Indian Country plunges into uncertainty as coronavirus reaches their communities
Wednesday, March 18, 2020
By Acee Agoyo
The coronavirus continues to wreak social and economic havoc in Indian County, with more and more tribes curtailing their operations as the first cases are confirmed in their communities.
On a conference call with members of the media on Tuesday, the Indian Health Service reported the first three "presumptive positive" cases at its facilities. But in a sign of the volatile nature of the crisis, a fourth was confirmed just hours later.
"This is an emerging, rapidly evolving situation," IHS Chief Medical Officer Michael Toedt said on the call. "More cases of COVID-19 are likely to be identified in the coming days."
"The potential public health threat posed by COVID-19 is very high," Toedt added, reaffirming a position the IHS has expressed to Indian Country since early March.
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According to Toedt, the first three COVID-19 cases were reported in the Portland, Great Plains and Navajo service areas of the IHS.
At the time of the call, the most recent incident emerged on the Navajo Nation.
“The individual who tested positive was referred to a higher level of care and is with one of our partner institutions,” Toedt said when asked about the first Navajo case. “All contacts are being thoroughly investigated as appropriate testing is being done.”
When pressed for additional details about the first three incidents, Toedt said the IHS was committed to protecting patient privacy.
“To protect patient privacy, we are not going to identify where individuals live,” said Toedt, who pointed out that the IHS network includes facilities in reservation and urban settings.
Indianz.Com Audio: Indian Health Service Chief Medical Officer Michael Toedt
But as soon as the call was ending, Navajo Nation President Jonathan Nez confirmed that a 46-year-old citizen reported symptoms to an IHS facility in Kayenta, Arizona. The patient was then transferred to a facility off the reservation in Phoenix, where further testing occurred.
“We have health and emergency experts who have been planning and preparing for this situation for several weeks," Nez said in a news release. "We call upon our Navajo people to do their best to remain calm and make good decisions by staying home to prevent the spread of the virus among our communities."
Just a few hours later, tribal leaders were sharing news of the second case. A "middle-age male" reported to the same IHS facility in Kayenta and is now being treated off the reservation.
“We are taking all proper actions at this time," Navajo Nation Vice President Myron Lizer said in a news release in the evening. "Through the power of prayer, we will overcome this pandemic as our ancestors did.”
In terms of land base, the Navajo Nation is the largest reservation in the U.S. It's also home to the largest population, Indian and non-Indian included, making it a likely area for coronavirus cases to emerge.
But the coronavirus is reaching into all parts of Indian Country, rural and urban alike. Though IHS officials declined to provide details, the case in the Great Plains Area was previously confirmed to have occurred in Charles Mix County in South Dakota, home to the Yankton Sioux Tribe.
The tribe declared a state of emergency after the governor disclosed the case, which affected a man in his 50s. And what was initially scheduled to be a two-day cleanup was extended by several days -- offices on the reservation remain closed through the end of this week.
"We are continuing the thorough cleaning of the facility and all programs are conducting intense cleaning of their own facilities," Chairman Robert Flying Hawk said in a March 13 memo.
Similar scenes were unfolding in tribal communities across the nation. Gaming establishments, schools, economic enterprises and other operations were being shut down or severely curtailed in hopes of stopping the spread of the coronavirus.
The Ponca Tribe is among those taking a hit. Its relatively new gaming facility, the Prairie Flower Casino in Iowa, shut down on Tuesday, after Chairman Larry Wright Jr. declared a state of emergency following confirmed COVID-19 cases in its service areas in Nebraska, Iowa and South Dakota.
On Monday, Wright announced a ban on travel for all employees and officials. Of the state of emergency, a contributing factor was the "shortfall in funding of IHS, and the impact that funding shortfall has on tribal nations," he said.
Such shortfalls are on the minds of many. In normal times, the IHS only meets about half of the needs of the 2.6 million American Indians and Alaska Natives the agency is supposed to serve.
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To start combating the coronavirus crisis, the U.S. Congress so far has approved $8.3 billion for federal agencies. But only $40 million was set aside for Indian Country, and advocates say that's not enough to help tribes and their communities, both in reservation and urban settings.
"It really paints a dire picture of what you're not getting access to, what you don't have, what you're not being communicated," Stacy Bohlen, the chief executive officer of the National Indian Health Board, said on a Tribal Leader Town Hall on COVID-19 that was hosted by her organization, the National Congress of American Indians and the Native American Finance Officers Association on Tuesday evening.
Tribal leaders have called on the Trump administration to set aside at least $120 million for the first Americans, a request that has not yet been answered. Neither has their request for the IHS -- rather than the Centers for Disease Control and Prevention -- to be in charge of the funds that are supposed to flow to Indian Country.
"The Indian Health Service has the cultural competency and the experience get the money out to tribes quickly," said Bohlen, a citizen of the Sault Ste. Marie Tribe of Chippewa Indians, whose nation is among the many that have shut down gaming operations.
"In order to achieve the greatest flexibility, we really have to have an eye for 638 self-determination contracting and compacting, which we currently don't have
with with the CDC," Bohlen added. That's not an option for the tribes."
— Navajo Nation President Jonathan Nez (@NNPrezNez) March 18, 2020
Tribes have asked the Department of Health and Human Services to execute an interagency transfer of the set-aside from the CDC to the IHS. Michael Weahkee, the Principal Deputy Director of the IHS, participated in the town hall but did not have an answer on the status of the request.
H.R.6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act, was the first vehicle Congress enacted to in response to the global pandemic. Title III requires "not less than" $40 million to be directed to Indian Country.
Two additional vehicles -- one of them is H.R.6201, the Families First Coronavirus Response Act, while the other is in development -- are making their way through the halls of Capitol Hill. Tribes are working closely with key lawmakers to ensure that funds flow to the IHS and to their communities.
"My guess is -- and it's only a guess -- it will be this week at the minimum to put together these things," Rep. Tom Cole (R-Oklahoma), a citizen of the Chickasaw Nation, said during the tribal leader town hall. "It will be in the next week before we know what is happening."
"There is an effort to move fast and big, if you will," Cole added.
The coronavirus has been confirmed in all 50 states, plus the District of Columbia and three U.S. territories. As of Wednesday morning, there have been at least 5,881 people who have tested positive for COVID-19. More than 100 have died, according to health authorities.
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