- General lack of testing, proper healthcare infrastructure and access to therapeutics 
- Sparsity of Western healthcare infrastructure such that those of the more withdrawn pockets of the land have to travel for hours to be treated by doctors or be seen at a hospital
- Remote living locations makes it difficult to get access to certain amenities that city dwellers take for granted like wifi and running water
- Limited access to both Telehealth and in-person treatment
- No intensive care units within the Nation, and thus patients who contracted the virus are sent to regional units
- Lack of infrastructure can be attributed to the growing indifference of American lawmakers and attempt to circumvent legal battles with Navajo representatives

Wake Forest University

- The Navajo Nation stretches across much of northeastern Arizona, southeastern parts of Utah and northwestern New Mexico [27,000 sq miles]
- Communities have long faced systemic inequalities brought upon by hostile U.S. Federal Gov't relations, and these have manifested to create a disproportionately burdensome situation for members during the pandemic
- Limited health services, broken infrastructure, and above-average rates of immunocompromising diseases all increase the vulnerability of AI/AN populations to the outbreak



Case Study: Navajo/Diné Nation 

- Navajo Nation surpassed NY State for the highest COVID-19 infection rates in the U.S. in May: 2304.41 cases per 100,000 people at its peak in May compared to the NY state rate rate of 1,806 cases per 100,000 according data from Johns Hopkins University
- Highest infection rate in the country; it is even greater than that of Wuhan at the height of the outbreak in China
- Navajo members were seven times more likely to contract the virus than other residents in New Mexico

Related Statistics

- Historically consistent lack of U.S. federal and state government support; failure to uphold its legal trust and treaty obligations
- U.S. Congress claims legals barriers as the prime cause of the lack of structural healthcare "development" 
- Subsequent general lack of federally-funded clinics and hospitals, or what the U.S. government denotes as "Western medicine" practitioners
- Call for federally funded Indian Health Organizations continually petitioned in Congress, still pending legal battles
- Although the nation suffered higher rates of exposure on a per capita basis, the nation doesn't qualify for "hot spot" relief under the Department of Health and Human Services criteria


Lack of Government Support

- Run by the state, over 98% of its students are eligible for the free or reduced lunch program compared to the state average of 55%
- 38% of its students live below the poverty line, according to 2015 data
- Financial struggles, under-payed staff, underfunded academic programs e.g. ACT or SAT prep
- Democratically run Navajo government was shut down on March 13th to the end of the calendar school year
- High school seniors staying outside school buildings for wifi during online school hours
- One senior moved Phoenix by himself, after his only parent died of COVID-19, to work construction while going to school online

Piñon High School Anecdote

Scarce Resources

Doshi, Sahir, et al. “The COVID-19 Response in Indian Country.” Center for American Progress, 2020, cdn.americanprogress.org/content/uploads/2020/06/17135604/COVID-19-Native-Response.pdf. 

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