Public Health office hits the ground running

By 
Luella N. Brien
Thursday, October 15, 2020
Public Health office hits the ground running
Courtesy photo
Tribal Public Health Technicians, Chelsea Old Elk and Diane Charette, prepare to do administer COVID-19 testing at the Indian Health Service clinic in Crow Agency for community members who have been called in by contact tracers or public health nurses.

The Crow people have been hit by the coronavirus pandemic harder than most other populations in the area.

According to the newly formed tribal Public Health and Human Services Department the reservation population has been diagnosed with 1,009 cases of COVID-19. If recent population estimates from the state of Montana are correct and 7,900 people live on the reservation, 12.77% of the population has been diagnosed with the virus.

Karl Little Owl, cabinet head of Public Health and Human Services and the Crow Tribe’s Public Health official said the department started in late August after a series of two COVID spikes.

Case data has not always been readily available. Indian Health Service, a federal program, has never released case numbers for the reservation. Thanks to a partnership between the tribe’s public health department and IHS tribal members are now privy to this important information, like declines or spikes in cases.

“My position has always been to get that number out there,” Little Owl said. “Actually, I kind of wanted that number out there, because I wanted folks to understand this was a serious issue. At the beginning of the pandemic some folks did we realize this was serious. And as it started affecting individual homes, either through a fatality or people being exposed themselves, the reality of this virus beginning to set in was when folks started to begin to take it seriously.”

As case numbers change, Little Owl said, the public is able to see how the public health department is making a difference.

“In the community, people think we aren’t doing anything,” he said. “We see the numbers, and they are going down, but we were not communicating that out there. We are now able to share the info now with the community. There’s no long delay to get the information out there anymore.”

Little Owl said now that the public health department is in place they are able to be transparent in their operations.

The health department came from needs assessments by the state of Montana, the Centers for Disease Control and IHS throughout the summer.

“One thing the CDC highly recommended was to increase our contact tracing capacity, so now we have tribal workers that are certified and trained to be contact tracers,” Little Owl said. “They were trained by the CDC and they work with the public health department at IHS.”

The extra contact tracers, according to Little Owl, are one part of a multifaceted effort that has helped contribute to the decrease in cases.

“In August, during the height of the pandemic in the area, people who tested positive were not contacted for several days, but now, sometimes in as little as three hours contact tracers are able to contact people who have tested positive and begin their investigation and calling all of that person’s contacts and get them in quarantine,” Little Owl said. “That’s probably the number one effective tool we have right now, and it’s had a drastic effect on our numbers.”

After that major surge in COVID-19 cases, Crow tribe Chairman Alvin “A.J.” Not Afraid requested a rapid deployment team from the Centers for Disease Control out of Atlanta Georgia, Little Owl said.

At the time of the request there were over 250 active cases of the virus in the county, which is mostly the Crow Reservation.

“We were caught off guard with those two spikes, Little Owl said.

The team worked to assess situation in the area working closely with Indian Health Service nurses in their public health department, as well as the tribe’s incident command.

“And now with the public health office we are working directly on the front lines.” Little Owl said. “We are building up our capacity by training employees to do contact tracing, to do testing, to make phone calls and go out in the field. To be community health workers.”

Little Owl said thanks to an increase in trained contact tracers, incident command staff and public health educators the public health office has able to get a better handle on COVID case management, public education and addressing stigma.

“One of the things that I take pride in, is we has several tribes reach out to us asking for technical assistance, asking for us to even come down to their reservations and share about what we are doing here, because they are having a challenging time working with the various entities in their particular areas, not having that working relationship with the county health or whatever entities are there,” he said. “Over here, at least I can get on the phone with Dr. (Carol) Greimann at the county and I know what’s going on or I can call the governor’s office. We have that working relationship now and that makes a big difference working on the local level.

The tribe’s Public Health Advisor, Mike Andreini said the direction the tribe is moving is promising.

“We’ve moved from a mitigation model to a harm reduction model,” he said. “There’s the testing to do the diagnosis. There’s the mitigation, with the masks and the handwashing and the education that goes on. Isolating, getting people out of the herd and then treatment and the hospitals being ready. We have done training, so if the spike comes back we don’t lose control. We are able to get on top of that, get on top of (contact tracing), and we have the tests. IHS has surged its capacity to take more patients and we’re in touch with the other hospitals in the area so that we can share resources. I think that’s important for people to know, that we are better than where we were, ever,” Andreini said.

The public health office coordinated COVID protocol during last weekend’s tribal election, where personal protective equipment, like sanitizer was available, and social distancing was mandated.

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