Month: December 2020

Lack of Information Contributes to Disproportionate COVID-19 Rates Among Oregon Latino Population

“It’s just really overwhelming,” said Anakaren Gutierrez Sandoval, a community health worker with the non-profit group Oregon Latino Health Coalition. “That’s the best way I can describe it. Everyone is just at max capacity.”

Sandoval is talking about the disproportionate affect that the COVID-19 pandemic has had on the Latino community in Oregon. While they make up about 12% of the population of Oregon, Latino Oregonians account for over 39% of coronavirus infections in the state. Several factors contribute to this – such as crowded housing, an overrepresentation of Latinos as essential workers, and lack of access to healthcare – but a leading consideration is the lack of information available to the community. While information on social distancing and mask-wearing seems to abound for English-speakers, resources in Spanish can be scarce.

“We have a 211 number where they could call to request assistance,” said Sandoval, “but a lot of times that was in English or they had technical difficulties being able to get that information.” Not only are Spanish-language resources hard to come by, misinformation on Spanish-language radio stations is plentiful. This lack of communication appears to have exacerbated or at least contributed to the disproportionate infection of the Latino community in Oregon.

“We’re in the middle of a pandemic,” said Mexican-American winemaker Cristina Gonzales, “But we’re also in a pandemic of misinformation. And that goes down the pipeline, down to our most disadvantaged and underrepresented groups.”

In the below graph, the blue bars represent positive tests of people who marked their ethnicity as Hispanic. While it is clear that these represent much more than 12% of the population, the data has been obscured in some ways by the differentiation between race and ethnicity.

In this second graph, the “LatinX” community appears to have suffered zero cases – this is because most people mark “white” (or another race) as their race, and identify themselves using the Hispanic ethnicity box. This data could lead to an inaccurate analysis of the pandemic’s effect on the Latino community in Oregon.

This data shows the reality that Oregon’s Latino community, especially in the agricultural sector, has suffered disproportionately from the COVID-19. Most of Oregon’s agricultural workers – especially in industries such as the wineries and Christmas tree farming in the Willamette Valley – are Latino, many of them migrant workers. Since low-income housing can be hard to find, families crowd into small apartments, sometimes with two or three families in one two-bedroom apartment in the Portland area. This makes social distancing near impossible. For agricultural workers, losing two weeks of pay can be disastrous financially, and many employers aren’t doing enough to allow workers to take enough time off, or even let them know if those opportunities exist.
But working from home is impossible for agricultural and service workers, who make up a majority of the Latino population. For those who are students or who do work in other fields, at-home work can also be inaccessible due to a lack of reliable access to the internet. This dearth of technology, as well as the language barrier, mean that reliable news media is scarce. Many families rely on word of mouth, news from their home countries, (which can include misinformation or health advice that differs significantly from US standards), and accurate signage and resources at the place of employment.

And employers aren’t always equipped properly to meet the needs of the community. Gonzales, whose vineyard is located just outside of Portland in the Willamette Valley, said even when employers are well-intentioned, overwhelm and the financial stresses of the pandemic can affect how resources are distributed. “You see the public health care signs of, you know, let’s be safe during COVID,” she said, “And they have them that are bilingual and in different languages. But some of it is that the employers themselves might not know how to get it. Or it’s just not being posted to where workers are able to see it. And then there’s illiteracy, where workers are potentially not able to read if it’s in English or if it’s in Spanish.”

Another problem is trust. Even when translated into Spanish and made available, many Latino people may be wary of official sources. “There’s a lot of mistrust of the government,” said Dr. Roberto Orellana, a professor in the School of Community Health at Portland State University. “No matter if it’s local government or federal government, for a lot of people, government is government. And when the government put your kids in cages, you don’t trust the government.”

Orellana also underscored the importance of word-of-mouth and messages from community organizations, such as Latino churches or family members, to help get the right information across. “The message has to come from the government,” he said, “but also from … local organizations.”

Gonzales, in addition to being very active in the Latino wine-making community, is on the board of the non-profit AHIVOY, (Asociación Hispana de la Industria del Vino en Oregon y Comunidad). AHIVOY provides education to vineyard workers (called “vineyard stewards”) in order to help them overcome socioeconomic barriers and access other careers within the wine industry, such as sales, working in tasting rooms, marketing, and even becoming winemakers themselves. Through partnerships with local community colleges, AHIVOY has helped vineyard stewards, who might have started out as migrant workers, gain an immersive English-language experience as well as knowledge and resources to start fulfilling careers. However, Gonzales said the pandemic has put a halt to all of that. When the community college closed their campus and moved classes online in the spring, AHIVOY had to temporarily cancel its program.

“Vineyard stewards don’t have access to the internet all the time,” said Gonzales, “So that would make if very difficult to run classes.” In-person resources are a necessary part of catering to lower-income students. Gonzales said she hoped the program would be revamped in 2021, with smaller class sizes.

Shutting down schools or moving to remote learning has been a challenge for the Latino community, both for children who may not have access to the internet for online classes, and for parents who rely on the information pipeline passed through their often English-speaking children. Orellana emphasized that it is vital for schools to “continue to provide evidence-based information to the students so they can take it into the family.”

Sandoval said this information blackout has meant that getting the help her organization offers to Latino workers has been difficult. The Oregon Latino Health Coalition aims to help the Hispanic community in Multnomah County, especially those in the agricultural industries surrounding Portland, access otherwise hard-to-reach resources. They provide Spanish-language help with filling out applications for aid and healthcare. But Sandoval said that even in 2020, when much of life seems to have moved online, the group relies most heavily on word of mouth to get information to their clients. For a recent drive-through COVID testing event, Sandoval said, “Most of the patients that signed up for it, it was through word of mouth. When we would try to do it on social media, it wasn’t effective.”

Without adequate resources and information available to the Latino community, Sandoval also said that migrant workers fear giving the necessary personal information for contact tracing to county and state officials. They are afraid it might be given to ICE and lead to deportation.

“We saw a lot of clients hesitant to accept any sort of financial aid or resources, because they felt like it could affect their immigration status,” she said. Even though the county does not report any of the information it collects to ICE, Sandoval said people are hesitant to trust officials, and don’t want to disclose information such as the other members of their household. This has led to hesitance in the community to get tested, as a positive test is associated with having to disclose this vital information to the authorities.

Many involved in community outreach in the Latino community said that because resources and staff are scarce, it has led to extreme overwhelm among those trying to help. “Everyone is like a deer in the headlights right now,” said Gonzales. “We’ve been in the pandemic for a little while, but still, it’s so much to take in and process. And, you know, to try to survive.”

