Indigenous Peoples and Human Rights

June 29, 2020

Navajo Epidemiology Center: More than half of Dine' coronavirus cases are 18 to 60 years old

Photo: Bitahnii Wilson is one of the Dine' grassroots volunteers struggling to bring water to Dine' in isolated homes who are in desperate need of water, food and supplies. Photo courtesy Bitahnii Wilson.

The Navajo Epidemiology Center reports that Dine' who live off the Navajo Nation and return home are a point of spread of coronavirus.  More than half of the cases, 64 percent, are 18- to 60-year-olds. Elderly males are at the highest risk of death.

Navajo Epidemiology Center delivers COVID-19 situational report to Health, Education, and Human Services Committee

WINDOW ROCK, Ariz. — Members of the Health, Education, and Human Services Committee (HEHSC) received a report regarding coronavirus (COVID-19) data from Ramona Antone-Nez, senior epidemiologist for the Navajo Epidemiology Center (NEC) on Wednesday, Jun. 24, via teleconference. 

The Navajo Epidemiology Department is housed within the Navajo Department of Health (NDOH) and is currently operating under the Navajo Nation Health Command Operations Center (HCOC). The COVID-19 operations public health branch of the HCOC consists of four pillars focused on epidemiology, contact tracing and case management, community mitigation and public health messaging.

Antone-Nez stated that the NEC has been creating situational reports detailing daily changes since the first confirmed case of COVID-19 on the Navajo Nation. The report presented to HEHSC was situational report no. 114 from Jun. 23. She pointed out that recent reports have inclucded some information from Navajo citizens residing in border towns and receiving care at facilities off the Navajo Nation in places like Gallup, New Mexico and Winslow, Arizona.

NEC collects information from different health care service units and tribal health organizations through a survey designed through the Survey Monkey online service or through NEC Info., which is a tool created by Navajo EPI. Information is collected daily and is then aggregated from the different service units. Antone-Nez reported the center also works closely with the New Mexico, Arizona and Utah Departments of Health, as well as Navajo Area Indian Health Service (IHS).

According to the report, NEC is aware of 50,185 COVID-19 tests that have been conducted by health care facilities and partners in and around the Navajo Nation resulting in 40,106 cumulative negative tests and 7,088 cumulative positive tests. Antone-Nez pointed out that the number of positive tests may differ from total cases due to multiple tests performed on the same individuals.

The report stated that, of the 7,088 reported positive cases, 3,363 or 47 percent were male and 3,725 or 53 percent were female. Of the positive cases, 933, or 13 percent, were ages 18 and younger, 4,535, or 64 percent, were 18- to 60-year-olds and 1,620, or 23 percent, were 60-plus year-olds.

The Navajo Nation has seen 3,754 total COVID-19 recoveries. NEC defines ‘recovered’ as a discontinuation of isolation, Antone-Nez said.

Of the total accumulated positive tests, 336 have resulted in mortality. 116, or 65 percent, of COVID-19 mortalities are represented by people under the age of 60-years-old and 220, or 65 percent, over the age of 60-years-old. 197, or 59 percent, of COVID-19 mortalities reported have been males and 139, or 41 percent, have occurred to females.

Antone-Nez pointed out that from this data, it seems that males over 60 years of age have a higher mortality rate than other age groups and genders. She stated that her departments have been using public messaging to encourage males aged 60-years and older to wear masks and seek medical care and testing sooner if they experience COVID-19 symptoms.
Antone-Nez’s report included a figure of the Navajo Nation COVID-19 cases by result date. She pointed out that from May 11th to May 12th, there was a jump from 147 to 240 cases. This drastic jump is due to a quality assurance cross-check between the different sources, meaning there were not actually 240 cases that day, but there were some cases that had not been reported.

As of Jun. 22, when this data was reported, the Navajo Nation has reported 17 days with the number of positive cases under 100. Antone-Nez called this good news.

The report also detailed the cumulative incidences of positive COVID-19 cases from Apr. 1 to Jun. 22 for the Chinle, Crownpoint, Ft. Defiance, Gallup, Kayenta, Shiprock, Tuba City and Winslow service units. Most of the service units are now reporting plateaus or downward trends with the exception of Winslow. That was the result of a recent change in reporting of the Jeddito community from Fort Defiance to the Winslow service unit.

Of the eight service units, it was reported that Chinle had 1,841 total cases, Crownpoint had 648 total cases, Ft. Defiance had 425 total cases, Gallup had 1,211 total cases, Kayenta had 1,013 total cases, Shiprock had 1,148 total cases, Tuba City had 588 total cases and Winslow had 206 total cases. Week- over-week, Tuba City and Winslow service units have seen percent change increases. The last portion of the report included a heat map of the total cases per service unit visualizing the information.

Antone-Nez informed the committee that the Tohajilee, Alamo and Ramah Navajo communities were grouped with the Crownpoint service unit. She also explained that discrepancies are common between Navajo EPI’s data and their partners’ because of the different ways terms are defined. This is not an issue, but Antone-Nez wanted to bring this to the attention of the committee.

“Where does it seem like the virus is coming from,” asked Council Delegate Carl R. Slater (Round Rock, Tsaile/Wheatfields, Tsé Ch’izhí, Lukachukai, Rock Point), vice chair of HEHSC. He also asked if the Navajo Nation closures, curfews and food distributions were working to reduce cases of COVID-19, stating that a decline in cases in his chapter communities isn’t evident.

Antone-Nez responded that they have been tracking transmission of COVID-19 that happens through both large and small gatherings and that partners were noticing that citizens who live off the reservation and come home are a point of spread. Ultimately, she was not equipped to answer those questions that day and that more time might be needed to interpret data. Antone-Nez said she would follow up with HEHSC.

Council Delegate Pernell Halona (Coyote Canyon, Mexican Springs, Naschitti, Tohatchi, Bahastl’a’a’) inquired about COVID-19 forecast models for the Navajo Nation. Antone-Nez stated that was not something her department had available yet, but would share. Delegate Halona suggested that information be made available to the general public, stating that it would help understand the COVID-19 situation better. Additionally, Council Delegate Daniel E. Tso (Littlewater, Pueblo Pintado, Torreon, Whitehorse Lake, Baca/Brewitt, Casamero Lake, Ojo Encino, Counselor), chairman of HEHSC, requested that data also be forwarded to the University of New Mexico.

The report from NEC was accepted by HEHSC after a vote of 4 in favor and 0 opposed. Delegate Slater concluded with requests to follow up on the effectiveness of Navajo Nation’s response to food and essential supplies distribution in reducing the number of COVID-19 cases and if there are patterns that will help the Navajo Nation prepare for a second wave. He also requested that information be distributed publicly in hopes of more accountability. Finally, Slater requested information on the needs of NEC as it relates to Coronavirus Aid, Relief, and Economic Security (CARES) Act expenditures.

MEDIA CONTACTS:, (928) 287-2085 Byron C. Shorty, INT Communications Director Timothy E. Benally, Public Information Officer Isabella S. Robbins, Staff Writer

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