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Confirmed cases of the novel coronavirus on the Navajo Nation rose to 49 on Tuesday, according to the Office of Navajo Nation President Jonathan Nez, with most cases concentrated in three northern Arizona counties.

The tribal nation’s first case was confirmed in Chilchinbeto, Ariz., last week and positive tests for the virus have grown each day since. The Navajo Times is reporting two deaths in northern Arizona could have been linked to coronavirus infection after it spread at a church rally earlier in March. No cases had been confirmed in Utah’s San Juan County as of Wednesday, and several early tests came back negative.

Over the weekend, Nez issued a stay-at-home order for all residents of the Navajo Nation with exceptions for essential supply runs.

“To prevent a massive public health crisis, every person must remain home,” Nez said at a news conference attended by the Navajo Times. “The fact is that the number of positive tests is growing. We know some may need food, medicine, or other essential items, but beyond that we shouldn’t have anyone traveling or going out into the public. This includes public gatherings and meetings.”

With only nine grocery stores scattered across its 17.5 million-acre expanse, the Navajo Nation’s rural character adds complications for residents in need of food or medical care, especially as economic uncertainty related to the outbreak continues to grow.

Some tribal members are organizing community relief efforts. Former Navajo Nation Attorney General Ethel Branch, for example, launched a GoFundMe campaign to raise funds for Navajo and Hopi families, which in 10 days brought in over $160,000 in donations and is prioritizing food deliveries to vulnerable populations.

The Navajo Housing Authority said it will suspend evictions and waive rental and home ownership payments through May while the Navajo Tribal Utility Authority announced it would be delaying utility disconnections and some fees.

As is the case in many hospitals around the country, employees of the Indian Health Service (IHS) near the epicenter of the outbreak reported running low on masks and other medical equipment. Nez reported a shipment of supplies was delivered to the tribe on Tuesday and would be distributed to medical facilities.

There are also tribal government efforts underway to distribute emergency funds.

On Friday, the Navajo Nation Council voted Friday to send $4 million to the Navajo Nation Department of Health and emergency response workers. The council also passed emergency legislation requesting the governor of New Mexico to facilitate the accessibility of up to $40 million in Medicaid funds to assist health care entities on the reservation.

“We learned during the H1N1 outbreak, that American Indians and Alaska Natives were disproportionately impacted — a report by the Centers for Disease Control notes that the death rate was higher than the rate for all other racial/ethnic populations combined,” Manley Begay, Jr., chairman of the Naat’áanii Development Corporation, said in a statement. “Now we are dealing with COVID-19 pandemic, which is notably worse than H1N1, and we cannot sit back while this crisis threatens our people.”

Since March 6, Congress has allocated more than $100 million to Indian Country through the Centers for Disease Control and the IHS. A letter sent to congressional leaders by a coalition of Native American groups last week, however, requests $1.2 billion to help tribal nations deal with the pandemic.

The Utah Navajo Health System, which runs a number of clinics in San Juan County, implemented drive-thru screening last week to prevent the spread of the virus and delayed nonemergency appointments. The clinics also received a $74,150 federal grant through the U.S. Department of Health and Human Services’ coronavirus preparedness grant program.

Zak Podmore is a Report for America corps member and writes about conflict and change in San Juan County for The Salt Lake Tribune. Your donation to match our RFA grant helps keep him writing stories like this one; please consider making a tax-deductible gift of any amount today by clicking here.