UPDATE AS OF APRIL 1, 2020

Navajo Nation is currently experiencing one of the largest outbreaks of COVID-19 among any Native community in North America. Navajo Nation press releases document the spread, which I summarize here.

The outbreak began on March 17, in the small hamlet of Chilchinbeto, located between Chinle and Kayenta in Navajo County. The first victims had recently traveled and are thought to have acquired the disease outside the reservation, but then unknowingly brought it back home with them. Infected people are contagious for one to two days before showing symptoms. Some people may be completely asymptomatic, but are still contagious. The outbreak quickly grew to 10 cases two days later, possibly thru a church service, and Chilchinbeto was put under lockdown. By March 21, cases appeared in Coconino, Apache, and McKinley Counties, either spread from Navajo County or possibly arriving independently from elsewhere.

As of March 31, the Indian Health Service reports that nearly 1,500 people have been tested, with only 9% of those tests coming back positive. This low rate of positive tests is typical of national trends.

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Seven people have died so far. New Mexico Governor Lujan Grisham reported, “we’re seeing a much higher hospital rate, a much younger hospital rate, a much quicker

go-right-to-the-vent rate for this population. And we’re seeing doubling in every day-and-a-half.” Ventilators can save lives, but experience from New York City shows that less than half of patients put on a ventilator survive. Navajo Nation may be especially vulnerable due to its high population of elders, as well as high rates of obesity and diabetes, all of which make COVID-19 more dangerous. The nearest major hospitals are several hours away, in Flagstaff and Gallup, though the early patients were transported all the way to Phoenix.

The data on confirmed cases, above, imply a doubling rate of every four days, slower than what Governor Grisham stated but still incredibly fast. Shelter in place orders are now in effect. Preliminary data from Washington and California show this can be successful in slowing the virus, making it the single most important measure. Studies have shown that if isolated family groups continue to each interact with one outside person, the benefits self-quarantine are essentially lost. Six to ten feet physical distancing from those outside a family group should be maintained at all times– and even attempted within family groups.

Because many elders live in and widely scattered homes, they need support obtaining groceries and other necessities. Extreme care should be taken while shopping and delivering food. Navajo Nation has also asked for more personal protective equipment (PPE), such as masks.