GALLUP — Vince Mariano was at home eating dinner with his family when the phone rang. It was news that his wife had tested positive for the novel coronavirus.

Some days later, while at work, he got another call: Mariano also tested positive. His two sons, ages 16 and 19, were positive, too.

“It was pretty shocking and pretty scary,” he recalled.

Mariano, who is Navajo, said he experienced relatively minor symptoms: headaches, body aches, fatigue. His wife went through some shortness of breath. His sons had mild symptoms.

All have recovered, but what Mariano remembers most is the fear.

“I thought, you know, ‘I’m immune to a lot of stuff,’ ” Mariano said. “But when I got it, it scared the heck out of me.”

That kind of panic lingers in Gallup and McKinley County, even as the spring and summer explosion of virus cases has begun to abate. The worry is understandable: The Western New Mexico city and surrounding area have seen more deaths from COVID-19, the disease caused by the virus, than anywhere in the nation — more per capita than even New York City, according to data compiled by the New York Times.

But as the hardscrabble town of 22,000 celebrates a recent sharp decline in both cases and deaths, local leaders say the threat of the virus is far from gone. In fact, they worry another surge may be on its way to a region where persisting health problems already have led to devastating losses.

Officials say the underlying factors that fueled McKinley County’s high mortality rate are still present in the community: an uncertain economy, the high diabetes rate, a lack of healthy food options, a poverty level nearly triple the national average and a severe lack of running water for many in the nearby Navajo Nation.

Fixing those problems will take a long time in a dusty swath of the state that has waited months, years and decades for solutions. But with fall and winter on the way, some worry they are running out of time.

“In the minds of our leadership, they do see that our communities had these issues for a long time,” said Wendy Greyeyes, an assistant professor of Native American studies at the University of New Mexico. “It’s just the cost of actually doing these things. The resources haven’t been there. The guidance hasn’t been there.”

A spring like no other

The pandemic hit Gallup and McKinley County with a devastating wrath. More than 230 McKinley County residents have died — almost 33 percent of the state’s 711 total deaths. Virtually anyone you talk to here knows someone who lost someone. Some people tell stories of entire families, like the Marianos, who were infected but survived. Some talk about families that were devastated.

Even for those who survived, the virus can carry a stigma. One woman, who didn’t want to give her name, said she is afraid of what might happen to her if her employer found out she’d been ill. She worries friends and neighbors might treat her differently if they knew, too.

“You don’t want to move. You don’t want to eat. Certainly you have to force yourself to do some self-care, what you can,” the woman said of her experience with the infection. “It wasn’t until I started to have the difficulty breathing and had to go back to the hospital I realized how serious it was.”

But if people’s lives have been altered, their way of living remains largely the same.

Many in the Navajo Nation come to Gallup to refill large water tankers hauled on truck beds and to buy groceries and other supplies for far-flung homes across the bone-dry Arizona-New Mexico borderlands. Between 30,000 and 50,000 people shop in Gallup every month, primarily from five Native pueblos and reservations, said Gallup Mayor Louie Bonaguidi.

An influx of people into the same stores and water collection points was a public health nightmare during McKinley County’s surge in April and May.

To protect Gallup and nearby tribes, the city went on lockdown for 10 days in May as cases climbed. Gov. Michelle Lujan Grisham sent state police, National Guard troops were mobilized and the bustling town settled into a strange, two-week silence.

Bonaguidi, who was sworn into office on the first day of the lockdown, said the effort let people know the virus is a life-or-death matter. It also let the city catch its breath as nearby Navajo Nation residents faced strict evening and 57-hour weekend curfews that have only recently been relaxed.

That kind of action, some say, was critical in helping beat back the virus.

“What I think is powerful about what’s happening with Navajo Nation and why Navajo Nation was able to start to flatten the curve is primarily because of the leadership,” Greyeyes said.

But some local leaders still worry about how the regional economic and social hub will survive a second spike health experts fear could strike this fall and winter.

“The thing we ought to be doing right now is preparing for winter,” said state Sen. George Muñoz, D-Gallup. “Whenever the second wave comes.”

Fixing the hospitals

While executives at Gallup’s two hospitals are working through major upgrades to add more beds and isolation rooms with negative air pressure and medical filters that can suck up the virus, Muñoz, state Rep. Patty Lundstrom, D-Gallup, and Sen. Shannon Pinto, D-Tohatchi, say they fear the facilities are still underprepared.

They worry about a lack of bed space. If a second spike in the area were to coincide with peaks in Albuquerque and Phoenix and Flagstaff, Ariz., hospital staff might have limited options for patients who needed to be transferred because of the short supply of local beds.

