Carrie Middle Tent still has side effects from a bout with COVID-19, which she caught more than two months ago. She still can’t taste or smell things like she once could. Members of her family got the virus too. They’re enrolled members of the Crow Creek tribe and live in Rapid City. For three days she had a small cough and chest pressure.
“I thought I was actually feeling pretty good, but that’s when I started getting really bad, short of breath,” Middle Tent says.
Then, she developed a fever, cold sweats, and even fainted.
“Just walking down the hallway, it feels like you just ran up a big ole hill. You have to sit down or it feels like you’re going to pass out,” she says.
Fourteen family members got the virus. She and her mother had the worst symptoms—both are diabetic. Middle Tent says they took her mother to the ER at Monument Health three times before she was admitted for 8 days--one of those days was Mother’s Day. Middle Tent wasn’t sure her mother would make it.
Carrie says her brother first got the virus—either from his construction job or while shopping at Wal-Mart, they’re not certain. She says once her brother developed COVID symptoms, he tried to limit his contact with their mother and his kids. But soon, family members started to fall ill. The virus quickly spread through their family’s three households.
“We all had contact with my mother and then whoever had contact with me,” Middle Tent says. “But, we’re all family, because we all felt safe with each other. We know who comes and goes in and out of our home. We know the places—we just know we were all being safe.”
Middle Tent says because of the positive cases, her family needed to quarantine for fourteen days. It was tough to keep enough food or supplies in the house.
While state health officials recommend a quarantine after exposure to the virus, South Dakota has been more hands-off than other states in its response to the pandemic.
Early on, Governor Kristi Noem said the state’s rural nature and low population could be an asset as the pandemic worsened.
All along, Noem says she has asked residents to be responsible. To stay at home if they don’t feel well, wash their hands often, and call their primary care doctor if they have symptoms.
That approach won glowing reviews from conservative media outlets. Recently, the governor talked with the Minnesota-based Center of the American Experiment.
“I did not order any businesses closed. I did not order a shelter in place for families. What I did was I gave them all the information that I possibly could, then I reiterated to them the importance of personal responsibility," Noem says. "I was going to give them the flexibility to make the best decisions to protect their families.”
Some tribal governments are taking a different approach. For months, there have been checkpoints on roads leading into the Cheyenne River and Pine Ridge reservations. Tribal Health officials say that lets them do contact tracing for coronavirus outbreaks.
Jerilyn Church is the CEO of the Great Plains Tribal Chairmen’s Health Board. It runs the Oyate Health Center in Rapid City. Church says urban Native Americans don’t have the same protections.
“In Rapid City, even though our populations have the same risk factors as our relatives on the reservation, they really can’t shelter in place--they can, but they’re still subject to the environment where none of that is being promoted or required. So it puts them at even higher risk," Church says. "And we’ve seen that.”
Census data show Native Americans make up 10 percent of the population in Pennington County. Great Plains Health Board statistics show tribal members make up 45 percent of confirmed COVID 19 cases. They make up 21 percent of COVID hospitalizations in the county and 28 percent of the deaths.
“It is impacting our population at a little bit higher proportion than other groups,” Church adds.
Church says the native population is at more risk for contracting COVID 19 because many have underlying health conditions.
“If we have one family member come, the likelihood of their entire household being infected is pretty high. It makes it pretty difficult for those families to get what they need," Church says. "Many rely on public transportation. It makes it really difficult for them to convalesce.”
In the eastern part of the state, COVID-19 has hit other communities of color. People of color make up 20 percent of the state’s population, but 63 percent of COVID-19 cases.
An early surge of cases at Smithfield Foods in Sioux Falls infected hundreds of meatpacking plant workers and their families. Most employees at midwestern meatpacking plants are immigrants or refugees.
Taneeza Islam is the Executive Director of South Dakota Voices for Justice. She says a federal order that forced meatpacking plants to reopen put minority communities at risk.
“Essential food production workers who must go to work and absolutely have no alternative, right? Their choice is to bring a paycheck home, go to work and get sick,” Islam says.
The state Department of Health does not have a racial breakdown of COVID cases from job-related outbreaks. It does track the overall cases at meatpacking operations. Eight-hundred and fifty-three Smithfield Foods workers contracted COVID 19. So did 171 workers at DemKota Ranch Beef in Aberdeen, 129 at Jack Links in Alpena and 105 at Dakota Provisions in Huron.
“There are many communities, starting with indigenous populations to all of these immigrant communities that are working in these blue-collar jobs, specifically—or any community that’s working in blue-collar jobs who don’t have that option for liberties, that are completely overlooked,” Islam says.
“We could say that social distancing is a luxury," Drew Harris, a population health consultant from Philadelphia, says. “We tell people, ‘Well, you’ve been exposed. Now, you have to quarantine yourself for 14 days.’ Well, you’re living in a home with 5 or 6 other relatives. It’s a two-bedroom place. Everyone is sharing everything. How are you supposed to do that?”
Harris says South Dakota is fortunate to have a low number of COVID cases so far. However, he says the pandemic has a larger lesson for us all.
“COVID has shined an incredibly bright light on existing disparities and is taking the most vulnerable people in our society and victimizing them even worse than they were before by the existing prejudices and racism in our society,” Harris says.
Back in Rapid City, Carrie Middle Tent says she still has some COVID symptoms.
“It’s different, now, it’s difficult,” Middle Tent says. “I get tired real easy. I just don’t do anything. I don’t have to do anything just to feel that. I try to motivate myself the best I could, but it’s just harder now.”
Middle Tent says her family had a rough experience.
“I’m just glad we’re all here and we got through it and we could tell our story. I don’t want to get it a second time. I don’t think my body could handle it. My mom already said it, ‘I don’t think I could live through a second time,’” she adds.
Middle Tent says they’re taking precautions - cleaning and disinfecting their homes and the vehicle her sons use to go to work. She makes sure they wear masks and use plenty of hand sanitizer. When family members visit, they meet outside and at a distance. In addition, she prays and burns sage – a traditional cleansing practice – to help keep her mind at ease.