Because so much of Oregon’s Spanish-speaking population is currently employed in the agricultural and service sectors, there are too few Latino nurses, community health workers, and Spanish-speaking government employees to address the crisis. “When the vaccine comes,” said Orellana, “we want to have this large workforce of trained Latinos, who are bicultural and bilingual, that can help our agencies, the state and community health centers.”

Sandoval echoed the call. “We’re all feeling like there just need to be more resources available,” she said. “Because until people can feel like they can stay home, and take care of themselves, protect themselves, without losing their jobs or their homes, the numbers are still going to continue to increase.”

Just an hour south of Tupelo lies Mississippi State University, nestled near the town of Starkville, or what others call the “Golden Triangle.” David Buys, an assistant professor in the Department of Health at MSU, has watched the coronavirus pandemic escalate since March. He says that the rate of coronavirus cases has climbed in the last few months in his home of Mississippi.

When Governor Tate Reeves began to create a stay at home order for the state, coronavirus cases were already increasing. On April 1, a statewide stay at home order was enforced to decrease contamination, except for businesses and services deemed essential, which were many. Gov. Reeves enforced a mask mandate in May, which required everyone to wear a face mask in public when social distancing was not possible.

But many have said that Reeves was late to enforce policies, and he has relaxed his mandates too soon. Reeves lifted the mask mandate in September, which didn’t help the new onslaught of cases that came in the Fall. Specifically, the race data has shown that coronavirus cases have increased among white communities, while the amount of cases has decreased among black communities.

Buys, the professor from MSU, says that the messaging from the state government could be one of the reasons that cases have increased. According to data published in November, this is the first time since June that the white community has exceeded the black community in coronavirus cases. Buys said this could be because of the political affiliations between white communities and the Republican government.

“I think the presidential campaign that has been so drawn on racial lines has emboldened white people to resist the precautions,” he said. “I think the federal government’s response has called into question the validity of science and the recommendations that have come forth from our public health and medical experts.”

Governor Reeves, a friend of Donald Trump’s and a first-term Republican, in March decided to wait and see how coronavirus would affect the state. He waited until April to declare stay at home orders, while local governors began restrictions as early as March 15. Reeves has continuously lifted state mandates since August and it has shown an uptick in cases.

Buys says that the number of cases will increase if Reeves doesn’t return the state back to a face mask mandate and create more social distancing restrictions.

“After the governor lifted the statewide mask mandate, and he has begun to implement pocket mandates depending on rates county by county. We know that people travel between counties, so they are going between counties and the public health opinion would be that the isolated mandates are not as effective as statewide mandates.”

Buys said that while he’s noticed an increase of mask-wearing and social distancing in black communities of Mississippi, the discretion among white communities has decreased, and this could be leading to the increase. According to data released by Mississippi State University in November, the number of cases has increased much higher in the white community, up to 57,924 cases. While among African-Americans, the number of cases is about 50,535.

Anecdotally, Buys said that he’s noticed more white people attending schools in person, traveling out-of-state, and doing activities that are not safe according to the Centers for Disease Control and Prevention.

“There appear to be many more minority families that are taking advantage of virtual schooling options than those that are not.”

The reason for this, Buys said, could also be due to the fact that black communities were hit hard by COVID-19 at the beginning of the pandemic, so there is a large increase in social distancing in this community. While white families, who have been notoriously Republican in the state, have leaned towards the information given by Governor Reeves and President Trump, which has led to confusion.

“White folks who were maybe more likely to be Trump supporters also bought the anti-science rhetoric that was coming from that administration.”

As you can see here, both the rise in cases and deaths are among white residents, while the number of cases and deaths among black residents has decreased.

This graph shows the difference in the number of cases between the two communities.

But Yulanda Haddix, who is the local president of the Mississippi NAACP Chapter in Tupelo, said that the data is showing a skewed version of the real crisis. She said that she thinks that African-Americans are still being infected at a higher rate but it’s not being presented properly.

“COVID is not decreasing in the black community, it’s just not reported in the black community. We don’t go and get COVID tested, it’s not readily available,” she said. “We live in a rural community, most of us don’t have health insurance. When we get an illness we treat ourselves, and we aren’t going to the doctor unless we have to go. That’s why it’s not reported as much.”

She said that although the data says differently, she believes that the African-American community is getting hit much harder. She said that because of systemic issues in Mississippi, many black residents don’t have access to health insurance or testing clinics located near their homes.

“Because we don’t have the availability of health insurance, or primary care physicians, we are not going to be diagnosed. By holiday time, I think we are going to gather. All we have is family. I think it is more prevalent in our communities, we are just not being counted.”

The data trends are still showing that white communities are increasing in COVID cases. According to data by the COVID Tracking Project, about 42% of coronavirus cases in Mississippi are African-American, while 48% are white. Even though the numbers show that coronavirus cases have increased among the white community, she said that COVID is disproportionately affecting the black community.

“In rural communities, or low-income or underserved, no one has three hours to get tested. And if you don’t have health insurance, most of the time you can’t get the test. Mississippi is the way it is because people allow it to be that way. The underserved continue to be underserved and the upper class is the upper class.”

While there are differences in the way that black and white communities are being affected, the data shows that coronavirus is affecting both communities at alarming rates. Some locals are saying that white residents don’t necessarily believe in the health consequences of COVID-19.

James Phillips, who said that many of his friends in Mississippi have contracted COVID-19, said that he thought the CDC guidelines are too restrictive and he thinks they are unnecessary. He said that he and his friends don’t believe that coronavirus is as harmful as it’s portrayed on the media.

“It was a big fear factor, for the ones at first who got it. But then they would get better, it was killing other people but it wasn’t bad for them,” he said. “Everyone I talked to had the same story. None of the people I knew had it bad. I no longer fear it.”

Since Governor Reeves rescinded the mask mandate, many residents have felt that they can go outside freely without wearing masks. According to the Mississippi Free Press, this has been seen amongst white people. Phillips said that he is one of the residents who doesn’t believe in the strict mask guidelines.

“I don’t trust the guidelines. I have been without a mask since the pandemic started, except to get on a plane. I’ve had no problems.”

Instead of issuing a statewide mask mandate, Governor Reeves has only enforced masks by county, and in counties that have the highest number of cases people are required to wear masks. While Reeves said that people should be wearing masks, there is no statewide law enforcing it. The number of cases is increasing, and as of December 5, about 164,931 coronavirus cases have been recorded in Mississippi. Yet, many residents are still not wearing masks.

