As coronavirus cases in Nevada begin to level out and more businesses are allowed to open this weekend, recent spikes in cases in tribal communities have leaders concerned that health metrics there are headed in the wrong direction.
In response, Pyramid Lake Paiute Tribe Chairman Anthony Sampson and Reno-Sparks Indian Colony Chairman Arlan Melendez tightened restrictions and stay-at-home orders, hoping to avoid widespread infection in their small communities as their health centers await more funding, testing and supplies.
“We have to be more cautious than the state because they have a larger population; we only have a little over 1,150 or 1,170 tribal members,” Melendez said in a video, adding that infections could increase as people in the surrounding urban area begin to leave their homes more frequently.
The Pyramid Lake Paiute Tribe reservation has the largest cluster of COVID-19 infection in Nevada’s tribal communities after confirming 24 cases Friday, an increase from 14 cases last week.
The Pyramid Lake Paiute health center has administered about 58 coronavirus tests, meaning just under half of the tests have resulted in positive cases in the community of 1,300 residents.
The Reno-Sparks Indian Colony follows closely behind after announcing 13 cases Thursday in the community of roughly 1,150 residents. The reservation is located in the ZIP code area with the highest infections in Washoe County, according to Washoe County Health District data.
The Fort Mojave Indian Tribe in Southern Nevada has reported five confirmed cases on the reservation, according to reporting from the Nevada Current, putting Nevada’s tribal communities total cases at 42.
But establishing orders to protect their communities is only half the battle. Tribal leaders are still trying to persuade some community members to take the pandemic and preventive guidelines more seriously.
“This time is crazy,” said Dawna Brown, health director for the Pyramid Lake Paiute Tribe. “Here at the clinic, we’re seeing some pushback with people whether they believe [the pandemic] is real or not … The virus doesn’t care what your bloodline is, what’s in your bank account, who you pray to. It’s here and it likes these bodies in motion, and people will not stop moving and we need to just sit still.”
Melendez and Sampson and their tribal health centers will work together moving forward to trace positive cases between tribal members in both the Pyramid Lake reservation and the Reno-Sparks Indian Colony after Melendez said that the surge of cases on the reservations may be linked to gatherings of tribal members across the two communities. The tribal leaders will try to keep tabs on overlapping contacts of positive cases.
“I’ve talked with chairman Sampson of Pyramid Lake tribe, [who] recommended that we work together with our health directors to try to make sure that we share information as to who's connected to who and who’s in contact with who, and I think that’s the best way we’re going to try to get a handle on this,” Melendez said.
Brown explained that the reservations are close in proximity to one another and the two tribes share many family members, adding to the traffic between the two areas.
“[The Reno-Sparks Indian Colony] health director and myself keep in close contact to discuss any trends or changes in either of our populations on a regular basis,” Brown said. “We are both doing our own contact tracing on our respective reservations/delivery areas and sharing information, as needed.”
In a video update Monday, Pyramid Lake Paiute Tribe Chairman Anthony Sampson pleaded that the community take the spread of the virus more seriously, especially if someone has coronavirus symptoms.
“We have too many people going out there that have been tested and that are doing what they want to do without any care of what’s going on,” Sampson said. “The more that you’re out there in public and you’re infected, you’re infecting everybody else. And that’s not good.”
The chairman took the video from inside his home, as opposed to inside the reservation’s tribal office as he had been doing, explaining that he was self-isolating after getting tested for the virus himself. The test results came back negative.
Melendez echoed Sampson in a separate video Thursday.
“This is a total effort of the community being responsible, too, so each one of us has a responsibility of not infecting somebody else,” Melendez said. “I hope everybody is learning here by the increase in cases how serious it is and we can make the effort to really stay home. It’s something that’s really concerning us right now.”
Supply limitations persist
As Brown and her staff at the Pyramid Lake tribal health center move forward into uncharted territory, she feels confident in their capability to do the best they can in treating their residents, but obstacles persist.
Calls to the health center’s hotline for COVID-related questions have increased since last week, but limited testing supplies hinder efforts to provide testing for all those who request it.
“I feel that my staff is totally qualified, we’re capable in that aspect,” Brown said. “It’s just the limitation on the testing supplies right now … and then just providing for the safety of my staff as far as PPE goes.”
