The Yellowhawk Tribal Health Center on the Umatilla Indian Reservation, Monday, in a photo from Dec. 14, 2020. The clinic has transformed into the tribe's COVID-19 crisis center.

The Yellowhawk Tribal Health Center on the Umatilla Indian Reservation, Monday, in a photo from Dec. 14, 2020. The clinic has transformed into the tribe's COVID-19 crisis center.

Bradley W. Parks / OPB

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Public health officials in Umatilla County say they are seeing a spike in COVID-19 cases linked to the Pendleton Round-Up. The annual rodeo was September 11-18 and compliance with the statewide mask mandate was apparently low. Umatilla County Public Health Director Joseph Fiumara said some people were symptomatic but chose to attend Round-Up anyway. In response to the surge in cases, the board of trustees for the Confederated Tribes of the Umatilla Indian Reservation have declared a public health emergency. Interim CEO of the Yellowhawk Tribal Health Center Aaron Hines joins us to talk about what this means for staff and patients.

This transcript was created by a computer and edited by a volunteer.

Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. A few weeks ago when the Pendleton Roundup was in full swing the Public Health Director for Umatilla County was concerned. He thought that big groups of people, a low vaccination rate, a lack of mask-wearing and the highly contagious Delta variant could mean a big increase in COVID-19 cases. It turns out he was right to worry. Earlier this week, hospitals and Public Health officials started reporting a quick uptick in cases at a time when they had been dropping in the state as a whole. To put it in perspective, the rate of new cases announced yesterday per capita was 15 times higher in Umatilla County than in Multnomah County. In response to this surge, the Board of Trustees for the Confederated Tribes of the Umatilla Indian Reservation declared a public health emergency. Aaron Hines is the Interim CEO of the Yellow Hawk Tribal Health Center. He joins us to talk about what this means. Aaron Hines, welcome to Think Out Loud.

Aaron Hines: Good afternoon and thanks for having me.

Miller: Thanks for joining us. So let’s start with some of the basics here. What is the role of the Yellow Hawk Tribal Health Center when it comes to the COVID-19 pandemic because I should point out that you are not a full-fledged hospital?

Hines: That is correct. Yellow Hawk Tribal Health Center is an ambulatory or outpatient healthcare facility that is for primarily the Tribal members of the Confederated Tribes as well as other Natives and those who are eligible to receive services here. With that said, Yellow Hawk recently became a Public Health Authority on its own. We’re one of four Tribes in the nation who hold such an accreditation. Our role in terms of dealing with the pandemic is very similar to that of a County Public Health Authority and we’re doing our job to do contact tracing and take care of all of our members with the resources that we have and the abilities as an outpatient healthcare facility. So a little different than what the hospital would do, but we still have a large role in protecting our community.

Miller: What is it like at the health center right now during this latest surge?

Hines: We are fairly busy with contact tracing, with testing. That was the big push, post Roundup. As you noted, the County Health Director was preparing for the surge. We also felt that this was going to happen. We didn’t think it was going to happen as quickly as it did. But day one, on Monday last week, returning from the Pendleton Roundup, we had a number of cases right out of the gate and for last week we had 77 total positives, which is a lot for our community. It’s very alarming that it did spike as quickly as it did. So because we’ve got so many, that means that we’ve got a lot of our staff dedicated to contact tracing. The Oregon Health Authority had worked with FEMA and they had a Mobile Unit out here for the month of September. They were at Wild Horse Resort and Casino. They also had a presence during the Pendleton Roundup down in the park that is right next to the Roundup grounds. And for this week and next week, we’ve asked them to partner with us to assist us with the testing just because we’re doing mass testing all day, every day. So that those individuals that want some peace of mind, want to know if they’re positive or not, just that the service is available. So it’s fairly busy around here right now.

Miller: You’re asking for more help to do testing or, I suppose, for contact tracing as well. Even with that help, will you have enough people power to do that testing and to call everybody who needs to be called?

