In this post, Anna Kemball reflects on the framing of Native Americans as ‘postapocalyptic’ people in the context of Coronavirus. She discusses the missing public health data on Native American rates of Covid-19 amidst histories of colonialism and health inequalities, and asserts the place of Indigenous studies in the critical medical humanities.
Forming around 6% of the world’s population, and protecting 80% of the world’s biodiversity, Indigenous peoples have been disproportionately affected by the Coronavirus pandemic. COVID-19 has functioned as a magnifying glass, exposing all kinds of societal and political issues. This is particularly true for Indigenous populations, for whom the pandemic illuminates, once again, the nexus between health, environmental injustice, settler colonial governance and Indigenous sovereignty.
Research into outbreaks of other infectious diseases – including influenza, SARS, and MERS – has already explored the politics of pandemics and theorised the ‘apocalyptic expectation’ of such outbreaks. Carlo Caduff’s ethnography suggests that preparing for flu pandemics has made health crises a permanent presence in contemporary society. A ‘pandemic imaginary’ is similarly proposed by Christos Lynteris, an imaginary that reconfigures what it means to be human as zoonosis transforms human/non-human relations. Yet a sustained engagement with Indigenous worldviews is missing from this body of important research. This lack of Indigenous perspectives is particularly amiss given such worldviews contain important insight into human/non-human kinship, the social determinants of health, and living through long-term health crises. As research responds to COVID-19, we should listen to Indigenous perspectives, from communities who have previously endured the devastating effects of infectious diseases to such an extent that they have already been framed as ‘postapocalyptic peoples’.
That the Native Apocalypse has already taken place is a view commonly held and explored by Indigenous writers and critical thinkers who work in Indigenous Futurism (a movement inspired by Afrofuturism). This view posits Native peoples as survivors of colonial contact and the decimation that occurred when ‘Old World diseases’ were brought to the ‘New World’. It is estimated that, only a century after Columbus’ arrival in 1492, epidemics, warfare, and other genocidal strategies had resulted in the deaths of between 80 and 95% of the Native American population. Lawrence W. Gross (Anishinaabe) argues that these histories of extermination, the concomitant weakening of social institutions, and the resulting intergenerational trauma has resulted in a ‘postapocalypse stress syndrome’ (PASS). Within this syndrome, which attempts to theorise what follows the survival of an apocalyptic event, Gross argues that a variation of PTSD becomes ‘pandemic to the society’.  Whereas social and political institutions might otherwise aid recovery from a large-scale disaster, PASS weakens such institutions, resulting in a recovery time that spans multiple generations. Recovery from this syndrome is complex but involves a strengthening of social institutions and a revitalisation of cultural worldviews that remains responsive to the current challenges faced by tribal nations.
The strategic framing of Indigenous communities as ‘postapocalyptic peoples’ has proved useful to celebrate the survivance of Native peoples, and the failure of settler governance to fully eradicate or assimilate Indigenous cultures. But there is a flip side. When this concept is appropriated by non-Indigenous people in positions of power and decision-making, the compartmentalising of Indigenous peoples as distinct, or “other”, from a country’s general population risks their erasure. When settler mythologising of Native peoples (for example, as ‘vanishing’, or as separate and thereby unaffected by non-Indigenous society) is reinforced, funding, resources and expertise are diverted away from communities in the present moment. To predict that Indigenous peoples will survive – because haven’t they always done? – breeds complacency at a time that urgently requires communication and collaboration.
The ‘vanishing Indian’ in public health data
Turning to the first wave of COVID-19 in the US, a paradox emerged as media coverage rendered Native communities especially visible at a time when their infection rates were being obscured in public health reporting. At first, all eyes were on the infection rates among the Navajo nation because it surpassed the rates in New York. However, this global media attention was focused on a single tribe (out of more than 570 federally recognised tribes), rather than the nation-wide picture. Comprising 2% of the US population, data surrounding Native Americans contracting COVID-19 were initially framed as statistical outliers. As the first wave peaked, only 80% of state health departments were releasing racial demographic data. Of these departments, half did not include Native American as a separate category but simply labelled such patients as ‘other’. Major cities with large Native populations, including New York, Chicago, and Los Angeles, failed to release racial demographic data that would present an accurate picture of the scale of the problem for urban Indigenous peoples, exemplifying the outdated notion that most Native Americans still live on reservations. This data ‘vanishing’ received media attention with fears raised over a health emergency that was being hidden from public view.
Of course there are difficulties, in such a quickly developing health crisis, of collecting and reporting the data needed to accurately reflect minoritized groups. However, for America’s Native peoples, as ‘another iteration of a long history of […] data deficits’, this absence carries serious implications for resource distribution, policymaking, and the continually underfunded Indian Health Service. Importantly, Abigail Echo-Hawk (Pawnee), Chief Research Officer of the Seattle Indian Health Board, explains why Native Americans constitute such a small percentage of the US population in the first place:
‘We are a small population of people because of genocide. No other reason. […] If you eliminate us in the data, we don’t exist. We don’t exist for the allocation of resources.’
