American Indian Culture and Research Journal

This is the second volume of a two-volume special issue of the American Indian Culture and Research Journal dedicated to the indirect impact of COVID-19 on Indigenous Peoples. The first, 44.2, reports on COVID-19’s extensive impact on Indigenous Peoples and the resulting variety of responses at community and local levels. This second volume, 44.3, provides specific research and insights for improving reporting, identification, and prevention of COVID-19 cases and deaths. Several contributors to this issue respond to the urgent need to ensure, for small populations, and Indigenous Peoples in particular, that data collection provides detailed information on race and tribal nation identifiers. Like this lack of data disaggregation, data inaccuracy also impedes understanding of the impact of a pandemic. Other researchers find that a hallmark of this pandemic—the shift from in-person to virtual interactions in many aspects of life—has clarified that innovative telehealth and virtual methods already underway for Indigenous Peoples may represent the frontiers of better health care, access, and service. “Moving Forward: No Scientific Integrity without an Acknowledgment of Past Wrongs,” a commentary emphasizing the necessary actions the US government must take if progress is to be made, concludes this special issue.

To monitor the progress of the COVID-19 outbreak, ensure equitable access to testing and treatment, and provide up-to-date information to Indigenous decision-makers engaged in setting up measures to protect their communities, the Manitoba Inuit Association (MIA) mobilized to work with the First Nation Heath and Social Secretariat of Manitoba, Ongomiizwin Research, and the Manitoba Government to identify Inuit in COVID-19 diagnostic tests, including Inuit who reside in Manitoba or those who come from Nunavut to the province to access health services. Provincial work was already underway to add Indigenous identifiers into provincial clinical health information systems; however, it was apparent early in April 2020 that reporting to Indigenous organizations on identified COVID-19 cases for First Nation, Metis, and Inuit People would be also be required in order for remedial measures to occur. This article describes the governance considerations needed to establish an information-sharing agreement with the Government of Manitoba and the role of the MIA in overseeing this process. Further background information is provided in addition to an extended discussion around the context in which Inuit are identified and receive healthcare services in Manitoba.

Death certificates are a crucial tool in public health, yet American Indians and Alaska Natives have long been misclassified after death, most often as white. During the COVID-19 pandemic, rapid provisional death counts have used data from death certificates to identify outbreaks and allocate resources. This paper interrogates common practices of funeral directors—who complete the demographic portion of the death certificate—as well as the social context in which they operate. The paper then reviews how these determinants of American Indian and Alaska Native misclassification may have changed during the pandemic and discusses implications for the quality of COVID-19 mortality data and opportunities for improvement.

American Indian/Alaska Native communities are at higher risk of poor outcomes from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The Northwest Portland Area Indian Health Board’s program Indian Country Extensions for Community Healthcare Outcomes (ECHO) initiated telehealth sessions for health professionals. All resources were centralized at www.IndianCountryECHO.org. In its first six weeks, the program had 4,579 attendees. Participants submitted 563 questions to specialists. There were 22,683 webpage views, more than three times the pre-COVID-19 baseline. Evaluation found 94 percent of clinicians reported knowledge increase and 93 percent reported greater social support, demonstrating that a teleECHO network serving Indian country is an important part of emergency response.

In a 2010 article, Traci Sylva, Pauline Chinn, and Charles Kinoshita note that Indigenous communities of practice generate solutions to “highly valued, real-world problems'” by connecting “science to culture, place, and community.” To provide Native American communities a collaborative space to address COVID-19, we developed Gathering Grounds, an Indigenous community of practice, or I-CP. Over one hundred individuals from Native communities nationwide participated in Gathering Grounds. We started with reviewing existing literature to identify existing approaches that honor Indigenous ways of building and maintaining relationships as well as best practices. This article discusses the I-CP’s development, shares community responses to COVID-19, and describes how the I-CP facilitates resource-sharing and growth opportunities.

Since January of 2020, the number of deaths in Indian country due to COVID-19 has steadily grown, bringing into stark relief the destructive effects of disease epidemics on historically marginalized communities. For Indigenous peoples, the ravages of the ongoing pandemic are part of a broader epidemiological history of devastation set in motion by European colonization. The robust body of historical and anthropological scholarship which has emerged to document the impacts of infectious disease on Indigenous people has typically reinforced settler-colonial narratives of disappearance and culture loss. Although we cannot deny the tragic and long-term consequences of foreign pathogens on the peoples of the Americas, Indigenous communities have creatively responded to and survived disease outbreaks. Drawing on ethnographic and oral historical sources, this article documents some of the strategies employed by Indigenous people across North America to explain and treat episodic viral spread from the seventeenth into the twenty-first centuries. Tracing the culturally grounded methods of disease management employed by Indigenous groups over time highlights the resiliency of Tribal nations during the ongoing coronavirus crisis.

Trust is essential for good patient care. Abuses in research and in medical care undermines trust in governmental medical care systems. Restoring trust involves acknowledging and correcting past harms to communities and individuals.