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Doctor On What It's Like To Fight The Coronavirus On The Navajo Nation

ARI SHAPIRO, HOST:

The Navajo Nation extends across parts of Arizona, Utah and New Mexico, and last spring it had more coronavirus cases per capita than any U.S. state. Now the infection rate is even higher. To talk about the challenges of fighting the disease on the Navajo Nation, we have Dr. Loretta Christensen on the line. She is chief medical officer of the Indian Health Services Navajo Area.

Thanks for joining us.

LORETTA CHRISTENSEN: My pleasure. Thank you for having me.

SHAPIRO: As you try to get this crisis under control, what are your biggest pinch points right now?

CHRISTENSEN: Yes. This second wave has been extremely challenging for us, and it is much more intense than the first. Major things that we are dealing with right now is a critical nursing shortage because we are competing with the entire United States, who is also surging. But we're very fortunate that we have a very exceptional staff, and they have found ways to create more ICU beds. One of our other really big challenges, however, is the neighboring states are also surging. And we do send our most critically ill to tertiary centers in Albuquerque, Flagstaff, Phoenix and Tucson. So as that gets tighter, we have to keep more patients in our facilities. And we do have finite bed capacity.

SHAPIRO: One bright spot is your contact tracing program, I understand, is really strong. And so do you have a clear sense of how the virus is being spread right now?

CHRISTENSEN: We actually do. And the majority of this wave right now has been due to gatherings. The Navajo people are very social, very family-oriented. And what happened was a lot of gatherings for family celebrations that had been put off for so long during this pandemic - they felt safe to go and meet with their families. However, that resulted in numerous clusters at the same time. It just became overwhelming. The numbers just kept getting higher and higher.

SHAPIRO: With cases spiking all over the U.S., what are the unique challenges to fighting this surge in the communities of the Navajo Nation?

CHRISTENSEN: Well, I think we have to look at the extreme rurality that we live in every day. And therefore, resources take time and effort to bring into this region. For example, supplies like high-flow oxygen and equipment, critical equipment like that - it is not right here. We have to really make a concerted effort to get our resources here for us to use.

SHAPIRO: You talked about the extreme rurality of the Navajo Nation. I know that this is the size of West Virginia that we're talking about and only 13 grocery stores. I mean, how does that complicate things?

CHRISTENSEN: Well, it does because people all have to go out and get food. So if you are all hitting those 13 grocery stores, there's a gathering of sorts of people just trying to get food to survive. We've had a really successful food delivery program to get food boxes, hygiene boxes. We take them to the families and say, please stay home. We're giving you what you need to quarantine or isolate for 14 days. And that's worked very well for us, but still, you're looking at a food desert. You want healthy, healing food to be what people have, and they don't have great access to that in the Navajo Nation.

SHAPIRO: I know that many people who live on the Navajo Nation don't have running water, and you've also run into challenges using hand sanitizer as an alternative. Tell us about that.

CHRISTENSEN: Yes. We estimate over 30% of our homes don't have running water, and some of those also don't have electricity, either. Our IHS Environmental Health and Engineering Services have really created 59 water transition points and given out 37,000 storage containers. So we are aggressively addressing our water issue, but as you imagine, it makes hand hygiene very challenging. So we do recommend hand sanitizer as an alternative, but we had a lot of hand sanitizer that came into the nation that was contaminated with very dangerous substances. And unfortunately, because some of our people that are addicted to alcohol do drink hand sanitizer, they were becoming extremely ill. And some did not survive.

SHAPIRO: Oh.

CHRISTENSEN: So we have cleaned that up. We now have available testing to test everything that's brought in the area and donated. And we're confident that we've really reduced the risk of the hand sanitizers because we need them.

SHAPIRO: You grew up on Navajo Nation lands. How do you think that informs your ability to help lead the response to the pandemic there?

CHRISTENSEN: Well, I do believe it gives me a different insight into our challenges. I understand our Navajo culture. My family and I have been in this area for a very long time. And so I think I have an unusual viewpoint in that I know what our normal is here and I know what our challenges are here. And I have found ways to address them along with my very excellent team that I have. And I think we've done a very, very effective job of working within the limitations here on Navajo Nation.

SHAPIRO: That is Dr. Loretta Christensen of the Indian Health Service.

Thank you for speaking with us today.

CHRISTENSEN: Thank you. Transcript provided by NPR, Copyright NPR.


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