Tribal Programs That Prepare For Public Health Crises Readying For Coronavirus Native health services are preparing for the eventual arrival of the coronavirus on reservations and in Native communities, but the system is already strained.

Tribal Programs That Prepare For Public Health Crises Readying For Coronavirus

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Coronavirus cases have popped up in Native American communities around the country, and now reservations are scrambling to prepare for more. The federal government is sending more money to the tribes, but right now resources are few. The Indian Health Service says it has 10 ventilators and six intensive care unit beds in the entire nation. It treats a population of more than 2.5 million. Eilis O'Neill has the story of tribes in the Northwest.

EILIS O'NEILL, BYLINE: The Shoalwater Bay Reservation is in southwest Washington, right on the Pacific Ocean. Kim Thompson is the tribe's health director.

KIM THOMPSON: This is where we have it set up so patients can come in through this back door. And then we have our masks and everything. Oh, here's...

UNIDENTIFIED PHYSICIAN: Hello. Hi.

THOMPSON: ...Our doctor right here.

O'NEILL: Thompson says the tribe's clinic will soon be able to take swabs from patients and send them off to a commercial lab to test for the novel coronavirus.

THOMPSON: We haven't set up the gowns or anything since we don't have all the testing material here yet.

O'NEILL: Shoalwater Bay is small and isolated, with about 100 residents, one gas station and a small casino.

THOMPSON: Funding is a unique challenge. We have a budget that we're allotted every year by Indian Health Services. And when that money runs out, then the - you know, we have to count on our third-party revenue.

O'NEILL: That is, payments from insurance companies.

VICKI LOWE: The smaller tribes are the most hit.

O'NEILL: Vicki Lowe is the director of Washington state's American Indian Health Commission and a descendant of the Jamestown S'Klallam Tribe. She says many tribal programs to prepare for public health emergencies like this one are strapped. Some rely on less than $5,000 of funding a year.

LOWE: So when there's an outbreak, an emergency like this, it just stretches them even thinner.

O'NEILL: Some tribes are closing their casinos to avoid spreading the novel coronavirus. Others are enacting rigorous cleaning procedures.

LOWE: If they have to close down a business, then they might lose some of their cash flow to help fund their staff.

O'NEILL: The Indian Health Service is distributing additional coronavirus funding, but it works out to only about $70,000 per tribe. And smaller tribes could get much less than that. Experts say that's a drop in the bucket compared to what's needed to pay for testing kits and for personal protective equipment for health care workers. And isolating and caring for infected community members will also require resources.

Lowe says, another challenge for tribes is that many of their members are medically vulnerable.

LOWE: American Indians and Alaska Natives do suffer from higher cardiovascular disease, asthma. Those chronic diseases make them at higher risk if they do contract the virus.

TONY JOHNSON: And we could imagine a situation where every speaker of a language could pass away.

O'NEILL: That's Tony Johnson, who's chairman of the Chinook Tribe just next door to Shoalwater Bay.

JOHNSON: The fluent first-language speakers of the languages of the Pacific Northwest are basically all in the demographic that is at really high risk.

O'NEILL: Johnson says memories of smallpox are also putting Native people on edge during this new pandemic.

JOHNSON: We live in a community where, again, not very long ago, more than 90% of our community died from imported disease.

O'NEILL: Johnson says he wants to make sure that doesn't happen now.

JOHNSON: Our real goal is to take care of our community that's endangered by this virus as long as it takes to get a vaccine.

O'NEILL: He's taking precautions, like not allowing his 9-year-old daughter to visit her grandparents. To protect the community's elders, Johnson has also canceled all tribal events, including a big annual storytelling gathering.

For NPR News, I'm Eilis O'Neill in southwest Washington.

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