Vast majority of local COVID-19 deaths have been Native American

According to the US Census Bureau, approximately 252,000 people live in Washington, Iron, Kane, Garfield, and Beaver counties. The five counties make up a single health district known as the Southwestern Utah Health District.

In contrast, the population of San Juan County is estimated at 15,000.

Despite the fact that the population of the Southwest Utah Health District is nearly 17 times larger than the San Juan County population, and despite the fact that the residents of Southwest Utah are generally older than San Juan County residents, the two areas have almost the same number of deaths due to coronavirus, 30 for Southwest Utah and 29 for San Juan County.

The death rate from the virus in San Juan County is more than 16 times higher than the death rate in Southwest Utah.

The comparison between Southwestern Utah and San Juan County is just one of many sets of numbers that tell the story that San Juan County has been devastated by coronavirus, but not all of San Juan County has been affected the same.

Approximately half of San Juan County’s population, 7,500 people, is made up of people who identify as American Indians. According to San Juan Public Health, of the nearly 700 cases of COVID-19 in San Juan County, at least 550 have been Native Americans.

Of the 91 hospitalizations, approximately 90 percent have been of Native Americans. And of the 29 COVID-19 deaths in San Juan County, at least 87 percent have been of Native Americans.

So while less than one in every 1,000 residents of Southwestern Utah has been hospitalized by coronavirus, one in every 100 Native Americans in San Juan County has been hospitalized with the virus.

Figuring out why some populations have been hit harder is a difficult proposition.

Some of the challenges may include access to health care, supplies, and water. This made it difficult for those living on the Navajo Nation and the White Mesa Ute Community to shelter in place during the early stages of coronavirus.

Efforts from nonprofits, such as Utah Navajo Health System (UNHS), to provide San Juan County American Indians with food, clean water and medicine has proved immeasurably helpful in the fight against coronavirus.

UNHS Chief Operating Officer Byron Clarke explains their work has been unique during coronavirus. “We’ve worked in partnership with several health departments, including the Navajo Nation, the state of Utah, and of course the county.

“We’ve taken on a public health role which is rare for a hospital. Hospital doesn’t normally do that, but we’ve worked in tandem with the county to do contact tracing and home visits.”

Clarke says they’ve been providing thermometers, and educational materials about quarantining and self-monitoring.

Despite efforts from UNHS and other nonprofits, additional challenges exist, regardless of donations.

Clarke says one of the largest factors that made coronavirus so devastating is the closeness of community amongst the Diné people.

“It’s very common to have several generations living in one home, where in other places across the country that’s more the exception,” said Clarke. “On the reservation, people are closer so it’s common to see two, three, maybe four generations living in the same house.”

Those living in multi-generational homes have an increased risk of spreading the virus to vulnerable elderly populations.

Clarke adds that the demographics are generally a little older on the Navajo Nation as a lot of younger people will move to border towns or larger cities.

Additionally, the communities within the Navajo Nation are closely knit and see each other very regularly.

The challenges of coronavirus extend beyond San Juan County and have been faced by the entire Navajo Nation. The Navajo Department of Health reports more than 100,000 Diné have been tested for the virus, with 10,000 positive cases and more than 500 deaths.

Efforts to flatten the curve by the Navajo Nation have included several drastic but seemingly successful methods. Tactics by the Nation have ranged from education about social distancing and hand washing, to mask mandates, restricting access to visitors, and nightly and weekend curfews.

Efforts made by San Juan County residents, aided by health officials from UNHS, the Navajo Nation, and San Juan Public Health, have resulted in an effective flattening of the curve in the county.

At the peak, San Juan County had 173 active cases on July 29. As of September 22, there are 20 active cases of COVID-19 in the county.

Although ethnicity is not specified in the weekly report, data is available by area. Of the 20 active cases, 10 are in the Mexican Hat/Halchita area.

Meanwhile there are just two other active cases in the rest of the Navajo Nation portion of San Juan County, including one case in the Aneth and Montezuma Creek area and one case in the Monument Valley and Navajo Mountain area.

The other active cases include one case in the Bluff area, four in Blanding, and three in Monticello.

In a recent video town hall with the entire Navajo Nation, Director of National Institute of Allergy and Infectious Disease, Dr. Anthony Fauci praised the Diné people for bringing down their caseloads despite seeing such a huge spike.

“You did that by abiding the things that I have been speaking about to the rest of the country almost on a daily basis,” said Fauci. “Wearing a mask uniformly, avoiding close contact, avoiding crowds, trying to do things outdoors versus indoors.

“The reason that you should be proud of what you’ve accomplished, is that you have proven that when you do these public health measures, you can turn around a serious surge of infection.

“I believe if the rest of the country looks at the model that the Navajo Nation has shown, that you can turn things around by carefully and assiduously adhering to the guidelines of avoiding infection, that we may see this happen throughout the country.”

Fauci added following those basic health measures of wearing a mask and social distancing during the upcoming Fall and Winter months is very important to avoid rapid spread of disease.

Clarke agreed with Dr. Fauci that infection control protocol of hand washing and social distancing has been the basic reason behind why the curve has flattened on the Navajo Nation.

“Our area has seen the death and damage it can do first hand, so they’ve taken it more serious,” said Clarke.

The flattening of the curve on the Navajo Nation comes as cases in Utah are surging with Utah and Salt Lake counties reaching record high case numbers.

Although the surge has not impacted San Juan County communities north of the Navajo Nation, an increase could come if cases spread across the state.

While Native American’s have disproportionately borne the brunt of COVID-19 thus far, San Juan Public Health Director Kirk Benge says other populations could see similar rates.

“Based on the data I’m seeing locally,” said Benge, “I don’t see any reason that as infections spread in the rest of our communities, that we won’t see similar numbers.

“I think the risk is more about having underlying health issues, diabetes, hypertension, and age. I think those at the end of the day are going to be the primary risk factors, but certainly having our Native American community get hit first has maybe skewed things for this first wave of the virus that came through.”

Clarke encourages everyone to continue to be diligent in using infectious control precautions of hand washing, social distancing.

“They’ve been around for decades and have been known to be effective,” said Clarke. “So until there’s an effective vaccine it can be deadly, and every life is worth taking those precautions.”