The numbers are stark.
Last week Navajo Nation health officials reported six new deaths Friday and 180 new cases of COVID-19. That adds up to 1,590 known coronavirus infections across the Navajo Nation and some 58 deaths.
That topline number places the Navajo Nation at 45 out of 55 states and territories, ahead of ten other jurisdictions.
What’s the story behind the data?
This is Trahant Reports.
The state and territory data from the Centers of Disease Control and Prevention includes three columns: Column A for the state or territory (which should include tribal nations, by the way); the number of confirmed cases; and the number of deaths. But if you insert a new tab, a filter for population, then the story grows even more significant.
Welcome to the world of the denominator. As one source put it: ‘‘Physicians lie awake at night worrying about numerators. Epidemiologists lie awake at night worrying about the denominators’
As Indian Country Today’s Jourdan Bennett-Begaye reported “denominators are key” to understanding the big picture of COVID-19 in Indian Country.
What population is counted determines our understanding about how widespread the disease is and where it will go next.
Take the Indian Health Service “service population” at 2,562,000. That means the reported infection rate is 0.08 percent. But if you calculate based on the IHS user population of 1.662 million, then the rate is 0.12 percent.
But that’s only the reported cases. We know this disease can be without symptoms and we don’t have enough testing to know how many people are really infected,
And that will be a much larger number.z
If you use the World Health Organization framework and the IHS service population that means we will eventually reach 5,778 cases and 275 deaths.
But numbers again are different if the 2010 Census with the American Indian and Alaska Native population at 5.2 million is used. Then the Indian health system could expect 12,017.2 cases and 572 deaths.
But all of that changes if a different denominator is used. The problem here is that we know the Census undercounts Indian Country. We don’t know by how many people, though.
This is when that number is absolutely critical.
I am Mark Trahant
