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If the Navajo Nation were a U.S. state, it would rank No. 3 for per-capita COVID-19 infections, behind only New York and New Jersey.

As of Monday, the country’s largest Native American reservation — which overlaps with Utah, Arizona and New Mexico and has 174,000 residents — had 813 confirmed cases of the virus and 28 total deaths, a per-capita infection rate of 468 per 100,000 people. New York’s infection rate, by comparison, was 994 per 100,000 on Monday.

San Juan County, Utah, had only 11 confirmed coronavirus cases as of Tuesday, according to the Navajo Epidemiology Center, but health officials warned that number could rise soon due to mobile testing centers being deployed along the Utah-Arizona border.

“We want the public to understand that over the next few days, we expect the number of confirmed cases in the county to increase rapidly,” said Kirk Benge, director of San Juan Public Health. “The count of confirmed cases will be driven primarily as a result of improved testing and case identification, not as a result of the further recent spread of the virus.”

The Utah Navajo Health System (UNHS) and the Utah Department of Health’s Utah Public Health Laboratory set up mobile testing units at the UNHS Navajo Mountain clinic on Monday and Tuesday. On Thursday and Friday, it will be stationed at the Monument Valley clinic.

Both areas already have confirmed cases of the virus, which have been linked to an evangelical church service held early last month in Chinchilbeto, Ariz.

The mobile team "will offer COVID-19 testing to anyone who self-attests to have symptoms, anyone who might be high risk or anyone who has had close contact with a confirmed case,” San Juan Public Health said in a statement. “Tests are free and open to everyone regardless of statehood or tribal affiliation.”

After the mobile units leave at the end of the week, only high-risk patients or those with serious systems will be tested in order to conserve a limited supply of test kits, San Juan Public Health said.

(Courtesy of the Navajo Nation)

The Navajo Nation declared a state of emergency on March 11, two days before the first case was confirmed, and imposed a nightly curfew on March 30 in an attempt to slow transmission of the virus. A 57-hour curfew was enforced last weekend with the Navajo Police Department issuing 115 citations.

“We saw a decline in the number of people traveling during the weekend,” Navajo Police Chief Phillip Francisco said, crediting the work of the department’s officers and the residents who voluntarily complied with the order.

The entire state of Utah had 19 confirmed deaths as of Tuesday — nine fewer than the Navajo Nation despite having a population that’s close to 20 times larger. (At least two deaths of Navajo Mountain, Utah, residents have likely been miscounted in Arizona, however, due to a lack of street addresses in some parts of the Navajo Nation.)

A lack of running water in 30% of Navajo Nation homes and the rural nature of many reservation settlements may be contributing to the high fatality rate.

Navajo Nation President Jonathan Nez held a livestream event on Tuesday from Arizona where he has been in self-quarantine since he and Vice President Myron Lizer were potentially exposed to the virus last week.

Nez announced that 57 ventilators and shipments of rapid test kits, which will show results in as little as 15 minutes, have arrived on the reservation. Health care facilities in Chinle, Ariz., and Gallup, N.M., received the rapid test kits Monday, which, similar to the deployment of the mobile testing centers in San Juan County, could lead to an increase in confirmed cases.

“You can expect a spike because of that,” Nez said.

He went on to note that two Navajo Nation police officers and at least one emergency medical technician have tested positive. “Our first responders — our warriors on the front line — are beginning to contract this virus, and we need to stay home," he said. "It’s no joke.”

But Nez encouraged residents not to give into negativity and read letters from Navajo citizens who said they have been brought closer together with family members during the pandemic.

“We all have been impacted here on the Navajo Nation," Nez said. "A super, super-majority of Navajo citizens out there are abiding by the shelter-in-place order. I want to say thank you for those who are listening to the order, to the doctors, to the nurses, to the police officers.”

Zak Podmore is a Report for America corps member and writes about conflict and change in San Juan County for The Salt Lake Tribune. Your donation to match our RFA grant helps keep him writing stories like this one; please consider making a tax-deductible gift of any amount today by clicking here.