Hines: Fortunately for us, because we’ve been able to receive some of the stimulus dollars, actually, a lot of the stimulus dollars that Congress has appropriated through the CARES Act, the Arts Funding that’s been provided. So we’ve been able to create positions specifically for covid assistance. We brought on more staff for that purpose. So it wasn’t very taxing and we weren’t solely using our staff this entire time. We’ve been fortunate to be able to use some of that funding, and that’s helped. Even without our current workforce and the Covid staff that we’ve been able to bring on with that funding that we’ve received, this emergency declaration that the Board of Trustees passed allows us to also pull other resources, whether it’s staffing, supplies and equipment, funding resources. We can pull from other Tribal organizations if we need whatever assistance. And we’ve done that right now just because with the testing that we’re doing, we also have our own Lab. That makes the turnaround time for the testing very quick because we’re able to identify those positive cases through our lab. Whether it’s the rapid test, we can do that within 15 minutes at its quickest when we do the Abbott ID Test, those take a little bit more time. Opposed to some of the other testing sites where they have to send it off to a testing lab that’s in Spokane or Portland or Seattle, wherever it might be. And it takes a couple of days. That’s the difference with our operations here, we can immediately identify within the same day somebody is positive and then kick that over to our public health staff and our contact tracers to inform those individuals and then start finding out who their potential contacts are and that’s what’s helped us really keep this from becoming a much larger surge than it could be is our own in house capabilities.

Miller: Although as you noted, 77 cases last week and that’s just on the Reservation. It’s smaller than you think it could be, but it’s not small. From the contact tracing you’ve been able to do, have you been able to directly attribute most of those cases or this rise in cases specifically to Roundup? Were people at Roundup or hanging out with people who were?

Hines: Yes. Part of the contact tracing process is to do our best to try to identify where the source came from, and what our contact tracers have been able to identify, at least through last week, 77, is that 40 of them were directly linked to the Pendleton Roundup and that was by them participating, whether it was going to the rodeo, the concert, the bull riding or just being amongst the masses down there during the week. Then there are potentially more that could, but through the contact tracing, it was hard to determine specifically one event that a person went to, whether it was Roundup, a social gathering at their home or... individuals attended many things where they could have been and potentially contracted Covid. So at least 40 of them and that’s just from last week as we’ll pull the data from this week at the end of the week. We’ll probably identify a few more.

Miller: We asked what people were thinking about in terms of this Roundup connected surge and on our Facebook page. Alice Gilson Hepburn wrote, ‘I’m pretty sure it was a calculated risk. The money from Roundup was more important to the people who made the decisions. Now, everyone has to suffer the consequences, even those who chose not to participate in Roundup.’ Do you agree with that assessment, that the people in charge knew this would happen and said going forward with Roundup is too important to stop it?

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Hines: Yeah. as somebody who wasn’t on the decision-making body, I won’t speculate as to what I think they knew or didn’t know, but I do know that they had a plan in place to try to help mitigate some of this. As to whether or not that plan worked, I think we’re definitely seeing the after-effects of the spike in Covid cases. From our end, we tried to do our best to make sure because we knew we’d have a lot of our Tribal members participating in the event because that’s just the connection that there has been since day one with the Pendleton Roundup is that the Tribe has participated and we put out some education on, ‘it’s an individual choice, but if you’re going to participate, please do your best to social distance, please wear your mask, please wash your hands, please stay home if you’re sick’. As to how well that message got out, and how much our individual Tribal members heeded that advice, maybe this surge could have been a lot larger because maybe some people did listen and stayed home. It’s hard to say but I think to that point, even those who didn’t participate are now feeling the effects because at this point those who are continuing to test positive are potentially contacts of those who did directly participate. And so it does have an effect. We’ve seen a similar surge after the Whisky Fest Concert back in July so we’re hoping that we can get over this surge, that it doesn’t continue to grow any larger, that we’ll be back to some kind of normal mode. Whatever normal is these days, in the next week or so.

Miller: The vaccination rate, I should point out, on the Reservation is below 50%, that’s below the state average. It reminded me that early on, when we were talking about vaccination efforts, the Tribal leaders had so many available doses. It seemed that the vaccination effort was going well enough that you were able to make some of those doses available to non-Tribal members in the community and people who are doing, for example, business on the Reservation. How do you explain that the overall rate, below 50% now?