Ashton Pittman, a reporter for the Mississippi Free Press and a native Mississippian, said that he’s seen people inside grocery stores and shops disregarding the CDC guidelines.

“In some cases, people are defying the social distancing and defying masks to make a political statement,” he said. “I’ve seen Republican politicians who are speaking at anti-masking events, a lot of these are happening in Desoto County.”

He said that Governor Reeves has been confusing because he’s trying to please both sides of the political spectrum, and he’s been acting too late.

“A lot of people aren’t taking him seriously. He’s not making anyone happy cause he’s trying to make everyone happy. There’s also a black and white split,” he said. “White people in Mississippi tend to believe Donald Trump, and he’s downplayed COVID-19. Black people don’t listen to Donald Trump, they tend to listen to the advice of medical experts.”

He also said that black people in Mississippi are being more careful because there were so many coronavirus related deaths early on in the pandemic.

“Black people in Mississippi are more likely to know someone who died early on in the pandemic. White people should be taking this more seriously, but the politics are overruling it.”

During the Covid-19 pandemic, the South Sudanese immigrant community of Nebraska have been hit hard, trapped in poor working conditions in an uncertain economy. Nebraska is home to one of the largest enclaves of South Sudanese immigrants in the United States, with an estimated 10,000 residents in Omaha alone. According to researchers University of Nebraska Omaha, the population of South Sudanese residents in Nebraska is small enough that its value is not publicly available, by the United States Census Bureau. This indicates that the Nebraskan South Sudanese population falls between 10,000 and 65,000 residents. The population of Black or African American residents in Nebraska is 100590 – therefore, South Sudanese Nebraskans could account for anywhere from 10%-64.5% of that sub-population.

Data from The Atlantic’s Covid Tracking Project reveals that Black or African American Nebraskans account for 5% of the state’s Covid-19 cases, and 6% of their Covid-19 deaths. The accuracy of Nebraska’s Covid-19 race data reporting is suspect, as state officials have only disclosed race data for 55% of cases, and 71% of deaths. In the graph below, we see that of Nebraska’s minority communities Black or African Americans, represented in turquoise, had the highest Covid-19 case rates, as of December 2^nd, 202. It should be noted that Nebraska does not report Covid-19 rates for the LatinX community.

But what factors contribute to these troubling statistics?

Organizations like the Catholic Social Services of Nebraska, and the Lutheran Family Services of Nebraska help place South Sudanese immigrants in jobs throughout the state. This is not an easy task, as 79.3% of South Sudanese immigrants come to America with a high school level education or less. The Nebraska Office of Health Disparities and Health Equities reports 52.7% of homes that speak African languages speak English less than “very well”. With these limitations, South Sudanese community members often can only find work in meatpacking warehouses, nursing homes, and as housekeepers – all high-risk jobs in the Covid-19 pandemic.

Prior to, and through the pandemic, the Trump administration has pursued an aggressive deregulation agenda, reducing safety standards for industrial and service workers. In 2017, the Trump administration halted electronic reporting of workplace injury and illness reports by the Occupational Safety and Health Administration. In June 2018, Trump’s Center for Medicare and Medicaid Services halved fines for nursing homes that violated safe working condition practices. Although the federal government was pressured to require greater transparency from nursing homes regarding Covid-19 outbreaks in May 2020, nursing homes are not required to inform staff members about case rates in their facilities.

But it is the conditions in the meatpacking industry, such as the Smithfield Foods warehouse in Crete, Nebraska and Noah’s Ark processing plant in Hastings, that have been the source of countless Covid-19 cases, and deaths. In February 2018, the Trump administration revised inspection standards for the Federal Food Safety and Inspection Service, reducing oversight of safety measures in meatpacking warehouses with the intent to increase food production.

A recent federal lawsuit filed by the American Civil Liberties Union documented how, in the absence of proper oversight, unsafe working conditions throughout the Nebraskan meatpacking industry created a breeding ground for Covid-19 infection. Workers were expected to stand shoulder to shoulder for hours at a time on processing lines and sat crowded together in small windowless cafeterias where they could not wear masks while eating. All the while, plants failed to take basic measures to protect their workers, such as adequate masks provision and Covid-19 testing. “It’s a terrible cycle,” says Albert Maribaga, a South Sudanese community leader, and employment specialist at the Catholic Social Services of Nebraska, “young men go to work at these plants, get sick and don’t know it, and come home and infect their families”.

The Nebraskan South Sudanese community faces socioeconomic factors, outside poor working conditions, that contribute to the spread and fatalities of Covid-19. Approximately 1 in 3 Black, non-Hispanic Nebraskans live in poverty. According to Christa Yoakum, Senior Welcoming Coordinator for Nebraska Appleseed’s Immigrants & Communities Program: “if workers don’t get Covid in the factory, they get it while carpooling to and from the factory because they cannot afford individual transportation”. Yoakum also points out, that often times both parents in immigrant households get infected with Covid-19, because both work in the same facility.

Cezar Garcia, a Community Organizer for Nebraska Appleseed’s Immigrants & Communities Program, highlights how community dynamics, brought on by economic stress, contributes to the spread of Covid-19 in the South Sudanese community: “often times meatpacking workers aren’t just providing for their immediate family, they support their extended family too”. The pressure to provide for such a large network of loved ones incentivizes family members to show up for work even if they test positive for Covid-19. It is common in Nebraskan South Sudanese communities for older members to live with their families, because they cannot afford housing in assisted living centers. While younger family members with more robust immune systems can fight off the symptoms of Covid-19, elders perish. At the time of our interview, Albert Maribaga knew of five community elders who had passed away that week.

South Sudanese meatpacking workers have relied on their company healthcare plans to protect them and their families during the pandemic, all too often these healthcare plans are insufficient. Albert Maribaga reports new meatpacking workers find themselves without coverage, as their healthcare deductibles are unmet. Maribaga also notes that long term hospital care is not covered in meatpacking healthcare plans. Workers infected with Covid-19 are forced to stay home without pay, with no room in their budget to seek the extended treatment necessary to deal with severe symptoms. Christa Yoakum alluded to another issue with meatpacking healthcare; many plans are not accepted by local hospitals, and in-network hospitals are too far away to access. Undocumented South Sudanese Nebraskans are unlikely to seek treatment altogether, as they are without social security numbers.

