FAQs - Federal Response in Indian Country
What is COVID-19?
COVID-19 is a new disease, caused by a novel (or new) coronavirus that had not previously been seen in humans. Because it is a new disease, scientists are learning more each day. Although most people who have COVID-19 have mild symptoms, COVID-19 can also cause severe illness and even death. Some groups, including older adults and people who have certain underlying medical conditions , are at increased risk of severe illness. While children are more likely to have mild or no symptoms with COVID-19 infections, a small number of children have had serious illness and late complications.
Where can I find the most-up-to-date information on COVID-19?
The Centers for Disease Control and Prevention’s website is the best place to find comprehensive updated information and guidance on COVID-19, including information on symptoms, treatment, schools, quarantine, travel, and more.
Why do COVID-19 guidance and recommendations keep changing?
The CDC‘s guidance changes because what we know about COVID-19 continues to change. This means guidance is updated as CDC learns more about what works best to reduce the risk of getting or spreading COVID-19.
What are the symptoms and the complications that COVID-19 can cause?
People with COVID-19 have reported a wide range of symptoms – from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. If you have fever, cough, or other symptoms , you might have COVID-19. We are still learning about late complications of COVID-19 and it does appear that some people have late or prolonged symptoms after the acute COVID-19 illness.
How do I protect myself?
- Get a COVID-19 vaccine and a booster shot if you are eligible .
- Wear a mask that covers your nose and mouth to help protect yourself and others.
- >Stay 6 feet apart from others who don’t live with you, especially indoors and in poorly ventilated spaces.
- Avoid crowds and poorly ventilated indoor spaces.
- Wash your hands often with soap and water. Use hand sanitizer if soap and water aren’t available.
For more information, visit the CDC webpage on How to Protect Yourself & Others .
What is CDC’s current recommendation for isolation and quarantine period for the general population?
Given what is currently known about COVID-19 and the Omicron variant, CDC is shortening the recommended time for isolation for the public. People with COVID-19 should isolate for 5 days and if they are asymptomatic or their symptoms are resolving (without fever for 24 hours), follow that by 5 days of wearing a mask when around others to minimize the risk of infecting people they encounter. The change is motivated by science demonstrating that the majority of transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after. These recommendations do not apply to healthcare personnel and do not supersede state, local, tribal, or territorial laws, rules, and regulations. Recommendations can change as new research comes out. For the latest information visit the CDC website. .
Should I be concerned about COVID-19 variants?
Viruses constantly change and become more diverse. Scientists monitor these changes, including changes to the spikes on the surface of the virus. By carefully studying viruses, scientists can learn how changes to the virus might affect how it spreads, how sick people will get from it, and the impact of the changes on the effectiveness of current vaccines. The Centers for Disease Control and Prevention tracks multiple variants circulating in the United States and provides an estimate of how common they are in the nation and at the regional level. This data will change over time as more information is available.
The recent emergence of the Delta and Omicron variants have further emphasized the importance of primary vaccination, boosters, and prevention efforts needed to protect against COVID-19.
Are masks required at IHS facilities?
Employees, contractors, Commissioned Corps officers, patients and other visitors to IHS clinics and hospitals must wear a facemask or respirator – dependent on their risk or work duties – regardless of vaccination status. Additional federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance, may also apply. Masks may still be required in some non-clinical IHS facilities. If you are not sure of the mask policy, please check with local leadership before visiting or entering a federal IHS facility.
How is the IHS working with federal, tribal, and urban Indian health facilities to promote awareness of changing guidelines, protocols, and processes related to COVID-19?
The Indian Health Service continues to work closely with our tribal and urban Indian organization partners and state and local public health officials to coordinate a comprehensive public health response to the ongoing COVID-19 pandemic. IHS holds regular calls with tribal and urban Indian health organization leaders from across the country to provide updates, answer questions, and hear concerns from tribal communities. For more information, please visit the IHS calendar. Additionally, IHS area offices provide technical assistance and support to tribal and urban Indian programs.
The IHS is also in constant communication with the CDC and other operating divisions across the Department of Health and Human Services. In addition, the IHS is in close communication with the White House and other non-HHS Departments across the federal government to ensure comprehensive communication is shared with Indian Country.
What is IHS doing to ensure the protection of their providers as they test and treat individuals for COVID-19?
The IHS is following CDC guidance for health care professionals. Many of our service units are screening individuals for COVID-19 prior to entering our health facilities to determine their risk for COVID-19 and to prevent additional infections within our facilities. Individuals suspected of having COVID-19 will be given a mask and cared for separately from other patients in a designated area with a provider. The IHS National Supply Service Center is distributing personal protective equipment, testing supplies, and other necessary supplies to regional centers and to IHS, tribal, and urban facilities as quickly as possible to address any supply shortages.
