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Across much of the country, experts fear rising COVID-19 infections this summer could foreshadow a more significant surge of the virus yet to come as temperatures cool off.

“We're kind of in the midst of a rapid run of covid cases throughout Indian Country,” said Dean Seneca, who identifies as Seneca. He is founder and CEO of 

, a public health and urban and regional planning company.

“We’ve had a slow incline in COVID-19 cases since the very beginning of May, end of April,” he said. According to Seneca, infections seemed to stabilize and even decline before skyrocketing, starting in the middle of June.

 than it did last year. In 2023, the nation saw an uptick in serious infections in early July that continued through September, according to hospitalization data from the Centers for Disease Control and Prevention.

Chief Medical Officer at Indian Health Service, Dr. Loretta Christensen, Diné, told ICT in an email, “While the number of cases is increasing, the rates of severe disease remain low.” 

She also pointed to Albuquerque, Billings, Montana, Oklahoma and Portland, Oregon as locations of notable increase in infections, according to IHS data as of Aug. 7. Hawai‘i and Minnesota are also experiencing a rise in infections.

If trends follow the same trajectory they did in 2023, the U.S. will likely see coronavirus infections continue to gradually rise and fall before a winter surge beginning in November.

“We’re still learning about the seasonality of COVID-19 infections. And I think a lot of it really depends on, and is driven by, the emergence of new variants,” said Dr. Laura Hammitt. She is the infectious disease program lead at the Johns Hopkins Center for Indigenous Health.

The current coronavirus surge is dominated primarily by the 

, which took over around the beginning of August. While viral mutations often make viruses more infectious and less deadly, there is concern COVID-19 mutations might not necessarily follow the trend.

 found the transmissibility and lethality of COVID-19 increased from 2020-2022. It suggested people should prepare for more variants that are better equipped to evade human immune responses.

Hammit says the number one thing individuals can do to protect themselves and those around them is to be fully vaccinated against the coronavirus. She says a perception of low infection risk is one of many hurdles public health experts are facing, in addition to dwindling resources such as access to COVID-19 self tests and vaccines.

“That reduction in resources means that it's much harder to conduct the type of outreach events that were really critical to driving up vaccine coverage, as well as outreach in remote or rural tribal communities,” Hammitt said.

Despite high vaccination rates early on in the pandemic, tribal communities have fallen behind. Many tribal nations and health care providers have shifted their focus away from COVID-19 to preventative services and treating chronic conditions, according to Will Funmaker, Ho-Chunk, director of the Great Lakes Inter-Tribal Epidemiology Center.

Vaccination rates among adult Native Americans and Alaska Natives are the lowest of all recorded ethnic groups, according to the CDC. The center estimates just 

 of Native adults received at least one dose of a COVID-19 vaccine. About 79 percent of Native Hawaiian adults received at least one vaccine, compared to the national average of about 81 percent.

Hammitt says one reason some people may be discouraged to get vaccinated is because of its efficacy. “I hear people say … they got a vaccine and they still ended up getting COVID after being vaccinated.”

She cautions that while vaccines may prevent infection, the most important reason to remain up to date with recommended shots is to reduce the risk of severe disease, hospitalization, or even death. “And it also reduces the chance of developing long COVID,” she said.

For Native Americans, the risk of severe illness is cause for concern due to the prevalence of pre-existing conditions such as cancer and diabetes, according to Seneca. He says long COVID is a serious concern in Indian Country.

“What I fear are the issues related to the long COVID, because that's kind of the unknown right now and how it's impacting our communities,” he said.

What is known is the effectiveness of vaccines and other precautions such as masking and social distancing. Currently, the best course of action against long COVID is to take precautionary measures.

Christensen said in an email, “[IHS] recommends that people remain aware and get tested when they have symptoms consistent with COVID. The recommendations include to stay up to date with vaccination, practice good hygiene (covering coughs/sneezes and handwashing), and improving ventilation in indoor spaces”

She added, some IHS clinics have reinstituted masking in response to the increase in hospitalizations, and “all testing and therapeutics remain available at the healthcare facilities.”

Despite high vaccination rates early on in the pandemic, tribal communities have fallen behind. Many tribal nations and health care providers have shifted their focus away from COVID-19 to preventative services and treating chronic conditions.

COVID-19 cases rise across Indian Country

A woman wearing a face mask receives a vaccine.

COVID-19 cases rise across Indian Country

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