Some Nebraskan institutions are developing programs to help their immigrant communities, centered around inclusion, employment, and awareness. For instance, in South Sioux City, newscasters have been broadcasting public service announcements about Covid-19 in the different languages of Nebraska’s immigrant communities. “These awareness initiatives are so important,” says Cezar Garcia, “I have heard stories about people who don’t know when or how to wear their masks, and they’ve been relying on the news to get that information”. Food banks across Nebraska have adjusted their models for food delivery, opting to subsidize restaurants and grocery stores that serve foods from immigrant’s home countries. Christa Yoakum has confirmed that an anonymous donor has financed an angel fund to help pay for the treatment of Covid-19 infected undocumented workers. The Worldwide Education Services have doubled down on their existing proposals to Nebraska’s state senate; lobbying for the certification of immigrant practitioners who held medical licenses in their home countries to be certified registered nurses and vaccine administrants.

The road to commensurate support for South Sudanese immigrants in Nebraska is long, but the Covid-19 pandemic has brought them unprecedented connection to non-for-profits. “Nebraska is a big state, we have relied on volunteers and word of mouth to build connections to immigrant communities,” says Yoakum “now, we have direct communication with community members, and we will strengthen and deepen our ties with them to provide long term support”.

American Indian tribal nations in Montana are inherent sovereign nations possessing sovereign powers, which are separate and independent from the federal and state governments. Despite this sovereignty, tribal nations are inextricably interconnected with these governments and their unequal power structures they are legally independent from. The COVID-19 pandemic, and the state’s mishandling of it, has threatened the preservation of cultures, language, and tradition and of these diverse sovereign nations. “Overcoming covid is going to really require the dismantling of all of these systems of oppression that have enabled the virus to kill so many people of color. It’s very clear that the experience of COVID is absolutely stratified along economic, racial, and geographic lines,” says Dr. Desi Rodriguez-Lonebear, an Assistant Professor at UCLA Department of Sociology and a citizen of the Northern Cheyenne Nation, located in present-day southeastern Montana.

According to The Atlantic’s COVID-19 Tracking Project, the American Indian/Alaska Native (AIAN) community makes up 6% of Montana’s population, however accounts for 13% of COVID-19 cases and 28% of deaths. This disparity in COVID-19 related deaths is not exclusive to Montana. Nationwide, Black, American Indian or Alaska Native (AIAN), and Hispanic or Latino populations are seeing higher death rates relative to white populations. The below chart shows the disproportionate amount of deaths per 100,000 people for both AIAN and white populations in Montana and the US.

As noted in the chart above, the AIAN population in Montana is facing a crisis, with 181 people per 100,000 dying. This number is alarming when comparing it to the white population in Montana, which is 28 per 100,000.

In Montana, the rates become even more alarming when looking at specific tribal nation data, if available. The Northern Cheyenne Reservation has 11,266 enrolled tribal members with about 5,012 residing on the reservation. As of December 4th, the reservation has seen 850 cumulative cases, and 34 deaths. There are 170 cases of COVID-19 per 1,000 tribal reservation members, an alarming number compared to 41 cases per 1,000 for white people.

Erasure of American Indians in Data Collection
Dr. Rodriguez-Lonebear directs the Data Warriors Lab, an Indigenous social science laboratory. She is the Co-Founder of the U.S. Indigenous Data Sovereignty Network, which helps ensure that data for and about Indigenous nations and peoples in the U.S. (American Indians, Alaska Natives, and Native Hawaiians) are utilized to advance Indigenous aspirations for collective and individual wellbeing.

“What we’re seeing within these publicly available data sets are just a snapshot of what’s actually happening on the ground. That’s largely because of the fact that these data sets being collected by county, state, and federal agencies have a long history of misclassifying, miscounting, and not counting indigenous peoples in this country. The urgency of the situation is even greater than what the data are telling us. And what the data are telling us is terrifying and shocking. In Montana, natives are dying at almost 12x the rate of white people in this state. If that doesn’t shock you, I don’t know what will.”

The need for up-to date and accurate tribal specific data is dire. Among many things, the pandemic has illuminated for many inside the margins the crippling inequity that plagues this country. In the past, we have seen the harmful impacts of inaccurate, incomplete, and flawed tribal population data, such as the Census. The Census directly impacts funding levels for tribal communities and failure to accurately and consistently account for the nuances in American Indian data leads to long-lasting and complex health, education, and economic inequities.

The chart below shows the quick rise of COVID-19 cases and deaths of AIAN people in Montana.

Although the data collected from the COVID-19 tracking project does a great job collecting data across state agencies, there is still a need for stronger data collection for AIAN communities.
“There is a significant problem with the lack of tribal identifiers in a lot of these covid data sets which is a symptom of a much larger issue where tribal identifiers are not being collected in administrative data sets that aren’t coming out of administrative agencies. Without having the ability to identify your tribal affiliation, or the ability to identify that you are an enrolled citizen of a tribal nation, tribal nations have difficult time figuring out the magnitude of all sorts of crisis and issues on their population,” says Dr. Lonebear when asked about the most dangerous consequences of gaps in data collection.

Another major issue with the misreporting of data is the inability to account for the unique cultural components of the nations. “Native populations are highly mobile populations. There is this constant flow on and off reservations in and out of urban and rural areas. In the middle of a pandemic, with a communicable disease like this, the inability to track that type of movement in these data systems – for example people accessing care through tribal or indian health service facilities or being tested there, but also accessing and being tested off the reservations, and those systems aren’t linked together – that’s a real problem.”
Risk factors from reservations to hospitals
The lack of data infrastructure isn’t the only issue Indigenous groups are facing. At the Fort Peck reservation, located in the extreme northeast corner of Montana, the Assiniboine & Sioux Tribes are losing about one member a day to COVID, according to Kaci Wallette, a Registered Nurse who worked at North Montana Health Service Poplar Community Hospital and serves as a second term Council Women on the Fortpeck Assiniboine Sioux Tribal Executive Board.

As the most rural reservation in Montana, one of the greatest challenges, according to Kelli, has been the limited capacity at the community hospitals and the distance between hospitals, which is about a four and a half to five hour drive. Kelli describes the pressures of working with COVID patients at a community hospital with limited capacity. “We had to call six different hospitals to try and find a bed for a recently admitted patient. That was in North Dakota, South Dakota, Montana, Wyoming, and finally the University of Utah had an open bed for him. That weekend that I worked, we flew out nine patients, and that was just night shifts, that wasn’t counting the day shifts. So for a community of 3,500 and we are flying out nine patients over three days, with a staff of three nurses and one doctor, and an ambulance crew, which I think they were going on ten calls a day… it’s just very overwhelming our rural community.”