Is it safe to travel?
The CDC continues to provide regular updated travel guidance.
Where do I find a COVID-19 vaccine near me?
To find a COVID-19 vaccine near you, visit the IHS Find Health Care webpage and contact your local IHS, tribal, or urban Indian organization facility to ask about vaccine availability. You can also visit vaccines.gov , text your ZIP code to 438829, or call 1-800-232-0233 to find locations near you.
Is my COVID-19 vaccine free?
Yes. The federal government is providing COVID-19 vaccines free of charge to all people living in the United States, regardless of their immigration or health insurance status.
Is it safe for my child and me to get a COVID-19 vaccine?
Yes, the CDC recommends everyone ages 5 years and older get a COVID-19 vaccine to help protect against COVID-19. Before recommending COVID-19 vaccination for children, scientists conducted clinical trials with thousands of children and identified no serious safety concerns. The benefits of COVID-19 vaccination outweigh the known and potential risks. Like adults, children may have some side effects after the COVID-19 vaccination. These side effects may affect their daily activities, but they should go away in a few days. COVID-19 vaccines have been used under the most intensive safety monitoring in U.S. history. You and your child cannot get COVID-19 from any COVID-19 vaccine.
What are the most common side effects after getting a COVID-19 vaccine?
After getting vaccinated, you might have some side effects, which are normal signs that your body is building protection. Common side effects are pain, redness, and swelling in the arm where you received the shot, as well as tiredness, headache, muscle pain, chills, fever, and nausea throughout the rest of the body. These side effects could affect your ability to do daily activities, but they should go away in a few days. Learn more about what to expect after getting a COVID-19 vaccine .
How many doses of COVID-19 vaccine will I need to get?
The number of doses needed depends on which vaccine you receive. To get the most protection:
- Two Pfizer-BioNTech vaccine doses should be given 3 weeks (21 days) apart.
- Two Moderna vaccine doses should be given 4 weeks (28 days) apart.
- Janssen/Johnson & Johnson COVID-19 vaccine requires only one dose.
If you receive a vaccine that requires two doses, you should get your second shot as close to the recommended interval as possible. However, your second dose may be given up to 6 weeks (42 days) after the first dose, if necessary . You should not get the second dose earlier than the recommended interval.
Do I need to get a booster shot?
Yes, COVID-19 booster shots are now authorized and recommended for people 12 years of age and older who have already completed their primary vaccination. The recent emergence of COVID-19 variants further emphasizes the importance of vaccination, boosters, and prevention efforts needed to protect against COVID-19. Boosters are recommended 5 months after completing a Pfizer or Moderna vaccine primary series, or 2 months after receiving a single dose of Janssen/Johnson & Johnson vaccine. Any brand of COVID-19 vaccine may be administered as a booster, which is referred to as “mix and match” boosters. Talk with your health care provider about which product may be right for you. Learn more about who is eligible and when you can get your booster shot from the CDC .
Do boosters mean that the primary COVID-19 vaccines aren’t working?
COVID-19 vaccines are working well to prevent severe illness, hospitalization, and death. However, studies show that after getting vaccinated against COVID-19, protection against the virus and the ability to prevent infection with variants may decrease over time and due to changes in variants. Data from clinical trials showed that a booster shot increased the immune response in trial participants who finished a Pfizer or Moderna primary two-dose series, or who received a Janssen/Johnson & Johnson single-dose vaccine. With an increased immune response, people should have improved protection against getting infected with COVID-19 or having less severe illness.
When am I considered fully vaccinated?
In general, people are considered fully vaccinated two weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or two weeks after a single-dose vaccine, such as the Janssen/Johnson & Johnson vaccine. If you don’t meet these requirements, regardless of your age, you are NOT fully vaccinated. Keep taking all precautions until you are fully vaccinated. You are still considered fully vaccinated if you have not received your booster shot yet.
If I already had COVID-19 and recovered, do I still need to get vaccinated with a COVID-19 vaccine?
Yes, you should be vaccinated regardless of whether you already had COVID-19. That’s because experts do not yet know how long you are protected from getting sick again after recovering from COVID-19. Even if you have already recovered from COVID-19, it is possible – although rare – that you could be infected with the virus that causes COVID-19 again. Learn more about why getting vaccinated is a safer way to build protection than getting infected. You may be vaccinated as soon as you are out of isolation after having COVID-19 infection.
