Lessons learned from responses to COVID-19 pandemic in rural, Indigenous, and isolated populations in the US and...

Rural, Indigenous, and isolated communities faced unique challenges and opportunities during the SARS-CoV-2 pandemic. Identifying lessons from these communities, which are rarely studied, is crucial for improving future crisis responses similar populations. This study aims to inform similar communities by centralizing lessons learned and improving preparedness for future health crises.

We examined three geographically and culturally distinct self-governing communities: a Tibetan Buddhist monastic community in southern India, Alaska Native communities in Interior Alaska, and the Cheyenne River Sioux Tribe in South Dakota. Through semi-structured interviews conducted from 2021 to 2022 with community members working in healthcare, education, law enforcement, and governance, we analyzed the policies implemented, the decision-making processes behind them, and the psychological experiences of community members during the pandemic.

The themes identified from the interviews included the creative mobilization of internal resources amid limited external support, such as community members assuming new roles like quarantine enforcement and using shared culture as a resource to change health behaviors. All three communities implemented travel restrictions. Reported stress on a personal and community level was high, particularly due to deaths caused by the pandemic.

Rural, Indigenous, and isolated communities responded to the COVID-19 pandemic with a range of strategies, including strict shutdowns, travel restrictions, community-driven support, and traditional healing practices. Despite demonstrating resilience and adaptability, they faced challenges such as resource limitations, enforcement difficulties, and community stress, highlighting the need for ongoing support and tailored approaches.