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. 2022 Aug 4;17(8):e0272089.
doi: 10.1371/journal.pone.0272089. eCollection 2022.

Diné Navajo Resilience to the COVID-19 pandemic

Wilfred F Denetclaw  1 , Zara K Otto  1 , Samantha Christie  1 , Estrella Allen  1 , Maria Cruz  2 , Kassandra A Potter  1 , Kala M Mehta  3
Affiliations

Diné Navajo Resilience to the COVID-19 pandemic

Wilfred F Denetclaw et al. PLoS One. .

Abstract

Objective: To date, there are no studies of COVID-19 cases and deaths in the Navajo Nation, US. The primary objective of this manuscript is to understand whether counties with a higher proportion of Navajo (Diné) population also had higher cases and deaths of COVID-19 and whether these dropped with vaccination.

Method: We undertook a cross-sectional analysis of county level data from March 16, 2020-May 11, 2021. Data were obtained from public repositories and the US Census for the Navajo Nation, including northeastern Arizona, southeastern Utah, and northwestern New Mexico. The primary outcome measure is the number of individuals with confirmed cases or deaths of COVID-19. A secondary outcome was COVID-19 vaccinations.

Results: The 11 counties in Navajo Nation have a wide variation in the percent Navajo population, the resources available (ICU beds and occupancy), and COVID-19 outcomes. Overall, there was a substantial increase in the number of cases from March 16 -July 16, 2020 (the height of the pandemic) with a doubling time of 10.12 days on Navajo Nation. The percent Navajo population was a strong predictor of COVID-19 cases and deaths per million population. COVID-19 vaccinations were inversely associated with COVID-19 cases and deaths in these counties.

Conclusions: The COVID-19 pandemic on the Navajo Nation is a story of resilience. Navajo Nation was one of the hardest hit areas of the United States, with peak cases and deaths due to COVID-19. With an aggressive vaccination effort, these cases and deaths were strikingly curtailed, showing the resilience of the Navajo (Diné) people.

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Conflict of interest statement

No authors have competing interests.

Figures

Fig 1
Fig 1. Number of confirmed COVID-19 cases from March 16, 2020, to May 11, 2021, by county, on the Navajo Nation plotted on an arithmetic (A & C) and logarithmic (B & D) scale.
Fig 2
Fig 2. COVID-19 confirmed cases per million (A), deaths per million (B) according to county level Navajo Population (n = 11 counties represented in the Navajo Nation), July 18, 2020.
Linear regression used, alpha is 0.05.
Fig 3
Fig 3. COVID-19 confirmed cases, COVID-19 confirmed deaths and vaccinations on the Navajo Nation.
A. Number of confirmed COVID-19 cases, by county over 1 year on the Navajo Nation. B. Number of confirmed COVID-19 deaths, by county over 1 year on the Navajo Nation.
See this image and copyright information in PMC

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