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Meskwaki Settlement, Tama, Iowa – The World Health Organization recently released information characterizing the coronavirus outbreak as a pandemic, applying the term for the first time to COVID-19, the disease caused by the virus. The Meskwaki Health Clinic and the Meskwaki Tribal Council continue to monitor the situation with updates from local public health agencies, Iowa Department of Public Health, and the Center for Disease Control coming daily. In Iowa, local communities including the Meskwaki Nation prepare as the outbreak continues.

Tribal Council is encouraging tribal members, staff, and the community to remain informed, but calm, and to practice safe prevention, both for the coronavirus and the spread of contagions in general.

1. Tribal Council met in special session today and determined that the Shelter In Place Declaration will stay. All Tribal entities will remain closed until Monday, April 20th. The council will review this as more information and details come into place as to the extent of the spread of the corona virus both on the settlement and in the state.
2. Friday, September 12, 2003 The Meskwaki Tribe's casino in Iowa will remain closed until a federally recognized leadership gains control of the facility, federal gaming regulators said on Thursday. In a final decision, the National Indian Gaming Commission extended the shutdown of the casino. The three members of the commission said they would consider changing their minds if the tribe proved.
3. Meskwaki Tribal Operations, including the Health Clinic and Pharmacy will be closed on Thursday, November 26th and Friday, November 27th for the Thanksgiving Holiday. Normal business hours will resume on Monday, November 30th.
4. DAN NIERLING / Courier Photo Editor Gamblers continued to test their luck today at the Meskwaki Bingo-Casino-Hotel despite a closure order issued by the National Indian Gaming Commission.

At this time, there are no confirmed cases in Tama County or on the Meskwaki Settlement. Tribal Operational Departments have been directed to take steps to incorporate additional preventative measures to adequately disinfect all office buildings and public spaces. Additional proactive methods are being taken on-property, including offering extra hand sanitizer, and wiping down high-traffic surfaces more frequently. Deep cleaning will continue until the outbreak is contained. Council has also enacted a workforce travel ban for all tribal entities which will be in place until May or later.

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WHAT IS CORONAVIRUS (COVID-19)?

Coronavirus is thought to be spread mainly between people who are in close contact with one another (within about 6 feet) through respiratory droplets produced when an infected person coughs or sneezes. It may also be possible to get the virus by touching a surface or object that has the virus on it, although this is not thought to be the main way the virus is spreading. At this time, there are no approved vaccines or mediations to treat coronavirus. Symptoms include fever, a dry cough, difficulty breathing, and pneumonia. See more by visiting: https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-factsheet.pdf

The risk of serious illness due to COVID-19 is the highest for people who are older and have underlying medical conditions. (People 60 and older accounted for more than 80% of the deaths in China, according to a major study in the Journal of the American Medical Association. Because the U.S. outbreak is in its early stages there is not reliable data on the ages and other characteristics of infected patients so experts have relied on the analysis of patients in China.)

WHAT SHOULD WE DO?

The Center for Disease Control (CDC) recommends staying at home when you are sick, avoiding close contact with sick individuals, cleaning objects that are touched often like doorknobs, countertops, phones, and appliances, covering your coughs or sneezes with a tissue, and frequent handwashing with soap and water. The US Department of Homeland Security also recommends avoiding touching your eyes, nose, and mouth, and maintaining your wellness in other areas of your life, including staying active, managing stress, and getting enough sleep.

The CDC is encouraging older people and people with severe chronic medical conditions (heart disease, lung disease, and diabetes) to stay at home as much as possible. Individuals at increased risk of severe illness should strongly consider staying home and avoiding gatherings or other situations of potential exposure, including travel.

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To help minimize the spread of the coronavirus, Tribal Council recommends each person makes choices that are the best for his/her own personal health and safety. These may include limiting visitors, maintaining distance from others (approximately 6 feet), limiting movement in the community, limiting personal travel, and staying home from large gatherings of more than 250 people.

EVERYDAY PRECAUTIONS:

• Avoid close contact with people who are sick.
• Take everyday preventive actions.
• Monitor local information including the tribal website at meskwaki.org for the most up-to-date information.
• Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
• If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
• To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc.
• Use a tissue or your sleeve to cover your hand or finger if you must touch something.
• Wash your hands after touching surfaces in public places.
• Avoid touching your face, nose, eyes, etc.
• Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones).
• Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
• Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

IF YOU ARE SICK:

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If you are sick with coronavirus or suspect you are infected, follow these steps:

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• Stay home except to get medical care. At this time, the Meskwaki Health Clinic is unable to test for the virus. If you feel you have been exposed or are experiencing symptoms, call the clinic at (641) 484-4094. Staff will help you to obtain an appointment at a testing facility. This will help keep other people from getting exposed and/or infected.
• Separate yourself from other people and animals in your home. Stay in a specific room and away from other people in your home. Use a separate bathroom, if available. Do not handle pets or other animals.
• Wear a facemask – the Center for Disease Control recommends that only people who are sick or are in close proximity to sick people use masks. If you are not able to wear a mask, then people who live with you should not stay in the same room with you, or they should wear a facemask if they enter your room.
• Avoid sharing personal household items – do not share dishes, drinking glasses, cups, utensils, towels, or bedding with other people or pets in your home. Clean them often.
• Cover your coughs, clean your hands often, and clean all “high-touch” surfaces.
• Monitor your symptoms and seek medical attention if your illness is worsening.
• Discontinue home isolation in consultation with the Meskwaki Health Clinic and/or your healthcare provider.
• For more information: https://www.cdc.gov/coronavirus/2019-ncov/downloads/sick-with-2019-nCoV-fact-sheet.pdf

Meskwaki Tribal Council in conjunction with the Meskwaki Health Clinic and Meskwaki Emergency Response has begun mitigation strategies to thwart the spread of the virus in our community to ensure the safety and social well-being of groups that may be especially impacted and/are at increased risk for severe illness. As community members adapt to probable disruptions in routine activities due to the outbreak, Tribal Council recommends each member put a “household plan” into place to prepare in the event quarantine is necessary.

