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U.S. flags fly near graves at the Lower Brule Indian Reservation, S.D., on April 22. Photo: Kerem Yucel/AFP/Getty Images

Native Americans across the U.S. are struggling to battle the coronavirus pandemic, as decades of poverty, poor health care and pre-existing medical conditions leave them vulnerable to high rates of infection.

Driving the news: The Navajo Nation, which stretches across three states and has been especially affected, is under its strictest weekend lockdown since the pandemic was declared, after a spike in cases, The Navajo Times reports. All gas stations and grocery stores must remain closed and essential workers have been told to stay home until the order expires on Monday at 5 a.m.

The big picture: Cities and states with resources have struggled to curb the coronavirus pandemic. Reservations are forced to confront the disease head-on, often without running water, medical infrastructure, adequate housing, electricity or reliable internet access for information.

  • Cramped living conditions make practicing social distancing difficult for a large percentage of Native Americans and a lack of running water makes frequent handwashing a challenge.

Why it matters: Tribes are concerned for their elders. The continued spread of the virus on reservations could hit vulnerable older Native Americans, who help keep their cultures alive by passing down language, customs and values.

The state of play: As of May 16, there are 3,632 confirmed coronavirus cases and 127 deaths in the Navajo Nation, according to the Navajo Department of Health.

  • Doctors Without Borders has dispatched a team of nine to help the Navajo Nation combat the virus. They will likely stay there until June.

Many Native Americans are also vulnerable to the coronavirus because of pre-existing conditions, such as heart disease, cancer, diabetes and respiratory diseases, according to the Indian Health Services.

  • Reservations' health care systems were underfunded before the pandemic.
  • Among the Oglala Sioux in South Dakota, only 24 coronavirus tests, six ventilators and four beds for quarantine are on-hand for the tribe's 50,000 members at Pine Ridge Hospital, The Washington Post reports.
“When you look at the health disparities in Indian Country — high rates of diabetes, cancer, heart disease, asthma and then you combine that with the overcrowded housing situation where you have a lot of people in homes with an elder population who may be exposed or carriers — this could be like a wildfire on a reservation and get out of control in a heartbeat. We could get wiped out."
— Kevin Allis, chief executive of the National Congress of American Indians, to The Washington Post

Many tribal members already live in poverty. Casinos provided some tribes with more income, but that revenue has dried up. Nearly 500 casinos closed as part of precautions to fight the pandemic.

  • Some Native American tribes are suing the Treasury Department for access to billions of dollars of coronavirus relief. It could become one of the most significant legal battles between tribal government and the U.S. in years, The New York Times writes.

Go deeper: African Americans are disproportionately dying from coronavirus

Go deeper

Updated Nov 9, 2020 - Health

23 states set single-day coronavirus case records last week

Data: Compiled by Axios; Map: Danielle Alberti/Axios

23 states set new highs last week for coronavirus infections recorded in a single day, according to the COVID Tracking Project (CTP) and state health departments. 15 states surpassed records from the previous week.

Why it matters: More states across the country are handling record-high caseloads than this summer.

Updated Aug 24, 2020 - Health

Florida surpasses 600,000 confirmed coronavirus cases

Emergency at Coral Gables Hospital near Miami on July 30. Photo: Chandan Khanna/AFP via Getty Images

Florida's confirmed coronavirus cases exceeded 600,000 on Sunday, the state's health department data shows.

Why it matters: Florida joins California as the only two states to surpass this milestone. Texas, which is reporting the third-most confirmed COVID-19 cases in the U.S. is not far behind, according to state figures and Johns Hopkins data. Florida has added over 100,000 cases since Aug. 5.

Aug 24, 2020 - Health

Americans want high-risk people to get a coronavirus vaccine first

Data: The Harris Poll; Chart: Andrew Witherspoon/Axios

If the U.S. is the first country to develop a coronavirus vaccine, most Americans don't want to share it right away with the rest of the world — but they're OK putting high-risk people at the front of the line within the U.S., according to a new Harris poll shared exclusively with Axios.

Why it matters: Whenever the first vaccine comes, there won't be enough to go around. Experts say both of those tiers of rationing — divvying up the available doses internationally, and then a risk-based system to decide who gets it first within each country — will be necessary.