The email from Indian Health Services last Friday contained some good news — a shipment of badly needed respiratory masks was now available.

There was just one hitch: The warranty on the masks had expired — “beyond the manufactured-designated shelf life,” according to the email sent by an IHS official to directors of health care and community programs for urban American Indians around the country.

Although IHS maintains the devices are still safe to use, Indian representatives said the email shared with The Washington Times typified the response to coronavirus for their communities, where health care standards lag and some officials are bracing for disproportionate impact from the rampaging coronavirus threat.

An enrolled tribal member who works at a casino in Oregon became the first known American Indian to became infected with COVID-19 last week. The Navajo Nation convened a response team last month, but is now awaiting word on how recently appropriated congressional dollars will reach them. And on Sunday evening, the president of the Oglala Sioux Tribe discouraged anyone not living on the sprawling Pine Ridge Indian Reservation in southwestern South Dakota to stay away until further notice.

“In order to further protect the health and general welfare of the Oglala Lakota Nation, I strongly recommend the general public coming from off the reservation to visit, to postpone your visits until a time deemed necessary that the travel suspension is lifted,” said OST President Julian Bear Runner in a statement.

The 574 federally recognized tribes are facing an additional hurdle as the virus spreads: a fractious relationship with the federal government, which is required through treaties to provide health care in return for the past ceding of lands. Last week, President Trump signed a law freeing up $8.3 billion in funding to boost resources — from developing vaccines within the Office of Health and Human Services to community health centers for underserved groups — to fight the epidemic that now has claimed two dozen lives in the U.S. That funding included $40 million in for tribal health programs, ranging from rural reservation clinics to the 12 epidemiology centers around the country. But much of the money will come through grants to the states, and then, in theory, to tribal nations. That’s a process that makes many Native leaders wary.

“While Congress passed the funding, the mechanism to get the money to both the tribes and native health programs doesn’t exist,” said Abigail Echo-Hawk, director of the Urban Indian Health Institute in Seattle. “Do I think [congressional funding] is enough? Absolutely not. Is it a good start? Yes.”

Leaders of the Navajo Nation, home to more than 20 federally funded health care facilities, also expressed frustration with ambiguity on how funding will reach their tribal government, where preparation efforts — paid for out of the tribe’s general fund — are already underway.

“Those types of details we don’t know,” Navajo Nation President Jonathan Nez told The Washington Times on Monday. “Those questions are being asked not just by Navajo, but all tribes.”

The email regarding IHS’s issuance of past-shelf-life respiratory masks only illustrates the problems fighting coronavirus in clinics and facilities that have been historically underfunded.

“I strongly believe we’re going to see disproportionate impact in our communities,” said Ms. Echo-Hawk.

With tribes like the Oglala Sioux moving to impose their own restrictions, Tara Sweeney, the Interior Department’s assistant secretary for Indian affairs, told The Washington Times that tribal governments have a right to exercise “self-determination.”

“Indian Affairs respects a tribes’ right to exercise self-determination in formulating appropriate responses to the health and well-being of their members and community,” said Ms. Sweeney.

Officials with Navajo Nation — where there are, so far, no confirmed COVID-19 cases — did not say they had plans to implement a travel ban for persons living off-reservation. But they did say some federal health care workers pulled from IHS facilities in or near the Navajo Nation to aid in coronavirus cases elsewhere could face a tribally-imposed 45-day lockout if they returned.

“We could revisit a travel advisory,” said Mr. Nez. “That is within our right.”

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