If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine. Talk to your doctor if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.
Experts are still learning more about how long vaccines protect against COVID-19 in real-world conditions. CDC will keep the public informed as new evidence becomes available.
Is it safe for me to get a COVID-19 vaccine if I would like to have a baby one day?
Yes. COVID-19 vaccination is recommended for people who are trying to get pregnant now or might become pregnant in the future, as well as their partners. There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in women or men. If you get pregnant after receiving your first shot of a COVID-19 vaccine that requires two doses (Pfizer or Moderna COVID-19 vaccines), you should get your second shot to get as much protection as possible. Learn more from the CDC.
What are the different types of COVID-19 tests?
COVID-19 tests can detect either SARS-CoV-2, the virus that causes COVID-19, or antibodies that your body makes after getting COVID-19 or after getting vaccinated. Tests for SARS-CoV-2 tell you if you have an infection at the time of the test. This type of test is called a “viral” test because it looks for viral infection. There are two types of viral tests: rapid tests and laboratory tests. Tests for antibodies may tell you if you have had a past infection with the virus that causes COVID-19. Your body creates antibodies after getting infected with SARS-CoV-2 or after getting vaccinated against COVID-19. Visit the CDC website for more on the types of COVID-19 tests .
Are IHS, tribal, and urban facilities testing for COVID-19?
Many IHS, tribal and urban facilities have access to testing for individuals who may have COVID-19. Contact your local IHS, tribal, or urban Indian organization facility for more information.
Do IHS, tribal, and urban facilities provide COVID-19 home test kits?
Self-testing is one of several risk-reduction strategies to reduce the chances of COVID-19 transmission. They may be used regardless of vaccination or symptom status. Many IHS, tribal and urban facilities have test kits that individuals may take home. Contact your local IHS, tribal, or urban Indian organization facility for more information.
Every home in the U.S. can also now order four free at-home COVID-19 tests . If you have difficulty accessing the internet or need additional support placing an order, you can call 1-800-232-0233 (TTY: 1-888-720-7489) from 8:00 am to midnight ET, 7 days a week.
What should individuals do if they have to wait for their test results?
Individuals should follow the advice of their health care provider. For a majority of individuals with mild symptoms, the CDC generally recommends staying home and monitoring your health to help protect your friends, family, and others from possibly getting COVID-19 from you.
When should you get tested for COVID-19?
Testing is critically important to help reduce the spread of the virus that causes COVID-19. If you have symptoms or had a known exposure to someone with suspected or confirmed COVID-19, you should be tested, regardless of your vaccination status. You may also consider self-testing to screen for COVID-19 immediately before an activity to see if you are positive for COVID-19. You should isolate if you test positive.
Should non-tribal members, who may live on a reservation or within a tribal community, go to an IHS facility for care?
IHS is the health care system for federally recognized American Indians and Alaska Natives in the United States. Non-beneficiaries may be able to receive care under a few different legal authorities. Specific questions about getting health care should be discussed with the health facility which you are looking to get care from. IHS has provided guidance regarding the treatment of non-IHS beneficiaries as necessary to prevent the spread of a communicable disease or otherwise deal with a public health hazard.
How can tribes, tribal organizations, and urban Indian organizations acquire materials such as personal protective equipment and sanitizers?
Tribal governments seeking assistance should first refer to Coronavirus (COVID-19): FEMA Assistance for Tribal Governments . These guidelines are intended for Indian Health Service, tribal health programs, and urban Indian organizations. IHS, tribal and urban Indian health programs should continue efforts to obtain needed supplies, especially personal protective equipment, through their established local processes, including any existing established relationships with state, city and county emergency operation centers. The National Supply Service Center in Oklahoma City also serves as a distribution center for personal protective equipment to IHS, tribal health programs, and urban Indian organizations.
Tribal Health Programs can access the Strategic National Stockpile in one of two ways once all local efforts have been exhausted:
- Follow specific guidance in Coronavirus (COVID-19): FEMA Assistance for Tribal Governments . Note: if a tribe chooses this method, IHS headquarters will not have visibility on the request. Please send an email to or CC IHS-SNS-Requests@ihs.gov to ensure that the IHS Incident Command Structure has the ability to track it once it has reached the FEMA WebEOC. Additionally, email or CC email@example.com to ensure the FEMA National Response Coordination Center tribal liaison is informed of the request. IHS can assist tribes as needed.