When cases spiked beyond control earlier this year, Gallup hospitals in April had to repurpose a local high school gym to hold 60 more beds for patients with severe COVID-19 symptoms.

“I think the facilities are terrible,” Lundstrom said. “They’re not going to be adequate, and if we thought they were, there would have not been the need to stand up the hospital in the Miyamura High School.”

The top two administrators at one of the hospitals, Rehoboth McKinley Christian Health Care Services, did not respond to requests for an interview. Ina Burmeister, chief development officer for the hospital, said in an email that “staff is experienced in caring for critically ill patients and we have an excellent board-certified critical care physician as part of our team.”

Gallup Indian Medical Center CEO Mark Alford said his hospital, which is owned and operated by the federal Indian Health Service, can meet the current demand. But hospital officials expect cases to rise.

“That’s part of what we’re making plans and preparations for, is at any point if it does start showing an uptick of positive COVID patients, then we should have a plan in place,” Alford said.

In preparation, the hospital is expanding to offer more beds in a prefabricated structure that will be installed in the parking lot. It also is placing medical-grade air filters and preparing to ensure every isolation room sucks in fresh air from outside and dispels potentially contaminated air.

The hospital also is hunting for more storage space to house a three-month supply of personal protective equipment it has not yet obtained, and it’s looking for more permanent staff. Up to 75 percent of the hospital’s nurses are temporary or volunteer workers.

If anything, Lundstrom and Chamber of Commerce CEO Bill Lee say the crisis has underscored the urgent need for a new hospital. Lundstrom said she has pressed the state’s congressional delegation and even President Donald Trump to fund a new facility.

“We need a modern medical facility for the Native American people in this region,” Lundstrom said. “I think that it has played havoc.”

The 60-year-old Gallup Indian Medical Center is housed in “an ancient building,” said Jonathan Iralu, chief clinical consultant for infectious diseases at the Indian Health Service.

When some new construction is completed by mid-September, the facility will have 44 rooms with negative airflow and 35 medical-grade high-efficiency particulate air filters that could help protect hospital staff and others needing care who don’t have the virus, Iralu said.

The hospital has only six intensive care unit isolation beds. Before winter, there will be up to 14 intensive care unit beds and 44 isolation rooms.

“So the entire hospital would be like one big isolation room,” Iralu said. “These upgrades are all to be able to handle a massive surge. We want to be extra ready in case every ICU bed in Albuquerque and Flagstaff and Phoenix are completely full. We want to be able to handle the care here in Gallup, and we think to do that, we really should trade a lot more negative airflow rooms.”

The hunt for water

Along N.M. 264 on the way to Window Rock, Ariz. — the seat of the Navajo Nation’s central government — olive-green shrubs dot an endless tan expanse punctuated only by the occasional mobile home, church or gas station.

In a land of parched earth, water has always been held sacred to the Navajo people. And yet, more than 30 percent of the 173,000-member Navajo Nation lacks running water.

“In this day and age, that is totally unacceptable. We live in the most powerful country in the world. We give aid and relief to war-torn countries in the billions. But yet right here in the middle of the most influential country in the world, Indigenous peoples — first citizens of this land — have been pushed aside for decades. Centuries,” said Navajo Nation President Jonathan Nez.

The lack of water pipelines only provides more hurdles to controlling the virus, Nez said. Without running water, it’s difficult to wash your hands. And although many Navajo families haul tanks of it back to their homes on a regular basis, families often seek to preserve water by reusing it when they can.

“In developing nations, not having running water is considered a health emergency and a crisis, whereas in the United States, we’re not defining it as that,” said Emma Robbins, director of the Navajo Water Project run by the Los Angeles-based nonprofit DigDeep.

While progress was made when the Navajo Utah Water Rights Settlement Act passed the Senate in June, the House still has not taken action on the federal legislation. If enacted into law, it would offer the Navajo Nation rights to 81,500 acre-feet of water a year from

the Colorado River Basin and $210 million in federal funding to build water infrastructure on Navajo Nation land.

Efforts to build pipelines have been bogged down for years by onerous federal barriers from a number of agencies that often don’t communicate with one another when tribes seek to go through the regulatory hoops to build anything, said U.S. Rep. Ben Ray Luján.

“A lot of the problems that exist within the various federal agencies working with the Navajo Nation is because they simply don’t talk to one another and there’s no meaningful consultation with the Navajo Nation,” said Luján, a Nambé Democrat. “If these federal agencies would simply communicate with one another and establish ways of working with tribal governments and embracing meaningful consultation, many of these hurdles could be addressed without even having to change a rule.”

