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Date: November 15, 2020

To: Dr. Jill Jim, Director of The Navajo Department of Health
From: Angelica Sabol
Subject: Proposed New Plan for Coronavirus Outbreak on Navajo Nation

New Regulations for COVID-19 on the Navajo Nation

Introduction: Coronavirus in the Navajo Nation

The coronavirus of 2020 is something that no one predicted. It has affected the whole world, and
each part of the world has dealt with its consequences in a different way. There are many
different aspects that needed to be considered when planning a safe course of action. The Navajo
Nation in particular has chosen an interesting route to make sure their people are staying safe.
The course that was taken by the reservation was the same that many other countries and only
some states in the United States: a lockdown.

The purpose of this proposal is to suggest a different strategy for ensuring safety within the
borders of the Navajo reservation during the pandemic. In comparison to the rest of the state of
New Mexico, the reservation makes up “53% of New Mexico’s confirmed coronavirus
cases” (Romero). In light of this startling fact, the Navajo Department of Health must change the
tactics currently being used. Since the beginning of the outbreak, the reservation has been having
lockdowns. There have been different levels of lockdowns— weekends, daily, or a mixture. In
light of the continued spreading of the virus, a different plan should be considered, and if
possible, put into action.

The Current Situation:

Lockdown Method
The lockdown method is
the system the Navajo
reservation is currently
using to limit the spread of
the virus. Figure 1 displays
the number of cases during
the course of the virus
along with the different
lockdowns. The graph
exhibits that even with the
lockdowns, the second
wave is still hitting the
Navajo Nation.

Currently, there is a daily

curfew is from “9:00 P.M. Figure 1: Daily Confirmed Cases on Navajo Nation in All

https://www.ndoh.navajo-nsn.gov/COVID-19/Data
MDT to 5:00 A.M.” (Public
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Health Order). For the last two weekends of October, the reservation has been on a 56 hour
lockdown— starts on Friday at 9:00 P.M. and goes to Monday at 5:00 A.M. Earlier in the year,
there have been different lockdowns— 57 hours, 32 hours, and partial weekends (Davis).

During these lockdowns, the borders of the reservation are patrolled to keep travelers from
passing through. All the stores are closed down and the people are not allowed to be farther than
five miles from their residents (Public Health Order). Economically, closing all shops and being
even closed off from travelers made the situation worse.

For the Navajo population this quarantine is difficult because of the number of family members
living under one roof. Another concern is that there are families living on the reservation that do
not have sufficient running water or electricity and who cannot afford to buy all their food in
advance (Grantham-Philips).

These lockdowns, while

somewhat necessary, have not
been entirely beneficial to the
people. Even with the help of
relief groups and donations, it
has been extremely strenuous
on those families. Also, as
Figure 2 shows, the COVID
cases have still been
consistently increasing over
the course of the pandemic.
Even though the cases may
have plateaued for a while,
the overall affect of the
lockdowns does not seem to
stop the spread as we would
have hoped.
Figure 2: Total Count of Cases Since March

https://www.ndoh.navajo-nsn.gov/COVID-19/Data Figure 2 shows that towards

the end of October and
beginning of November we are seeing the second wave of COVID-19 starting to hit the Navajo
Nation. We need to consider the effects this will have on the Navajo Nation, specifically the
families that do not have enough water or electricity when it starts to get cold as well as the
effect on the economy.

Another major problem that the people on the reservation are dealing with is the amount of space
in the hospitals and facilities for treating patients. This is a concern because as Va said in
“Navajo Nation Experiencing Second COVID-19 Wave,” they usually move “‘the sickest
patients out to other hospitals in Arizona and New Mexico’” (Davis). With this in mind, we
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should consider different options for this area besides lockdowns that will be better for the
people of that area.

The Proposal
In the grand scheme of things, it is logically given the current situation to have assumed that a
lockdown could solve our problems. However, to successfully reduce the number of people
infected with coronavirus within the Navajo Nation, we must combine different solutions that
others have already tried. However, these combined strategies must meet the following
objectives:
• Minimize social contact
• Reduce coronavirus outbreaks within communities
• Economically support the reservations during this time of economic stress
• Provide adequate resources for care facilities

Step 1
In anticipation for the worsening of the second wave of COVID-19, make sure hospitals have all
the resources they need. Within this step, small structures will need to be built or set up outside
the hospitals and/or facilities. This will be anticipation of the overflow patients. The second
minor step is to send the reservation more resources needed in the hospitals so that they are
better equipped for the winter months and flu season. Hospitals are an important for treating
anything, so this should be a top priority.

For this step, even if only the

major hospitals within the
reservation were given an extra
building or temporary structure,
that could make a huge
difference. There are 12 health
care facilities within the Navajo
Nation. However, as Figure 3
shows, there are only 6 larger
facilities within the region and to
narrow it down further, within
New Mexico there are only 3
facilities.

