. It’s a constant calculation for the nurses and pharmacists on the clinical team as the community members come and go in the clinic.
“It is high pressure,” admits nurse Kelsey Short. “That is kind of the craziest part, all the logistics of keeping that vaccine safe and keeping it effective. There was pressure to not waste a single dose. To be as responsible as we can with this resource that is wanted all around the world right now. Because we have access to that resource, we have to do the best we can.”
As the appointments wane at the end of the night, the team scrambles to use the last of the vaccine. Despite the delay in opening the clinic, the community rallies to make sure everyone receives it. Not a single dose is wasted.
Before they head home, the team gathers outside as fireworks light up the sky above Old Crow. For the community, setting off government fireworks that day was a way to say “Mahsi’ Choo” – thank you – to the vaccinators.
By the time the team arrives back in Whitehorse, they will have wrapped up a 24-hour workday they will never forget.
Learning from the past
The lockdown in Old Crow looked different from southern cities. The community may not have restaurants to shut down, but shared community meals are a part of everyday life.
“I think it was extremely difficult,” explained Chief Dana Tizya-Tramm. “Close contact and being with one another, having tea and sharing, bringing meat to young mothers, or packing or cutting wood for elders, and all of the interactions in between, are very dependent on face-to-face.”
“It’s also difficult for people to enforce when someone enters your space, because of the cultural context, having to stop and tell the person we can’t do this is also difficult because of that high level of inherent respect in all of our dealings. So the way that this played out the interplay between the personal and the collective as a community, it was a great shock.”
There was a time when Old Crow was not a permanent settlement, but instead a seasonal fishing village. While the Gwich’in were nomadic people – travelling to follow seasonal food sources — trade was centered in several central communities throughout the traditional territory. During the early 1900s Rampart House — not Old Crow — was one of those trading centres.
In 1911 an outbreak of disease – recorded as smallpox, but most likely the flu – afflicted over 90 people and sent Rampart House into quarantine. The main devastation of this event was the burning of possessions and cabins. While the Vuntut Gwitchin at that time remained seasonally mobile, the outbreak motivated the central trade hub to relocate from Rampart House to the fish camp now known as Old Crow.
Modern Old Crow is a microcosm of other places around the world, according to Tizya-Tramm. While most people want to do the right thing to keep everyone safe, a few outliers doubted the realities of COVID-19 or the necessity of a vaccine.
Much of the communication from the nation focused on keeping elders safe. Around a fifth of the population of Old Crow is made up of seniors. Posters and social media posts implored the community, “Come together as Gwich’in by staying apart.”
In the past, Vuntut Gwitchin citizens headed out on the land when disease reared its head. Families would spread out, often avoiding communities for months based on news of a contagious outbreak in places where people gathered.
Many community members took the same approach during the early days of the COVID-19 pandemic, spending as much time as possible out on the land with their loved ones.
“It took away a lot of the COVID social anxieties and reinforced the strength of the community, as well as getting people out on the land, which is always in and of itself a medicine to our people. So although we shifted away from travel, that doesn’t mean that we were not traveling out to our camps and our traditional territories,” said Tizya-Tramm.
On Feb 19 the mobile team returns. It’s Team Togo arriving with the second dose.
This time the weather is on the side of the vaccinators. Knowing it will still be a 19-hour day, the team tries to catch some sleep on the plane. In the quiet, Nurse Kelsey Short touches her nose to the airplane window, staring out into the darkness at the green aurora dancing for those who stay awake.
On the ground, action begins immediately.
A contingent of five trucks, one school bus and four snowmobiles greet the teams to transport them to Chief Zzeh Gittlit School. Cars are fairly rare in the community, but all resources are being utilized for the vaccination.
Short hauls her precious vaccine cargo to an RCMP truck. A couple of nurses hop into a sled attached to the snowmobiles – hitching their parka hoods up for a snowy -25 C ride to the school.
Logistics lead Dwayne Rogowski steps forward, and tables and chairs materialize from under the auditorium stage as Togo snaps into a coordinated plan for transforming the school gymnasium into a socially distanced clinic in just 30 minutes.
“All of us are pretty adaptable and willing to be like, ‘Okay, what needs to get done?’ Everybody knew, because we all volunteered, it would be hard work. But I think in the end, you just feel like it’s important work.”
The team fuels up on bannock, quinoa salad and caribou stew prepared by community members. Students attending school will later be offered a chance to peek into the clinic. On foot and on snowmobile, almost the entire village will make their way here during the day.
“The community was so excited and happy to have us. So that was just amazing. You know, you feel really appreciated right at the moment and it makes it easier to do those long hours,” Short said later. “They were long days, but that’s okay. We’d put in any effort to get this vaccine out to people.”
After they receive their shots, elders take their place in the waiting area. They turn their chairs around to face one another and catch up in the 15 minutes they must wait after the Moderna dose to make sure there are no adverse reactions.
It’s been a year of uncertainty, but there are warm greetings and smiling eyes above cloth masks.
Looking to the future
The Vuntut Gwitchin have faced deadly viruses before. The list is long. Diseases like smallpox, Spanish flu and tuberculosis have moved towns, changed lives and sent children away – some who never returned.
But not this time.
“I remember looking out on our landscape and, just for a moment, my heart would sink because of just how much we were not able to accomplish this year. That’s very, very difficult to face,” said Tizya-Tramm. “This has been a year – I wouldn’t say a waste – but this has been a year of stasis, where everything was put aside, and COVID, rightly so, was dealt with.
“But on the other side, we did make it through this without a single infection in the community,” he continued. “Our people understand partnerships. Partnerships aren’t just about the good times, it’s all about the hard times. Canada and Yukon were there. And that’s the only reason we have the level of success we do today.”
This work was supported by the National Geographic Society’s Emergency Fund for Journalists.
Contact Haley Ritchie at firstname.lastname@example.org