Prevalence of Post–COVID-19 Condition and the Potential of Tribal Public Health Capacity

Abstract

Objective:

COVID-19 exacerbated health inequities for American Indian/Alaska Native (AI/AN) populations. Tribal public health departments and Tribal Epidemiology Centers are critical in addressing these challenges, particularly among people on or near tribally owned land. In this study, we described an example of the value of Tribal Epidemiology Centers and tribal public health departments and estimated the prevalence of post–COVID-19 condition (PCC), defined as symptoms persisting ≥90 days postinfection, in a tribal community.

Methods:

This retrospective cohort study evaluated the prevalence of PCC and functional limitations among adults diagnosed with COVID-19 on the Tule River Reservation from July 2020 through February 2023. Tule River Indian Health Center, Inc staff conducted telephone surveys to assess symptoms at 30 and 90 days postinfection and functional outcomes using the Post–COVID-19 Functional Status scale. We stratified prevalence rates by age and sex and compared functional limitations before and after infection.

Results:

We estimated PCC prevalence at 21% (15 of 76). We also found that 37% (24 of 65) of survey participants reported more functional limitations after COVID-19 infection than before.

Conclusions:

Our study highlights the need for further research and inclusion of AI/AN communities in PCC research and new vertical policy solutions such as those used for diabetes. AI/AN communities have had inequitably higher rates of COVID-19 and appear poised to also have inequitably higher rates of PCC.