Tribal Nations and the Pandemic: What Worked and What Didn’t Work

Despite huge loss of life during the COVID-19 pandemic, tribal nations have led the way in immunization, witnesses said at a hearing Tuesday of the House subcommittee for state indigenous peoples -United.

“We consider our work with IHS [Indian Health Service] be successful, ”said Rodney Cawston, president of the Colville Business Council for the Confederated Tribes of the Colville Reservation in Nespelem, Washington.

The IHS-Colville Tribes collaboration has enabled 40% of the vulnerable population of these tribes – approximately 3,000 patients with underlying health conditions – to receive a vaccine.

And about 850,000 doses have been administered by IHS in Alaska as of March 22, said William Smith, president and Alaska region representative for the National Indian Health Board. In some communities, vaccination rates for the elderly have even reached 90%, he said. Alaska was the first state to open vaccine eligibility to anyone over 16.

Charles Grim, DDS, MHSA, secretary of the Chickasaw Nation Department of Health in Ada, Oklahoma, said more than 35,000 vaccines have been administered to Indians and non-Indians.

He also noted that due to non-essential business closures early in the pandemic, as well as effective screening, testing and contact tracing, the Chickasaw Nation was able to maintain a 7-day deadline. . positivity rate it was 50% below community and state. The nation has also developed the “Chickasaw Caring Chalets“where people who contracted COVID-19 could self-isolate.

Delays in urban areas

Despite these successes, some Native Americans and Alaska Natives, especially those in urban areas, are still waiting their shot.

Francys Crevier, who identifies as Algonquin and heads the National Council of Urban Indian Health in Washington, said some Urban Indian organizations (UIOs) were “very impressed” with their “Neighborhood office” – one of the twelve regional offices under the aegis of the IHS which serve a specific geographical area of ​​the country – and its capacity to distribute vaccines.

Still, “some of our employees are going back to booking to get the shot,” said Crevier, who said she personally weighed the risk of traveling by plane to get the shot.

One of the reasons for the delay in distribution to urban Indian groups was communication problems between UIOs and federal agencies, such as the Department of Health and Human Services.

For example, the deadline for deciding whether to receive an IHS or state vaccine has not been clearly communicated to UIOs nationally, Crevier explained in his written testimony. Some UIOs learned of the deadline from regional offices, but because there was no “national communication” from HHS, many UIOs were unaware of the deadline and “felt rushed” in their selection.

She urged the subcommittee to ensure that in the future, agencies with jurisdiction over urban Indian health (HHS, CDC) communicate directly with UIOs. Currently, IHS has a policy that only requires it to “confer” with UIOs, she said.

While more vaccines are definitely needed in general for tribal people, Crevier stressed that she did not want to see doses taken from other tribes and given to UIOs.

Indian health challenges

Beyond the deployment of the vaccine, tribal leaders told the subcommittee, which is part of the House Natural Resources Committee, some of the reasons for the disproportionate number of deaths from COVID-19 among tribal people. According to a 2020 CDC report, the age-adjusted mortality associated with COVID-19 in Native Americans / Alaska Natives was 1.8 times that of non-Hispanic whites.

Subcommittee chair Teresa Leger Fernandez (DN.M.) noted that even a year after the pandemic, “the Native American and Native populations of Alaska continue to have high rates of infection, hospitalization and highest COVID-19 hospitalizations. mortality rate in the countryside.”

Adrian Stevens, acting chairman of the board of directors of the National American Indian Housing Council in Irving, New York, explained that in many tribal communities, three or more generations live under one roof, which makes it “impossible for families. to practice safe social distancing ”.

He also noted that less than 10% of homes on Native American lands have interior plumbing, according to a Housing evaluation report 2017 Ministry of Housing and Urban Development, making it difficult to take basic pandemic precautions, such as frequent hand washing.

Lack of funding to meet the health needs of the tribal people is a perennial problem, Crevier said. She pointed out that the Recommendation of the National Tribal Budget Formulation Working Group for IHS for FY2022 is just under $ 13 billion with around $ 201 million earmarked for urban Indian health compared to $ 63 million currently.

“A celebrity bill”

Rep. Don Young (R-Alaska), a prominent member of the subcommittee and longest-serving member of the House, recommended that Fernandez work with other members on drafting a “new bill on Native Americans “to address the tribal issues of housing, water, sewage, education, transportation,” you name it, “he said.

“Do it [an attention-getting] the celebrity bill … so that we can really get something to the front, ”said Young, who telephoned the hearing. talk and not much action. “

Fernandez told Young: “You couldn’t see all the smiles and nods when you suggested such a historic and comprehensive Native American bill… Alaskan and Hawaiian.”

Last updated on March 25, 2021

  • Shannon Firth has been reporting on health policy as a MedPage Today Washington correspondent since 2014. She is also a member of the site’s Enterprise & Investigative Reporting team. To follow

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