Although several states, including Utah, have decreased COVID-19 regulations, the virus continues to spread. One major population that has seen significant effects of the virus is the Navajo Nation.

CNN reported on May 18, 2020 that the Navajo Nation — which spans parts of Arizona, Utah and New Mexico — had reported 4,002 cases of COVID-19 with a population of 173,667. The resulting infection rate is higher than New York’s, which has been deemed the U.S. epicenter of the virus.

“Do I have to be a member of the Utah Jazz? Do I have to have a different skin color or different socioeconomic status to get tested? A lot of our BIPOC community members experience that,” said Alastair Bitsoi, a member of the Navajo Nation and speaker at the Utah Tribal Town Hall which took place virtually via Zoom and Facebook Live on Thursday, May 21.

Bitsoi was one of seven speakers at the town hall which was aimed at spreading education and awareness about COVID-19 in general and how it affects Utah’s American Indian community. 

Bitsoi shared his story about how he experienced some COVID-19 symptoms such as a fever and sore throat. He had recently traveled to New York City and Washington D.C., so he figured he could have the virus. 

“I think the fever was when I realized I’m sick. On Wednesday, March 11 when the Utah jazz players shut down the NBA league and Utah shut down and cases in New Mexico, where I’m originally from, were traced back to New York, I realized that I probably had some of the COVID symptoms,” Bitsoi said. 

When he wanted to know for sure, though, he was denied testing multiple times. 

“I know with Intermountain they told me I didn’t meet the CDC guidance at the time, I had a fever but I wasn’t exposed to a known positive COVID case at the time, so they cited the Utah Department of Health as the reason for denying me the test in the first place,” Bitsoi said. “How can you deny me healthcare? In the different rooms that I was in, at Intermountain Healthcare, I was yelling at the provider, I was telling the provider: healthcare is a basic human right, I should not be denied testing.”

Then, Bitsoi attempted to get tested through the University of Utah.

“I tried to get tested and I told the health professionals at the University of Utah how I was being treated as a patient in the time of a pandemic. It was kind of frustrating to go through the denial of the bureaucratic testing. It was a mess. How in the world is a regular native indigenous person going to navigate this through the pandemic? It felt like I had to still lie to get testing,” Bitsoi said. 

Bitsoi said because of his experience, he has become more stressed out for the members of the Navajo Nation. 

Katarina Benally, one of the public health nurses of the Utah Navajo Health System, sees the effects of the pandemic on the Navajo Nation in Utah firsthand. Benally conducts contact tracing and wellness checks for the entire strip of the Navajo Nation in Utah.

“When it comes to our jobs as public health nurses, we do the best we can for our patients. Obviously, we do the contact tracing, but we are in a different position when it comes to the reservation as a lot of our family members don’t have running water or electricity or they have to travel at least an hour to gather groceries,” Benally said.

When Benally and the other public health nurses tell a family someone has tested positive, they advise them to isolate themselves in their home for 14 days and provide them with the necessities to get them through that time without having to take the risk of leaving their house.

“We have been delivering medications, food and water, delivering masks. Some patients don’t have thermometers at home. We’ve done wellness checks, some patients are just now being discharged from surrounding hospitals in our areas, and so we will go to their homes and check on them and make sure they are doing ok, check their vital signs, see if there is anything we can help them out with,” Benally said.

After Benally and the other public health nurses tell a family about a positive case of an individual, often family members and neighbors grow concerned they may have been in contact with the virus — and panic ensues. 

“When it comes to this pandemic, we do see a lot of panic at our clinics. When we have those mass testings, and a lot of people come back positive, then we have the family members or neighbors of the people who have tested positive — there is a lot of fear. It might have to do with the media and how the virus is portrayed and a lot of them think that ‘if I have the virus, I’m going to end up in the hospital,’” Benally said. 

Benally explained she and the other nurses do the best they can to educate their patients about the steps they should follow if they experience symptoms. Going to the hospital is not always necessary, and they only need to seek emergency services if they experience trouble breathing, have chest pain or a high fever that won’t come down with medication. 

“We do the best that we can to calm their fears and provide education,” Benally said. 

Shawn Begay, public health director with Utah Navajo Health System, has also observed issues with educating Navajo members of COVID-19. “At UNHS I was actually out educating a lot with the different chapter houses and the biggest thing is: how do you describe this disease in Navajo? There’s really no words to translate,” Begay said. 

Along with educating members of the Navajo Nation about the pandemic, Begay is highly concerned about the lack of basic necessities that are hindering families from being able to practice proper social and physical hygiene. 

“That is one thing we see here is an issue down here on the reservation, is a lack of resources for the basic needs of running water. On the frontline, that is a concern. Obviously cleanliness is great but if we don’t have access to those things, what are we doing to try to help them meet these needs?” Begay said. 

In order to address the pertinent issue of running water, Begay said Johns Hopkins University Center for American Indian Health recently reached out with a plan. They are looking to place homemade water basins at the individual’s homes that do not have running water.

On April 10, 2020 the President of the Navajo Nation, Johnathan Nez, instituted a curfew because people were not following stay-at-home guidelines and positive cases were increasing on reservations. 

“He doesn’t want the large groups of people running to the border towns. The Navajo PD has been on hand as well too. We have stopped people as they are leaving to educate them on the importance of the curfew,” Begay said.

While education about the pandemic is helpful to quell the spread temporarily, Melissa Zito, Indian Health Liaison and Health Policy Consultant from the Utah Department of Health, recognizes that more needs to be done at the state level.

“Where the state could really support the Navajo Nation and the Utah portion of the Navajo Nation specifically is to look at how can we provide the sample collection kits that were available — how do we get those to them, how do we support their efforts knowing that increasing testing is a great way to ‘put your finger on the pulse’ of what’s happening community-wide?” Zito said.

Zito discussed the partnership between the Utah Department of Health and UNHS and why this relationship is especially important during times of crisis, like the current pandemic.

“For the state of Utah, understanding that we don’t have the expertise to understand those cultural nuances and communities that the Utah Navajo Health System has. In addition to that, they have a well laid out infrastructure and capacity to reach all of those hard-to-reach communities,” Zito said. 

Zito also explained why testing has been difficult in Utah in general but also in the Navajo Nation.

“It was difficult for the state of Utah because the assay that goes into the testing, our public health lab had determined that it was contaminated and so for about three and a half weeks it was difficult to do any testing,” Zito said. 

While testing has been difficult due to a lack of resources, Bitsoi believes some cultural biases are at work. 

“There is a different culture here in Utah. Some of that cultural bias came out towards me when I was trying to navigate the healthcare system. I had to use my political, emotional, spiritual, and physical will to fight the virus,” Bitsoi said.

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@kayleighwiththechrony