COVID's assault on Native Americans

The coronavirus has taken a devastating toll on indigenous communities across the U.S. Here's everything you need to know:

How bad were the outbreaks?

Native Americans and Alaska Natives have been hit harder by the pandemic than any other community in the U.S. They are 3.5 times more likely to be infected with COVID-19 than whites, and are 1.8 times more likely to die from the disease, according to the Centers for Disease Control. Nationwide, 1 in every 475 Native Americans has died from the coronavirus, compared with 1 in 645 African-Americans, another hard-hit group. In Mississippi, 1 in every 127 indigenous people has died of COVID-19; in the Navajo Nation — a sprawling reservation that straddles Arizona, New Mexico, and Utah and is home to 175,000 people — more than 1,150 have died, a rate of about 1 in 160. Last May, the reservation registered the highest infection rate in the U.S. The pandemic has worsened severe substance-abuse issues and poverty on reservations, in part because of the shuttering of Native-run casinos. "Everyone has been impacted," said Amber Kanazbah Crotty, a Navajo tribal council delegate. "Some families have been decimated."

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Why such a heavy toll?

It's partly because Native communities are so poor, and have had such limited access to health care. In some remote areas, there is one hospital for an area the size of Delaware, and the Indian Health Service, a federal program that serves 2.6 million people, is underfunded and understaffed. A third of Native Americans live in poverty, and the population disproportionately suffers from chronic health conditions — including obesity, diabetes, liver disease, hypertension, and respiratory disease — that heighten the risk of dying from COVID. Even before the pandemic, Native Americans had an average life expectancy 5.5 years lower than the national average. "We're more at risk [of COVID] because we are Native people living in the U.S., where we have been experiencing this kind of oppression for the past 500 years," said Abigail Echo-Hawk, chief research officer at the Seattle Indian Health Board and a member of the Pawnee Nation. Many Natives live in crowded, multigenerational households, exacerbating spread to vulnerable old people. As of mid-January, 565 of the Navajo Nation's 869 deaths were among people age 60 and older. The loss of so many elders has been uniquely devastating to Native communities.

Why is that?

Elders are revered in Native communities, and serve as repositories of history and culture. They pass down Native languages, oral histories, songs, prayers, medical knowledge, and cultural traditions. "It's like we're having a cultural book burning," said Jason Salsman, a spokesman for Oklahoma's Muscogee Nation. "We're losing a historical record." In the Navajo Nation, many hataalii — practitioners of traditional medicine — have died. Among the Cherokee, who in 2019 initiated a program to preserve their dying language, dozens of the remaining speakers have been lost to COVID over the past year. "Our language, culture, and traditions is what makes us Cheyenne," said Desi Rodriguez-Lonebear, a Cheyenne and an assistant professor of American Indian studies at the University of California. "But we're losing our teachers."

What is being done?

In some areas, tribal leaders have instituted safety measures beyond state and local mandates. In the Navajo Nation they've banned large gatherings, organized pro-masking campaigns, and enforced curfews and stay-at-home orders, putting up checkpoints and threatening violators with fines and jail terms. Some tribes, such as the Eastern Band of Cherokee in North Carolina and Oglala Sioux in South Dakota, have at times barred nonresidents from reservations. On the federal level, $8 billion was allocated to Native American communities as part of the first coronavirus relief package last March — though many Natives complained that a months-long delay in allocating the money cost lives. In early February, President Biden signed a major disaster declaration for the Navajo Nation that cleared the way for additional federal funding for vaccine distribution and medical staffing.

Are Native Americans getting vaccinated?

Yes. In fact, Native communities are well ahead of the general population when it comes to inoculating their members. Over half of Navajo Nation residents have received at least one shot, for example, while the Rosebud Sioux of South Dakota have been inoculated at double the state rate. With the virus rampaging through the reservations, tribes have created aggressive outreach programs to get vaccines to remote populations. A strong sense of community — and fear of extinction — has increased compliance rates. In a recent survey, 75 percent of Native Americans said they'd be willing to get the vaccine — 20 percentage points above the general population. The main motivation, the study reported, "was a strong sense of responsibility to protect the Native community and preserve cultural ways." The high Navajo vaccination rates are "enough to give our people real hope," said Navajo Nation President Jonathan Nez. "We got through smallpox, we got through tuberculosis, and we will get through this." Still, tribal leaders express concern about damage to their communities that will be felt long after the pandemic passes. "I fear the long-term impacts on mental health, our children, community resilience and cohesiveness," said Rodriguez-Lonebear. "We're in the middle of a massive storm, and we're not prepared for the aftermath."

New hope for neglected tribes

After decades of federal neglect, tribal leaders are cautiously optimistic about securing more money and attention from the Biden administration. On the campaign trail Biden — who notched key wins in Arizona and Nevada with help from Native voters — issued a detailed agenda of policies intended to aid Native Americans, ranging from reinstating the White House Tribal Nations Conference to investing in Native agriculture. He has nominated a Native American, Deb Haaland, to head the Department of the Interior, which plays a significant role in Native American affairs. Tribal leaders say they hope to see a series of other actions from the Biden administration to improve infrastructure, stem environmental damage, and fully fund the long-criticized Indian Health Service. "We're helping other nations with billions in aid," said Navajo Nation President Nez. "We should be working on improving quality of life for the first citizens of this country, who are being ignored."

This article was first published in the latest issue of The Week magazine. If you want to read more like it, you can try six risk-free issues of the magazine here.