The use of drones for the delivery of supplies, medical equipment, diagnostic testing, and medical treatments to remote first nations communities in Alberta during COVID-19

Introduction: For members of remote Indigenous communities, accessing healthcare often requires travel to off-reserve locations, which is both burdensome to the individual and increases the risk of contracting COVID-19. Remotely Piloted Aircraft Systems (RPAS), or drones, offer a potentially cost-effective method for reducing that burden and risk by removing geographic barriers and increasing timeliness and accessibility of supplies, equipment, and remote care. Objectives: To demonstrate the potential of RPAS-delivered technology and supplies in diagnosis, evaluation, and treatment, including RPAS-delivered ultrasound (US) machines;to co-develop governance and operating manuals with local Indigenous communities;and to use this work as a scalable model for fully operational RPAS-based medical delivery systems. Methods: Our team is developing and pilot-testing innovative RPASbased medical delivery solutions at the systems, regulatory, technological (software and hardware), and procedural levels. This includes working with Transport Canada for Beyond Visual Line of Sight approval;RPAS fleet development and testing;custom payload system design and fabrication (i.e. refrigerated unit for vaccine delivery);procedural development (i.e. risk and safety assessments);Detect and Avoid System testing and refinement;and pilot-testing COVID-19 test kit fidelity and remote US functionality. Results: We have successfully delivered PPE (gloves, gowns, masks) and COVID-19 test kits. We confirmed that the delivered RNA COVID- 19 test samples contained no decay in signal or testing capabilities. We also delivered a sanitized Tele-mentored Self-Diagnostic US and successfully Tele-mentored a patient in performing a proficient selfadministered US at a remote location. Conclusion: RPAS-based medical delivery models offer an innovative approach to addressing longstanding issues of healthcare access and equity, and are particularly relevant in the context of COVID-19 and preventing pandemic spread.