Cherokee Nation COVID fight at ‘box it in’ stage
A closed pharmacy entrance at the W.W. Hastings Outpatient Health Center in Tahlequah is seen in March. Tribal officials said there is no indication that conditions have improved locally regarding containing COVID-19. CHAD HUNTER/CHEROKEE PHOENIX
TAHLEQUAH – With little national guidance in March, Cherokee Nation officials began a fight with COVID-19 that has evolved into what a senior health leader calls a “box it in” strategy.
“The strategy is pretty simple,” said Lisa Pivec, senior director of CN Public Health. “It’s test widely, isolate all infected people, find everyone that person was in contact with and quarantine them for 14 days.”
Addressing Tribal Councilors in late September about the tribe’s pandemic response, Pivec said that initially, “every bit of Public Health staff worked through the closedown.” Now, staff spends most of its time trying to contain the coronavirus with case investigations and contact tracing, Pivec said.
“The majority of Public Health staff are engaged in one of those two activities right now, full-time, seven days a week,” she said.
As of Oct. 7, the CN reported 2,472 confirmed cases of COVID-19 within Health Services, an increase of 900 over the past 30 days. Several hundred of those cases are active, said CN Public Health Medical Director Dr. David Gahn, who has offered tribal leaders a daily COVID-19 report since the start.
“What’s so hard about this virus is that people are contagious two to two-and-a-half days before symptoms start,” he said. “And onset of symptoms are generally mild. Many of our cases that we work with, it starts out with a runny nose or a scratchy throat or headaches.”
Because there are still unknowns surrounding COVID-19, concerns linger about the potential long-term affects for survivors.
“I worked with a young woman yesterday who for several weeks now has continued numbness and tingling in her extremities,” Gahn said. “So this is very concerning. It’s not just the mortality we’re concerned about, but the longer-term morbidity.”
More than 20 deaths have been associated with COVID-19 within the tribal health system. Most were CN citizens age 65 years or older.
“It’s difficult for us to calculate a mortality rate for Cherokee Nation,” Gahn said, “because we know there are citizens who get their care outside of our Health Services or they might have tested positive here, gotten sicker and gone to another hospital and might have passed and we don’t know about it.”
A CN map of the COVID-19 risk level within reservation boundaries shows a mix of “accelerated” and “rapid” spread. In counties such as Cherokee and Adair, virus transmission is considered widespread, according to the data, while in counties that include Craig, Delaware, Sequoyah and others, the spread is deemed a more severe “uncontrolled.”
“No indication that things are getting better yet,” Gahn said.
According to the state’s COVID-19 website, as of Sept. 7, the Oklahoma State Department of Health reported 94,352 confirmed cases with 1,075 deaths in the state.