Finding a bed for COVID patients to be treated on in these communities is only half that battle. The recovery and rehabilitation process is a long one, according to Kelli. “Once patients get flown out, it’s a long tedious recovery. Patients usually require physical therapy because when they’re on the vent, muscle mass deteriorates pretty rapidly. When patients get off the vent, they don’t remember because they’ve been sedated for so long. Patients are having to go to a long term care facility to teach them how to walk again and rebuild their muscles. That’s another challenge we’re facing because we don’t have those long term care facilities around this area. That means longer time away from their family. It’s a big burden, I think, to catch it and then have to try to recover by yourself. You have to be a very strong person to want to recover and make it back to your family once you get flown out. Patients have a long road of recovery ahead of them.”

A team of Indigenous researchers at UCLA and the University of Arizona, which includes Dr.Rodriguez-Lonebear, identified the key risk factors, aside from the legacy of an oppressive colonial statehood, contributing to the alarming COVID-19 infection and death rates. These include lack of complete indoor plumbing, access to running water, access to relevant information in Indigenous languages, and overcrowding in the home. The research outlines what measures must be in place in order to protect American Indian communities from COVID-19 and future pandemics, tribal communities must have access to potable water, culturally-relevant information via community preferred media, and strengthening of tribal public health and household infrastructure as delineated in government treaties and other agreements.

Preserving American Indian Culture
As sovereign nations which have been historically erased from the public sphere, there is a dangerous existential threat to American Indians and their histories, memory, and culture.
Nitakechi Hυshitomi, a reconnecting Native and founder of the Organization for Indigenous Autonomy from Peoria, Illinois shares what he believes the implications of the virus means for the culture of indigenous peoples. “I believe that our culture is at risk, specifically language and religious practices. Native American societies in general are less of a written history people as we rely heavily on oral tradition being passed down by elders. As elders are called to the creator, we lose that much more of our histories.”

Kelli shares a similar sentiment when considering the long-lasting impact of COVID-19 on the community. “The demographic that we’re seeing hit hardest on our reservation is the 45-65 year old male population. That age group carries a lot of cultural aspects of our reservation. Any member loss does because that’s part of our history. That is another challenge that we are struggling with right now.”

Kelli believes that a culture of shame and embarrassment around the virus is also what is causing this group of tribal men to die at higher rates. “As a tribe, we’ve been trying to push the message out to everybody to not be ashamed if you catch this… it is nothing to be ashamed of. Let people know so we can provide services and support.”

Dr. Rodriguez-Lonebear shares “We are losing elders, some of our last language speakers who hold so much knowledge around ceremonies and way of life. We are just really approaching a crisis point that is going to become increasingly more urgent to really think about how we are going to perpetuate our cultures and way of life… because without that, who are we as indigenous peoples?”

Grieving and mourning the community
The collective grief felt by the community expands beyond generations and reservations. Alongside the rise of distance learning, celebration and concerts, there has also been a rise in distance mourning, recoveries and funerals. This is causing deteriorating mental health and will continue to be a major health crisis for communities all around the globe in the coming years.

For indigeouns people, grieving elders and members of the tribe at a distance has already begun to take a toll on the survivors. As an interconnected community, Dr. Rodriguez-Lonebear considers how this survivor’s guilt and trauma shouldered by those adjacent to lives lost will impact collective memory and healing. “What we’re not talking about is the toll that this is going to take on our collective ability as indigenouns peoples to heal our collective memory and a whole different realm of intergenerational trauma that we’re going to experience from this. We can’t mourn the dead like our cultural protocols require us to do. We can’t sing our people home who have passed on. We can’t gather in the ways that we have always gathered from the very beginning of time and try to survive.”

As a stark contrast to the individualistic nature of American culture, the interconnected nature of Indigenous peoples has allowed for the suregence of collective action and community support. At Fort Peck Reservation, Kelli shares the community currently offers food boxes for those who are on quarantine. The affected members get a food box once a week for quarantined individuals and their households. The reservation has also partnered with the CDC which is helping the tribe with daily incident reports and media campaigns. John Hopkins University is also on the ground helping with efforts for households that don’t have phone access, checking in on the vulnerable populations that are on quarantine, and providing money for folks to purchase thermometers. Lastly, the tribe is working with the local hospital, Northeast Montana Health Service to purchase bulk orders of over-the-counter medication including zinc, vitamin d, mucinex, tylenol, and vix vaporub to include in weekly food packages.”

A Path Forward
Preserving the past and present of indigenous communities in Montana to ensure a fruitful future will require a commitment to sovereignty and collective action. Hυshitomi’s Organization for Indigenous Autonomy is already paving a path forward. Hυshitomi shares in an email “The OIA is a group designed to promote land sovereignty in the Native American, Hispanic/Chicano/Latinx, and Pacific Islander communities. We advocate and work towards the establishment of sovereign Native nations. We believe that the American, Canadian, and other settler governments were designed to slaughter, oppress, and disenfranchise the communities we serve. Our network works with various movements dedicated to sovereignty, both Indigenous lead and otherwise.”

A future of sovereign, yet networked indigenous data collection and archival preservation project is also already in the works thanks to Dr. Rodriguez-Lonebear. “One of the things I’m involved with right now is figuring out how to build an integrated data system for my tribe, The Northern Cheyenne Nation. How can we develop a true data system that links together all the data sets that we have on our tribal members and our tribal citizens across all federal agencies, across all the different services that are being provided, across the different healthcare systems that are being accessed. Taking a big picture approach to ‘what does an integrated tribal data system look like’ and ‘how do we build it’ and ‘what is that going to take?’ Right now I’m in feasibility study with my nation trying to figure that out. It’s a hard thing, it’s a big ask, but we know we’re going to need that moving forward to be able to protect and serve our citizens.”

Lastly, Kelli shares how her tribe’s re-engagement with cultural customs of previous generations has been a silver-lining of the pandemic. “One good thing that i’m seeing is the resurgence of some of our medicinal plants and roots coming into play; smudging up our house, bare root tea, sweetgrass. Some of those medicinal herbs and remedies that we relied on for generations are now coming back. That is a part of the culture that we’re regaining.”

Latino communities in Georgia hit hard by COVID-19

When the pandemic hit, Georgia-based non-profit Hispanic Alliance shifted its services. The mission now was to make sure no Latino family in the city of Gainesville went hungry. The Hispanic Alliance, known as La Alianza, in Spanish, received 40,000 pounds in food donations and has distributed fresh, nutritious and culturally appropriate ingredients to 9,000 families since April, according to Vanesa Sarazua, founder and executive director of the Hispanic Alliance.

“Our operations switched to helping people with basic needs,” said Sarazua, who contracted COVID-19 in July. “We don’t see the situation getting any better.”

