Yahoo奇摩新聞 Worried about COVID-19, Navajo Nation ignores CDC, keeps masks and social distancing
As the COVID-19 pandemic began spreading across the world, Graham Beyale at first figured he'd be safe inside his home along the dusty red dirt roads of the Navajo Nation reservation.
But as more news came out about how the virus spread – and how quickly – Beyale got nervous. At the time, he was living in a traditional one-room home called a hogan with 11 other people. No running water. No toilet.
Like many of his 400,000 fellow Diné, most of whom live on the 27,000-square-mile reservation sprawling across northern New Mexico, Arizona and a small portion of southern Utah, Beyale, 31, knew medical care could be a long drive away. And the Navajo, who have high rates of diabetes and obesity, have historically been susceptible to viral infections, including the 2009 H1N1 swine flu epidemic.
Worried about protecting both his own health and of those around him, Beyale moved into a tent, powering his cellphone via solar panels. He still lives there today, wearing a mask for the rare times he's around others, even though he and most other Navajo have been vaccinated.
A year after experiencing one of the deadliest COVID-19 outbreaks in the nation, the Navajo Nation is rapidly approaching herd immunity via an aggressive vaccination campaign. Still, tribal leaders said they will continue to require curfews, gathering limits and masks, even though federal health guidelines state those restrictions are generally unnecessary among vaccinated people.
Health experts and Navajo alike said generations of lessons about how susceptible Native Americans are to outside diseases and infections have taught them to be extra-careful about public health.
"On the Navajo Nation, you have a collective mentality that's there: 'What I do affects the people around me, my family, and therefore I need to be more responsible and more careful, because it's not just about me,'" Beyale said. "So I don't mind wearing a mask. I don't mind getting vaccinated. Because if there are still people who are dying from this virus, then I have an obligation to take of myself and the people around me."
COVID-19 hit Native Americans hard
COVID-19 hit many urban, coastal areas hardest at first, then quickly sickened Native Americans across the country. Native Americans were 3.5 times more likely to get the coronavirus than non-Hispanic white Americans, and their mortality rate was twice of white Americans, according to Centers for Disease Control and Prevention data.
Native Americans were also more likely to get sick younger than other Americans; 40 years old was the average age of the infected, compared with 51 for white Americans. Early data showed that COVID-19 case rates among Native Americans were nearly 600 per 100,000, compared with 169 per 100,000 for white Americans, according to data the CDC acknowledges probably understates the severity of the situation because of poor data collection on COVID-19 cases and race and ethnicity.
Today, more than 70% of the eligible population served by the Indian Health Service on the Navajo Nation has been fully vaccinated, giving the reservation one of the highest vaccination levels nationally, tribal officials said. Overall, more than 104,000 people have been fully vaccinated, and health officials are now working on kids ages 12 to 15.
Although they are now permitting in-person gatherings of up to 15 people and gradually allowing roadside craft sales, tribal health officials said they're unlikely to relax the restrictions, especially because they're also considering reopening to visitors. Tribal parks, including the popular Monument Valley and Antelope Canyon areas, have been closed for more than a year, eliminating a major income stream from tourists.
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The CDC has said vaccinated people can resume normal activities without wearing a mask or distancing if allowed under local or state rules. Navajo officials said tourists from other areas will still be required to wear masks when visiting, at least in the short term.
The caution exercised by the Navajo reflects both a traditional belief in the importance of community and the knowledge that Native Americans have to look after themselves. Centuries of mistrust and broken promises by state and federal officials have left some Navajo skeptical, at best, of outsiders.
Notah Ryan Begay III, 48, said most of his fellow Navajo understand that the reservation's health care system could easily get overwhelmed again. Begay, a former professional golfer, now runs a nonprofit dedicated to improving health and wellness education for Native American young people. He said longstanding health inequities faced by the Navajo and other Native Americans, in part driven by the past "extraordinary human rights violations” committed by white settlers, have made tribes cautious.
“We can ill afford another outbreak," he said from Albuquerque. "What tribal leaders have learned is that in times of desperation, in times when resources are limited, we’ll be the last in line.”
Navajo officials locked down the reservation on March 20, 2020, but by May Navajo Nation had the highest per capita infection rate in the United States.
Overall, at least 1,300 Navajo Nation residents have died from the pandemic, with two-thirds of the dead ages 60 and older, according to tribal officials. That's a devastating loss of culture and history to a people who depend heavily on their elders for traditional teachings, language instruction and day-to-day guidance, tribal officials said.
The Navajo are the largest Native American tribe in the United States. The majority live on the reservation, which is about the size of West Virginia. As many as 40% of reservation residents, including those in Beyale's hogan, lack running water or electricity at home, which makes it hard to follow even the most basic of pandemic-fighting guidance: Wash your hands.
"One of the things that the pandemic has shown is how fragile the system is," Beyale said. "It was crazy when it came to the U.S., but when it came to the Navajo Nation, it was even more extreme."
