COVID-19 Among American Indian and Alaska Native Persons — 23 States, January 31–July 3, 2020
Sarah M. Hatcher, Christine Agnew-Brune, Mark S. Anderson, Laura D. Zambrano, Charles E. Rose, Melissa A. Jim, Amy R. Baugher, Grace S. Liu, Sadhna Patel, Mary E. Evans, Talia Pindyck, Christine Dubray, Jeanette J. Rainey, Jessica Chen, Claire Sadowski, Kathryn Winglee, Ana Penman‐Aguilar, Amruta S. Dixit, Eudora Claw, Carolyn Parshall, Ellen Provost, Aurimar Ayala, Germán González, Jamie Ritchey, Jonathan Ryan Davis, Victoria Warren‐Mears, Sujata Joshi, Thomas Weiser, Abigail Echo‐Hawk, Adrian Dominguez, Amy Poel, Christy Duke, Imani Ransby, Andria Apostolou, Jeffrey McCollum
Abstract
with >70% complete race/ethnicity information and five or more laboratory-confirmed COVID-19 cases among both AI/AN persons (alone or in combination with other races and ethnicities) and non-Hispanic white (white) persons. Among 424,899 COVID-19 cases reported by these states, 340,059 (80%) had complete race/ethnicity information; among these 340,059 cases, 9,072 (2.7%) occurred among AI/AN persons, and 138,960 (40.9%) among white persons. Among 340,059 cases with complete patient race/ethnicity data, the cumulative incidence among AI/AN persons in these 23 states was 594 per 100,000 AI/AN population (95% confidence interval [CI] = 203-1,740), compared with 169 per 100,000 white population (95% CI = 137-209) (rate ratio [RR] = 3.5; 95% CI = 1.2-10.1). AI/AN persons with COVID-19 were younger (median age = 40 years; interquartile range [IQR] = 26-56 years) than were white persons (median age = 51 years; IQR = 32-67 years). More complete case report data and timely, culturally responsive, and evidence-based public health efforts that leverage the strengths of AI/AN communities are needed to decrease COVID-19 transmission and improve patient outcomes.