Sarazua said the organization’s November food distribution was the second largest one, with 700 families receiving assistance through their drive through. The first largest event was in May, with 750 families receiving boxes of food.  

As the coronavirus tears through the nation, in Georgia, Latinos continue to disproportionately feel the impact of the COVID-19 pandemic. Latinos or Hispanics, of any race, make up 9.8% of Georgia’s population, but they account for 15% of coronavirus cases in the state. 

The following graphs show the racial breakdown of COVID-19 cases in Georgia. The state has reported a total of 443,822 cases of COVID-19 and 8,971 coronavirus-related deaths as of Dec. 6. With roughly 1 million residents, Latinos account for 52,897 of all cases in the state and 536 deaths as of Dec. 6, according to the COVID Tracking Project, a volunteer organization launched by The Atlantic dedicated to collecting data on COVID-19 in the United States and its territories. 

The COVID Tracking Project flagged the group’s case proportion as suggestive of ethnic disparity due to three criteria: it is at least 33% higher than the Census Percentage of Population, it remains elevated whether the project includes or excludes cases with unknown race or ethnicity and it is based on at least 30 actual cases or deaths.

For Sarazua, the pandemic has exacerbated the disparities Latinos faced before the crisis, such as limited access to healthcare. The Centers for Disease Control and Prevention identified discrimination, healthcare utilization and occupation as factors that contribute to increased COVID-19 risk among racial and ethnic “minority” groups. 

Sarazua said many Latino Georgians in her community struggle with not knowing when they should seek medical attention, and losing their jobs and working less hours, as those who are undocumented are excluded from federal economic aid. “They had to tough out the covid storm on their own with no resources,” Sarazua said. 

The high number of COVID-19 cases among Latino Georgians may be in part due to their overrepresentation in the essential workforce, including farm and poultry factory workers. 

“The jobs they have to do are critical,” Sarazua said. “The immigrant workforce is important.” In Georgia, one in eight workers is an immigrant, making up a crucial part of the state’s labor force, according to the American Immigration Council. 

Back in April, hundreds of poultry workers in Hall County, in northeastern Georgia, tested positive for the novel virus. Hall County, with a population of 206,349 residents, has so far reported 12,352 cases of the coronavirus, and has in the past two weeks reported 419 cases per 100,000 residents. Hispanics or Latinos make up 9.4% of the population of the Hall County city of Gainesville, known as “Poultry Capital of the World,” according to the U.S. Census Bureau.

One out of every four Latino poultry workers were testing positive for COVID-19, according to local reports from June. Latinos make up 30% of the workforce in the meat and poultry industry but 56% of cases, according to Atlanta Magazine.

Meanwhile, in southern Georgia, cases have spiked due to infections among farmworkers, according to the nonprofit Georgia Health News. In May, COVID-19 cases tripled in Echols County after a testing event held by the South Health District and the Migrant Farmworkers Clinic, Valdosta Daily Times reported. Latinos make up 24.6% of the population in Echols County, according to the U.S. Census Bureau. 

Among initiatives to address the disparities affecting Latino communities in the state, Emory University teamed up in August with the Mexican Consulate in the capital city of Atlanta totest Latino residents for COVID-19. Other organizations, like Community Organized Relief Efforts, have conducted free testing in Georgia. The Latino Community Fund launched in March a COVID-19 relief fund to assist vulnerable communities, aiding in food distribution, testing and rent payments. 

“We need to discuss how to make things better while it’s still fresh in our minds,” Sarazua said. “We need to improve on protecting critical, frontline essential workers in a crisis. It’s very important to discuss and plan ahead as a nation.” 

Alaska’s Covid-19 death rate is among the lowest in the country, yet the state has one of the highest death rates of Native Hawaiian Pacific Islanders (NHPIs).

Despite the 14% surge in cases on Nov. 27, the state’s per capita Covid-19 death rate has remained one of the lowest, at 16 deaths per 100,000 people. The national rate is about seven times that, at 81 deaths per 100,000 people. However, the state has not escaped one nation-wide trend: the enduring systemic, health and social inequalities that have put people of color, especially NHPIs, at increased risk of contracting or dying from the virus.

“(NHPIs) are facing the highest Covid-19 case rates of any race and ethnicity throughout the country,” said Ninez Ponce, director of the UCLA Center for Health Policy Research during a webinar (UCLA CHPR), and one of the founders of the NHPI Covid-19 Data Policy Lab.

As shown in the graph below, the mortality rate of NHPIs has been disproportionately high since the onset of the pandemic, at 68.3 per 100,000 people, according to data obtained from The Atlantic’s Covid Tracking Project. The next highest mortality rate was among American Indian/Alaska Natives (AIAN) at 23 per 100,000 people.

The highest number of NHPI deaths in the state has been nine, but Ponce says that for a group that is so small, “waiting until the 10th death could be too late for these communities.”

The state’s epidemiology report cites that underlying health conditions, along with “long-standing health and social inequities” can partly explain the state’s race-based disparities. However, there are other factors endemic to Alaska that contribute to the challenges faced by this group.

Arne Krogh, a dentist who has a private pilot license in Alaska, says that geography, weather, the lack of transportation infrastructure makes it more difficult for NHPI and AIAN communities to be served and get access to healthcare.

“A lot of them can’t drive because they’re not on the road system. If they need to be ambulanced it’s by air to Anchorage mostly. On a day like today, I’m looking outside my window and it’s snowing sideways. The visibility is probably two miles, so it’s hard to get in and out of some of these places when the weather’s like this. When you add the fact that they’re not on the road system, and you’re always fighting the weather elements up here, it just exacerbates the health care and the lack of services. Even though we want to, it’s just hard to get out there,” Krogh said in a phone interview.

These communities are typically shut off from outside visitors and accessible only by boat or plane, with their only lifeline being through carrier delivery. “These places don’t have level three trauma hospitals,” Krogh said. “Typically, the nurse is also the mailman or the teacher. You have a lot of different people wear different hats.” Lacking the healthcare infrastructure needed to treat Covid-19 complications, many patients have to be flown to Anchorage in a turboprop or small jet, and if the case is severe, they have to go as far as Seattle or Portland.

Joseph Seia, executive director of the Pacific Islander Community Association of Washington, lived in Alaska for eight years and his mother currently lives there. Seia says that the reason why Pacific Islanders have been more affected than Alaska Natives, despite having similar health issues and social practices, is because there are no medical services tailored to NHPIs. Alaska Natives and American Indians do have health centers and organizations that specialize in treating them, such as the Alaska Native Medical Center, the Alaska Native Indian Health Service and the Alaska Tribal Health System.