PREPAREDNESS:

In the event that a community or home quarantine is necessary, be prepared.

• If you don’t already have them on hand, consider purchasing a pain reliever such as Ibuprofen or Tylenol, stomach remedies like Tums or Pepto-Bismol, cough and cold medicines like Alka-Seltzer Cold Plus, Kleenex, and fluids with electrolytes like Gatorade. These will help alleviate symptoms should you be infected with the virus.
• The CDC recommends collecting and maintaining your health records – contact the Health Clinic if you need a list of your current diagnoses and medications at (641) 484-4094.
• Make sure you have a two week supply of any current medications on hand. Call the Meskwaki Pharmacy if you need prescriptions refilled at (641) 484-9451.
• If a community quarantine is determined necessary: Have two weeks’ worth of food on hand. It’s a good time to stock up on crackers, tuna, soup, rice, and beans. Pet owners will want to make sure they have extra pet food on hand.
• Extra Supplies – While the warnings about coronavirus should be taken seriously, it’s important to remain calm. At this time, the CDC is suggesting supply preparation for a two-week period of time. Odds are that you already have the baseline of things you need at home. Preparedness, in this case, is just getting a few little extra things to round it out. Walmart and HyVee in Marshalltown both offer order ahead then pick-up options and on-line food delivery can be made through Amazon.
• THINGS YOU DO NOT NEED: Masks – the CDC recommends that only people who are sick or are in close proximity to sick people use masks.

For now, all facilities including Meskwaki Bingo Casino Hotel, the Meskwaki Travel Plaza, the Meskwaki Settlement School, Tribal Center, Health Clinic, Pharmacy, and others will remain open. Tribal Council, in conjunction with the Health Clinic and Meskwaki Emergency Response, will continue to be in contact with other local response partners to be ready for when/if the virus arrives on the Settlement. If that happens, further information will be distributed and updated as the situation changes.

For the latest information, community members are encouraged to visit the Meskwaki.org website at www.meskwaki.org and the Centers for Disease Control and Prevention website at https://www.cdc.gov/coronavirus/2019-ncov/index.html.

If you think you have coronavirus, CALL THE MESKWAKI HEALTH CLINICAT (641) 484-4094 for further direction and information.

Tribal Council met in special session today and determined that the Shelter In Place Declaration will stay. All Tribal entities will remain closed until Monday, April 20th. The council will review this as more information and details come into place as to the extent of the spread of the corona virus both on the settlement and in the state. Staff will continue to be paid.

TO STOP THE VIRUS, IT IS IMPERATIVE THAT WE ALL STAY HOME AND FOLLOW SOCIAL DISTANCING PROTOCOLS.

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From Health Director Rudy Papakee:

As of March 31, there are 11 positive cases within Tama County. This number will continue to increase as more testing becomes available. The good news is that all of the Natives who tested positive to date, are recovering. While Iowa has not peaked with cases across the state, the effects of closures and social distancing has still yet to be felt. However, with symptoms of COVID-19 taking 2 – 14 days to manifest, from a public health standpoint we are hoping to start seeing the results of prevention efforts paying off over the next couple of weeks.

These prevention efforts are still needed from all of you reading this. Continue social distancing, do not visit others in their home, don’t allow people into your home, practice good cough and sneeze etiquette, and by all means, stay home if you are sick. I know this may sound like a broken record but with no vaccine or a cure for the disease, these steps are necessary to ensure we minimize those infected. With no timeline projected, your efforts will be rewarded when life can return to normal.

Information changes daily on the virus and while there is no cure, I am sure some of you have read or even heard from the President that hydroxycholorquine (HCQ) and azithromycin are a potential cure. The FDA recently announced the emergency use of the drugs even though this is an unproven treatment. Patrick Bolte, Meskwaki Chief Pharmacist, in an email stated, “ Limited data showing either drug works and both are on national shortage. Grinnell was told not to use azithromycin because it was not showing efficacy (it shouldn’t because COVID is a virus and azithromycin doesn’t treat viruses). HCQ is restricted to admitted patients that 1) have a +CT scan, +fever and require oxygen or 2) +COVID test, +fever and require oxygen.” Dr. Frost, Meskwaki Medical Director, in a follow up email stated, “ I have not received any supporting memos from CDC or WHO regarding these treatments in the outpatient setting.” With this information the Meskwaki Clinic will not be prescribing either medication for anyone who tests positive within our facility. If additional information comes forward that supports the use, the Clinic will reevaluate their protocols.

Finally, I want to thank all of you who continue to abide by the shelter in place initiative and those following the social distancing protocols. I know this isn’t easy as we are a social group already. But we as a community have the ability to stop the virus from infecting others but we must remain diligent in our daily activities.

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Real time updates are provided through Facebook on both the SETT and KSETT pages and on our website at www.meskwaki.org. Please watch for updates as they become available.