To provide these three medical

centers with a temporary
building for overflow during
these months of the second
wave, the target time frame
Figure 3: Navajo Birth Cohort Study (NBCS) Collaborating Hospitals— Navajo Nation
would be a month. These https://www.atsdr.cdc.gov/sites/navajo_birth_cohort_study/about.html
building would also have the
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potential to be used as COVID testing centers for the winter months so that people do not have to
go into the medical centers.

Step 2
The main aspect of the lockdowns and curfews was to keep keep people from seeing friends at
restaurants and bars and having the unnecessary exposure. So in hoping to keep the circle of
people that each person has to come into contact with low, curfews should still be enforced.
Curfews make sure that there are no gatherings at night after work. However, the weekend
lockdowns should not continue. The lockdowns have not statistically proven to have the effect
we wanted in the first wave. Instead of a lockdown, a curfew should be enforced for the same
hours that the curfew has during the weekdays. The benefits of a curfew rather than a lockdown
are:
• Stores can stay open
• Travelers can pass through, boosting the economy (however, out of state travelers will not be
able to cross the border within the Navajo Nation)
• Groceries and essentials can still be
bought on the weekends
• Still prevents gatherings on the weekend

Step 3
Since the lockdowns will be taken away,
there will seem to be more freedom when
it comes to social distancing and
quarantining. To prevent people from
taking advantage of this newfound
freedom, some rules for the weekends will
have to be put into place. Such rules could
include but are not limited to:
• Designate one family member to get
groceries on weekends
• Gloves and masks are both required
• No gatherings of multiple households
• Warnings for first time offenders
• Fines for repeat offenders

With these rules in place, the people on

the reservation could still social distance
while not being totally confined to their
houses. Figure 4 demonstrates the proper
way to wear a mask for maximum
protection.


Figure 4: Face Mask Mistakes

https://www.copperfieldhill.com/blog/?p=707
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Conclusion:
The whole purpose of this new proposal was to present a new way to ensure the safety of the
Navajo Nation during COVID-19. This proposal suggested that new temporary facilities be built
for the major medical centers on the reservation, curfew for all days of the week, and propose
some rules for weekend shopping.

Overall, the cost for this proposal is not exceedingly large considering there were three different
aspects to this proposal. The first step will be the only one that requires funds. It will cost at
minimum approximately $3,000,000. That would be using a million for each building for the
medical facilities.

The first benefit is that even without the current lockdowns, social distancing and minimal social
contact will still be managed. With the regulations in place, the weekends should still be as safe
as the weekdays.

The second benefit is that economically, people will still be able to pass through those
communities on the reservation that rely on travelers. With the weekends opening up, people
from within the Navajo Nation will be able to go to other towns and support each other.

Finally, the medical facilities will be better equipped for this second wave and will have the
resources and space to treat all who are in need. This alone will help the Navajo Nation as their
supply of resources in the hospitals have been low for this whole pandemic.

Thank you for the opportunity to present this proposal to the Navajo Department of Health. In
the next week, we will be contacting you to finalize this proposal and move to the next steps in
this process.

If there is any suggestions you have that would improve the plan, we would be glad to hear them.
Also, if you have any questions or concerns please contact us at asabol@unm.edu.

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References

“About Navajo Nation.” Centers for Disease Control and Prevention, Centers for Disease
Control and Prevention, 30 June 2015, www.atsdr.cdc.gov/sites/
navajo_birth_cohort_study/about.html.

Davis, Theresa. “Navajo Nation Experiencing Second COVID-19 Wave.” Albuquerque Journal,
Oct. 28, 2020. ProQuest, http://libproxy.unm.edu/login?url=https://www-proquest-
com.libproxy.unm.edu/docview/2455084057?accountid=14613.

Davis, Theresa. “Navajo relief group prepares for a second wave of COVID-19 cases.”
Albuquerque Journal (NM), sec. Abqnews Seeker, 3 Sept. 2020. NewsBank: New Mexico
Newspapers, info web.newsbank.com/apps/news/document-view?
p=NewsBank&docref=news/17D427A6D88D33B8. Accessed 1 Nov. 2020.

Grantham-Philips, Wyatte. “On the Navajo Nation, COVID-19 Death Toll is Higher than any US
State: Here’s how You can Support Community Relief.” USA Today (online), Oct. 24,
2020. ProQuest, http://libproxy.unm.edu/login?url=https://www-proquest-
com.libproxy.unm.edu/docview/2453899647?accountid=14613.

“Navajo Nation.” Navajo Nation, Department of Information Technology (DIT), 2011,

www.navajo-nsn.gov/.

“Navajo Nation COVID-19 Dashboard.” Navajo Nation Department of Health, NNDIT, 2020,
www.ndoh.navajo-nsn.gov/COVID-19/Data.

Romero, Simon. “New Mexico Invokes Riot Law to Control Virus Near Navajo Nation [with
Graphic(s)].” New York Times, May 04, 2020. ProQuest, http://libproxy.unm.edu/login?
url=https://www-proquest-com.libproxy.unm.edu/docview/2397895035?
accountid=14613.