The federal CARES Act delivered some $714 million in pandemic aid to the Navajo Nation. Even after receiving the money in May, the Navajo government is still fighting to extend a Dec. 30 deadline the Trump administration has imposed on spending CARES Act money.

Nez blasted the Trump administration over the short deadline, which he says isn’t nearly enough time to spend much of that money on building new water pipelines and new homes for Navajo Nation residents. Both projects are central efforts to combatting the coronavirus in the long run.

The ability to turn on the tap and wash your hands is crucial to preventing the spread of the virus. So, too, is having a place for family members to isolate in a culture where many families live with several generations in a single home. Nez has plans to use federal aid to build more homes.

“The CARES Act was for all U.S. citizens throughout this country for relief because of this virus,” Nez said. “But the first citizens of this country had to wait months in order to get their share of CARES Act funding. And that just shows you the priorities in Washington.”

Staying positive

Since they were ill, Mariano and his family have gone back to living their lives largely as normal. Or at least as normal as can be.

Mariano is back at work as a plumber and maintenance man for Muñoz Corp., a 12-person construction business owned by the state senator. Mariano said he’s grateful he and his family all had relatively mild cases of the virus.

“I tell people on a scale of 1 to 10, I had about a 4,” he said.

Others had it worse. His sister ended up in the hospital but recovered. His wife’s grandfather died.

The Marianos wear masks, wash their hands frequently and remain cautious. He said he worries his friends could blame him if they or a family member contract the virus because so little is still known about it.

Even weeks after his recovery, Mariano said he still feels a momentary wave of illness. It seems to disappear as quickly as it came on.

But mostly, the 52-year-old said he worries about his extended family and friends who have so far evaded sickness.

“Some families, they lost a lot of relatives on the reservation,” he said. “Some lose three or four in a family, and you’re like, ‘Man, that is bad.’ Gratefully, that did not happen to us. That’s the part that really scares me.

“To me, it is not just a game or it’s not a hoax,” Mariano continued. “You hear on the news, ‘Be careful.’ Some people think it’s not [serious]. But I wish everybody would listen and obey the rules. If we obey all the rules — I don’t know, it will slow down.”

(21) comments

Amy Earle

According to the Navajo Nation Health Department 9,394 Navajos living on the reservation have contracted the virus and 478 have died. This doesn’t include those who live off the reservation in NM, AZ, and Utah. Rarely does the media discuss the heavy toll the virus has taken on the Navajo people. Most Americans outside the southwest have no idea of the shocking conditions so many Navajo are living in. No running water, no electricity, distant and poor health care is completely unacceptable in a land of plenty. This does not include the poor access to healthy food or the health consequences from now defunct uranium mining and the use of coal to heat homes. Rarely a day goes by where a a young native person only 20 or 30 dies from the virus. This should be a national shame and it isn’t. Our native people deserve better and they deserve to have the treaties the federal government made with them to be honored. It’s my hope that our own NM lawmakers go to the national media so that the American public can be made aware of the plight of our countries first people. I can’t believe they wouldn’t demand that their lots improve immediately not decades from now.

Rachel Thompson


HRH Prince Michael Jauregui

Ms. Earle, you made some great points.

Overstand, -if you will- for YEARS I've confronted the shameless, 3rd-class citizenry relegated to our Native American sisters and brothers. For far-too long, the U.S. "Government", their "Corporate America" benefactors and their Media (s) associates have elevated one particular ethic group in this nation, while utterly ignoring the challenges -and vast contributions - of others. No other group, per capita, serves this country's military more than Native Americans, followed by Latino/Hispano Americans. Of course, we've seen how well that's worked-out for those two particular groups. Only, in "America".

Meanwhile, so-called Service Organizations and celebrities have spent large amounts of time and money providing water, food and schools for far-away continents. Some, which detest Americans and the West. All the while, inexcusably forgetting the urgent and great needs of our own continent, and citizens. Again, we've all seen how well that worked out for "America".

And, you ain't seen nuthin' yet.

Rachel Thompson

The U.S. Army Corps is building hospital facilities in many locations across the country. And, National Guard troops are also helping. Why can't the Army Corps be invited in to quickly beef up hospital facilities, building a storage facility for PPE? The Army Corps built the entire water distribution system for the U.S. Capitol and parts of northern Virginia in the last century. And wow, the U.S. Senate has passed a bill with water rights but the U.S. House has not? I wonder what Ben Ray Lujan says about that.