Recognizing the disproportionate impact the virus had, the federal government poured more than $9 billion in aid to the Indian Health Service, which oversees clinics across reservations nationally. The Federal Emergency Management Agency has been assisting with vaccination and testing logistics.
Navajo Nation President Jonathan Nez said the hard lessons of smallpox, tuberculosis and swine flu prompted his leadership team to act more strictly than state and municipal governments in surrounding states. As a sovereign nation, the Navajo run their own schools, health care and government.
Nez said that at first, the lockdowns offered an unexpected benefit: Young people stuck at home had more time to learn directly from their elders. But that tradition of having multiple generations under the same roof also made it easier for the pandemic to spread.
"The Navajo people, when this virus came into the nation, it hit us at our weakest," Nez said in an interview in March. "We like to be in multigenerational dwellings or homes. That's who we are. We have our aunties and uncles living with us, grandmas and grandpas. And once the virus came into the household, it just spread quickly."
Nez said the lack of protests against mask mandates, curfews and other control measures demonstrated the Navajo's strong sense of community responsibility. And their willingness to maintain the restrictions reflects their understanding of why they're important, he said.
"We could have been hit a lot harder, it could have been a lot worse, if it wasn't for the Navajo people respecting their public health professionals," he said. "We are seeing the light at the end of the tunnel, transitioning out of the worst part of this pandemic."
Today, Nez said he's not sure when Navajo Nation health officials might recommend relaxing the restrictions, and he has set a vaccination goal of 75%. He remains concerned about the spread of coronavirus variants across the reservation.
"I know you heard CDC say you don't have to wear a mask if you're fully vaccinated," Nez said at a public briefing this week. "The thing there is, how do we know people are vaccinated? We are being very cautious because we have been hit hard here on the Navajo Nation."
Libby Washburn, a White House special assistant to the president for Native affairs, said tribes across the country have done an "incredible job" of responding to the pandemic after the initial outbreaks. She said high case rates startled many experts, along with tribal health officials, and the Biden administration respects tribal authorities' legal rights to set their own policies based on that experience. The Navajo Nation has had more than 30,000 confirmed cases.
Washburn said federal officials continue to prioritize access to testing, vaccines and the logistics needed to get shots in people's arms.
"I think the whole country was watching as they dealt with it, and they dealt with it admirably," said Washburn, a member of the Chickasaw Nation of Oklahoma who has worked extensively in New Mexico. "With the number of deaths, it really shook them, that this was really serious. We're proud of what they’ve done, proud of what all of the tribes have done, all across Indian country."
'They've done the best job'
Just off the reservation at the 105-year-old Cameron Trading Post near the east entrance to the Grand Canyon, longtime general manager Josh Atkinson, who is white, said he understands why his neighbors and friends are being cautious.
Atkinson's family is now in its fifth generation running the post, which sells Navajo frybread tacos along with crafts from Plains, Pueblo, Hopi and Navajo artists, including elaborate hand-woven traditional blankets. Most of the staff is Native American, he said.
The trading post was having its best month ever in March 2020 when the Navajo Nation ordered a shutdown. And while the post isn't on the reservation, Atkinson said, he thought it best to respect the Navajo Nation's rules.
“We felt that their protocols were the right way to go. And we still feel they’ve done the best job," he said. "None of our employees ever contracted COVID at work, but they lost family, they lost friends. We had to take what we felt was the best route.”
Atkinson, 56, said the post is still reeling from the loss of on-site weaver Elsie Glander, who died in November at 75 after she became infected with the coronavirus. An unfinished rug sits on the loom where she worked for years, awaiting the hands that once weaved $55,000 heirloom collectibles.
“Her loom is still sitting there, almost like a memorial to her," Atkinson said.
Atkinson said the trading post is slowly getting back to normal, with limited dining and a growing number of tourists stopping by. He said it's time for the Navajo Nation to start opening to the public, which would help his business.
“Do I think they’re being a little too conservative so right now? I do. But the Navajo Nation president and the governor of Arizona haven’t called me for my opinion," he said.
He added: "A certain amount of conservatism doesn’t hurt."
Back in Shiprock, Beyale is still living in his off-grid tent, where he plans to stay as he practices native farming and land management. He'd always wanted to focus on that, he said, but the pandemic brought home to him how dangerous it is for the Navajo to depend on outsiders for even basics like food. Most of the reservation is considered a "food desert" by federal officials because of low incomes and long drives to grocery stores.
Beyale said strengthening the tribe's true sovereignty, not just by exercising its rights to issue public health orders but by growing its own food, would help it better weather coming problems, including the next pandemic.
"I'm really looking to reground myself and reestablish my relationship with my environment, with the ground, with water, with my food," he said. "That's who we are as a basis of people, as Diné – our relationship with each other and with the environment around us, this idea of kinship that extends beyond our own species. I want to show what's possible, that you don't have to compromise so much of ourselves and the land just to survive."
This article originally appeared on USA TODAY: Navajo Nation ignores CDC, fights COVID with masks, social distancing
