COVID-19 spreads among unsheltered
By Marley Shebala
DinÃ© Bureau firstname.lastname@example.org
WINDOW ROCK, Ariz. – There are 89 clients of the detox center in Gallup who came into contact with a COVID-19 positive client in early April or late March that could be wandering around in Gallup or on surrounding reservations. Navajo Area U.S. Indian Health Services Director Roselyn Tso reported to the Navajo Nation Council Naabik’iyati Committee Thursday that the 89 individuals, who should be in self-quarantine for 14 days, were among 170 individuals that IHS, at a very high level, traced and tracked from their contact with a Na’nizhoozhi Center Inc. Detox client who tested positive for COVID-19 April 8.
Tso noted that IHS believes that the first positive cases of COVID-19 at NCI were around March 30.
She said IHS tested 81 of the 170 individuals and 59 tests returned positive, which is more than 50%.
High-risk lifestyle made riskier
Tso repeatedly emphasized that the individuals who use the services of NCI lead a high-risk lifestyle that has become even riskier because of the pandemic, and many of them will not voluntarily comply with public health emergency guidelines to get tested and self-quarantine if they come into contact with an individual who tested positive.
“The problem is the 89 cannot be located,” she added.
Tso noted again that the 89 are a high-risk population for spreading the virus because they aren’t social distancing, wearing masks and gloves, or washing their hands.
“We are talking community spread,” she said. “We are trying to figure out how to get information back
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to their families, children, mothers, fathers.”
Tso explained community spread mean a person who is positive and who returns home where there is more contact made with additional people.
It’s this type of community spread that IHS is seeing throughout the Navajo Nation, she said.
Tso said that on April 10, she briefed the Navajo Nation Office of the President and Vice President, the Navajo Health Operation Command Center, and the Navajo Nation Department of Health about the NCI situation, which at the time demanded immediate shelter for individuals because NCI was shut down.
She explained that NCI was closed because it was not suitable for a pandemic.
“You cannot put everybody into one room now and expect them to be OK and not expect to add to the situation that is happening right now,” Tso said.
A few days after positive cases of COVID-19 were reported by IHS to NCI in late March, NCI employees began contacting the Independent and reporting their concerns about NCI Executive Director Kevin Foley’s decision to continue placing everyone who was brought in by the Gallup Police for protective custody to NCI into one large holding room.
The employees, in separate interviews, reported that the NCI clients slept next to each other, had sex with each other, shared one drinking cup, and didn’t wear masks.
They said Foley also ignored their requests for masks, gloves, hand sanitizers, gowns, shoe covers, and a plastic shield at the desk where NCI employees signed in individuals who were brought in by the police to NCI.
Coughing, high fever
Employees reported that the first client who tested positive arrived at NCI coughing, and when they took his temperature, it was extremely high. He was then transported to Gallup Indian Medical Center where he tested positive for the virus.
They said that GIMC then sent down health workers to begin tracing and tracking individuals he came into contact with before coming into contact with individuals in NCI’s holding cell.
Employees recalled that the individuals who were tested by IHS were transported back to NCI and told to self-quarantine until test results came back.
They said IHS began calling NCI concerning positive test results for about 30 individuals, which they said they estimated because Foley was not sharing who the individuals were so the NCI employees would help locate them because most of the NCI clients are repeatedly returning to NCI.
Employees said that after an employee tested positive, they begged Foley to shut down NCI.
When he denied their request because NCI provided an essential service, and continued to ignore their requests for personal protective equipment and to stop putting NCI clients in one huge holding cell, most of the employees refused to work under such life-threatening work conditions.
Tso said the Navajo Area IHS is leading the effort to contain the NCI outbreak with RMCH, the New Mexico Health Department, McKinley County and the Navajo Health Department.
She said they were able to secure more than 200 rooms from various hotels in Gallup, which is where NCI is located.
But Tso said about 10% of the individuals in need of shelter, who are told to self-quarantine, leave their hotel rooms and continue to move around and possibly continue to do community spread.
“We continue do what can for population and we will continue to be a party to find solutions for this unique group of people,” she said.
Emergency rooms overwhelmed
Tso said the closure of NCI has also overwhelmed the emergency rooms of GIMC and Rehoboth McKinley Christian Hospital with individuals who would usually go to NCI and that is preventing the hospitals from keeping beds open that they were trying to keep open for extremely sick COVID-19 patients.
She said IHS is also struggling with an option to contain and keep individuals in place for self-quarantine for 14 days, which involves calling in the National Guard to contain and keep individual in self-quarantine.
Tso said IHS, the city, McKinley County, and the state and Navajo health departments are preparing the youth detention facility in Gallup to house individuals with high-risk behavior who need to be quarantined.
She emphasized to council delegates again that Gallup Mayor Jackie McKinney informed her that he has “limited communication” with the Navajo Nation or its command center.
Navajo voice needed
But Tso said an official of the Navajo Nation needs to be at the table during the discussion of bringing in the National Guard because IHS hopes that whoever is brought in will treat the individuals with high-risk behavior who need to be quarantined with respect.
“As IHS, we cannot force people in place,” Tso said. “We are health care workers and not the judicial system.”
This reporter attempted several times to interview Foley about the closure of NCI and the accusations by employees that he failed to provide them with PPE and prevent the spread of COVID-19 by continuing to pack NCI clients into one holding room, but Foley did not return phone messages.
Navajo Nation Council Naabik’iyati Committee Chairman Seth Damon informed the Naabik’iyati that Foley did not respond to an invitation by the committee to make a report about the closure of NCI to them.