Multijurisdictional outbreak of COVID-19 associated with a wake/funeral event in a northern Saskatchewan First Nations community.

Background Sixty-eight laboratory-confirmed cases of the coronavirus disease 2019 (COVID-19) (12 in Alberta [AB], 56 in Saskatchewan [SK]) were linked to a gathering at a hospital in Alberta on June 1-4, 2020, and a wake/funeral in a First Nations community in northern Saskatchewan on June 9-11, 2020. Objective The objectives were to provide a comprehensive description of the epidemiology of the outbreak and describe the chains of transmission to inform the hypothesis that there were multiple introductions of COVID-19 at the wake/funeral. Methods Case investigation and contact tracing was conducted by local public health in AB and SK. The Public Health Agency of Canada conducted a centralized case analysis. An epidemic curve and a Gantt chart for period of communicability were created to support or refute whether there had been multiple introductions of COVID-19 at the wake/funeral. Results Illness onset dates ranged from May 31 to July 1, 2020. Ages ranged from 2 to 80 years (median age=43 years). Five cases were hospitalized; there were no deaths. The available case exposure information supports the hypothesis that there had been multiple introductions of COVID-19 at the wake/funeral. Public health authorities in AB and SK declared the outbreak over on July 20, 2020; based on two incubation periods (i.e. 28 days) following the illness onset of the last primary case. Conclusion During multijurisdictional outbreaks, data sharing, coordination across health authorities and centralized analysis is essential to understanding the events that lead to the outbreak and possible hypotheses around chains of transmission.