Coronavirus cases have spiked on the Navajo Nation in recent weeks.
The sprawling reservation spread across three states now has more cases per capita than any other U.S. state except for New York and New Jersey.
As of Monday, the Navajo Nation had 1,197 positive coronavirus cases. It has a per capita infection rate 10 times higher than that of neighboring Arizona. Forty-four people have died, more than in 14 other states.
Navajo officials announced a continued weekend curfew order until the end of the month as health officials try to get the outbreak under control.
Noel Smith is the Navajo Nation reporter for the Farmington Daily Times. She said she's heard the term 'community spread' a lot when officials try to explain the high numbers.
“That makes sense to me because we do have residential homes where there are multiple generations living together,” she said.
Smith also said that many places in the nation have multiple people living on the same plot of land. So there may be a house for one family, a hogan for the grandparents and a trailer where more extended family is living.
Besides the closeness of family and communities, another reason why the virus could be spreading is the lack of running water on the reservation. According to the Navajo Nation Department of Water Resources - up to 30 percent of homes on the Navajo Nation do not have running water.
“We have several homes that do not have running water and you have health officials saying one way to combat the virus is to frequently wash your hands and if you don’t have running water in the home how can you do that?” Smith said.
While hand sanitizer could help, it is -- of course -- in short supply.
Another issue facing the Navajo Nation is health care. An already underfunded and overstretched system is struggling to keep up.
The Coronavirus Aid, Relief and Economic Security (CARES) Act provides $8 billion for Native American and Alaska Native Tribes. But the National Congress of American Indians estimated tribes would need up to $20 billion to properly fight the virus.
Complicating matters even more is the remote nature of homes on the reservation, as well as a high rate of underlying health conditions.
“Navajos, as well as all Native Americans, do have high rates of diabetes. There are high rates of cancer,” Smith said.
Leaders of the nation are fighting to get more dollars to address the outbreak -- but the funding has been slow.
“Right now, I know the Indian Health Service is starting to get the equipment to do rapid testing for COVID-19,” Smith said.
But that help comes weeks after the first cases were reported.
For now, stay-at-home orders have been mandated by the Navajo Health Service, as well as strict curfews on nights and weekends through the end of April.
If the disease continues to spread at dangerous levels, it has the potential to devastate already dwindling Native American populations.
Noel Smith, Navajo Nation reporter, Farmington Daily Times