Gallup, New Mexico is now in as stringent of a lockdown as we’ve seen in the United States. The situation has moved on from my last post, where I claimed that while it was a good thing that the Navajo Nation had not restricted movement outside of the reservation, this lack of restriction on movement was undermining its own curfew (since people could — and did — just leave). Gallup’s (outgoing) Mayor did what the Navajo Nation would not — that is, restrict entry into Gallup, which was then extended for another three days. The restriction is slated to be lifted tomorrow (May 07) though there is some talk of an extension.
The lockdown is being enforced. There are local and state police, as well as the New Mexico National Guard, at all roads leading into Gallup, and entry is granted only to those who can show proof of residence (e.g., through state issued ID with a Gallup address) or essential workers. That is a significant and unprecedented policy shift – it essentially locks out tens of thousands of Native Americans (primarily from the Navajo Nation) who would ordinarily come into town to shop at the beginning of the month when pay checks, social security checks, and other government assistance checks are received.
It’s worth thinking about the justification of this “full” lockdown policy against its alternatives, especially in light of an important and emerging body of evidence about the transmission dynamics of COVID-19. What we are learning is that probability of transmission is highest during close contact in enclosed spaces, and that susceptibility to contraction increases with age. In other words, the highest risk of transmission is in crowded indoor environments and for older people. It’s not clear that a full lockdown is necessary to minimize the risks of transmission relative to less stringent policy alternatives.
Right now, there are two possible policy options on the table: (1) a full lockdown and (2) a partial or targeted lockdown. I think that (2) is preferable to (1) for reasons I make clear below. Some of these reasons apply most clearly in this specific case (in virtue of, e.g., Gallup being a “border town”) while others generalize more broadly. I also note that the third option is “do nothing” (no policy response whatsoever) but I’m assuming – and I hope we are all in agreement on this by now – that is not a sensible course of action. It’s worth considering the two options in more detail:
Full lockdown. Gallup NM is close to a “full lockdown” in the sense that it has completely restricted entry for non-residents and there is a curfew for residents. Even essential businesses (except hotels) were told to close early (5pm at the beginning of the lockdown, though that has now eased to allow them to stay open until 8pm after 3 days). Lockdowns can be more or less stringent, of course, but this seems to me to be one of the more stringent, credibly enforced policy that I’ve seen put in place in the United States.
Is this policy justified? I don’t think so. First, the lockdown will stop people from getting critical supplies they need. As I said in the last post, 30% of people on the Navajo Nation lack access to potable water and frequently travel to border towns like Gallup to get it. A policy that limits access to water undermines the justification of the policy insofar as the policy is intended to reduce regional COVID-19 infection rate. You can’t wash your hands without water.
Note that there is an obvious question as to whether the policy is aimed at reducing regional (read: Navajo Nation, McKinley County, Cibola County, San Juan County, etc.) infection rate rather than local (read: McKinley County) infection rate. I think the goal should be the former for a number of reasons (both moral and practical), but whether the political incentives make it so is another question. Either way, the problem is regional rather than local, so the policy will eventually catch up – one way or another.
Second, assuming that people will need to get basic supplies from somewhere, the policy may shift the problem elsewhere. That might be good if “elsewhere” is spread out across a number of border towns and places on the reservation, but it would be bad if “elsewhere” is just another single border town (like Farmington or Grants). If the “beginning of the month” crowding at Gallup’s Wal-Mart was the worry that the policy was intended the mitigate (hint: I think it was), then shifting that crowd elsewhere doesn’t make “regional” sense. The crowd needs to be “spread out,” so to speak. One implication of this is that we ought to be cognizant about what is happening with all that pent-up demand: will there be the same amount of people heading to Wal-Mart when Gallup opens up or has that it been satisfied elsewhere? Presumably we should be taking steps to ensure the latter and preparing, just in case, for the former. (I note here that the State of New Mexico has set up potable water sites on the reservation and the Navajo Nation has also been handing out food and water supplies as well, presumably driven by the same concerns I’m outlining.)
A complete (or as complete as we’ve seen) lockdown imposes significant costs not just to business but also, as implied above, to consumers who need certain markets to remain open. (When I say need, I mean need.) Presumably, the state should clear a pretty high justificatory bar for the use of coercive state power that restricts such movement and shutters critical markets. And remember, too, that the Navajo Nation has a mostly rural population, with large swaths of its geography lacking cell reception and internet access, and so sitting at home ordering Amazon Prime is just not a viable option for a lot of people. Restricting access to Gallup is restricting access to basic goods and services that people on the Nation need.
Targeted lockdown. If not a full lockdown, what else? I think there is some consensus that a partial or targeted lockdown is probably the socially optimal policy. We’re moving towards that elsewhere: require consumers and workers on the front lines to wear masks and other PPE as applicable, have limits on how many customers in a store or place of business (especially crowded places like a single Wal-Mart), and install “COVID friendly” store architecture at places of work (sneeze guards, spread out workstations, etc.) All of this coupled with a robust test-and-trace strategy, of course, which we should expect to be resource and labor intensive (relative to other parts of the country) given the physical geography of the Navajo Nation. The point is to keep markets open while minimizing risks associated with their operation rather than closing them completely.
These are all things we know by now. But what about COVID relevant behavior outside of the purview of lockdown policies? The emerging evidence on transmission dynamics we have is pointing to the home and other crowded-enclosed-spaces (outside of places of business, e.g., social gatherings) as primary sites of transmission. The Navajo Nation is ripe for domestic transmission given widespread extended family cohabitation with a fairly large younger population. In other words, lots of young people living with their elders in closed quarters. We should be cognizant of the fact that easing from full-to-partial lockdown will (probably) increase the likelihood of intra-family transmission, as younger people will be most likely to be out and about and then go home to their older family members. Given that the infection rate is so high despite demographics and population density of the Navajo Nation, it seems as though intra-family transmission should be receiving a lot more attention than it has been.
One way to mitigate the risk here is to allow individuals who need to be out and about (such as essential workers) to voluntarily quarantine away from their families in unused hotel rooms (of which, by the way, there are a lot, since the State of New Mexico issued a rule placing a 25% ceiling on hotel occupancy about a month ago). Voluntary is important here, though, and whether there will be uptake if this offer was on the table is an open question.
One other aspect to either strategy, one that is receiving less attention but deserves more, is the role that informal rules and norms play in the overall infection rate. A full or partial lockdown won’t do much if there are still rituals or religious events – the sorts of events that are intimately tied up with Navajo culture and identity – being held on the reservation. These events tend to involve close contact between many people, both young and old, along with singing in sometimes enclosed spaces for extended periods of time. (“Singing” is particularly relevant here given the role it plays in the aerosolization and thus transmission of the virus.)
To be clear, I don’t know if events such as these are still being held, but I don’t think that, as a matter of policy, we should assume that there won’t be some degree (maybe even high degree?) of non-compliance in this regard. Ritual and religion are a central feature of life in this part of the world — a fact that any risk minimization strategy should be mindful of. And since there is no way that the Navajo Nation police (or any other law enforcement agency) will be able to enforce social distancing guidelines to ensure anything close to 100% compliance for reasons I’ve mentioned elsewhere, we’ll need to rely on community-wide expectations (and attendant social sanctions) for a high degree of compliance. Are we working on that? We should be.