The center is continuing to screen residents before administering tests.
“There’s no way we can test everybody here,” Brown said. “So we still go through the CDC’s (Centers for Disease Control and Prevention) screening questions. If people meet the criteria or if they have had contact with someone with a confirmed positive case, they will get a test.”
The health center has three boxes that contain 22 test swabs each and one Abbott rapid testing machine. The test swabs are sent to Quest Diagnostics and results normally take 24 to 48 hours.
All of the health center’s testing supplies have been provided by the Indian Health Service, a federal organization responsible for U.S. tribal health care. Brown said she is expecting another shipment of testing supplies, but is unsure when it will arrive.
Any shift towards more testing will result in more positive cases on the reservation, Brown said “that’s just simple math.”
However, Brown acknowledged that the reservation’s proximity to Reno, about 35 miles northeast, and to the Washoe County Health District could be beneficial because residents can drive into town for additional resources and testing locations.
But as her staff continue to test residents in a drive-thru method at the health center, Brown worries about their safety amid a shortage of gowns. The health center staff includes one physician assistant, two registered nurses, a few medical assistants, one pharmacist and one pharmacy technician.
Washoe County has donated masks, gloves and hand sanitizer to the health center, and Brown continues to reach out to several government agencies for additional supplies and funding to support the health center in its efforts amid the pandemic.
The Pyramid Lake Paiute Tribe is just one out of 574 other federally recognized tribes in the U.S. and one of 27 in Nevada that also desperately need additional funding and supplies, and there are only so many supplies to go around.
“We’re putting out the message to everybody at some point,” she said, “but we know that everybody is putting those requests in. So we understand that they’ve only got so many gowns to give out to everybody.”
This situation concerns many tribal leaders who say they’d rather not have to feel like they need to compete against one another for funding and supplies. Walker River Paiute Tribe Chairperson Amber Torres said the funding and supplies offered by the federal government are like “peanuts on a table” that tribes are “pit against one another” for.
As for funding distribution, Brown said the health center has received $675,000 from the $8 billion allocated for tribal communities in the Coronavirus Aid, Recovery and Economic Security (CARES) Act, in addition to other sources.
Other tribes, like the Walker River Paiute Tribe, have yet to receive funding from the CARES Act specifically allocated for tribal communities.
Torres said her community has received funding from other sources like the Indian Health Service, the United States Department of Housing and Urban Development, Title 6 Elder’s Nutrition program and the Bureau of Indian Affairs, but not from the United States Department of the Treasury, responsible for distributing the funding approved in the CARES Act.
As sovereign nations, tribal leaders have the authority to establish measures that will best protect their communities.
Since the state’s stay-at-home order was set in early March, tribes have enacted additional orders for their reservations, like curfew hours for residents and closing reservation borders to non-residents, in addition to social-distancing requirements.
Both chairmen Melendez and Sampson have also added additional measures this week as the rest of the state continues to ease restrictions.
The Pyramid Lake Paiute Tribe announced Thursday that an order to keep the reservation’s borders closed to non-residents is extended through July 31. The tribe also announced Friday that it will screen traffic entering or exiting the reservation at two checkpoints.
The order to extend the closure of the reservation for non-residents financially affects the tribe as Pyramid Lake normally attracts many visitors for recreational purposes and 25 percent of fishing permit sales go to the tribal council’s coffers.
Pyramid Lake Fisheries director Dan Mosley acknowledged that the lake sees an increase in visitors during this time of year, especially on holidays like Memorial Day weekend and Independence Day.
But the measure is necessary in the tribal council’s efforts to mitigate the spread of infection.
“I’m pleading with you people,” Sampson continued in the video update. “This is not a drill. This is a reality, and it’s going to hurt people if we lose somebody.”
Melendez announced a similar measure. The Reno-Sparks Indian Colony will use decal stickers to tag and identify tribal members’ cars, so stationed tribal police officers can identify non-residents attempting to enter the reservation.
“We’re going to try to be a little more restrictive in making sure that people follow the laws like the curfew and also the stay-at-home order,” he said. “Our police will be really monitoring that real closely and will probably be stopping some people.”
Melendez said the first and second offense of the orders will result in a $500 fine each and the third offense can result in an arrest.