- Recognizing the sovereign status of tribes and the direct government-to-government relationship with tribes, tribal health programs may contact their respective IHS Area Emergency Management Point of Contact (EMPOC) who can provide technical assistance and will follow the steps in our Indian Health Service Federal, Tribal and Urban (I/T/U) Guidance to Accessing Medical Supplies and Personal Protective Equipment (PPE) through the Strategic National Stockpile (SNS).
What is the Strategic National Stockpile and do tribes have access to it?
The HHS Assistant Secretary for Preparedness and Response’s Strategic National Stockpile is the nation’s largest supply of potentially life-saving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local supplies to run out. When state, local, tribal, and territorial responders request federal assistance to support their response efforts, the stockpile ensures that the right medicines and supplies get to those who need them most during an emergency. The stockpile is organized for scalable response to a variety of public health threats. Strategic National Stockpile requests are limited to supplies and equipment for healthcare purposes only, and require that existing supply and other acquisition options be exhausted. For requests for personal protective equipment that are not healthcare related (law enforcement or other), please contact your FEMA Regional Tribal Liaison.
What funds are available to tribes and urban Indian organizations to address COVID-19?
The IHS has received a historic investment of more than $9 billion to provide resources for IHS, tribal, and urban Indian health programs to address long-standing health inequities experienced by American Indians and Alaska Natives by ensuring a comprehensive public health response to the ongoing COVID-19 pandemic. We have worked closely with tribes and urban Indian organizations throughout this pandemic to get resources out to facilities as quickly as possible.
What financial resources will be available to help tribes and urban Indian organizations recoup administrative costs associated with closures and overtime costs for our providers?
We encourage tribes, tribal organizations, and urban Indian organizations to work through all local, state, and federal avenues for any potential resources. We also encourage tracking costs associated with COVID-19 response activities. This information will help identify needs across the Indian health system and inform discussions about any potential additional resources that may become available.
How does the American Rescue Plan Act support Indian Country?
The American Rescue Plan Act includes more than $6 billion for the IHS. The resources included in this bill will assist IHS, tribal, and urban Indian health programs combat COVID-19, expand services, and recover critical revenues to better serve American Indian and Alaska Native communities.
What technical support is available for tribes to develop Emergency Planning protocols? Should tribes enact an emergency declaration to address COVID-19?
The Federal Emergency Management Agency has developed a Frequently Asked Questions tool for tribes to use in determining how to request a presidential emergency or major disaster declaration independently of a state. Additionally, Ready.gov, an official website of the Department of Homeland Security, has specific content geared toward Indian Country for general emergency preparedness , including ready-made resources that may be of value.
What resources are available to tribal communities for technical assistance in disinfection and/or sanitation protocols?
CDC has developed recommendations around environmental cleaning and disinfection protocols for health departments and other employers.
What resources are available to tribal communities for technical assistance in preparing for re-entry: key considerations for returning employees to the workplace during the pandemic?
The CDC and OSHA have both provided consistent guidance on considerations for returning to work. One CDC guidance page addresses what fully vaccinated people can now do and what steps they may still need to take. CDC provides separate guidance for those who are not fully vaccinated or otherwise at risk due to underlying health conditions. The OSHA workplace guidance focuses specifically on the unvaccinated or at-risk worker population. In general, the more closely employees interact with others and the longer that interaction, the higher the risk of COVID-19 spread. Unvaccinated or at-risk workers should continue to protect themselves by practicing everyday preventive actions. Tribal entities should support employees getting vaccinated and implement or maintain the 11 multi-layered preventions listed in the OSHA Guidance .
If there is an outbreak in my tribal community, how do we conduct an effective quarantine operation?
CDC has provided guidance about community mitigation plans for schools, workplaces, and community locations.
How can my community issue communications about COVID-19?
CDC has prepared guidance on how to develop a communications plan before an outbreak of COVID-19 in your community, during an outbreak, as well as post-outbreak communications.
What other federal resources are available to assist tribal communities?
Tribal governments and their members are an essential part of our nation’s emergency management team. FEMA is committed to supporting Indian Country in its efforts to build more resilient and better prepared communities. For additional questions, begin by contacting the FEMA Regional Tribal Liaisons in your area. FEMA's liaisons help build relationships with tribes in their area, helping them understand and use FEMA's programs — especially during times of disaster.
Is it safe to get healthcare during the pandemic?
Your health is essential. When it’s time to schedule an appointment, contact your local facility to make an appointment with your doctor. Staff will guide you to the best care option for your needs, whether that’s a telehealth visit, phone visit or in-person visit. We have implemented several new practices to help protect you so you can continue to get safe, quality care.
In an emergency, do not hesitate to call 911 or visit your nearest hospital emergency room.