Harvey Morgan II

A quick glance at the bill shows it to supply water to the Utah portion of the Navajo Nation. I guess Lujan maybe wanted some help for the NM portion of the Navajo Nation. Who knows what else may be buried in the bill.

HRH Prince Michael Jauregui

Congratulations Mr. Gerstein, for a most excellent piece.

Over the years, I've briefly spent time in "G-Town" during my sojourns

and always felt welcomed.

May The Most Holy Savior of The World, Christ King Yeshua, bless the people of Gallup, N.M.!

Lee DiFiore

They're building private residences for people using covid relief funds? Just wow.

Jim Klukkert

Lee- Treaty Obligations. most often broken or ignored, but still the Law.

Lee DiFiore

There's a treaty that says in the event of covid pandemic, build private homes? Interesting.

Edward Mendez

Yes A-Hole. It's there in black and white!!! You must be dismayed that these First Nations people should want or have private home with running water as protections again Covid 19. Shame on them again, RIGHT?!?!?

Jim Klukkert

Are you an idiot Lee? Treaty obligations predate the Pandemic. In exchange for giving up their lands and all wealth therin; being marched by Carson often to their deaths; and putting up with Nativist No Nothings like you, the Dine, among other tribes are waiting for the Feds to meet their Legal Obligations under Treaties.

You are kidding me ¿right?

Lee DiFiore

Jim and Edward, you lefties are quick to start the name calling when you don't have facts or reason to back up your arguments. And Jim, if you tear yourself away from the talking heads on fake news long enough and really read this article, you will see it is about the pandemic, not about treaties signed decades or centuries back. What does building people private homes have to do with pandemic funds? And, if we're going to build everyone private homes on the taxpayer dime as "protection against covid-19". why stop with native americans? I mean taxpayers paid for my home Jim, didn't they pay for yours?

Jim Klukkert

Lee DiFiore- Sorry you did not get the Memo, but Indigenous Nations were recognized by the Federal Government when a Tribal Nation and the nation of the USA signed a treaty.

Treaties were signed that surrendered certain Native rights in exchange for the Federal promises of certain benefits. So that is why the Feds sometimes provide housing on what are called reservations, which is the land that Federally recognized Indigenous Nations hold sovereignty.

No treaty says "in the event of covid pandemic, build private homes."

That was only part of your snide comment on the terrible tragedy that has fallen on the Dine. You get all upset when folks cannot dine in restaurants, but all snarky when Native Peoples suffer and die at rates far more grievous than white folks.

We really did not expect better from a Racist like you, nor did we expect better from a name caller who labels one major political party as "dimocrats."

Jim Klukkert

Okay Lee, you have convinced me. You are not only an idiot, but you are also totally ignorant of American history.

You write that if I stop listening to "the talking heads on fake news long enough and really read this article, you will see it is about the pandemic, not about treaties signed decades or centuries back."

Anything event, long ago or in contemporary time, in the long history of First Nations, inevitably has much to do with "treaties signed decades or centuries back." These treaties, and their implementation or lack thereof, are what have defined the present circumstances of Native Americans.

The long history of broken treaties is well known to most of us and certainly is not fake news. I just love the 'studied ignorance' of the Alt-Right. It is not name calling when I label fans of the Stars and Bars, 'Racists.' It is not name calling when I label as 'Racists,' white folks who claim ignorance of the history of the US Genocide of Native Americans.

So please do not accuse me of name calling when I call out your Racism. You sir, are a Racist.

Jim Klukkert

Sorry Lee, if I was not clear. "Stars and Bars" is a nickname for a flag go the Confederacy. In your ignorance ignorance of American history, you may not know that.

Of course, in your racism, you may have that flag hanging in your bedroom.

Lee DiFiore

Still no facts on why PANDEMIC MONEY is being used to build private residences as the article states. Just more name calling. If anyone should be getting money these days to build or rebuild it's the many small businesses and others burned out or looted by left wing "peaceful protesters" from your side of the political spectrum. I haven't seen any burning or looting attributed to "racists" (i.e., anyone who doesn't goose step to your radical leftist agenda).

Lee DiFiore

Sorry Jim, if I was not clear "goose step" is a reference to dictatorships, most of them socialist or communist based where alternative opinions or thoughts are not allowed. Perhaps you are practicing in your bedroom.

Stefanie Beninato

You do know that most affordable housing projects have large federal subsidies? Get your knickers out of their twist.

Stefanie Beninato

And better than giving it to corporations, including foreign owned, so their CEOs do not suffer a bonus cut.

James Morris

Excellent reporting.

Ted Nugent

This article is exactly why Navajo people should not vote other than Biden/Democrat November 2020.

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