On a chilly pre-dawn morning, Molly Brown pulled into Dr. John “Bull” Durham’s Flagstaff driveway and started to load her truck with six-foot-long rolls of blue fabric.
Brow,n the executive director of the Northern Arizona Volunteer Medical Corps, would normally be at Durham’s garage checking on medical supplies for one of the two trips her organization makes to Haiti each year to do orthopedic surgeries on locals without access to medical treatment. With the COVID-19 pandemic canceling those trips, NAVMC, led by Durham and Brown, has redirected its efforts to support healthcare workers on the Navajo and Hopi reservations with personal protective equipment (PPE).
That morning, Brown drove the fabric to Tuba City, where Durham works as an orthopedic surgeon for the Tuba City Regional Health Care Corporation. He had a team of volunteers from the hospital dental program who were waiting to convert it into reusable hospital gowns. In addition to the fabric, Brown had a plastic bag containing 44 neatly folded gowns that had been sewn in Flagstaff at the Threaded Together sewing cooperative under a contract paid for by NAVMC.
One gown in particular was going directly to Dr. Jarred McAteer, a physician at the Tuba City hospital who is working directly with patients battling COVID-19 in the intensive care unit and the respiratory care unit at the hospital.
NAVMC’s involvement with providing PPE on the reservation started shortly after the first cases arrived at Tuba City.
“Two months ago, the chief medical officer came to me and said we need PPE.” Durham said. “It turns out that across the nation and around the world, there has been a shift from medical staff using surgical gowns made out of fabric, which are laundered and reused, to using disposable gowns made from plastic. At Tuba City they were using 300-400 disposable gowns each day. No one in the country could get disposable gowns and Tuba was running out.”
In a bitter irony, most disposable gowns are made in China and as that country went into lockdown, factories were closed and even if there were supplies there was no way to ship them. One of the manufacturing centers of disposable gowns and N-95 masks is in Wuhan, China where the COVID-19 pandemic originated.
As hospitals and medical systems across the nation saw their supply of disposable gowns dry up, each came to the same conclusion that the solution was a return to making reusable gowns from materials that could be laundered. In Flagstaff at the outset of the pandemic, Susan Haefner, a pediatric intensivist at Flagstaff Medical Center, started a volunteer program sewing gowns out of TyVek house wrap. While those gowns filled an immediate need, they didn’t breathe and were uncomfortable to wear during a 12-hour shift caring for patients.
The race was on to source a breathable fabric that met certain medical standards where it could be used safely to protect against contamination.
“We started looking for fabric that met AAMI standards (Association for the Advancement of Medical Instrumentation), which is a way that gowns are ranked for what level of protection they offer,” Durham said. “When all of my elective surgeries were canceled, I had the time to start researching and to locate the fabric that we would need. We got 3,000 yards of fabric and were able to convert that and some other fabric into 1,200 gowns. I had done an assessment by calling all of the medical centers across the reservation to see what they needed.
“I spoke with a friend, Christy Thuet, a pediatrician who used to work on the reservation and who now works in Salt Lake City, about how we could help all of the different service units across the reservation from Tuba to Chinle to Fort Defiance, Gallup and Shiprock, and she had pilots who can fly stuff.
“Then we got a call from W. L. Gore to say that they had 8,500 yards of fabric in a warehouse and wanted to have it made into gowns to support both Flagstaff and the reservation. That material was sent to the Arizona Apparel Foundation and was turned into 4,700 gowns. NAVMC paid $11 per gown and was able to then take another 1,250 gowns up to distribute across the reservation.”
The sewing teams at Threaded Together in Flagstaff and the dental team in Tuba City are still cutting fabric and converting it into gowns to serve the needs of the medical centers on the reservation.
“The majority of NAVMC’s funds right now are going toward this project. NAVMC’s focus right now is more than 80% local,” Durham said.
“NAVMC’s mission has always been to help provide for the healthcare and welfare of the underprivileged and now we are doing that for our own people. ... It’s been going on for eight weeks and it’s in no way slowing down. It’s not a surge, it’s just a slow, steady continuum. The gown program has created a paradigm shift for the healthcare workers being able to care for the sick.”
After months of delayed operations due to the COVID-19 pandemic, staff with the 2020 census began delivering questionnaires to front doors this week.
“We’re excited to be back in the community delivering questionnaires,” said Tammy Parise, the Census Partnership Coordinator for Arizona.
The questionnaires census staff are delivering wont be received by everyone. Instead, they go out to households which rely solely on a postal box to receive their mail. For those households, census staff will be dropping off questionnaires to their front doors.
With as field operations resuming, Parise said the census also has to navigate the new challenges the pandemic has presented. In the case of delivering questionnaires, that means dropping off paperwork at homes without actually interacting with the residents.
“We are not knocking on the doors of households and therefor not interacting with the resident, rather we’re just leaving the questionnaire at the door of the resident,” Parise said.