Are there telehealth resources available for tribal citizens in rural area and areas distant from healthcare services?
In April 2020, the IHS announced the expansion of telehealth services during the COVID-19 response . Expanding telehealth allows more American Indians and Alaska Natives to access healthcare they need from their home, without worrying about putting themselves or others at risk. IHS service units and their clinicians who are using the system will obtain verbal consent from patients who meet with their provider via a telehealth appointment. Health care providers are required to verify the patient at the beginning of each encounter and are not authorized to record the session.
IHS has also made available telehealth specialty services to IHS hospitals as needed to respond to the potential surge in hospitalized and critically ill patients. This allows for critical care consultation for patients managed in an IHS intensive care unit, and for critically ill patients receiving care at hospitals without an ICU in the process of transfer to a higher level of care.
Many IHS facilities continue to use telehealth services by replacing office visits for things such as prescription refills for chronic conditions with phone calls for some patients. Service units are also screening individuals for COVID-19 either by phone or prior to the patient entering our health facilities to determine their risk for COVID-19 and to prevent additional infections within our facilities.
The HHS Office for Civil Rights will exercise enforcement discretion and waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency. Learn more here .
Can tribes and urban Indian organizations utilize Purchased/Referred Care to pay for quarantining, testing, or hospitalization of COVID-19 patients?
ll Indian Health Service Purchased/Referred Care programs are treating COVID-19 testing and treatment as medical priority one (emergent or acutely urgent care services) until further notice. Tribal health programs are not required to follow IHS medical priorities, but may choose to use them as guidelines. Urban Indian organizations do not participate in the PRC program but, consistent with the terms of their agreements with IHS, may use their existing funds for awards to subcontractors.
What mental health resources are available for individuals who may enter quarantine or become presumptive positive for COVID-19?
CDC has provided resources on coping with stress during the COVID-19 pandemic .
Does the IHS have the capacity needed to treat COVID-19?
IHS facilities have existing Purchased/Referred Care agreements with a vast network of specialty care providers. If one or more referral partners reach capacity, we can access other referral providers. IHS facilities are communicating and coordinating with their local and regional partners to ensure continued access to care for our patients.
Are there codes in the IHS Resource Patient Management System for COVID-19?
Following the Centers for Medicare & Medicaid Services and Centers for Disease Control and Preventions guidance, IHS has added diagnostic and testing codes to RPMS to capture data regarding COVID-19 as they become available. To address COVID-19, the IHS has released codes for the International Classification of Diseases 10th modification (ICD-10), Current Procedural Terminology (CPT), Systemized Nomenclature of Medicine Clinical Terms (SNOMED CT) and Healthcare Common Procedure Coding System (HCPCS).
How can tribes, tribal organizations, and urban Indian organizations escalate staffing resource requests through FEMA if they are unable to find critically needed staff through their usual resources?
The first and best method for tribal and urban Indian organization health programs to seek supplemental staffing is to follow their usual process for hiring and contracting staff, as well as their processes for onboarding volunteers. Staffing companies and recruiting firms should be utilized first. If tribal and urban Indian organization health programs are not able to access critical staffing through their usual method, they should inquire if state and local government partners can perform or contract for the performance of the requested work. If an organization desires to request Direct Federal Assistance, and the request for personnel is a result of the COVID-19 emergency and not a pre-existing condition, then they should contact their IHS Area Emergency Management Point of Contact (EMPOC) who can facilitate submission of a FEMA Resource Request Form for a request for staffing from the VA or the Department of Defense. This is done through a request for a Mission Assignment.
How do tribes, tribal organizations, and urban Indian organizations request deployments for USPHS Commissioned Corps officers?
During the COVID-19 national emergency, requests from tribes, tribal organizations, and urban Indian organizations for deployments of USPHS Commissioned Corps officers should also be elevated through the IHS Area Emergency Management Point of Contact (EMPOC). This would be considered a request for Direct Federal Assistance. The IHS Area EMPOC can facilitate submission of a FEMA Resource Request Form for a request for a Mission Assignment.
Who should prospective health care practitioners contact if they are interested in working or volunteering?
Health care practitioners interested in working or volunteering for the Indian Health Service should contact an IHS recruiter. Current vacancies are also posted in the Career Opportunities section of the IHS website.
What impact will COVID-19 have on the IHS Scholarship Program and Loan Repayment Program?
What impact will COVID-19 have on National Health Service Corps and Nurse Corps participants?
Please see the National Health Service Corps and Nurse Corps: Coronavirus (COVID-19) Frequently Asked Questions for information about these programs and their response to COVID-19.