‘Breaking Point’: Navajo Hospitals Warn Of Bed, Nurse And Oxygen Supply Shortages

During a livestreamed briefing on the pandemic, several doctors working at hospitals in the Navajo region described a health care system at its breaking point.

“I am a very concerned about this second rise in COVID-19 cases that we’re seeing locally,” said Dr. Jonathan Iralu, an infectious disease specialist at the Gallup Indian Medical Center. “It’s gotten to the point where our facilities are deeply challenged and getting to the point of being overwhelmed.”

Navajo Nation ― the largest American Indian reservation in the United States, spanning roughly 27,000 square miles across portions of Arizona, New Mexico and Utah ― was able to reduce the spread of the virus in the early fall after being hit especially hard in the late spring and early summer. But cases, hospitalizations and deaths across the reservation have begun to rise at an alarming rate in recent weeks, as those numbers surge in other areas of the U.S. as well.

As of Wednesday, there have been more than 17,000 confirmed cases on Navajo Nation and at least 658 deaths, according to data compiled by the Navajo Department of Health and Navajo Epidemiology Center.

“What we see is really unprecedented since the influenza pandemic of 1918,” Dr. Ouida Vincent, clinical director of the Northern Navajo Medical Center, said during the briefing Thursday.

Securing enough respiratory support systems, like high-flow oxygen machines, has been a challenge and one that is likely to get worse as hospitals nationwide compete for supplies, several doctors said during the briefing Thursday.

“On Friday, we had too few high flow machines for the numbers of patients needing them,” Vincent said. “We were able to make adjustments but it was traumatic for staff.”

“Our greatest concern is the potential for having to allocate resources if demand for our resources exceeds supply,” she added. “So we are trying to proactively address that so that our hospital staff do not have to make those decisions.”

The Northern Navajo Medical Center is operating at about 50% of its nursing staff, a staggering vacancy rating exacerbated by school closures and fatigue that could continue to get worse, Vincent said.

Several hospitals in the Navajo area are operating at close to full capacity and transporting patients who need more intensive care has been extremely challenging, according to the doctors.

“What we know is that our hospital beds are full and when we try to send a person other hospitals in New Mexico or Arizona, they are essentially 100% full,” Iralu said.

“I saw nurses who really care ― they’re deeply dedicated to their work ― but they’re very very tired,” he added. “You can see the worry lines on their faces above their face masks … We are truly in crisis mode here on Navajo.”

Doctors, public health officials and Navajo leaders pleaded with residents to adhere to coronavirus restrictions, including wearing masks, social distancing and washing hands frequently.

Dr. Eric Ritchie, chief medical officer for the Chinle Comprehensive Health Care Facility, urged community members not to travel and to continue to practice mitigation measures even if they test negative for the virus.

“Our hospitals are reaching a breaking point,” Ritchie said during the briefing. “We are going to face a moment in time when our hospitals are stretched even further than they were in May. … These are not normal times.”

Navajo Nation President Jonathan Nez announced Thursday that he was extending the stay-at-home order and reinstating the weekend curfews for at least another three weeks. Under the executive order, residents (excluding essential workers) are not allowed outside of their home between 8 p.m. and 5 a.m. Mondays through Thursdays, or from 9 p.m. on Fridays through 5 a.m. on Mondays.

Nez said his office is also planning to issue a major disaster declaration for Navajo Nation to secure additional resources from the U.S. government.

“Hospital resources are at capacity or even over capacity,” Nez said during the briefing. “Critical life-saving equipment is in very short supply.”

“We need your help,” he said, speaking to residents. “You can help us and you can help your fellow Navajo citizens, your Navajo relatives. We are related through clans. We are all in this together. This is entirely in our hands.”