“The health provisions in Alaska are for Alaska Natives and other Native Americans. I don’t think those places serve Pacific Islanders, even though there are lot of similarities as far as the health needs. The state of Alaska already has existing relationships with Alaska Native Tribes, and have agreements to support [their] health. Similarly, Pacific Islanders need to nurture that relationship with the state to ensure there’s a safety net for our people” Seia said in a phone interview.

Seia says that the state’s long, harsh winters increase the chances of having many of the preexisting conditions that make people more vulnerable to the virus, such as obesity and diabetes. “When I moved to Alaska, I gained 100 pounds in the first year. I feel like that is a very typical experience when (Pacific) Islanders move to Alaska or grow up there, because of the six to seven months of winter. That makes it really challenging for folks to prioritize their physical health.”

These endemic factors could be part of the reason why the death rate of NHPIs in Alaska is one of the highest in the nation, without having the largest population of NHPIs. In fact, as shown in the graph below, the top three states with the highest population of NHPIs, California, Hawaii and Washington, are not among the states with the highest death rates of NHPIs. The Pacific Islander Covid-19 Response Team, a group of NHPIs researchers, health experts and community leaders, reports that the states with the highest case and death rates are Arkansas, Iowa, Louisiana, Illinois and Alaska.

However, it is difficult to observe any nation-wide virus trend with certainty because only 30% of states are reporting NHPI disaggregated data, according to the UCLA CHPR. Many other states lump together NHPI and Asian American as a single race category.

“(NHPIs) are highly distinguishable, but there’s a frequent aggregation with other racial groups or otherwise complete omission from demographic data. NHPIs are historically and presently overlooked, even in a time when racial disparities in Covid-19 are a significant topic of national public health discussion. With a high-stakes pandemic, there’s an urgent need for widely available disaggregated NHPI data,” said Karla Thomas during a webinar, a scholar from the NHPI Covid-19 Data Policy Lab at UCLA’s CHPR.

Nationwide, there are other contributing factors to the high death rate. According to Thomas, who is part of the community herself, one in four of them work in essential roles, many are undocumented and are a very communal population. They frequently gather for traditional events like chiefly bestowments and religious ceremonies, which have continued even with rising cases of Covid-19.

UCLA’s CHPR has partnered with the Pacific Islander Covid-19 Response Team to generate reports that are sent to community constituents in the hopes of allocating more resources to help NHPIs. They’ve also planned and implemented infrastructure for informing and supporting families about the virus. Many of their presentations are in Samoan to ensure faith-based leaders, who are primary NHPI-language speakers and trusted messengers of the community, spread the information as widely as possible.

“Pacific people are a minority with a majority mindset. Moving forward, there is a need we have all uncovered. This work is spiritual in its nature. Everyone from (the NHPI Response Team and UCLA) sees this work as a spiritual venture into something greater, because we all hold ourselves – as people who collectively think, eat, live and breathe together in the Pacific Islands – as responsible to each other,” said Thomas.

Iowa’s Asian Americans Experience Increasing Racism Under COVID-19 Pandemic

By Shiyu Xu

Rachel Li is a sophomore majoring in medical anthropology and music at University of Iowa. When the U.S. began reporting its first COVID-19 cases in February, Li attended a comedy event hosted at the Iowa Memorial Union. During the event, where an individual in the audience stood up and made a COVID-19 joke towards Asian Americans.

“I was one of maybe three Asians there,” Li said. “The host called him out, and I ended up approaching him to stand up for myself. He ended up leaving after he was confronted by both me and the host.”

During this fall semester, Li was walking on the UI campus surrounded by white students, when a maskless woman put her hand up to her face when she approached Li and immediately dropped it as soon as she passed her.

During the pandemic, the Asian community has confronted the dual-threat: the infection of the Covid-19 virus and the infliction of xenophobic assaults.

In one of the whitest states in the country, the Chinese nationals and immigrants in Iowa are vulnerable to the increasing racial tension in their everyday life.

Shu Wan, a graduate student from University of Iowa, launched a project called “An Oral History of Iowa’s Chinese Americans and Nationals Experiences during the COVID-19 Pandemic”, which conducts oral history research in three major towns in Iowa, including Ames, Iowa City, and Des Moines. 

Through the research, many Asian individuals shared their experiences during the ongoing pandemic.

Caitlyn Valencia, a Filipino third-year and first-generation student, says she is frustrated with the racist language used to describe the virus.

“I don’t feel welcome here, and it’s not right because America is supposed to be built off of diversity,” Valencia said. “It’s sad that now privilege includes being looked at as a person instead of a scapegoat. Nowadays being Asian also means being viewed as a target for blame.”

Iowans of Asian or Pacific Islander descent make up 2.7% and 0.1% of Iowa population, according to the State Data Center, with Des Moines, Ames and Iowa City having the largest numbers. That percentage is projected to grow to 4.4% by 2050.

According to Iowa state’s Covid-19 data, more than 221,000 people have tested positive as of Dec.3. Among them, around 6,254 are Asian. The death rate for Asian community in the state is 1.4%.

The chart below shows the total positive cases among each race in Iowa. Among the minority races, Asian’s number is the second highest, following those who identify as black.

The Iowa Civil Rights Commission has had two race discrimination complaints filed by Asians so far this year, said Elizabeth Johnson, executive director of the commission. There were eight in 2019 and 12 in 2018. Eleven were filed in 2017 with eight in 2016.

Johnson said that under the Iowa Civil Rights Act, any person has 300 days from the last discriminatory incident to file a complaint alleging discrimination. “Therefore, it is entirely possible that many claims alleging discrimination related to COVID-19 have not yet been filed,” she wrote by email to the Register and IowaWatch.

The graph down below shows the number of deaths from Covid-19 among each racial group in Iowa. Similar to the total case number, the death number for Asians in the state is the second highest, following the black  community.

To keep track of incidents in Iowa, the Asian alliance has created an online form where community members can submit reports of harassment and discrimination.

Reports show racial discrimination against Asians and Asian-Americans have increased since the start of the COVID-19 pandemic hit the United States.

During the COVID-19 pandemic, there have already been almost 2,600 reported cases of anti-Asian discrimination in the U.S. between March and July 2020. More than half of Asian Americans are worried about being subject to COVID-19-related hate crimes and discrimination, according to the 2020 Asian American Voter Survey.

COVID-19 tears through African immigrant communities in North Dakota as nonprofits struggle to keep up

When Matuor Alier first started experiencing symptoms of COVID-19 in mid-October, he quickly took steps to isolate himself from his community in Fargo, a city on North Dakota’s eastern border with Minnesota.

