Monitoring COVID-19 and Building Capacity with Northern Plains Tribes & the Future of Pandemics Abstract The spread of COVID-19 across the world and throughout the United States has brought extant disparities in health care resources and capacity into new focus as the various health, economic, and social harms of COVID- 19 disproportionately fall upon under-invested communities. Ongoing limitations in testing capacity, medical infrastructure and resources, and strong community partnerships are leading to greater spread of COVID-19, more difficulty in balancing precautionary isolation vs economic decisions, and a lack of data to guide public health policies. At the same time, efforts to overcome these issues that are led by faraway groups without local knowledge or consent can not only result in the promotion of ineffective solutions over local needs, but can also perpetuate ongoing harms to health, social, and economic concerns. Therefore, solutions that aim to address COVID-19 public health capacity in under-resourced environments must include local resources, local consent, and ensure long-term capacity, shared equity, and data control for participants. Here, we propose to leverage pre-existing resources and partnerships between the Stanford School of Medicine & tribal affiliates to upgrade existing laboratory infrastructure for conducting COVID-19 diagnostic tests, health consultations, and tribe-wide public health data management and policy. This capitalizes on existing resources built with the Native BioData Consortium (NBDC)?an Indigenous-led research group- from its collaboration with the SPHERE Project 1 Bio- Repository for American Indian Capacity, Education, Law, Economics, and Technology (BRAICELET) center. The work proposed here was designed to result in a tribe-governed health resource being operational within 6 months to conduct COVID-19 diagnostic tests and monitoring on an ongoing basis for improved public health.
The Northern Plains Tribes are disproportionally affected by the COVID-19 pandemic and face elevated rates of morbidity and mortality due to minimal access to testing, an already challenged healthcare infrastructure, and delayed responses to implement Public Health Safety Measures. With support from the SPHERE: BRAICELET team, the Native BioData Consortium (NBDC) is poised to branch out as a locally-informed COVID-19 monitoring and translation resource center for the Tribe's Public Health Effort, leveraging a pre-existing setup as a first-of- its-kind tribal biorepository and research facility (locally-run and housed within Tribal boundaries). This proposal aims to upgrade (and sustain) local capacity at NBDC with training and development of Safety (PPE) and Lab Protocols for COVID-19 testing equivalent to CDC standards (including standard qPCR test, serology methods and adapting wearables in a tribal setting), as well as bioethically disseminate the testing results to Tribal Public Health Officials through a secure web-based Portal strategy (with insight from Community and Science Advisory Groups).
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