Many communities still connect through satellite, which is not very reliable. As a personal reference, my parents live in Rankin Inlet, and they have satellite service. I am completely unable to connect with them through video. Their cell service is extremely spotty. I cannot always get through to them on their cellphones. Their community in Rankin Inlet is quite similar to many communities across the north that do not have fibre optic.
When we are looking at health appointments in the Northwest Territories, our major medical service centre would be in Yellowknife. If we are unable to get services in Yellowknife, we go south to Edmonton. Because of COVID, many medical appointments are postponed. In our community, we go to video appointments, but if you are in a northern or extremely remote community, those services are unavailable to you.