Fighting COVID-19 in Indian Country

Friday, August 21, 2020

Full statement from Secretary of Health and Human Services Alex M. Azar II:

One of the most important duties we have at HHS is providing healthcare, human services, and public health programs in Indian Country, where we work in partnership with Tribes to improve the health and well-being of American Indians and Alaska Natives.

Even in ordinary times, delivering services in Indian Country is a serious challenge. The Indian Health Service provides care in some of the most remote parts of America—in fact, some of the most remote inhabited places on earth. I had the chance to hear about some of this work firsthand last week during a trip to Alaska, where I met with leaders of the Alaska Native Tribal Health Consortium, which oversees IHS services in Alaska, about how they’ve battled COVID-19 and worked to continue delivering services during the pandemic.

The pandemic has brought new challenges to our work with tribal communities: not only healthcare delivery, but also services like child care, supports for older Americans and Americans with disabilities, and more. The IHS team, other parts of HHS that work on tribal issues like the Administration for Native Americans at ACF, and Tribes have come together to respond in remarkable ways.

American Indians and Alaska Natives have suffered disproportionately from COVID-19, being hospitalized at a rate 5.3 times that of the general population and with rates of infection 3.5 times higher than non-Hispanic whites. We’ve seen serious outbreaks of the virus in a number of IHS-served areas, including the Navajo Nation, Phoenix and Whiteriver in Arizona, and the Mississippi Choctaw reservation.

Tragically, the virus has struck members of the IHS family. We mourn the loss of a number of IHS employees who have died from the virus, and many more members of the IHS team have contracted the virus in the line of duty or seen family or colleagues fall ill. In many cases, IHS employees are not just fighting for the lives of their patients—they’re fighting for the health of their communities and loved ones.

The heroic work of IHS providers, in cooperation with Tribes, has delivered lifesaving care during these difficult times. To help protect patients from the virus and ensure there was capacity for COVID-19 patients, IHS hospitals took advantage of regulatory flexibility to offer more services via telehealth and open alternate care sites. The Navajo Nation in Arizona suffered a significant outbreak, but working closely with CDC’s Tribal Support Section, they have been able to drive down the spread of the virus substantially. Earlier this year, I met with leaders of the Oneida Nation in Wisconsin, which received a CDC grant to review their public health response to COVID-19 so far and address lessons learned.

We’ve supported IHS providers by sending 470 rapid point-of-care testing machines to track the spread of the virus, and we allocated $500 million from the HHS Provider Relief Fund to the tribal healthcare system. This week, Deputy Secretary Hargan visited tribal communities in New Mexico to learn about how they’re delivering care during the pandemic, including through a new expansion of IHS’s work with Project ECHO, which uses technology to deliver virtual healthcare training to rural areas.

IHS has been at the cutting edge of learning how to control the virus in rural settings. Last month in The New England Journal of Medicine, doctors from the Whiteriver Indian Hospital published the results of their innovative use of contact tracing and oximeters to detect early illness among sparsely populated communities, which the New York Times recently featured.

For years, IHS has been developing new and innovative ways to deliver care to rural communities. One example is Alaska’s Community Health Aide program, which employs certified health aides to deliver basic primary care, dental care, and behavioral health services in places where these services would otherwise be inaccessible. I’ve gotten to see this program in action in places as remote as the Aleutian Islands and communities north of the Arctic Circle. This summer, we announced that the Community Health Aide Program would be expanded nationwide, a recognition of its success and part of the administration’s overall work to improve tribal and rural healthcare.

Over the last several years, IHS has made major strides. We have fought for and won substantial increases in funding from Congress, including full funding of staffing for new and replacement IHS facilities, while also covering contract support costs so more and more Tribes can run their own facilities. Under Admiral Weahkee, IHS established its first-ever Office of Quality, which has already delivered results in securing accreditation for IHS facilities.

During the pandemic, Americans have been so grateful for the heroic work of all healthcare providers, and no one epitomizes the bravery and sacrifice of our healthcare heroes better than the men and women of the Indian Health Service. Each of us should be proud to work at a department that is home to IHS.

I want to say a special thank-you to every member of the HHS team serving on the frontlines, and especially everyone at IHS: not just the physicians, nurses, pharmacists, dentists, technicians, and other healthcare providers but all of the cooking, cleaning, administrative, maintenance, and security staff who make it possible for patients to receive care.

Your department, your communities, and your country are proud of your work and more grateful than ever.

Alex M. Azar II
Secretary of Health and Human Services