Guidance and Tips for Tribal Community Living During COVID-19

Social Distancing and Coping During COVID-19

Everyone has a role to play to reduce and slow the transmission of COVID-19. Social distancing is an essential step in preventing the spread of COVID-19. Social distancing is reducing physical interaction between people and it lowers the chances of spreading illness between people. Practice social distancing by putting space (at least 6 feet) between yourself and others. It is especially important during the COVID-19 pandemic to protect people who are at higher risk for severe illness from COVID-19.

These people include older adults and people of any age who have serious underlying medical conditions. People can follow social distancing by reducing how often they are physically near others, reducing the overall number of people they are physically near, and by keeping at least 6 feet away from others when they do leave their homes. Staying physically apart is important, even in places like the workplace, school, when shopping, or in other places in your community. The goal of social distancing is to reduce the risk of spreading COVID-19.

Social distancing may make some people feel socially or culturally isolated, and possibly lead to loneliness, depression and poor health. It is important to use other non-physical ways to connect with family and friends, like sending a letter, phone calls, video calls, or social media. Exercising in or around your home or yard and sitting or working outside, close to home, can also help.

Social distancing to stay healthy and safe may prevent people from following some traditional and ceremonial practices. This may be especially relevant for American Indian/Alaska Native (AI/AN) communities, but it is very important to use social distancing to reduce the spread of COVID-19.

Below are some ways to cope with social distancing (also known as physical distancing) and the stress COVID-19 may cause:

• Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic continuously can be upsetting.
• Take care of your body and mind. Take deep breaths, meditate, stretch, and exercise regularly.
• Try to eat healthy, well-balanced meals.
• Get plenty of sleep.
• Avoid alcohol and drugs.
• Connect with others online or on the phone and talk with people you trust about your concerns and how you are feeling.
• Make time to relax and do activities you enjoy that can be done while social distancing.

Coping with stress during a COVID-19 outbreak will make you, your loved ones, and your community stronger. Learn more.

Preparing Your Family and Household for COVID-19

AI/AN communities with multi-generational households or those in rural or tribal areas may experience unique challenges with social distancing, access to grocery stores, water, and local and tribal health services. However, there are several steps individuals can take to keep your home and family safe.

Wash hands often following these steps:

• Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
• Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
• Scrub your hands, palms, back, between fingers and around fingernails for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
• Rinse your hands well under clean, running water. If you do not have running water, make sure your water source is clean.
• Dry your hands using a clean towel or air dry them.
• If you can’t wash with soap and water, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol.
  • Place a dime-sized amount in your palm and rub hands together, covering all parts of the hand, fingers and nails until they feel dry
• Remind everyone in the household to avoid touching their face and cover their coughs and sneezes with the inside of their elbow or with a tissue, and then throw the tissue away.
• Regularly clean frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks, and electronics (see below for special electronics cleaning and disinfection instructions)) with household cleaners and EPA-registered disinfectantsexternal icon that are appropriate for the surface, following label instructions.
  • Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.
• It is important for people at higher risk for severe illness, hospitalization or death from COVID-19, to limit time spent away from the home. People at higher risk for severe illness include include older adults and those with certain underlying conditions.
• Based on what we know at this time, pregnant women might be at an increased risk for severe illness from COVID-19 compared to people who are not pregnant. Pregnant women have had a higher risk of developing severe illness with other respiratory infections. There may be an increased risk of adverse pregnancy outcomes, such as preterm birth, among pregnant people with COVID-19. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick. It is always important for pregnant women to protect themselves from illness.
• Lack of access to grocery stores, water and health services may require more frequent trips to the store. If possible, send individuals that are not at higher risk for severe illness from COVID-19 to gather essentials for the home.
  • Wear a mask in public settings, like grocery stores and pharmacies, where it may be more difficult to maintain social distancing.

Recommendations and Tips for Multi-Generational Tribal Households during the COVID-19 Pandemic

People who live in multi-generational tribal households may find it difficult to take precautions to protect themselves from COVID-19 or isolate those who are sick, especially if space in the household is limited and many people live in the same household.

Everyone in the household should take steps to stay healthy and protect each other from getting sick.

• Wash your hands often with soap and water for at least 20 seconds. If you can’t wash with soap and water, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
• Avoid touching your eyes, nose, and mouth.
• Limit trips out of the house. If you must leave the household, wear a mask, and stay at least 6 feet, or about two arms’ lengths, away from others. This is called social distancing.

• Avoid having visitors (anyone who does not live with you) inside your household. This may be difficult given most communities are close knit and people visit each other often, but it helps reduce the spread of the virus that causes COVID-19. If people must visit, visitors should wear masks and stay outside, if possible, while keeping at least 6 feet distance.

Members of the household should consider ways to limit the risks when there is a need to leave the house like going to a grocery store or market, tribal healthcare facility, or pharmacy. If possible, have at least two weeks of medications and supplies available.

Elders and people who have underlying medical conditions, such as diabetes or serious heart conditions, should avoid caring for the children in their household, if possible.

If people at higher risk must care for the children in their household, the children in their care should not have contact with people outside the household. Members of the household who are at higher risk should also avoid caring for people of any age who are sick.

Provide a separate bedroom and bathroom for the person who is sick, if possible. If that’s not possible, try to separate them from other household members as much as you can. Keep people at higher risk separated from anyone who is sick.

• If possible, have one person in the household take care of the person who is sick. This person should be someone who is not at higher risk and should limit contact with other people in the household.
• Keep at least 6 feet between the person who is sick and other household members. If this is not possible:
  • Avoid hugging, kissing, and sharing food or drinks with the person who is sick.
• Have the person who is sick wear a mask, if they are able.
• Wash your hands for at least 20 seconds or use hand sanitizer that contains at least 60% alcohol after interacting with or cleaning up after the person who is sick.
• Avoid sharing household items at the same time, such as towels and dishes, with the person who is sick.