ShyAnn Raining Bird, a 29-year-old mom, political organizer and member of the Blackfeet Nation, tested positive for the coronavirus on July 7. What she initially thought were allergy symptoms quickly worsened.
“I couldn't sit up without losing breath,” Raining Bird said.
Eight days later, she found herself fighting for air in an emergency room on the reservation. The pandemic’s effects had largely been blunted at that point, and cases were low.
“I was her first COVID patient, so the nurse kind of freaked out,” Raining Bird said. “She was like, ‘You need to try to take breaths,’ and I was trying, I was trying. She was like, ‘Suck the oxygen in. Honey, you are getting blue. And once you go blue, there's nothing I can do.’ That scared me even more.”
As Raining Bird’s condition deteriorated, doctors wanted to fly her to the nearest intensive care unit in Kalispell, 100 miles away. But the weather and wind didn’t cooperate. So she was rushed into an ambulance and sped through mountains for two hours.
“At one point, I completely stopped getting oxygen,” Raining Bird said.
Her illness was exactly what the Blackfeet Tribal Business Council worried about when it decided to close the reservation to all non-essential activity in March. That also shut down public access to the east side of Glacier National Park at the start of tourist season, when many Blackfeet businesses make most of their annual income.
Economic losses from a border shutdown are one thing. Losing tribal members to COVID-19 is another. Native Americans make up less than 7% of Montana’s population, but account for almost a quarter of the state’s total COVID cases and 39% of deaths from the virus, according to a report from the Montana Department of Public Health and Human Services. Nationwide, the percent of Native Americans and Alaska Native people with COVID-19 who require hospitalization is five times higher than that of white people, according to a recent U.S. News and World Report analysis. And as Raining Bird found out, health care on the Blackfeet Reservation was not able to treat her condition. In fact, all serious COVID-19 cases in Glacier County, which surrounds the reservation, have to be transported elsewhere.
“So, you know, Native people don't have health issues because they're Native American, right?” said Rosalyn LaPier, a Blackfeet and Metis associate professor at the University of Montana. “They have health issues because they have poor health care.”
LaPier grew up mostly on the reservation and is splitting her sabbatical year between Browning, where her 79-year old mother lives, and Missoula.
“It's the underlying health issues that are exacerbated by a system that is not actually working to address those health issues because of chronic underfunding,” she said.
According to the Center for American Indian Health, Native Americans already had higher rates of infectious disease severity and death than any other population in the country — prior to the pandemic. Dr. Teresa Brockie, an assistant professor at Johns Hopkins University School of Nursing, works at the center and said there needs to be change within the national Indian Health Service — that’s the agency responsible for providing federal health services to American Indians and Alaska Natives — to fix this disparity.
“I think those tribes that receive primarily their health care through Indian Health Service, the ice has gotten thinner. It's significantly thinner,” Brockie said. “And health outcomes are getting worse. Life expectancy is decreasing.”
She said examining indigenous health on a tribe-by-tribe basis is the best way to really understand what’s going on and what resources are needed. But as a June Montana Budget and Policy Center report points out, it’s also important to recognize that Native Americans in the state experience underlying health conditions and economic challenges because of “a long history of racist public policies, ongoing settler colonialism, and underinvestment.”
Brockie is a member of the White Clay Nation (Gros Ventre) and grew up on the Fort Belknap Reservation. She thinks tribes in Montana like the Blackfeet and others around the country were smart to act decisively when the pandemic hit despite a lack of services.
“I think we're, I don't know, I don't want to say comfortable, but we're used to crisis,” Brockie said. “So we seem to pull together best in crisis.”
Overall, people say quick thinking seemed to work to delay the health impacts of the pandemic. The tribe’s COVID-19 incident commander Robert Des Rosier was optimistic in early September.
“We were able to hold off that virus and keep it out of the community for over 100 days here,” Des Rosier said. “I think we went 105 days without having a local case.”
But that hasn’t lasted. After 83 active cases were announced Sept. 24, the tribe issued a two-week, reservation-wide shutdown. Tribal Chairman Tim Davis stressed the urgency of the situation during a Facebook Live event, asking members to “please help us get this under control so we don't have to bury some of our people.”
Days later, active cases soared to 112, and by mid-October, they hit 390. A pandemic response team from the Centers for Disease Control and Prevention arrived then to assist with the outbreak by providing updates for the public and training for healthcare facilities. The National Guard sent resources, too. As of Oct. 26, COVID-19 claimed the lives of 18 tribal community members on and off the reservation. The reservation’s stay-at-home order is now extended into November as new cases in the region grow at one of the fastest rates in the state.
Just outside of Babb, 70-year-old Charlene Burns and her husband are hunkered down on their ranch. They’ve been here for months. And they said if staying put prevents more deaths on the reservation, it’s worth it. To bring people together during the shutdown, Burns created a Facebook group.
“I wanted to get ahead of the condemnation and that fear response and start letting people know they're not alone, they’re not isolated,” Burns said. “Instead of shame and blame, to try to bring strength and courage to them.”
Decisions to close borders and impose curfews aren’t without controversy. COVID-19 survivor Raining Bird said it’s hard to see the rest of the state not on the same page as her tribe. Online, the chatter can take a turn for the ugly. There’s talk of taking pictures of violators, turning people in. A viral outbreak can spread across households and generations. That risk underpinned the tribe’s concern that its elder population — who hold much of its cultural heritage — needed isolation and sacrifice.
Visitors to the grocery stores in Browning have their temperature checked. They often wear gloves. LaPier, the UM professor, called going out into the rest of Montana a culture shock.
“It is almost like two realities where one group of people are really taking it seriously and intentionally trying to address you know, that there's a pandemic going on, and then another group of people just has definitely become much more lax.”
Back in Browning, Raining Bird took COVID-19 as seriously as she could this summer. Her husband visited her from the other side of a window, so their child would have at least one healthy parent. But she needed help. So when she asked her mother to move in, Raining Bird knew the risks.
And in fact, COVID-19 eventually infected all three generations — grandmother, mother and child. Neither Raining Bird’s daughter, 11, nor mother, 59, were hospitalized. But she’s still dealing with lingering effects like joint pain and weak lungs.
“I actually am just now being able to go on walks again and not get short of breath,” Raining Bird said.
The fear that what happened to Raining Bird could happen to tribal elders is what led the tribal council to shut down their borders back in March. Tribal council member Stacy Keller said in September that with Native Americans disproportionately affected by the virus nationwide, it was the right call.
“I think it's probably the best decision that we made,” she said.
This story was edited by Rob Chaney with support from the Solutions Journalism Network.
MBPC is a nonprofit organization focused on providing credible and timely research and analysis on budget, tax, and economic issues that impact low- and moderate-income Montana families.