Cradled by Great Smoky Mountains National Park, the Qualla Boundary—our land—comprises 56,000 acres in western North Carolina, across five counties. Not unlike other American Indian nations, the EBCI has rates of diabetes, heart disease, hypertension, and substance abuse far exceeding the national averages for other subgroups. Knowing that these factors would put the EBCI at extreme risk for the coronavirus, tribal health officials began discussing the potential impact on the Qualla Boundary with Principal Chief Richard Sneed very early—before January 20, when the United States reported its first case of COVID-19.
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After comparing COVID-19 response models from Europe and Asia, tribal health officials identified South Korea’s model of mass testing, contact tracing, and isolation of cases as the most effective and adaptable for our situation. They argued that those best practices, in addition to public education and quarantine, would be essential for keeping the tribe safe.
Tribal leaders did not wait for state and federal guidelines. In March, North Carolina was not encouraging mass testing, especially of asymptomatic residents, because the state—and regional communities—did not yet have the infrastructure to support such expansive measures. By contrast, beginning on March 15, the tribe funded and implemented mass COVID-19 testing for EBCI members and residents of the Qualla Boundary. The chief executive director of the Cherokee Indian Hospital, Casey Cooper, arranged a partnership between the tribe and a regional health nonprofit to help locate and purchase personal protective equipment, assist with data collection and analysis, and institute testing protocols. Around the same time, the hospital-nonprofit team built groups of contact tracers made up of accountants, social workers, nurses, and others.
The tribe also moved quickly to shut down the Qualla Boundary. “In early conversations with the chief, I told him, ‘You’re going to see stay-at-home orders from other states. I am going to recommend that you shut this government down. I’m talking everything,’” Vickie Bradley, the EBCI’s secretary of health and human services, told me in an interview. When Chief Sneed called for data to back up the recommendation, Bradley was ready. “I had conviction. Casey [Cooper] had conviction. Everything was based on data,” she told me. In response, Chief Sneed issued, on March 13, a state of emergency and then, eight days later, an addendum shutting down businesses. He also made the decision to close our borders, by instituting road closures to all vehicles but those providing crucial services.
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With businesses closed, concerns over the economic stability of the tribe became the main topic of conversation among tribal members and those in the region who have come to rely on the EBCI’s employment and businesses. The EBCI sent tribal employees home but continued to pay them, and they paid essential workers—police officers, nurses, emergency management, and others—double-time. Fortunately, several years of strategic budgeting had built a cash reserve that allowed Harrah’s Cherokee Casino Resort, the economic driving force for the tribe and, in truth, the region, to stay closed for more than two months.