Yellowhawk Tribal Health Center (Yellowhawk) is providing testing for enrolled Tribal Members of the Confederated Tribes of the Umatilla Indian Reservation (CTUIR) while resources and capacity for providing this testing can be sustained. An appointment is required for all testing done at Yellowhawk. Testing needs have been distributed as outlined below.

• Those with Active Symptoms, Close Contact – To continue throughout the declared state of emergency. During the COVID-19 pandemic Yellowhawk patients who present with COVID-19 symptoms or have been in close contact (within six feet for 15 minutes or more) with an individual who has tested positive for COVID-19 can be tested for COVID-19. This testing will continue for the remainder of the declared state of emergency. Yellowhawk will also continue to test CTUIR first responders and essential healthcare works who have been exposed to an individual who has tested positive for COVID-19.

• Individuals at High Risk – To continue as resources and capacity allow. Yellowhawk patients who are at higher risk of complications if they contract COVID-19, including individuals 60 years or older, residents of a group care setting, or individuals with chronic diseases such as diabetes, kidney disease, lung disease, or heart disease, can be tested for COVID-19. Employees of CTUIR entities that have been determined to be critical by the Incident Command Team (ICT) will be tested for COVID-19 on a case-by-case basis.

• All CTUIR Tribal Members – To continue as resources and capacity allow. Enrolled Tribal Members of CTUIR, including those without symptoms or exposure to an individual who has tested positive for COVID-19, can be tested once every 14 days. If an individual develops symptoms or becomes a contact to a positive COVID-19 case, they can receive further testing even if it has not been 14 days since their last test.

COVID-19 TESTING is available by appointment only. The testing clinic will offer appointments Monday-Friday 8 a.m. to 4 p.m., except Tuesday morning closures and days Yellowhawk is closed. Call your Patient Care Coordinator (PCC) LaShay Miller (541) 240-8655, or Yellowhawk’s COVID line, (541) 240-8557. When calling main line, ask to be transferred to your PCC if you have questions or concerns about testing or would like to set-up an appointment for testing.

A case is someone who has tested positive for COVID-19 with a viral test.

Individuals who test positive must go into isolation. Isolation is when someone is required to stay at home and away from other people. This isolation period will last at least 10 days and will not end until your symptoms have improved and you have not had a fever for at least 3 days without taking any fever reducing medications.

A contact is someone who has been within 6 feet of someone who tested positive for COVID-19 for at least 15 minutes. If you were a close contact of this person from 2 days before they developed symptoms or from 2 days before they tested positive if they have no symptoms, the case should name you as a contact.

Anyone named as a COVID-19 close contact by a COVID-19 case will be contacted via phone call or letter by Yellowhawk or the local health department of their residence to inform them that they are a contact and will need to stay home under quarantine. The period of quarantine will be determined by the last date of your contact with a positive case.

Yes, you can be named as a contact multiple times and will be required to quarantine each time. You will receive a letter of quarantine each time you are named a contact.

QUARANTINE keeps someone who was in close contact with someone who has COVID-19 away from others.

ISOLATION keeps someone who is sick or tested positive for COVID-19 without symptoms away from others, even in their own home.

The spread of a new virus like COVID-19 can be stressful. It is normal to feel fear and anxiety about COVID-19 as positive cases appear in local communities, and as routines are disrupted by social distancing and home isolation.

Stress during this time can have a big impact on home lives. It is normal to feel like things are out of control, but there are ways to bring down stress levels. To reduce stress, it is important to learn how to recognize the signs of stress and to learn strategies for managing stress. For some people – like those who experience violence at home – more help may be needed to support a safe home environment.

