Navajo Nation and Other Native American Reservations Hit Hard by Covid-19

https://www.cybercoastal.com/navajo-nation-and-other-native-american-reservations-hit-hard-by-covid-19/

127 40 6 years ago

dghughes• 6 years ago

About ten years ago H1N1 hit First Nations people really hard here in Canada. About 1/3 of the hospitalizations were First Nations women.

PDF http://www.nccah-ccnsa.ca/Publications/Lists/Publications/At...

gpm• 6 years ago

About 1/3 of the hospitalizations were First Nations women.

Huh? That doesn't sound right.... and indeed looking at your source it isn't... but in some sense it looks like it might actually be worse than that

Indigenous people accounted for 27.8% of all hospital admissions reported to PHAC during the first wave, but only 6.1% of hospital admissions during the second wave (Helferty et al., 2010).

Less than a third of hospitalizations were indigenous people (both genders), it seems, and later

Rolland Harris et al. (2012), for example, found that Indigenous women accounted for 16.2% of hospitalized cases, [... continued below]

So indigenous women are 1/6th of hospitalizations (which makes sense with 1/3rd of hospitalization being indigenous people). But

[... direct continuation of previous quote] 18.2% of ICU cases, and 50% of fatalities attributed to H1N1 influenza of those reporting ethnicity across Canada when both waves of the pandemic were combined.

Indigenous women were half of the total deaths???

I feel like something weird must be going on with these statistics.

danharaj• 6 years ago

https://www.cbc.ca/news/canada/manitoba/ottawa-sends-body-ba...

dmurray• 6 years ago

The article doesn't really go into why the reservations were worse hit than other US areas. They are "sovereign" "nations" so surely they have some autonomy to set their own lockdown, travel policies, and other responses to the pandemic.

Did they have even worse governance than the US generally? Or dense living conditions? Or particularly vulnerable age profiles? I get that they're not generally wealthy, but probably wealthier than places like Vietnam and Mongolia which contained the spread very well.

kingkawn3• 6 years ago

Reservations are prisoner of war camps from the 19th century that persist to this day. It is more illuminating to compare them to other similarly situated people around the world in terms of their social services and freedom to develop self governance

sterlind2• 6 years ago

It's more complicated than that, at least now. Having land, even crummy land away from the ancestral homeland, is better than not having land, because:

a) you can afford to live there, as an extremely economically disadvantaged group.

b) your tribe is in one place, instead of scattered, which makes it possible to continue to have a group identity and

c) you have at least limited autonomy.

I know people in tribes that have been shafted by the BIA and refused official recognition or land. It hurts. See the documentary "Promised Land" [0] for their account.

0. https://www.promisedlanddoc.com/

agilebyte• 6 years ago

From a news story here in Canada about Navajo - their nation is a "food desert" so people have to keep driving to the cities to buy everything, exposing themselves in the process (can't do Foodora/Uber Eats/Instacart). Lack of PPE seems to be a general problem as well.

TeaDrunk2• 6 years ago

Several native nations traded their land for the promise of acceptable healthcare as part of treaties, which has not been held up to standard.[0]

Additionally, native nations in fact have tried to set their own lockdown and travel policies. State governments have threatened them for doing so.[1]

[0]. "For Native Americans, Health Care Is A Long, Hard Road Away" - https://www.npr.org/sections/health-shots/2016/04/13/4738483...

[1]. "'I’m protecting my people': Tribal citizens defend coronavirus checkpoints amid threat from state" - https://www.indianz.com/News/2020/05/11/im-protecting-my-peo...

kgin• 6 years ago

I could see that affecting death rate, but not the rate of infection/spreading.

boomboomsubban2• 6 years ago

Health care on reservations is already generally far below most US standards, and then they aren't receiving much of the federal/state support specifically for this.

Reservations basically operate with only the local government. Imagine your town trying to source all the required goods themselves while there's a supply shortage.

voyager23• 6 years ago

Some tribes (Navajo Nation included) are still receiving direct health care. There's a huge hospital in Gallup, NM, as well as another in Shiprock. Health care is supplied by the federal Indian Health Services (of HHS). In no way should this be construed as "far below" most US Standards. Other tribes have opted out of direct health care preferring to receive Title 638 funds to administer for their health care. These tribes' health care naturally varies with the way the individual tribes administer their programs. The Navajo Nation is larger than the state of West Virginia, so the analogy of town-level government wouldn't seem to apply.

astine• 6 years ago

The Navajo reservation is one of the least densely populated parts of the country so that's not it. Lack of infrastructure is a bigger issue. Many if not most of these people live close to the poverty line and so don't have many options with regard to quarantine. It's not like they can stock up and stay inside for a month.

It's also not like the nation can just isolate from the rest of the country. Much of the nation lives and/or works off of the reservation in nearby towns and cities. Bear in mind that by-and-large, the Navajo are not living a traditional subsistence lifestyle anymore. They simply don't have the land or resources to do that so the reservations are not self-sufficient.

sgslo• 6 years ago

Anecdotal:

My mother-in-law works at a hospital adjacent to a large reservation. They're treating large numbers of natives.

She says people from the reservation refuse to practice any social distancing or wear PPE.

voyager23• 6 years ago

Having lived on reservations, Navajo Nation being one of them, I'd opine that the co-morbidities are the main contributing factor. The diabetes rates on the rez are many times that of the US population as are the rates of alcoholism. Also households are very often multi-generational and more crowded than in the US.

Yes, they do have their own lockdown policies. On a drive in western NC this past month, we had to turn around as the Qualla Boundary was blocked by tribal police.

prpl• 6 years ago

I grew up in Farmington, this was my first thought, but also the rate of homelessness off the rez has always been very high (also with the same comorbidities), throw in the drop in oil price over the last 5 years, you have an area with additional economic depression.

