Guidance and Tips for Tribal Community Living During COVID-19
What is Social Distancing (also known as Physical Distancing)?
Everyone has a role to play to reduce and slow the transmission of COVID-19. Social distancing is an essential step in preventing the spread of COVID-19. Social distancing is reducing physical interaction between people and it lowers the chances of spreading illness between people. Practice social distancing by putting space (at least 6 feet) between yourself and others. It is especially important during the COVID-19 pandemic to protect people who are at higher risk for severe illness from COVID-19.
These people include older adults and people of any age who have serious underlying medical conditions. People can follow social distancing by reducing how often they are physically near others, reducing the overall number of people they are physically near, and by keeping at least 6 feet away from others when they do leave their homes. Staying physically apart is important, even in places like the workplace, school, when shopping, or in other places in your community. The goal of social distancing is to reduce the risk of spreading COVID-19.
Coping with Social Distancing During the COVID-19 Pandemic
Social distancing may make some people feel socially or culturally isolated, and possibly lead to loneliness, depression and poor health. It is important to use other non-physical ways to connect with family and friends, like sending a letter, phone calls, video calls, or social media. Exercising in or around your home or yard and sitting or working outside, close to home, can also help.
Social distancing to stay healthy and safe may prevent people from following some traditional and ceremonial practices. This may be especially relevant for American Indian/Alaska Native (AI/AN) communities, but it is very important to use social distancing to reduce the spread of COVID-19.
Below are some ways to cope with social distancing (also known as physical distancing) and the stress COVID-19 may cause:
- Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic continuously can be upsetting.
- Take care of your body and mind. Take deep breaths, meditate, stretch, and exercise regularly.
- Try to eat healthy, well-balanced meals.
- Get plenty of sleep.
- Avoid alcohol and drugs.
- Connect with others online or on the phone and talk with people you trust about your concerns and how you are feeling.
- Make time to relax and do activities you enjoy that can be done while social distancing.
Coping with stress during a COVID-19 outbreak will make you, your loved ones, and your community stronger. Learn more.
People who need help or know someone that needs help with stress or anxiety can contact the Disaster Distress Helplineexternal icon at 1-800-985-5990, or talk to a counselor or social worker that may be available in your area.
Preparing your Family and Households for COVID-19
AI/AN communities with multi-generational households or those in rural or tribal areas may experience unique challenges with social distancing, access to grocery stores, water, and local and tribal health services. However, there are several steps individuals can take to keep your home and family safe.
Wash hands often following these steps:
- Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
- Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
- Scrub your hands, palms, back, between fingers and around fingernails for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
- Rinse your hands well under clean, running water. If you do not have running water, make sure your water source is clean.
- Dry your hands using a clean towel or air dry them.
- If you can’t wash with soap and water, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol.
- Place a dime-sized amount in your palm and rub hands together, covering all parts of the hand, fingers and nails until they feel dry
- Remind everyone in the household to avoid touching their face and cover their coughs and sneezes with the inside of their elbow or with a tissue, and then throw the tissue away.
- Regularly clean frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks, and electronics (see below for special electronics cleaning and disinfection instructions)) with household cleaners and EPA-registered disinfectantsexternal icon that are appropriate for the surface, following label instructions.
- Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.
- It is important for people at higher risk for severe illness, hospitalization or death from COVID-19, to limit time spent away from the home. People at higher risk for severe illness include include older adults and those with certain underlying conditions.
- Based on what we know at this time, pregnant women might be at an increased risk for severe illness from COVID-19 compared to people who are not pregnant. Pregnant women have had a higher risk of developing severe illness with other respiratory infections. There may be an increased risk of adverse pregnancy outcomes, such as preterm birth, among pregnant people with COVID-19. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick. It is always important for pregnant women to protect themselves from illness.
- Lack of access to grocery stores, water and health services may require more frequent trips to the store. If possible, send individuals that are not at higher risk for severe illness from COVID-19 to gather essentials for the home.