Recognizing the signs of stress

A person’s body can react to stress in strong ways. People have different signs of stress, but they may include:

• An increase or decrease in energy and activity levels
• An increase in frustration, with outbursts of anger and frequent arguing
• Having trouble relaxing or sleeping
• Not wanting to eat or eating too much
• Worrying much more than usual
• Wanting to be alone most of the time
• Not able to feel pleasure or have fun
• Feeling depressed, anxious, or fearful
• An increase in alcohol use or use of illegal drugs

Strategies to manage stress

Stress can be managed, even when it feels like it’s impossible to deal with. Here are some strategies to reduce stress at home:

• Take breaks from watching, reading, or listening to news stories, including social media. Instead, read a book or watch a show that takes the mind off the news.
• Care for the body! Take deep breaths with eyes closed, stretch, or meditate. Try to eat healthy, well-balanced meals, get plenty of sleep, and avoid alcohol and drugs.
• Exercise! Get outside for a walk, or do an in-home workout.
• Connect with others through a phone call or video chat! Share concerns and feelings with a friend or family member.
• Try to laugh! Humor is a great way to calm the mind.

Support for those at risk of violence in the home

People who experience violence or abuse at home may be experiencing increased stress and danger during this period of social distancing and home isolation.

If someone is experiencing violence or abuse in their home, they are not alone. There are many resources available to help:

• The National Domestic Violence Hotline is 24/7, confidential and free: 1-800-799-7233 and through chat.
• The National Sexual Assault Hotline is 24/7, confidential and free: 800.656.HOPE (4673) and through chat.
• The StrongHearts Native Helpline for domestic/sexual violence is available 7am-10pm CT, confidential, and specifically for Native communities: 1-844-762-8483.
• The SAMHSA Disaster Distress Helpline offers 24/7, confidential and free crisis counseling: 1-800-985-5990.
• They can also reach out to a friend, co-worker, or family member who can check in with them about their safety and support needs, and help them make plans for staying somewhere else if their situation becomes dangerous.

We all can support those at risk by reaching out to loved ones, friends, neighbors, and coworkers to see if they have the care and support they need, and if they feel safe at home. If you suspect someone you know may be experiencing violence or abuse at home, consider reaching out to let them know you are available to talk. You can also call the free, confidential National Domestic Violence Hotline 24/7 at 1-800-799-7233.

Help is just a phone call away:

+ Yellowhawk Behavioral Health: 541.240.8670

+ For instructions on accessing Telehealth click here.

+ Suicide Prevention Lifeline: 1.800.273.TALK (8255)

+ Lifeways: 1.866.343.4473

+ Problem Gambling: 1.877.MYLIMIT

+ SAMHSA Disaster Distress Line:1.800.985.5990

+ Oregon Alcohol & Drug Helpline: 1.800.923.4357

+ Crisis Text Line: 741-741

+ Lifeways: 1.866.343.4473

Online Resources:

+ Smart Recovery: smartrecovery.org

+ Addiction Recovery Guide: addictionrecoveryguide.org

+ NA Recovery: na-recovery.org

+ AA Chats: aachats.org

+ Healthful Chat: healthfulchat.org/drugs-and-alcohol-chat-room.html

+ Sober Courage: sobercourage.com/support-online

+ Addiction Recovery Guide: addictionrecoveryguide.org

+ For information about the Connections App for individuals in recovery click here.

Help locating AA/AN meetings:

+ Locations of local meetings in our area: www.district3aa.org

+ Resources to talk with and access for information: www.na.org

+ Talk to a professional: www.sober.com

+ Keep up on things happening in recovery: https://www.oregonrecovers.org/

The most common symptoms of COVID-19 are fever, cough and difficulty breathing. If you have these symptoms but have not been around anyone who you know has COVID-19, you may have COVID-19 or another respiratory virus. COVID-19 is spreading in many communities in Oregon and Washington, but several other respiratory viruses are going around as well.

If you have fever, cough or difficulty breathing and have not been around anyone who has been diagnosed with COVID-19, you should stay home away from others until:

1. At least 3 days (72 hours) have passed since you stopped having symptoms.
   This means you no longer have a fever without the use of fever-reducing medications and your respiratory symptoms (e.g., cough, difficulty breathing) are gone.

