Important update: Healthcare facilities
CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more
UPDATE
Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the guidance for fully vaccinated people. CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place.
UPDATE
The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here.
UPDATE
Travel requirements to enter the United States are changing, starting November 8, 2021. More information is available here.

Guidance and Tips for Tribal Community Living During COVID-19

Guidance and Tips for Tribal Community Living During COVID-19
Updated Aug. 23, 2022

CDC is reviewing this page to align with updated guidance.

Social Distancing and Coping 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. If you are not fully vaccinated, 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 Helpline at 1-800-985-5990, or talk to a counselor or social worker that may be available in your area.

Preparing Your Family and Household for COVID-19

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.
  • Clean high-touch surfaces and objects regularly (for example, daily or after each use) and after you have visitors in your home.
    • Focus on high-touch surfaces and objects (doorknobs, tables, handles, light switches, phones, remote controls, and countertops). For more information on cleaning and disinfecting safely, see Cleaning and Disinfecting Your Home.
  • 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 older adults and those with certain underlying conditions.
  • Pregnant and recently pregnant people are more likely to get severely ill with COVID-19 compared with non-pregnant people. If you are pregnant, you can receive a COVID-19 vaccine. Getting a COVID-19 vaccine during pregnancy can protect you from severe illness from COVID-19.
  • 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 and Tips for Multi-Generational Tribal Households during the COVID-19 Pandemic

Learn about our recommendations for multi-generational tribal households during the COVID-19 pandemic and tips for caring for a sick household member.

Key Points

  • Some people, including elders and people with underlying health conditions, are at an increased risk for severe illness or death due to COVID-19.
  • People living in multi-generational households with elders or with people with underlying conditions should take steps to reduce the risk of spreading COVID-19. Get vaccinated against COVID-19 to remain safe and protect others. When caring for a sick household member, monitor and treat their symptoms and make sure to prevent spread of germs.

Recommendations for Multi-Generational Tribal Households

American Indian/Alaska Native (AI/AN) communities with elders, parents, and children living together in households and in rural, tribal areas experience unique challenges with physical distancing and access to grocery stores, water, and health services.

tribe family

It is important for people at an increased 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 elders and people with certain underlying conditions. Pregnant people may also be at an increased risk for severe illness from COVID-19 compared with people who are not pregnant.

If your household includes one or more people who are at an increased risk, then all family members should take precautions to reduce the risk of spreading COVID-19 and get fully vaccinated.

  • If you are fully vaccinated, you can start doing many things that you had stopped doing because of the pandemic.
  • When choosing safer activities, consider how COVID-19 is spreading in your community, the number of people participating in the activity, and the location of the activity.
  • Outdoor visits and activities are safer than indoor activities, and fully vaccinated people can participate in some indoor events safely without much risk.
  • If you haven’t been vaccinated yet, get vaccinated.

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.

 How do I stay safe when taking trips outside the home?

When you make trips outside the house:

  • Wear a mask if you are not fully vaccinated. Follow proper use, removal, and washing when wearing a reusable mask.
  • boy and mom with masks

    Stay at least 6 feet (about 2 arm lengths)  away from others while shopping and in lines.

  • Avoid riding with or providing transportation for multiple passengers from members of different households. If that’s not 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, such as door handles, handrails, and seatbelt buckles, with EPA-approved disinfectant 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.
  • Keep yourself safe when returning to work by following your employer’s back-to-work guidance.

How can we keep safe household members who are at increased risk?

If a household member has COVID-19, provide a separate bedroom and bathroom for the person(s) who is sick. If that’s not possible, try to separate them from other household members as much as you can. Keep people at increased risk separated from anyone who has COVID-19.

  • A person at increased risk should not take care of the sick household member.
  • Keep at least 6 feet between the caretaker and the person who is sick.
  • Avoid hugging, kissing, and sharing food or drinks with the person who is sick.
  • Wear a mask when caring for the sick person.
  • 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:

  • house

    Open a window, if possible.

  • Maintain at least 6 feet between beds. If this isn’t possible, sleep head to toe.
  • Put a curtain around or place another physical divider, such as a 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

  • Wear disposable gloves when cleaning and wash their hands immediately afterwards.
  • Open outside doors and windows before entering the bathroom, if possible.
  • Turn on the bathroom ventilating fan, if possible.
  • Wait as long as possible (several hours) before entering the room to clean and disinfect or to use the bathroom.
  • Ensure safe and correct use and storage of disinfectants, including storing products securely away from children.

Everyone in the household can take steps to stay healthy.

  • Get vaccinated.
  • Wash hands often following these steps:
    washing hands
    • 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 faces 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-approved disinfectant that are appropriate for the surface, following label instructions.
    • Read the labels of household cleaners for 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.
  • If possible, send individuals that are not at higher risk for severe illness from COVID-19 to gather essentials for the home, such as food and medications.

Tips for Multi-Generational Tribal Households

Individuals who are at increased risk for severe illness include:

  • Those ages 65 and older
  • People living 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 conditions (asthma), and compromised immune systems (those with transplants or HIV/AIDS)
  • Pregnant and recently pregnant people

Important Ways to Slow the Spread for Everyone

If caring for a sick household member:

Monitor for emergency signs, such as:

  • Trouble breathing.
  • Continual pain or pressure in the chest.
  • New confusion.
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone.

Prevent the spread of germs:

  • Avoid sharing personal household items, like dishes, towels, and bedding.
  • Have the sick person wear a face mask (if available). If sick individuals are unable to wear a face mask, the individual caring for the sick person should wear a face mask when in contact with them.
  • Have sick household members use a separate bathroom (if possible).
  • Avoid having any unnecessary visitors.

Treat symptoms:

  • Make sure the 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.

To Request Assistance

For questions, issues, or requests, tribal leaders can contact CDC.