Frederica Freyberg:

Now to COVID news and to Keshena, where the Menominee Nation in the midst of the tribal vaccination program. One Wisconsin tribe switched from state services to the federal Indian health service for vaccine supply. That’s the St. Croix Band of the Ojibwe. Others including the Menominee continue to work with state government for vaccine allocation. We check in now with the tribal public health officer for the Menominee Nation, Dr. Amy Slagle. Thanks very much for joining us.

Amy Slagle:

Thank you.

Frederica Freyberg:

How many vaccinations do you need to give and how many have been given to date?

Amy Slagle:

We plan to give around 9,000 if we meet our goals. And so far we’ve given a little over 700.

Frederica Freyberg:

Wow. So —

Amy Slagle:

As of this morning.

Frederica Freyberg:

We know that the state health department reports having trouble getting enough vaccine. What is happening with availability for you?

Amy Slagle:

Well, it’s been — I would call it — the best way to describe it is variable. We have gotten as many as 200 vaccine in a week and we have had as little as one vial in a week, which was last week, ten doses. So it’s been a little bit all over the map. But in general what we’re expecting now is to get 200 to 300 a week, including our second doses. So it’s been a little anxiety-provoking because we don’t know which day it’s coming and we don’t know how much we’re getting until the last minute, making it very difficult to schedule people ahead of time.

Frederica Freyberg:

Yeah. Absolutely. But presumably, you, like others, would like to see just a lot more of it coming your way.

Amy Slagle:

We sure would. We would like to get our very high-risk population vaccinated as quickly as possible. We have some advantages. The state has allowed us some leeway with sovereignty issues. So we are a little ahead of phase 1B compared to other areas. We’re vaccinating 70 and older right now and we are well into our essential workers. So that’s why we’re 710 plus vaccines in with already all our health care done, first responders and many elders. But we’ve got a large group of people 40 to 65 years old with multiple health problems that are quite vulnerable and at risk for COVID and we’d like to get them vaccinated as soon as possible.

Frederica Freyberg:

Did you have to overcome mistrust of the vaccine?

Amy Slagle:

There are issues particular to the Menominee Tribe that do bring mistrust into the equation. It may be different than what we’re seeing nationally. It has to do with historical problems with smallpox and broken treaties and failures of the government to come through for Native Americans and other public health calamities. So the political issues are not really part of our problem. It’s convincing people that the government really does mean to deliver the good thing and the right thing and the life-saving thing here. So the historical perspective is really important here.

Frederica Freyberg:

Yeah. And very real. So I know that you just spoke to the fact that you had a high-risk population even among the younger age groups. How has COVID-19 impacted the community where you practice?

Amy Slagle:

Well, we’ve had about 30 deaths total. Half of those are Menominees on the reservation. Half live off the reservation either in contiguous areas or a few remotely in the state. We’ve had 950 COVID cases, which doesn’t sound a lot compared to Menominee or Madison, but when you look at that on a per capita basis, Menominee has had the greatest case burden per capita up until a few weeks ago and we had that spot for many months. So per capita, we’ve had a very high burden of COVID and we’ve had plenty of deaths.

Frederica Freyberg:

Are people heeding safety guidance around distancing and masking?

Amy Slagle:

Publicly and in workplaces, it’s very good. I think people take the recommendations seriously. The tribe has had emergency orders in place which fortunately we’re able to supersede whatever the government is currently doing with approving or disapproving those. But the tribe takes it very seriously and they want to protect each other and they have been strong with that message. The problem where we’ve seen the safety come is — or problems with it is in homes, where it’s multigenerational. That’s one of the beautiful things about the Menominee, is their love for family and their connections. So there’s lots of visiting and there’s over-crowding in homes and that’s where we’ve seen a lot of spread. The other place we’ve seen is people who work outside the area, where safety measures aren’t enforced and they bring it home because they work in a place where masks weren’t enforced.

Frederica Freyberg:

Doctor, we wish you well with this and we will continue to check in. Dr. Amy Slagle, thank you very much.

Amy Slagle:

Thank you.