Hines: I will say that I’m shocked that our rate isn’t higher than what it is right now. It’s currently 47% and that is very saddening that we’re not higher. But you’re right -- at the onset, we were one of the few Tribes who were fortunate enough to get the vaccines immediately, and that was due to the fact that we had a deep-freeze freezer, which is what you needed to be able to house the vaccines to ensure that they didn’t defrost and then become unusable. And so we had a lot of vaccines available. We did a huge outreach and education push on why individuals should get it. I think our population is no different than any others and that we’re not immune to those who unfortunately believe false news, fake news on what goes around about the vaccine. There’s a lot of misinformation out there. And so we’re now working on a new strategy to re-educate the population on what the vaccine is, what it does and how it can help. Hopefully that will change some minds and I know unfortunately for some individuals out here, it has taken them to see first hand whether they’ve gotten it directly and they weren’t vaccinated or they’ve seen a family member who was unvaccinated, we’ve had a few Tribal members that have passed away and that unfortunately it took those events for some individuals to this idea, I’m going to get the vaccine and we’d like it to not have to get to that point. Hopefully, we can get true and accurate information out there that they would be more willing to believe to make better health choices.

Miller: One thing I’m curious about is we’ve heard so much and we’ve seen so much over the last year and a half about people in non-Tribal communities pushing back against local elected officials or national elected officials, telling them what to do in terms of public health. Do you see the same dynamic at play with Tribal members pushing back against Tribal leaders or Tribal elders saying, Hey, don’t tell me what to do. I don’t trust the government?

Hines: Probably, definitely a conversation for another day in regards to Tribal members and trusting the federal government. But in short, …

[Voices Overlapping]

Miller: I meant, no, that would be, that’s a gigantic other... . I meant Tribal members, trusting Tribal government.

Hines: Along the same lines, just trusting government in general, there’s a long-standing history of being able to trust authority on things. And so for the vaccine, I would say it hasn’t been so much that there is a push back on us trying to promote the vaccine, as there is on some of the guidelines that we establish during a Reservation Declared Emergency, which is what we’re in right now. So in terms of…

[Voices overlap]

Miller: ...the number of people who can gather in homes, for example.

Hines: Exactly. Don’t tell me what I can do in my home and what we’re trying to put out there is we’re not trying to tell you what to do in your home, but we’re offering you guidance on what would at least help minimize your risk of spreading Covid because that’s, where we see where Covid is getting spread is in the homes in social gatherings. It’s easier for us to implement regulations for the Tribe, Tribal Organizations, whether it’s the government, Yellow Hawk, the Casino. Each organization has done a very good job of ensuring that the individuals that go into those buildings are wearing their mask, doing their best to social distance. I mean, there’s arguments made that doesn’t happen at the Casino. However, they still enforce the Mask Rule and that’s what helps prevent the spread, and again clarifying, it’s not going to be a 100% guarantee that you’re not going to get it or spread it, but these are all measures to help keep it from spreading.

Miller: And just briefly before you say goodbye. My understanding is that Yellow Hawk Tribal Health Center recently extended the vaccination deadline for staff from September 30th meaning tomorrow, one month to October 31st. How many staff members or what percentage still need to get vaccinated?

Hines: So here at Yellow Hawk we have roughly, it’s been fluctuating here lately. We’ve got roughly about 140 staff members and we’ve got 15 I believe, individuals who still need to get vaccinated. So we’ve got a very good vaccination rate within this organization, I believe that’s roughly 80, almost 90%. We have individuals that have their beliefs as to why they, or rationale, as to why they don’t want to get the vaccine and that’s fine. We’re not trying to say that people shouldn’t think what they want to think, but that’s been a challenge. So the extension for getting the vaccine was due to, we’re now in an emergency that we need to deal with. And so because we’re all so busy and it’s all hands on deck dealing with this pandemic right now, this emergency here on our Reservation, trying to take care of personal matters. Do we deal with Covid what, you know? Yes, we could try to do it all at once, but we’re spreading everybody just much thinner. So let’s get through this Emergency and then we’ll continue dealing with the vaccine mandate.

Miller: Aaron Hines. Thanks for your time today. I appreciate it.

Hines: Thanks for having me.

Miller: Aaron Hines is the Interim CEO of the Yellow Hawk Tribal Health Center.

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