Contact Tracing for Native Americans in Rural Arizona

Close, Ryan M; Stone, Myles

doi:10.1056/nejmc2023540

Cited by 17 publications

(16 citation statements)

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“… 6 9 Navigating the COVID-19 response in these settings requires creative solutions adapted to available resources as well as the specific cultural context. 11 12 …”

Section: Introductionmentioning

confidence: 99%

COVID-19 response by the Hopi Tribe: impact of systems improvement during the first wave on the second wave of the pandemic

Humeyestewa¹,

Burke

Kaur

et al. 2021

BMJ Glob Health

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The Hopi Tribe is a sovereign nation home to ~7500 Hopi persons living primarily in 12 remote villages. The Hopi Tribe, like many other American Indian nations, has been disproportionately affected by COVID-19. On 18 May 2020, a team from the US Centers for Disease Control and Prevention (CDC) was deployed on the request of the tribe in response to increases in COVID-19 cases. Collaborating with Hopi Health Care Center (the reservation’s federally run Indian Health Service health facility) and CDC, the Hopi strengthened public health systems and response capacity from May to August including: (1) implementing routine COVID-19 surveillance reporting; (2) establishing the Hopi Incident Management Authority for rapid coordination and implementation of response activities across partners; (3) implementing a community surveillance programme to facilitate early case detection and educate communities on COVID-19 prevention; and (4) applying innovative communication strategies to encourage mask wearing, hand hygiene and physical distancing. These efforts, as well as community adherence to mitigation measures, helped to drive down cases in August. As cases increased in September–November, the improved capacity gained during the first wave of the pandemic enabled the Hopi leadership to have real-time awareness of the changing epidemiological landscape. This prompted rapid response coordination, swift scale up of health communications and redeployment of the community surveillance programme. The Hopi experience in strengthening their public health systems to better confront COVID-19 may be informative to other indigenous peoples as they also respond to COVID-19 within the context of disproportionate burden.

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“… 6 9 Navigating the COVID-19 response in these settings requires creative solutions adapted to available resources as well as the specific cultural context. 11 12 …”

Section: Introductionmentioning

confidence: 99%

COVID-19 response by the Hopi Tribe: impact of systems improvement during the first wave on the second wave of the pandemic

Humeyestewa¹,

Burke

Kaur

et al. 2021

BMJ Glob Health

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“…For example, the one exception to the pattern of disparate risks among non-whites was the finding of no difference in incidence and mortality risk for Native Americans in Michigan as compared to whites. These results may reflect the concerted effort to prevent transmission in Native communities 26 . However, this may also reflect the fact that cases among American Indians and Alaska Natives have disproportionately been categorized as occurring among the “Other” race/ethnic groups 27 .…”

Section: Discussionmentioning

confidence: 99%

“…These results may reflect the concerted effort to prevent transmission in Native communities. 26 However, this may also reflect the fact that cases among American Indians and Alaska Natives have disproportionately been categorized as occurring among the "Other" race/ethnic groups. 27 Other important groups are not included in census statistics.…”

Section: Discussionmentioning

confidence: 99%

Racial disparities in COVID-19 mortality are driven by unequal infection risks

Zelner

Trangucci

Naraharisetti

et al. 2020

Preprint

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Background. As of August 5, 2020, there were more than 4.8M confirmed and probable cases and 159K deaths attributable to SARS-CoV-2 in the United States, with these numbers undoubtedly reflecting a significant underestimate of the true toll. Geographic, racial-ethnic, age and socioeconomic disparities in exposure and mortality are key features of the first and second wave of the U.S. COVID-19 epidemic. Methods. We used individual-level COVID-19 incidence and mortality data from the U.S. state of Michigan to estimate age-specific incidence and mortality rates by race/ethnic group. Data were analyzed using hierarchical Bayesian regression models, and model results were validated using posterior predictive checks. Findings. In crude and age-standardized analyses we found rates of incidence and mortality more than twice as high than Whites for all groups other than Native Americans. Of these, Blacks experienced the greatest burden of confirmed and probable COVID-19 infection (Age- standardized incidence = 1,644/100,000 population) and mortality (age-standardized mortality rate 251/100,000). These rates reflect large disparities, as Blacks experienced age-standardized incidence and mortality rates 5.6 (95% CI = 5.5, 5.7) and 6.9 (6.5, 7.3) times higher than Whites, respectively. We also found that the bulk of the disparity in mortality between Blacks and Whites is driven by dramatically higher rates of COVID-19 infection across all age groups, particularly among older adults, rather than age-specific variation in case-fatality rates. Interpretation. This work suggests that well-documented racial disparities in COVID-19 mortality in hard-hit settings, such as the U.S. state of Michigan, are driven primarily by variation in household, community and workplace exposure rather than case-fatality rates. Funding. This work was supported by a COVID-PODS grant from the Michigan Institute for Data Science (MIDAS) at the University of Michigan. The funding source had no role in the preparation of this manuscript.

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“…The program has had an impact slowing the spread of COVID-19 on the reservation, and seems to have had a positive impact on the local COVID-19 mortality rate as well. 1 With multiple physicians dedicated to contact tracing and performing home visits, a void was left in the outpatient clinics. The director of outpatient medical services who routinely practices with the pharmacists assigned to the internal medicine clinic requested assistance managing these physicians' patients.…”

Section: Patrick Galdun L Michelle Vaughnmentioning

confidence: 99%

“…The program has had an impact slowing the spread of COVID-19 on the reservation, and seems to have had a positive impact on the local COVID-19 mortality rate as well. 1 …”

mentioning

confidence: 99%