Connie Chan

Brooke Warren

Phuoc Le

By PHUOC LE MD, CONNIE CHAN and BROOKE WARREN

Since the World Health Organization (WHO) officially declared COVID-19 a pandemic on March 11, 2020, we have been changing our daily lives to protect the highest-risk populations: older adults and people with chronic medical conditions. We are asked to follow sensible guidelines like social distancing and thorough hand-washing. Although one may have a gut-reaction to put their own safety at the forefront during these times of crisis, it is essential that we are taking the necessary steps to protect populations with additional vulnerabilities – rural tribal communities.

With the announcement that COVID-19 reached the Confederated Tribes of Umatilla Indian Confederation on March 9, 2020, it was evident the virus would not stay confined to urban and metropolitan centers like some previously predicted. The experience in China with COVID-19 clearly reflects the vulnerability of rural communities because many people travel routinely from urban to rural. Experts who conducted an epidemiological study in Hubei province, the initial epicenter of the COVID-19 pandemic, noted in their report: “…most public medical resources are concentrated in cities but are relatively scarce in rural areas. Therefore, prevention and treatment of 2019-nCoV in rural areas will be more challenging if new phases of the epidemic emerge.”

Figure 1. The site in South Seattle where King County placed several temporary housing units to house patients undergoing treatment and isolation in response to COVID-19 (source here).

Dalee Sambo Dorough, Ph.D. (Inupiaq) reminds us that American Indian/Alaskan Native (AIAN) people have “had a whole history of epidemics that have devastated [their] communities in the past.” These historical traumas are compounded by the reality that more AIAN people have underlying health conditions, putting them at even greater risk for morbidity and mortality due to COVID-19. For example, in 2010, the Indian Health

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