AND

2. At least 7 days have passed since your symptoms first started.

• If symptoms worsen, call your healthcare provider.
• In an emergency, call 911.
• Stay home and away from others for 14 days to avoid getting others sick. Some people may have mild illness and feel well enough to go out. DO NOT do this because it will spread disease.
• Inform those you’ve come in contact with as they should stay at home to prevent the spread of germs.
• Cover coughs and sneezes with a tissue, then throw the tissue in the trash and wash hands.
• Wash your hands often with soap and water for at least 20 seconds or use hand sanitizer.
• Avoid touching your eyes, nose, and mouth.
• Drink plenty of water.
• Stay in a specific room and away from other people in your home. Use a separate bathroom if possible.
• Do not shake hands, hug, or touch others.
• Avoid sharing items such as bedding, clothing, towels, and dishes with other people in your household.
• Every day, disinfect all “high touch” surfaces multiple times a day. These surfaces include: counters, tabletops, faucet handles, phones, and doorknobs. Common household cleaners and disinfectants are recommended. Wear gloves if possible.

Funeral/Large Gathering Guidelines for Compliance of Social Distancing

As COVID-19 continues to spread in the surrounding areas, it is imperative that social distancing guidelines are followed to control the spread of COVID-19 throughout our community and within the Confederated Tribes of the Umatilla Indian Reservation, decrease the burdens on hospitals and equipment supplies, and lessen the number of infections and deaths caused by this disease.

Dressing

It is recommended that mortuary staff conduct the dressing for all bodies. Tribal members may be present to offer the song and prayer while standing a safe distance away from others.

In cases where someone has died of COVID-19, the body should not be touched prior to being prepared for viewing. Anyone assisting in preparing the body should wear proper personal protective equipment (PPE) including gloves, isolation gown, face shield or googles, and facemask, to protect face, body and eyes from potential exposure.

Services

The Longhouse is available for Washat services. Up to 50 individuals are able to attend services taking place indoors. Graveside or other outdoor services may have up to 100 individuals in attendance. All attendees are advised to follow by the recommendations below:

• Do not attend if you are feeling sick.
• All individuals maintain social distancing of at least six feet from any person who is not a member of their immediate household.
• Cloth masks are recommended for all attendees.
• Restrict the use of pall bearers to the minimum number necessary, eight or less.
• Attendees whom wish to attend and remain in their vehicles while maintaining social distancing will not be subject to self-quarantine.

Limit Attendance

Attendance is limited to either 50 people for services occurring indoors or 100 people for services taking place outdoors. Request all those who are experiencing cold or flu-like symptoms to stay home.

All attendees should self-quarantine for 14 days following attendance.

Protect Elders

Elders and those with underlying health conditions such as COPD, asthma, diabetes, kidney disease or heart disease, who are most at risk for a serious viral infection, should not attend.

If elders are in attendance, it should be a priority that all attendees limit contact with elders and provide them ample space (6 feet) to follow social distancing.

Limit Person to Person Contact

Even though someone is not feeling sick, they still could have the novel coronavirus and pass it to others. Limiting contact with others is the best way to ensure the virus does not spread. This includes:

• All attendees wear cloth masks and wash hands frequently. If there are no hand washing stations, hand sanitizer should be used frequently and after handling any items that are handled by multiple people
• Use disinfecting wipes on all hard surfaces and prioritize multiple cleanings to surfaces that will be touched frequently such as door handles
• Standing 6 feet away from others who are not a member of your immediate household
• No handshakes, hugs or physical touch
• If food is being provided, as few people as possible should serve it. It should not be buffet style. Those serving should practice good hand washing, wear gloves, wear masks and frequently sanitize all serving utensils.
• Tables and chairs should be set for every other space
• Give-away items should be either avoided or held at another time

Attendance Tracking

One attendee will be responsible for logging the names of all attendees. This attendance log will be provided to the Public Health Officer at Yellowhawk Tribal Health Center and will be kept confidentially. This log will be used in the event that a funeral attendee tests positive for COVID-19 in the two weeks following the funeral and all funeral attendees need to be notified that they may have been exposed.