Alier, a 32-year-old social worker who came to North Dakota in 2008 as a refugee from what is now South Sudan, was able to work from home while he was ill, quarantining in his home while enduring chills and fits of coughing. But the experience made him even more aware of how difficult dealing with COVID-19 was for other members of his community: North Dakota’s growing population of refugees and immigrants, particularly from Africa.

“When the pandemic hit in March, they weren’t getting the information,” Alier said. “They were not understanding what was going on.”

According to the latest data from the COVID Tracking Project, Black North Dakotans had the highest rate of COVID-19 cases relative to their population in the state, eclipsing even other vulnerable groups such as Native Americans. While the state does not release racial data for deaths from COVID-19, the infection rate is over 9,000 per 100,000 for Black people, compared to about 7,200 for people identifying as white, as seen in the chart below.

These numbers reflect what activists and government officials have seen in the state as the virus has devastated African immigrant communities. North Dakota has endured a wave of infections in the fall, and currently has the highest case rate in the nation, but immigrants are particularly vulnerable to the virus due to higher rates of poverty and language barriers that prevent them from getting information about COVID-19.

In response, nonprofit organizations and volunteer groups dedicated to helping immigrants and refugees in North Dakota have stepped up to provide groceries, safe spaces to quarantine and translation assistance for non-English speakers seeking information about COVID-19.

“They don’t speak the language, they don’t have anybody advocating for them,” said Clarissa C. Van Eps, president of the North Dakota chapter of the National Association for the Advancement of Colored People, or NAACP. “We’re telling them that they have a safe space with us and telling them the things that we can do for them if needed.”

Nationwide, people of color have been disproportionately affected by COVID-19 due to a range of factors, including poverty, essential worker status and pre-existing health conditions. But the racial disparity in COVID-19 infections in North Dakota reflects larger trends particular to the state, which has experienced rapid demographic change in recent years. Over the past decade, the population of North Dakotans identifying as a race other than white has grown from just under 10 percent to 13 percent. The largest growth has been in the Black community, whose numbers have more than tripled since 2010, according to data from the U.S. Census Bureau.

The majority of this increase is driven by growing numbers of “New Americans” — a catch-all term for immigrants and refugees who have come to North Dakota seeking economic opportunity or political asylum. The percentage of foreign-born North Dakotans stood at 4.7 percent in 2018, up from just under 2 percent in 2000. While the state has significant populations of Asian immigrants, including Bhutanese refugees, the largest group identifies as Black, and includes immigrants from Somalia, Sudan, Liberia, Eritrea and the Democratic Republic of the Congo.

With a population of about 125,000, Fargo is North Dakota’s largest and most diverse city, and reflects many of these recent demographic trends. The city’s plentiful jobs in the manufacturing and healthcare industries, along with a relatively low cost of living, have attracted waves of immigrants, while North Dakota as a whole leads the country in refugee resettlement per capita.

But some of the very opportunities that pull New Americans to the region also make them more vulnerable to COVID-19, according to Hukun Dabar, executive director of the Afro-American Development Association of Fargo-Moorhead. Immigrants working manufacturing or retail jobs cannot work from home, while those in the healthcare industry spend more time in COVID-19 hotspots such as nursing homes and hospitals. Immigrant communities tend to be lower-income and less likely to own their own homes, while the state of North Dakota did not enact a rent moratorium during the pandemic.

“At the end of the month, the landlord wants the rent,” Dabar said. “They can’t stay home even one day from work, because they have kids to feed, they have rent to pay, they have bills to pay.”

Cultural and social factors heightened their vulnerability. Stigma against immigrants — who were sometimes blamed for spreading COVID-19, Dabar said — led some to avoid reporting their symptoms, while language barriers caused a general lack of information about the virus and its effects. Many immigrant families also live in large, multi-generational households where one infected person can spread the virus to multiple others, Dabar added.

To address these complex issues, nonprofit and volunteer groups have played a prominent role. Alier helped found the ESHARA Project — which stands for Ethnic Self Help Alliance for Refugee Assistance, and brings together seven community-based nonprofit organizations in the Fargo area — in 2016 as an employment assistance program for New Americans, and worked on pivoting the coalition to COVID-19 response in June. Throughout June and July, ESHARA coalition members helped nearly 300 people with rental assistance, grocery delivery services, and help getting tested for COVID-19 or filing for unemployment benefits.

Other groups have also stepped in to help, including the North Dakota chapter of the NAACP. The chapter, which was only created a few months ago in the wake of nationwide protests over racial justice and is still in the process of joining the national NAACP organization, has mustered volunteers and funds to distribute groceries and provide places to quarantine, according to Faith Shields-Dixon, the group’s vice president.

But it’s been difficult to see the disease ravage immigrant communities across the state, she noted.

“We’ve seen some loss of life — some of the pillars of the community have passed away from COVID,” Shields-Dixon said. “Everywhere people are dying from this disease. But we know that being able to provide those extra resources can lift the load off of them, and be able to assist them during this tragic time.”

Death data by race is unavailable in the state because the number of deaths among people of color is so small that releasing it would potentially allow individuals to be identified, a violation of health privacy regulations, said Grace Njau, an epidemiologist at the North Dakota Department of Health. But she said that despite the high rate of COVID-19 cases among New Americans, the rate of deaths for this population tends to be low because they are often younger and healthier than other groups.

At the same time, Njau said steps taken by the state to combat the virus can benefit all who are impacted by it. On November 14, North Dakota Gov. Doug Burgum implemented a statewide mask mandate and announced new restrictions on social gatherings for the first time since the start of the pandemic, complementing requirements that already existed in larger cities like Fargo and Bismarck. Njau said she sees this as a positive sign, and that the rate of new infections has already begun to drop.

“For now, I’m a little bit more optimistic in terms of our outlook,” Njau said. “But how long it lasts depends on how long we can keep up our masking and social distancing. If things hold at a steady state of where we’re at currently, I would say we’re heading in a positive direction.”

But even if cases drop, challenges will remain for New American communities in particular. Dabar said the state needs to provide more assistance to small business owners — many of whom are immigrants — facing losses due to COVID-19, while Alier added that children of immigrants tend to struggle with distance learning because their parents may not be able to afford the technology or help them if they don’t speak English.

“New Americans are taxpayers, they go to work every day, and they’re not people who always depend on benefits,” Dabar said. “So they need to see them as neighbors. They’re a big part of the state of North Dakota, because they’re not going anywhere.”