Native American tribes brace for coronavirus: 'It's going to be a test'

The normal sound of students shuffling through the hall has been replaced by silence at Marty Indian School, a kindergarten to grade 12 facility on the Yankton Sioux Tribe's reservation in South Dakota.

Following in the footsteps of other school officials across the country, Superintendent John Beheler said the decision was made to close Marty Indian on Thursday and Friday ahead of this week's spring break. It comes after an Indian Health Service patient in Charles Mix County, where the school and reservation are, tested positive Wednesday for COVID-19, the disease caused by the coronavirus, health officials said.

An Indian Health Service official said the person had traveled to a conference in the United States, and others who came into contact with the patient were being tested as well.

"We'll have to start looking at relational ties to the individual and if there are any relatives in attendance in our school," Beheler said.

Even in this sparsely populated prairie land of rolling hillsides and bluffs, the paralyzing effects of the global coronavirus outbreak have hit home.

The tribe on Friday approved a "declaration of disaster," which means its offices will be closed this week for cleaning, while employees are banned from traveling to major cities and states affected by the virus, and the tribe's 9,000 members are being asked to stay away from public gatherings. For students at Marty Indian School, a plan to see the Minnesota Timberwolves play the Los Angeles Lakers this month was abandoned after the NBA announced it is suspending the rest of the season.

"Demographically, we have a situation here that a lot of our kids live with elders and their grandparents, and so we have to take these precautionary measures," Beheler added.

But leaders of Native American tribes across the country acknowledge that it's only a matter of time before they may be thrown into a similar situation as the Yankton Sioux, and have begun banning forms of travel and declaring a state of emergency.

Most pressing is the need for federal funding that can provide medical supplies and testing kits, said Jonathan Nez, the president of the Navajo Nation, the largest tribal reservation in the United States spanning the corners of Arizona, New Mexico and Utah.

"We're asking Congress to intervene to make sure that we get the funding we need," Nez said.

This month, Sen. Tom Udall, D-N.M., the vice chairman of the Senate Committee on Indian Affairs, led a bipartisan group of 27 senators to ask Vice President Mike Pence to ensure all tribal leaders and urban Indian health departments are not left out of the conversation to combat the coronavirus and are provided with the $40 million in funding for their efforts.

The House of Representative's emergency relief package, which is awaiting Senate approval, allocates $64 million to the Indian Health Service to address the coronavirus' impact on the more than 2.5 million American Indian and Alaska Native population the agency services.

The amount, however, still falls short of the $94 million for emergency funding sought by the National Council of Urban Indian Health. But council spokeswoman Meredith Raimondi said it's still an improvement from when Urban Indian Organizations missed out in past emergency funding, such as for the Zika virus.

"Our biggest concern right now is that there's not really a funding mechanism for the CDC to distribute funds to Indian country," Raimondi said, adding that she'd like to see an interagency agreement coordinate funding.

"Because of bureaucracy, it can take a while," Raimondi said.

The majority of Native Americans don't live on a reservation, she added, but many still get health care through Indian health programs.

Udall said the Trump administration's "insufficient response" to COVID-19 could leave Native American communities to "bear the worst costs of this public health crisis." He told NBC News that his office is in contact with federal agencies to make sure funds are dispersed swiftly, there's a funding release timeline and that coronavirus testing is accessible in Indian country.

On Wednesday, Udall introduced a bill that would allow tribes to apply directly to the CDC's public health emergency preparedness program, which provides states and some cities access to federal resources meant for getting them ready for public health emergencies. Tribes are currently ineligible.

"Tribal communities face unique challenges in responding to public health threats, and we need to do everything we can to make sure that Native Americans don't get left behind," Udall said.

The potential spread of the coronavirus on reservations is compounded by already existing disparities affecting the Native American population, including barriers to accessible health care, poor health, unemployment and generational poverty.

In 2017, the chairman of the Yankton Sioux Tribe, Robert Flying Hawk, testified before the U.S. Department of the Interior's Bureau of Indian Affairs about how the closing of inpatient care at an Indian Health Service hospital and the shuttering of a 24-hour emergency room had created hardships for his community.

A series of extreme weather events that devastated South Dakota last year and affected reservations, including the Yankton Sioux, exposed how difficult it was for tribes to get federal funding.

The Pine Ridge Indian Reservation, home to the Oglala Sioux Tribe in South Dakota, was in a state of emergency a year ago because of the extreme flooding.

On Tuesday, Oglala President Julian Bear Runner declared a state of emergency because of the coronavirus. He said the tribe had still not received any testing kits from the federal government.

"Who knows how long we will be walking with this disease and not be able to properly diagnose that, quarantine and treat those who have been affected," he told the Argus Leader. The tribe has also banned travel for tribal employees.

As of Saturday, South Dakota reported one death related to the coronavirus: a man in his 60s with underlying health conditions.

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In an email, Indian Health Services told NBC News that all of its facilities are capable of testing patients for COVID-19 at no cost. After the case in Charles Mix County, the agency added that it is "working closely with [South Dakota] to identify anyone else in the community who has been in close contact with the patient and may need to be tested."

In eastern Oregon, the Confederated Tribes of the Umatilla Indian Reservation had to temporarily close its casino last week after an employee contracted the coronavirus. Tribal officials said there were no known cases involving tribal residents.

The Navajo Nation has also declared a state of emergency, although there were no confirmed cases of the coronavirus on the reservation as of Saturday. Some residents have been tested, but the testing was done through state health departments, not through Indian Health Service, which could reach more people.

Nez said his COVID-19 Preparedness Team is monitoring the states and counties within the reservation and community health representatives have been going door to door to check on the elderly and other vulnerable people. At least 30 to 40 people have been tested, with drive-up testing also available in New Mexico.

To get the word out to more people, tribal leaders announced the translation of COVID-19 into the Navajo language: Dikos Ntsaaígíí-Náhást'éíts'áadah.

The Navajo Nation is susceptible to the spread of the virus as a popular tourist destination and the home of four casinos, Nez said. Arizona has tracked at least 12 coronavirus cases, while New Mexico has had at least 10.

The reservation dealt with its own outbreak in 1993 of the hantavirus, a severe pulmonary disease spread by rodents. The mortality rate for the Navajo was 44 percent, higher than the general population, according to a 2016 federal government report.

"It's going to be a test," Navajo member Vernon Livingston, 38, said of the response to the latest outbreak.

Livingston, who lives on the reservation near Window Rock, Arizona, said the news of the coronavirus has sent people panic-buying toilet paper and food at markets. While he applauds the community health representatives and tribal leaders with making sure residents understand the coronavirus, Facebook remains the common way for people to share what's going on.

He worries about the stigma of dealing with illness and some people seeking the use of medicine men and local traditionalists with warding off a new disease that currently has no vaccine.

"If people start getting sick, us Navajos will think of how we're going to fix it," he added. "A lot of us Navajo men can be really stubborn about going to the hospital - we think, we'll stay home and fight it. But this is something different."