Seek prompt medical attention if your illness is worsening (e.g., you start having difficulty breathing). Before going in, call your healthcare provider and tell them that your symptoms are consistent with COVID-19. Put on a facemask, if possible, before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting your infection. If you have a medical emergency and need to call 911, tell the dispatch personnel that you have symptoms consistent with COVID-19.

Stay home, except to get needed medical care.
You should not leave your home, except for getting medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-sharing, or taxis.

Separate yourself from others in your home, as much as possible.

People: As much as possible, you should stay in a specific room and away from other people in your home. Sick people should not share a bedroom with people who are not sick. Also, you should use a separate bathroom, if available.

Animals: You should restrict contact with pets and other animals while sick because we do not have enough information yet to know if this virus could affect your pets. When possible, have another member of your household care for your animals while you are sick. If you must care for your pet, wash your hands before and after you interact with them.

Avoid sharing personal household items.

In this case, sharing is NOT caring! You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. After using these items, they should be washed thoroughly with soap and water and dried before use by others. Your laundry should be washed on the hottest setting appropriate for the fabric.

Clean all high-touch surfaces every day.

High touch surfaces include counters, tabletops, doorknobs, light switches, remote controls, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have any bodily fluids on them. Use a household cleaning spray or wipe, according to the 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. Remember to never mix different types of cleaning products.

Wear a facemask, especially if you are around others.

If you are having flu-like symptoms, it is recommended to wear a facemask around others to help prevent the spread of infection. If you call your healthcare provider and are told to come into the office, you will be given a facemask to wear during your visit. At Yellowhawk, the triage desk just inside the front doors will ask you screening questions about your symptoms, take your temperature, and provide you with a facemask that you must wear the entire time you are in the clinic.

Cover your coughs and sneezes.

Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can and immediately clean your hands as described below.

• Wash your hands often with soap and warm water for at least 20 seconds.
• If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60 to 95% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
• It is best to use soap and water, especially if hands are visibly dirty.
• Avoid touching your eyes, nose, and mouth with unwashed hands.

The Centers for Disease Control and Prevention has guidelines for cleaning your home to help prevent the spread of COVID-19. You can find specific instructions online, click here.

Wearing a cloth face covering CORRECTLY can help prevent the spread of COVID-19 to others. When you go out on essential trips, follow these “do’s”.

Remember those under age 2 or individuals who cannot take the mask off on their own should not wear a face covering.

Wearing a Face Covering:

Putting a face covering on

• Wash your hands
• Place face covering of your nose and mouth
• Make sure you can breath easily

Taking a face covering off

• Take off your face covering without touching the front or inside of the mask
• Fold outside corners together
• Put aside for washing
• Wash your hands

For more information on face coverings, including sew and no sew patterns, check out the CDC website: https://www.cdc.gov/…/prevent…/diy-cloth-face-coverings.html

Diabetes & COVID-19

• Risk of diabetic related complications of COVID-19 infections is lowered when your blood sugar is kept under control
• In case you would get sick, have a list of all medications you take, the dosages, and how often you take them (you can ask the Yellowhawk Pharmacy staff to print a copy of this for you)

If you take Metformin, insulin, or any other medication, continue to take it as prescribed

• Make sure to refill your medication and diabetic sensors on time – schedule your refill through the Yellowhawk Pharmacy by calling (541) 240-8690
• Call the Yellowhawk Pharmacy at (541) 240-8691 to arrange for parking lot pick up or home delivery of medication, or if you need help replacing a diabetic sensor

Follow dietary recommendations your healthcare provider has given you, even when planning emergency food supplies

