Posted on May 4, 2020

Underfunded Native Nations Battle Coronavirus Outbreaks

Reid Wilson, The Hill, May 3, 2020

Native American health systems are stretching to a breaking point under a growing number of coronavirus cases flooding into rural clinics and hospitals that are unprepared for the case load.

At least 3,600 cases of COVID-19 have been confirmed by the Indian Health System. The vast majority of those cases are in Navajo Nation, where more than 2,200 people are sick.

There were stretches in April during which the number of coronavirus cases per capita was growing as fast in the Navajo Nation as in New York City, the epicenter of the American outbreak.

“We’ve been hit very hard with COVID in the Navajo area,” said Loretta Christensen, the chief medical officer of the Navajo Area Indian Health Service. “Our emergency operations center is working 24 hours a day, seven days a week.”

The Indian Health Service, a division of the federal Department of Health and Human Services, has opened three sites to handle coronavirus patients across Navajo land, one in Arizona and two in New Mexico.

Michael Toedt, the chief medical officer of the Indian Health Service, said the agency was working to dramatically expand testing and that the federal government had already distributed $1 billion in COVID-related funding to tribal governments, appropriated through the first three rounds of relief legislation passed in the last six weeks.

The Navajo Nation isn’t the only tribe to suffer; IHS teams have confirmed more than one hundred COVID-19 cases through its Albuquerque, Nashville, Phoenix and Portland offices. In Wyoming, four members of the Northern Arapaho tribe have died of the disease, more than half the total number of coronavirus deaths in the state. Dozens of members of the Cherokee Nation and the Choctaw Nation in Oklahoma are sick, as are more than 30 members of the Mandan, Hidatsa and Arikara Nation in North Dakota.

In Oregon, the virus claimed the life of Bobby Begay, the leader of a village in Yakama Naton.


Many Native nations are in remote rural areas where cell phone service is limited, complicating basic epidemiological practices like contact tracing. But their remoteness has also helped delay the arrival of the coronavirus, and several tribal governments have taken steps that are more proactive than local non-tribal governments. Tribes in Montana issued shelter-in-place orders before the state did. The Navajo Nation is under curfew.


Native hospitals and clinics are also plagued by a chronic staff shortage.


The billion dollars that has already been allocated to Native governments is only a first step. The federal CARES Act included $8 billion in funding for Native nations, the largest amount ever appropriated by the federal government to tribal governments. Included in a $20 billion provision funding hospitals is another $400 million carved out for tribal hospitals, said. Rep. Tom Cole (R-Okla.), a senior House appropriator and a member of the Chickasaw Nation.


Still, some in Congress said they planned to push for more funding for tribal governments.


Some are concerned that even after Congress appropriated so much money to tribal governments, that money has been delayed in arriving. {snip}