In June 2020, attempts by tribal organizations to gain access to data from federal agencies were obstructed; the Centers for Disease Control and Prevention refused requests from tribal epidemiologists for data that was otherwise available to state authorities. Within these refusals, tribal leaders have reported that federal officials have questioned the legal position of tribes as sovereign entities, distinct nations with the constitutionally recognised right to self-govern. In contrast to the abundance of media attention, it took until August 2020, for a study to be released by the CDC confirming that Native Americans have contracted the virus at disproportionate rates – 3.5 times higher than the rates of non-Hispanic whites – but, again, the study notes the limitations of missing data which precludes further analysis.
These instances of statistical erasure and the obstacles placed between Native health organisations and the data they need to tackle the pandemic are only two of the more recent strategies used to undermine Indigenous sovereignty. In the midst of a challenging health crisis, such decisions may at best appear misguided, or uninformed. But they point to the need to situate current public health practice in the present within longer histories of coloniality, health governance, and pathologisation.
Health governance and scholarship after COVID-19
COVID-19 continues to impact communities around the world, effecting rapid responses from our public healthcare institutions. We’ve seen the rise and fall in infections rates, successive lockdowns and stay-at-home orders. With the monumental efforts to develop vaccines now resulting in the first roll-outs of vaccinations, researchers in the humanities and social sciences now face the ‘slower’ task of examining what the world has lived through this year. The importance of situating Native experiences of COVID-19 within longer colonial histories of health governance has already been stated. Equally, we must look ahead towards the health policies to come.
Applying Penelope Ironstone-Catterall’s warning surrounding influenzas scholarship to the current health crisis, scholars must be alert to how the COVID-19 outbreak might be mobilised. Ironstone-Catterall warns that ‘imaginaries of contagion are deployed to justify increased intervention in bodies and serve as the ground on which demands for governance and self-governance are legitimated’. How conclusions are drawn concerning COVID-19 and Indigenous populations risks reasserting colonial governance over Indigenous bodies. Interventionist or paternalistic policies must be scrutinised via the long histories of such healthcare interventions in settler colonies. Equally, we should be aware of policies and rhetoric which maintain, rather than challenge, the reduction of Indigenous peoples to health indicators of deficit, or which expect Native peoples to comply with a set ‘of pre-determined, measurable characteristics of the non-Indigenous ideal’.
The many ways in which settler colonialism negatively impacts wellbeing should not be confined to this year. Rather, the interrelation between coloniality and health inequities has occurred for centuries. But for both the medical humanities and Indigenous studies, as disciplines currently manifesting their own ‘critical turns’, 2020 is a reminder of the urgent need for greater collaboration. Here is an opportunity to address together the current health inequities and legacies of settler colonialism by scrutinizing the erasure of Native peoples from COVID-19 discourse.
Anna Kemball is an AHRC-funded PhD candidate in the School of Literatures, Languages & Cultures at the University of Edinburgh. Her thesis explores representations of health and wellbeing across a range of contemporary Indigenous literatures, bringing Indigenous literary studies and the critical medical humanities into closer relation. Her work on Māori representations of schizophrenia is published in the Journal of New Zealand Literature.
 Kristian Bjørkdahl and Benedicte Carlsen, eds. Pandemics, Publics, and Politics: Staging Responses to Public Health Crises (Palgrave Macmillan, 2019); Damir Huremović, ed. Psychiatry of Pandemics: A Mental Health Response to Infection Outbreak (Springer, 2019).
 Carlo Caduff, Carlo, The Pandemic Perhaps : Dramatic Events in a Public Culture of Danger (University of California Press, 2015)
 Christos Lynteris, Human Extinction and the Pandemic Imaginary (Routledge, 2019)
 Sidner, Larson, Captured in the Middle: Tradition and Experience in Contemporary Native American Writing (University of Washington Press, 2000).
 Grace L. Dillon, Walking the Clouds: An Anthology of Indigenous Science Fiction (University of Arizona Press, 2012).
 Nathan Nunn and Nancy Qian, “The Columbian Exchange: A History of Disease, Food, and Ideas,” Journal of Economic Perspectives 24, no. 2 (2010): 163–88.
 Nunn and Quian, “Columbian Exchange,” 165.
 Lawrence W. Gross, Anishinaabe Ways of Knowing and Being (Routledge, 2016), 7.
 Gross, Anishinaabe, 45.
 Rebecca Nagle, “Native Americans being left out of US coronavirus data and labelled as ‘other’,” The Guardian, 24 April, 2020, https://www.theguardian.com/us-news/2020/apr/24/us-native-americans-left-out-coronavirus-data
 Sahir Doshi et al. The COVID-19 Response in Indian Country: A Federal Failure. Center for American Progress, June 2020, https://www.americanprogress.org/issues/green/reports/2020/06/18/486480/covid-19-response-indian-country/.
 Echo-Hawk qtd in Nagle, “Native Americans.”
 Penelope Ironstone-Catterall, “Narrating the Coming Pandemic: Pandemic Influenza, Anticipatory Anxiety, and Neurotic Citizenship,” in Criticism, Crisis, and Contemporary Narrative, ed. Paul Crosthwaite (Routledge, 2011), 81–94, p.81.
 Kerryn Pholi, “Is’ Close the Gap’a Useful Approach to Improving the Health and Wellbeing of Indigenous Australians?” Australian Review of Public Affairs: Journal 9, no. 2 (2009): 1–13, p.10.
 Aileen Moreton-Robinson, ed., Critical Indigenous Studies: Engagements in First World Locations (University of Arizona Press, 2016).