• Choose foods low in added sugar
• Choose whole grain carbohydrates if possible
• If using canned fruit, drain and rinse the fruit to remove syrup and juice or use frozen fruit for lower sugar content
• Try to plan meals around fresh, frozen, or canned vegetables, and use smaller portions of pasta, rice, and potatoes
• If you are prone to low blood sugar, keep things like jam, honey, regular soda, or hard candies on hand

For more information visit: https://www.diabetes.org/coronavirus-covid-19

Lung Disease & COVID-19

• The risk of asthma, COPE, or other lung disease related complications of a COVID-19 infection is lowered when your condition is well controlled
• In case you would get sick, have a list of all medications you take, the dosages, and how often you take them (you can ask the Yellowhawk Pharmacy staff to print a copy of this for you)

If you use an inhaler, use a nebulizer, or take any other medication, continue to do so as prescribed

• Make sure to refill your medications on time – schedule your refill through the Yellowhawk Pharmacy by calling (541) 240-8690
• Call the Yellowhawk Pharmacy at (541) 240-8691 to arrange for parking lot pick up or home delivery of medications
• If you have a rescue inhaler or other medication you do not use often, check its expiration date

Keep a log of what’s normal for you so you have a baseline to compare symptoms to if you begin to feel sick

• On a normal day when you are not sick, how often would you experience coughing or shortness of breath?
• What usually triggers your asthma or COPD symptoms to worsen? (i.e. smoke, cold temperatures, exercise)
• If you have a peak flow meter at home, what is your normal range when you use it?

For more information visit: https://www.lung.org/blog/update-covid-19

Kidney Disease & COVID-19

• The risk of kidney disease related complications of a COVID-19 infection is lowered when your condition is well controlled
• Patients on dialysis should continue going to their regularly scheduled appointments
• If you have concerns about your dialysis appointment contact the facility directly for more information about the steps they are taking to keep patients safe

CONTINUE TO TAKE ALL YOUR MEDICATIONS AS PRESCRIBED

• Make sure to refill your medications on time – schedule your refill through the Yellowhawk Pharmacy by calling (541) 240-8690
• Call the Yellowhawk Pharmacy at (541) 240-8691 to arrange for parking lot pick up or home delivery of medications
• Have a list of all medications you take, the dosages, and how often you take them (you can ask the Yellowhawk Pharmacy staff to print a copy of this for you)

Follow dietary recommendations your healthcare provider has given you, even when planning emergency food supplies

• If you want help thinking of meal ideas or planning what foods to have on hand, check out the link below for suggestions from the National Kidney Foundation
• They have both low sodium and low sodium, low potassium, and low phosphorus food lists

For more information visit: https://www.kidney.org/covid-19

Heart Disease & COVID-19

• The risk of heart disease related complications of a COVID-19 infection is lowered when your condition is well controlled
• Be sure to take time for exercise and self-care (while following social distancing guidelines) to help maintain your heart health

CONTINUE TO TAKE ALL YOUR MEDICATIONS AS PRESCRIBED

• Make sure to refill your medications on time – schedule your refill through the Yellowhawk Pharmacy by calling (541) 240-8690
• Call the Yellowhawk Pharmacy at (541) 240-8691 to arrange for parking lot pick up or home delivery of medications
• Have a list of all medications you take, the dosages, and how often you take them (you can ask the Yellowhawk Pharmacy staff to print a copy of this for you)

Follow dietary recommendations your healthcare provider has given you, even when planning emergency food supplies

• If you want help thinking of meal ideas or planning what foods to have on hand, check out the link below for suggestions from the American Heart Association
• They have other tips for staying healthy too, like ideas for staying active and relieving stress

For more information visit: https://www.heart.org/en/about-us/coronavirus-covid-19-resources

Cancer & COVID-19

• Cancer patients are at increased risk of severe COVID-19 infections, especially if you are currently undergoing chemotherapy or have had a bone marrow transplant
• Before your doctor’s appointments, call your provider to see what special steps they are taking to protect high risk patients from COVID-19 infections

