WAGNER, S.D. — Kenneth Cook still feels a twinge in his chest.

It has been more than two weeks since he tested positive for COVID-19 and the effects are still lingering as he looks out over Lake Wagner.

The virus kept him away from his wife and three children while he quarantined and he spent a chunk of the time meditating, determined to beat an illness that has caused 150,000 deaths throughout the country.

At 43 years old, Cook was otherwise healthy and followed precautions to avoid contracting COVID-19 while running typical errands and going to work as the treasurer for the Yankton Sioux Tribe.

He does not know how or where he contracted the disease — which was compounded by strep throat — but he knew it could not be the end of him. Cook returned to work Friday, July 24, for the first time since July 7 as the tribe continues to aid tribal members who have tested positive for COVID-19, as American Indians account for 81 of the 99 positives in Charles Mix County, per the South Dakota Department of Health.

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“I knew I had to focus on myself. I had to get better,” Cook said. “I had phone calls coming in and had the moral support. I knew I had to get through those days and try to get healthy.”

It was the strep throat that arrived first. It was so intense that he left work early and a nap did not solve the problem. Eventually, his throat was so congested that he decided to visit Indian Health Services and, after a rapid test, Cook was informed that he not only had strep throat, but COVID-19 as well.

As the pandemic progressed, Cook and his family decided they would quarantine in Fort Randall Casino in Lake Andes, S.D., in the event of a positive test. Since closing due to the pandemic, the casino has made rooms and cabins available for members of the Yankton Sioux Tribe that have contracted or come in contact with COVID-19.

'Determined to be proactive'

Spending 10 days in a cabin away from family was a daunting proposition, but Cook feared passing his illness to family members. American Indians account for 9% of South Dakota’s population, according to the United States Census Bureau, but the South Dakota Department of Health figures show that 16% of the state’s 8,444 positive cases are from American Indians.

“When I first found out that I had COVID, I was like, ‘Man, I can’t have this,’” Cook said. “I was determined to be proactive and not let the COVID advance. I always tried to stay ahead of it. I was sitting outside and some thunderstorms came in and the cold air came in off that system, I took advantage of it and that really helped my lungs.”

Discomfort from strep throat kept Cook awake for nearly 38 hours and even slightly changed his facial features, but shortly after antibiotics began to clear his throat, COVID symptoms set in. In the early hours of July 9, Cook awoke from his sleep drenched in sweat and body shaking uncontrollably from a fever, he said.

Guzzling Pedialyte helped bring down the fever and quell the chills, and by Friday, he started feeling better. But later in the day, the chest congestion and a dry cough began and caused shortness of breath. He also lost his appetite, rarely eating during his quarantine and he ultimately lost 10 pounds during the process.

Even as shortness of breath hampered him, Cook took advantage of staying in the cabin, allowing him to walk around outside and practice breathing exercises. He was forced to take intermittent breaks, but he believes it helped him recuperate. By Monday, July 27, he was able to go for a job as his symptoms finally began to subside before returning home.

“If I’m in a hotel room, I figured there was no way I could get myself better just being isolated in a room,” Cook said. “So, I chose a cabin to move about freely outside. … When the shortness of breath came, the pain level was probably a seven. I continued to improve with my personal health.”

Cook’s wife has been tested three times since his positive test, all of which came back negative.

A tribal effort

Cook called his bout with COVID-19 “a setback,” but he was quick to note how many people are exponentially affected.

According to the Centers for Disease Control and Prevention, American Indians are five times more likely to be hospitalized due to COVID-19 than white people.

They are more susceptible to obesity and high blood pressure, per the United States Department of Health. They are also 50% more likely to be diagnosed with heart disease and 50% more likely to smoke cigarettes than non-Hispanic white adults, while being twice as likely to have diabetes than white people.

Thirty-three Charles Mix County residents have been hospitalized, the third-highest total in the state behind, Minnehaha (354) and Pennington (130), despite having 9,292 residents compared to Minnehaha’s 193,134 and Pennington’s 113,775.

“Some homes have 14 people in three- or four-bedroom homes,” said Derrick Marks, Yankton Sioux Tribe Business and Claims Committee member. “That’s asking for the virus to spread. There’s been some disheartening times during the last few months, but to see the Yankton Sioux Tribe and our COVID task force come together and assist our people has been encouraging.”

The Yankton Sioux Tribe has attempted to tackle the pandemic and save tribal members from contracting COVID-19 by lending aid in some unique areas.

The tribe received $13 million from the federal COVID-19 relief fund, which allows tribal members to quarantine at the casino free of charge, while the tribe also helps with groceries during quarantine, a one-month access to Netflix and even a prepaid cellphone in an attempt to make sure those affected stay home and get healthy.

The tribal council has also partnered with IHS for a drive-thru swab test in July in Lake Andes, with another scheduled for Aug. 6. Nine-hundred people were also tested for COVID antibodies through an event by the tribe and Wagner Community Memorial Hospital Avera, according to hospital Chief Executive Officer Bryan Slaba. Face masks are also mandatory in tribe-owned facilities.

“We prefer (people) go home, because 14 days is a long time by yourself,” Yankton Sioux Tribe Vice Chairman Jason Cooke said. “I think being at home with somebody is a little easier, but some of us don’t have internet or phones. It’s really a choice of the person and we’ll take them their food and water. Whatever they need.”

Despite all of the precautionary measures, tribal members are still at risk. As other tribes in South Dakota have been battling with state officials to maintain COVID-19 checkpoints on state and county highways, the Yankton Sioux Tribe does not have that option.

The Yankton Sioux Tribe reservation is a checkerboard, interspersed with federal and state lands, which makes it more difficult to create precautionary mandates. People who work for tribal members are on administrative leave, thanks to a government stimulus package, but many who work for nontribal businesses have to go to work.

Security will soon be implemented to roam tribal lands to enforce shelter-in-place policies, but setting up checkpoints on multiple communities scattered across 40,000 acres was not feasible.

“We had a tribal resolution for shelter-in-place, but (Wagner and Lake Andes) had nothing,” said Marks, the Business and Claims Committee member. “We couldn’t really enforce a shelter-in-place, we could only ask that our people honor it. You see things like the tribal hall shut down, but the city hall open. … The two ecosystems are really battling each other and we started noticing.”