- Wear a mask in public settings, like grocery stores and pharmacies, where it may be more difficult to maintain social distancing.
Recommendations for Multi-Generational Tribal Households
People who live in multi-generational tribal households may find it difficult to take precautions to protect themselves from COVID-19 or isolate those who are sick, especially if space in the household is limited and many people live in the same household.
Everyone in the household should limit risks
Everyone in the household should take steps to stay healthy and protect each other from getting sick.
- Wash your hands often with soap and water for at least 20 seconds. If you can’t wash with soap and water, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
- Avoid touching your eyes, nose, and mouth.
- Limit trips out of the house. If you must leave the household, wear a mask, and stay at least 6 feet, or about two arms’ lengths, away from others. This is called social distancing.
Note: Masks should not be placed on children younger than 2 years old, anyone who has trouble breathing or is unconscious, or anyone who is unable to remove the mask without assistance.
- Avoid having visitors (anyone who does not live with you) inside your household. This may be difficult given most communities are close knit and people visit each other often, but it helps reduce the spread of the virus that causes COVID-19. If people must visit, visitors should wear masks and stay outside, if possible, while keeping at least 6 feet distance.
Limit the risks when taking trips out of the house
Members of the household should consider ways to limit the risks when there is a need to leave the house like going to a grocery store or market, tribal healthcare facility, or pharmacy. If possible, have at least two weeks of medications and supplies available.
When you make trips outside the house:
- Choose one or two people in the house who are not at higher risk to make the trip.
- Wear a mask. Follow proper use, removal, and washing of the mask.
- Masks should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.
- Stay at least 6 feet (about 2 arms’ lengths or little over the length of a canoe paddle) away from others while shopping and in lines.
- Don’t touch your eyes, nose, or mouth.
- Don’t ride in a vehicle with members of different households. If that’s not possible:
- Avoid riding with or providing transportation for multiple passengers, whenever possible. Limit close contact and create as much space as possible between passengers in the vehicle.
- Open the windows or use the vehicle’s vents to bring in fresh outside air.
- Handle only your own personal items.
- Avoid touching your eyes, nose, and mouth.
- Clean and disinfect commonly touched surfaces (e.g., door handles, handrails, seatbelt buckles) with EPA-approved disinfectantsexternal icon after each trip.
- Wash your hands for at least 20 seconds right away after you return home. If you can’t wash with soap and water, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
- Maintain as much physical distance as possible from those at higher risk in the home. For example, avoid hugging, kissing, sharing food (e.g., using the same fork or sharing the same foods), and drinking from the same cup.
- Keep yourself safe when returning to work by following your employer’s back to work guidance and these CDC return to work tips.
Family members who are at higher risk should avoid caring for children and those who are sick
If people at higher risk must care for the children in their household, the children in their care should not have contact with people outside the household. Members of the household who are at higher risk should also avoid caring for people of any age who are sick.
Separate a household member who is sick
Provide a separate bedroom and bathroom for the person who is sick, if possible. If that’s not possible, try to separate them from other household members as much as you can. Keep people at higher risk separated from anyone who is sick.
- If possible, have one person in the household take care of the person who is sick. This person should be someone who is not at higher risk and should limit contact with other people in the household.
- Keep at least 6 feet between the person who is sick and other household members. If this is not possible:
- Avoid hugging, kissing, and sharing food or drinks with the person who is sick.
- Have the person who is sick wear a mask, if they are able.
- Wash your hands for at least 20 seconds or use hand sanitizer that contains at least 60% alcohol after interacting with or cleaning up after the person who is sick.
- Avoid sharing household items at the same time, such as towels and dishes, with the person who is sick.
If you need to share a room with someone who is sick:
- Open a window, if possible.
- Do not open windows and doors if doing so poses a safety or health risk to household members (e.g., risk of falling or triggering asthma symptoms).
- Maintain at least 6 feet between beds, if possible. If this isn’t possible, sleep head to toe.
- Put a curtain around or place another physical divider (e.g., shower curtain, large cardboard poster board, quilt, or large bedspread) to separate the sick person’s bed.
