The 2019 coronavirus pandemic began with an apparent cross-species transmission of the virus from an exotic animal species to a human host. From there, the virus, #COVID19, exploded across the globe and has been reported in nearly every country. The coronavirus preferentially infects the upper respiratory tract (URT) of its victims and establishes disease in the lungs and respiratory tract. Human to human transmission is reportedly by aerosolized droplets containing virus, and by contact with contaminated surfaces and transmission to the URT through hand to face contact. Epidemiologists and researchers have pointed to social isolation and quarantining as the most effective means to stop transmission until a neutralizing vaccine is available in 12-18 months.
Pueblo of Acoma Tribal Council issued a #StayAtHome order in early March 2020 to acknowledge the importance and functionality of social distancing. That action effectively closed all nonessential work in the Tribe. The state of New Mexico issued a statewide #StayAtHome shortly after. Nationally, as 9 April 2020, nearly 17 million people in the US are unemployed as a result of the service-based economy. Cibola County, the home county for Acoma, had am employment rate of 6.5% prior to #COVID19. Economists predict a national unemployment rate of at least 12-13%. Unemployment coupled with societal stresses from social isolation and economic and financial losses have increased the burden on the mental and behavioral health of the entire nation and Pueblo of Acoma is no exception. Recent reports have suggested a dramatic rise in domestic violence abuse at home and a significant increase in on the job alcohol consumption.
Acoma is as concerned for alcohol misuse, substance and opioid use disorders, at-risk behaviors, mental health and behavioral health status as is Substance Abuse and Mental Health Services Administration (SAMHSA). The Tribe has instituted a virtual/telehealth program to continue to address the needs of the people of Acoma. The SAMHSA Emergency COVID19 program will be a welcome resource and asset base to the community of Acoma as we develop a comprehensive and refined Telebehavioral health program for the COVID19 pandemic and predicted following waves of infections.
Evidenced-based practices (EBP) and culturally responsive best practices have been identified by the Health and Human Services Division (HHSD) of Acoma as well as Acoma Behavioral Health Services (ABHS). We have adapted several EBPs to virtual settings using Zoom for videoconferencing and doxy.me for one-on-one consultations between clinicians and clients. An HHSD system for client contact and intake has been established with formal data collection, collation and analysis procedures created. The Acoma Emergency COVID19 will address the required activities within a newly created telehealth program, supported in part by the Indian Health Service Telebehavioral Health Center for Excellence (TBHC) and local and regional partners including the Indian Health Acoma-Canoncito-Laguna Service Unit Hospital near Pueblo of Acoma. Treatment, supportive and recovery services are in place and will be applied to the Acoma Emergency COVID19 project.
Based on current capacity, experience and relevant partnerships and Tribal Council support, Acoma Emergency COVID19 will be in position to implement the telehealth component to address the current COVID19 pandemic and any potential subsequent waves of infection with the four-month requirement. By the end of the 16-month project, Acoma will be positioned to run traditional and telehealth services in parallel to better serve the needs of the people of Acoma.