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A SARS-CoV-2 Outbreak Illustrating the Challenges in Limiting the Spread of the Virus — Hopi Tribe, May–June 2020

2020; Centers for Disease Control and Prevention; Volume: 69; Issue: 44 Linguagem: Inglês

10.15585/mmwr.mm6944a5

1545-861X

Jocelyn Hirschman, Harpriya Kaur, Kay Honanie, Royce Jenkins, Duane Humeyestewa, Rachel M. Burke, Tracy M. Billy, Oren Mayer, Mose Herne, Mark Anderson, Ravikiran Bhairavabhotla, Graydon Yatabe, S. Arunmozhi Balajee,

Long-Term Effects of COVID-19

On June 3, 2020, a woman aged 73 years (patient A) with symptoms consistent with coronavirus disease 2019 (COVID-19) (1) was evaluated at the emergency department of the Hopi Health Care Center (HHCC, an Indian Health Services facility) and received a positive test result for SARS-CoV-2, the virus that causes COVID-19.The patient's symptoms commenced on May 27, and a sibling (patient B) of the patient experienced symptom onset the following day.On May 23, both patients had driven together and spent time in a retail store in Flagstaff, Arizona.Because of their similar exposures, symptom onset dates, and overlapping close contacts, these patients are referred to as co-index patients.The co-index patients had a total of 58 primary (i.e., direct) and secondary contacts (i.e., contacts of a primary contact); among these, 27 (47%) received positive SARS-CoV-2 test results.Four (15%) of the 27 contacts who became ill were household members of co-index patient B, 14 (52%) had attended family gatherings, one was a child who might have transmitted SARS-CoV-2 to six contacts, and eight (30%) were community members.Findings from the outbreak investigation prompted the HHCC and Hopi Tribe leadership to strengthen community education through community health representatives, public health nurses, and radio campaigns.In communities with similar extended family interaction, emphasizing safe ways to stay in touch, along with wearing a mask, frequent hand washing, and physical distancing might help limit the spread of disease.The Hopi are a Native American tribe and a sovereign nation, primarily residing on the 1.5 million-acre Hopi Reservation in northeastern Arizona (2).The Hopi Tribe leadership declared a COVID-19-associated state of emergency on March 17, which was followed by a stay-at-home order March 23 (with projected reopening on June 20).On April 13, HHCC reported its first laboratory-confirmed COVID-19 case in a patient residing on the Hopi Reservation, and cases continued to be diagnosed at low levels through May.However, at the beginning of June, HHCC reported that during the preceding 14 days, the number of new cases had increased sharply, from 1-2 to 10-15 per day (J Hirschman, MD, CDC, personal communication, June 2020).