And Parise said as staff continue to work in the field, staff will be following the regulation put in place bu the state and local governments to help prevent the spread of the virus.
Additionally, staff have been issued masks, gloves and sanitizer to use in the field or when door knocking eventually begins later in the year, Parise said. And staff are expected to use that personal protective equipment when social distancing is not possible, Parise said.
Earlier this year, Parise said the pandemic had effectively stopped their ground operations and as a result, she said the census has extended the timeline for when residents are able to respond.
“For self response, that was previously set at July 31, we have now extended the opportunity for households to respond to the census up to and including October 31. So we have an extended window for households to respond to the census,” Parise said.
So far in Coconino County the response rate has been low, only about 34%, but Parise chalked a lot of that up to the disruption of the census caused by COVID-19.
And because of that, Parise said now that their staff are once again in the field, she’s confident they’ll achieve a full count.
“COVID-19 presented challenges for us all but now that we're back in the field, households are receiving their questionnaire packets and are able to respond,” She said. “So we’ve adapted just like many others have.”
The virus also disrupted their ability to hire everyone they need and put many more employees essentially on furlough. Parise said they kept field offices open throughout the last few months but nonetheless, for many employees there was simply no work to do.
And Parise said all that means they are still looking to hire staff, primarily in Greenlee, Navajo and La Paz counties.
A federal agency has approved two permits for a hydroelectric dam developer to study the Little Colorado River located on Navajo Nation for their applications to build up to four dams.
However, in early March the same developer, Pumped Hydro Storage, submitted a third groundwater dam application in Big Canyon, which is a dry canyon attached to the Little Colorado River. The Federal Energy Regulation Commission (FERC) has yet to accept the application for Big Canyon, according to Pumped Hydro.
The first two dam projects on the Little Colorado River caused significant backlash from Native American tribes and environmentalists in 2019. The preliminary permits would not allow Pumped Hydro to begin building anytime soon, but would only allow them to begin studying whether the site is feasible for their pending hydroelectric dam projects.
The developer's Little Colorado River applications ask for a total of four dams that could hold thousands of acre-feet of water and would create and store electricity. The electricity would connect with the Moenkopi switchyard near Cameron through a 22-mile-long, 500-kilovolt transmission line.
The Little Colorado River is known to many for its light-blue colored water that feeds into the Colorado River above the Grand Canyon National Park land at the confluence.
Environmentalists heavily oppose the dams because they were located on critical habitat for the threatened humpback chub. The chub was recently downgraded on the list of species from endangered to threatened in part because of their recovery within the Little Colorado River.
The river is considered sacred to several Native American tribes that objected to the project. The Arizona Daily Sun reached out to leaders and offices of the Navajo Nation and Hopi Tribe who did not respond for comment avid the severe outbreak of COVID-19.
Roger Clark, Grand Canyon program director at the Grand Canyon Trust, said he felt the permit was inappropriate given the large opposition.
“We knew FERC rarely rejects preliminary permits like this,” Clark said. “We thought if there might be an exception to approving the application, this would be it.”
While issuing the preliminary permits, FERC said the groups who voiced their concerns about impacts to endangered species and tribal lands were done “premature” and could be filed again at a later date.
Steve Irwin, the applicant of Pumped Hydro Storage, was also surprised to hear the company’s first two permits were accepted. He figured FERC would put the Big Canyon application out for a public comment before accepting the Little Colorado River applications. He said the company submitted the third application hoping to calm opposition to the company's proposals.
“Only one of these projects is going to go there,” Irwin said. “We tailored the new one to get it out of the Little Colorado to avoid all of the aquatic issues by putting the lower reservoirs in a dry canyon.”
FERC officials did not respond to requests for comment before press time.
The Big Canyon application could create four dams and draw upon groundwater for its reservoirs.
Big Canyon is known to be dry throughout most of the year, excluding flooding during heavy rain. The project recommends building a two-lane asphalt road connecting Highway 89 north of Tuba City to Big Canyon. Big Canyon is connected to the Little Colorado River and located 23 miles away from Tuba City.
Clark said he was still reviewing the specifics of the project after recently learning of the Big Canyon application, but was shocked that the Big Canyon proposal had as many dams as the first two permits combined. His main concern was whether pumping groundwater would impact the Little Colorado River reserves, which are largely unmapped.
“Whether it’s impeding the main stem of Colorado or taking it from groundwater that feeds the Little Colorado, it’s still a risk altering that natural river course and harming the biological and cultural resources,” Clark said.
Three of the four dams are proposed to be hundreds of feet tall by hundreds of feet wide. The fourth dam is expected to be 10,000 feet wide by 200 feet tall. The four reservoirs would contain approximately 73,000 acre feet of water among the four reservoirs and have an energy output of 3,600 megawatts.
“We thought if we do that we don’t lose that much power, and we solve the fish issue, then let's do it.” Irwin said.
FERC has not accepted the application, according to Irwin. If the agency accepts it, the public will have a 60-day window to submit comments.