COVID-19 response by the Hopi Tribe: impact of systems improvement during the first wave on the second wave of the pandemic

Abstract

The Hopi Tribe is a sovereign nation home to ~7500 Hopi persons living primarily in 12 remote villages. The Hopi Tribe, like many other American Indian nations, has been disproportionately affected by COVID-19. On 18 May 2020, a team from the US Centers for Disease Control and Prevention (CDC) was deployed on the request of the tribe in response to increases in COVID-19 cases. Collaborating with Hopi Health Care Center (the reservation’s federally run Indian Health Service health facility) and CDC, the Hopi strengthened public health systems and response capacity from May to August including: (1) implementing routine COVID-19 surveillance reporting; (2) establishing the Hopi Incident Management Authority for rapid coordination and implementation of response activities across partners; (3) implementing a community surveillance programme to facilitate early case detection and educate communities on COVID-19 prevention; and (4) applying innovative communication strategies to encourage mask wearing, hand hygiene and physical distancing. These efforts, as well as community adherence to mitigation measures, helped to drive down cases in August. As cases increased in September–November, the improved capacity gained during the first wave of the pandemic enabled the Hopi leadership to have real-time awareness of the changing epidemiological landscape. This prompted rapid response coordination, swift scale up of health communications and redeployment of the community surveillance programme. The Hopi experience in strengthening their public health systems to better confront COVID-19 may be informative to other indigenous peoples as they also respond to COVID-19 within the context of disproportionate burden.

Communication and engagement of community members from ethnic minorities during COVID-19: a scoping review

“…A theme across nearly all included studies was the role of community leaders in the development of communication materials or as trusted messengers. This is consistent in the literature 59–61 including studies in low resource settings, 62 63 where faith leaders and indigenous community leaders were key partnerships in using models and other stakeholder engagement approaches to strengthen public health systems and to message within multicultural communities. Beyond the focus on traditional leaders in the community, there was a strong recognition of the need to work with young people to support community participation in public health activities during pandemics and emergencies.…”