BurningFrog3• 6 years ago

PSA:

Vitamin D deficiency is a strong factor, not for getting Covid-19, but for bad outcomes.

It's especially common for people with dark skin, since that blocks the ability of producing Vitamin D from sunlight.

If that's part of what's happening to the Navajo, I don't know, but you should probably eat Vitamin D pills, especially during this indoor lockdown, and if if you have dark skin.

crmrc114• 6 years ago

https://nutrition.bmj.com/content/early/2020/05/15/bmjnph-20...

"There is no strong scientific evidence to show that very high intakes (ie, mega supplements) of vitamin D will be beneficial in preventing or treating COVID-19."

SpicyLemonZest• 6 years ago

I'm not sure how you managed to pull that quote out without reading the sentence immediately before it, saying that you should take a supplement during this indoor lockdown.

lordnacho• 6 years ago

But the GP says deficiency is the problem, not that having loads and loads will help.

BurningFrog3• 6 years ago

The virus is a few months old.

Strong scientific evidence usually takes a lot longer than that to establish.

Also: I'm not advocating "very high" doses. A normal daily supplement dose should be just fine.

pmachinery2• 6 years ago

He wasn't saying high intakes of vitamin D would prevent or treat COVID-19, he was alluding to a belief that vitamin D deficiency reduces the chances of recovery from COVID-19. Obviously to correct vitamin D deficiency people require high intakes.

It's not good for people to be just advising "eat vitamin D" though.

People should consult a doctor to determine a) to what extent they are deficient (or not), and b) that they have no health issues that make taking vitamin D dangerous.

scottLobster• 6 years ago

Joe Rogan had Dr Rhonda Patrick on a few days ago and gave a detailed rundown of the research into vitamin D vs Covid/respiratory illness in general, among other topics (timestamped to the start of Vitamin D talk but the whole podcast is definitely worth a listen)

https://youtu.be/4_ZJ8YDOX6g?t=1771

Vitamin D insufficiency has been strongly correlated to COVD-19 deaths and severe symptoms in various locations, although obviously more data is still needed to prove causation.

Either way unless you work outside you should probably be on 5000 IU of Vitamin D a day just to compensate for sunlight deprivation.

Kye• 6 years ago

This link will probably not work once his exclusivity deal kicks in.

danans• 6 years ago

Vitamin D deficiency is a strong factor, not for getting Covid-19, but for bad outcomes.

It might be a strong factor - this isn't yet demonstrated conclusively by enough peer reviewed studies yet, so it shouldnt be described as conclusive. Thankfully, there a long history of vitamin D supplementation, so unlike hydroxychloroquine, it isn't likely to increase death rates. At worst it might just do nothing.

Also, a number of common foods contain or are supplemented with vitamin D. Assuming that somebody has no fundamental issues with vitamin D absorption from food, a typical healthy diet that includes some of those foods should be sufficient to keep a person out of vitamin D deficiency, with no pill-based supplement needed.

teknopaul3• 6 years ago

Stats indicate that Vit D defficiency is very common. i.e. a typical diet does not provide enough vit D.

A "typical healthy diet" can provide even less vit D since much of the vit D consumed it from fortified milk and breakfast cereals.

I think a lot of people would benefit from boosters right now. As you say, it does no harm.

dehrmann• 6 years ago

It's especially common for people with dark skin

The Navajo have been in the general area (the US forcibly moved them, but the latitudes are similar) of where they are now for a long time. Their skin tone should be well-adapted to the region, unless they're not going outside.

BurningFrog3• 6 years ago

Yeah, I'm not sure how much this applies to the Navajo on the reservation specifically.

If they're living a regular American lifestyle, which often produces Vitamin D deficiency even for the palest white people, they will be affected even more.

But I mostly intended this as general advice for the HN readership.

teknopaul3• 6 years ago

Only 600 years per wikipedia.

protomyth2• 6 years ago

The tribe where I currently work and used to live has taken action. There is a 10PM curfew, a ban of gatherings, and no official travel allowed. If you leave the state or go to three of the more populated cities (because they have cases), you are a required to self isolate for 14 days before returning to work. The community college is online only for the summer.

The casino had a very limited reopen with a lot of social distancing rules, but not a whole lot of enthusiasm from workers since most make more on unemployment than working. Basically, opened for the fishing crowd.

I would imagine the two main causes are housing and IHS. Let's face it Indian Health Service is not that good and actively a problem under the best of circumstances. A politician who actually believes in government provided health care could go a long ways to proving it by making IHS work. Search for "don't get sick after June" for a documentary on the subject. They did two very credible attempts to kill a couple of family members and misdiagnosing AIDS without waiting for test results didn't help my friends marriage one bit. I do admit to still being a might bit bitter over having to have three operations to fix a botched root canal.

The second is housing. Housing is scarce on many reservations which means large family groupings. Now, I understand some visitors from DC think its great that families live together like "the old days", but its not great, or cultural, and it sucks. Overcrowding isn't fun and not having access to the normal (e.g. mortgage from bank) with going through the tribe or a special program is really an issue. A former college president lived in his parents basement until he and his wife could afford to buy a house outright (well, a mobile that they moved). Its gotten better in recent years (better federal program), but large crowded houses get infected fairly fast.

The National Guard has been doing mass testing in ND and did do one on the reservation. It looked well organized and they were pushing a lot of people through. I was told later (we had the window blinds to the parking lot closed to avoid any privacy violations) that they had no positives.

I do wonder about the statistical differences between reservations and versus the general population. I am not always confident on the reported statistics.

Navajo Nation and Other Native American Reservations Hit Hard by Covid-19

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