To protect your health:

• Do not allow anyone who does not live in your home to visit in person – encourage your friends and family to call you on the phone or video chat with you instead
• Wash your hands often with soap and water for at least 20 seconds
• If you have to leave your home stay at least 6 feet away from other people at all times
• If your doctor cancels a regular cancer screening appointment, reschedule it as soon as possible

CONTINUE TO TAKE ALL YOUR MEDICATIONS AS PRESCRIBED

• Make sure to refill your medications on time – schedule your refill through the Yellowhawk Pharmacy by calling (541) 240-8690
• Call the Yellowhawk Pharmacy at (541) 240-8691 to arrange for parking lot pick up or home delivery of medications
• In case you would get sick, have a list of all medications you take, the dosages, and how often you take them (you can ask the Yellowhawk Pharmacy staff to print a copy of this for you)

For more information visit: https://www.cancer.org/about-us/what-we-do/coronavirus-covid-19-and-cancer.html

People everywhere are talking about coronavirus (COVID-19) on the news, social media, television commercials and more. Adults aren’t the only ones hearing about it, and just like adults, kids may be overwhelmed, stressed, and frightened about what they are hearing. Parents, family members, and other trusted adults can help them understand what they hear in a way that is honest, accurate, and reduces anxiety or fear.

Tips for talking with kids

Remain calm and reassuring. Kids hear not just what you say but how you say it. Use a calm voice and try not to seem worried.

Be available to listen and to talk. Schedule time each day to relax and connect with your children. Make sure they know they can come to you any time they have questions. Talk together about fears, worries and other feelings. Encourage them to call or video chat with friends and family to check on others and stay connected.

Pay attention to what they see or hear on television, radio, or online. Limit what they watch. Point them to age-appropriate content so they don’t end up finding news shows or outlets that scare them or have incorrect information. Talk together about what they are hearing and correct any false information.

Watch for changes in behavior. This may mean that they are anxious or not coping well. They may have trouble sleeping, complain of headaches or not feeling well, get cranky, be more clingy, or seem distracted. Keep reassuring them, talk to them about their feelings, and try to stick to your normal routines.

Provide facts. Give them honest, direct answers and facts that are appropriate for their age. Explain that some stories on the Internet and social media may be based on rumors and incorrect information.

Give them some control. Tell them what they can do to reduce the spread of germs and keep themselves and others safe.

• Stay home and away from people who are sick.
• Cough or sneeze into their elbow or a tissue, then throw the tissue into the trash.
• Wash hands with soap and water for at least 20 seconds, especially after coughing or sneezing, going to the bathroom, and before eating or making food.

Be a good role model. When you show empathy and support to those who are sick, they will too. Pay attention to your own healthy habits, technology use and mental health. Show them that taking a break and protecting your own mental health is important. Let your kids know that it’s normal to feel worried and stressed out sometimes. Share with them how you deal with stress in a healthy way.

Getting the conversation started

Start by asking a child what they’ve already heard. Most children will have heard something, no matter their age.

Ask what questions they have. Keep the conversation direct and easy to understand. Answer their questions, but don’t offer more detail than they are interested in.

Follow your child’s lead. Some kids may want to ask lots of questions and talk every day about COVID-19. Others may not be interested in talking about it much at all. Both are ok.

It’s ok to say “I don’t know.” If your child asks about something and you don’t know the answer, find the answer together. Check CDC.gov/coronavirus for up-to-date, reliable information.

Keep checking in. Talk about current events and what they are hearing about, their questions, and their feelings. Help them think through stories they hear about. Ask questions like: What do you think about this story? Why do you think this happened?

Keep explanations age-appropriate. Balance simple, direct facts with reassurances that they are safe and will be taken care of, especially for younger children.

Older children may need more discussions and information. Help them identify facts from rumors.