Native Americans Fight Coronavirus and Deficient Data

“The disparities we see there with Covid are aligned with those that we see for hospitalizations and deaths due to influenza and other respiratory viruses,” said Allison Barlow, director of the Center for American Indian Health at Johns Hopkins University.

Native Americans — particularly those living on reservations — are more prone to contract the virus because of crowded housing conditions that make social distancing difficult, she said. And years of underfunded health systems, food and water insecurity and other factors contribute to underlying health conditions that can make the illness more severe once contracted.

Yet understanding the extent of how Native American people have been disproportionately affected by Covid-19 is extremely difficult.

Calculating how many people who identify as Native American have had the virus and how many have died of it is nearly impossible because federal data tracking individual coronavirus cases often omits information about the race and ethnicity of people; such information is missing from about half the cases reported to the C.D.C., which serves as a clearinghouse for cases reported by state and local authorities.

Even when such information is collected, it is uncertain how accurate it is. Miscounting can begin at testing sites and health clinics, public health officials said, where health care workers sometimes do not record a patient’s race and ethnicity data, or simply guess without asking a patient.

The Indian Health Service has identified at least 30,987 cases among Native Americans and Alaska Natives, but tribal nations are not required to share their data. Just under half of tribal health centers and 61 percent of urban health services serving Native Americans have provided case information, an I.H.S. spokeswoman said.

After suing the C.D.C., The Times obtained a database with the characteristics of 1.5 million individuals who tested positive for the virus through the end of May. The data showed that people who were Black or Latino were three times as likely to become infected as people who were white.