If you need to share a bathroom with someone who is sick, the person who is sick should clean and disinfect the commonly touched surfaces in the bathroom after each use. If this is not possible, the person who does the cleaning should:
- Open outside doors and windows before entering the bathroom, if possible. If you have one, turn on the bathroom ventilating fan.
- Wait as long as possible before entering the room to clean and disinfectexternal icon or to use the bathroom.
- Ensure safe and correct use and storage of disinfectants, including storing products securely away from children.
- Wear disposable gloves when cleaning and wash your hands immediately afterwards.
If more than one household member is sick, have household members who are sick stay in one area of the home, separated from household members who are not sick.
Individuals who are at risk include:
- Age 65 years and older
- Live in a Nursing Home or long-term care facility
- People with underlying medical conditions like diabetes, obesity, liver disease, serious heart, chronic kidney and lung (i.e. asthma) conditions and diseases, and compromised immune systems (i.e. transplants or HIV/AIDS)
- Pregnant women
It is important for people who are at higher risk for severe illness:
- Stay at home and away from crowds.
- Make sure you have access to several weeks of medications and supplies so you don’t have to go out of the home.
- When you go out in public, keep at least 6 feet away from others. Do not go to places where people are sick.
- Wash your hands frequently, as described above.
If someone in your home is sick with COVID-19
- Have everyone continue to practice good handwashing methods as described above.
- Clean and disinfect surfaces, doorknobs and other commonly touched surfaces with common household disinfectants daily.
- Remind everyone to avoid touching their face, and cover coughs and sneezes with the inside of their elbow or with a tissue, and then throw the tissue away.
- As best as possible, isolate the individual with COVID-19 in a separate bedroom and bathroom away from others.
- Take care of the emotional health of your family, including yourself.
- Avoid sharing personal items like phones, dishes, bedding, or toys.
If caring for a sick household member
Monitor for emergency signs, like:
- Trouble breathing.
- Continual pain or pressure in the chest.
- New confusion.
- Bluish lips or face.
Prevent the spread of germs:
- Avoid sharing personal household items, like dishes, towels, and bedding.
- Have the sick person wear a facemask (if available). If sick individuals are unable to wear a facemask, the individual caring for the sick should wear a facemask when in contact with them.
- Have them use a separate bathroom (if possible).
- Avoid having any unnecessary visitors.
- Make sure individual with COVID-19 drinks a lot of fluids to stay hydrated and rests at home.
- Use over-the-counter medicines to help with symptoms.
- For most people, symptoms last a few days and get better after a week.
Other COVID-19 Guidance for Tribal Members
Other guidance dedicated to tribal members can be found through the following links:
- What Tribal Members Need to Know About COVID-19pdf iconexternal icon
- Guidance for Providers Working with Elderspdf iconexternal icon
- How to Prevent the Spread of Coronavirus (COVID-19) in the Homepdf iconexternal icon
- How to Care for Yourself at Home During COVID-19pdf iconexternal icon
- How to Care for Someone at Home During COVID-19image iconexternal icon
- Tips for Elders and Their Caregivers During COVID-19image iconexternal icon
- Children and Grief During COVID-19pdf iconexternal icon
- Managing Stress During COVID-19pdf iconexternal icon
- Tips for Safe Grocery Shopping During COVID-19pdf iconexternal icon
- Cleaning and Disinfection for Households
- Washing Hands with Shared Wash Panspdf iconexternal icon
- Recommended precautions for household members, intimate partners, and caregivers in a non-healthcare setting
- Use of Masks to Help Slow the Spread of COVID-19
Households Living in Close Quarters: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/living-in-close-quarters.html
Living in Shared Housing: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/shared-housing/index.html
Shared and Congregate Housing: https://www.cdc.gov/coronavirus/2019-ncov/community/shared-congregate-house/index.html
COVID-19 in Racial and Ethnic Minority Groups: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html
Guidance and Tips for Tribal Community Living During COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/community/tribal/social-distancing.html