Administration Core

COVID-19在世界各地和整个美国的传播带来了现存的差异， 医疗资源和能力成为新的重点，因为COVID 19的各种健康，经济和社会危害不成比例地落在投资不足的社区。检测能力持续受限，医疗 基础设施和资源，以及强大的社区合作伙伴关系正在导致COVID-19的更大传播， 在平衡预防性隔离与经济决策方面更加困难，并且缺乏数据来指导公众 卫生政策。与此同时，克服这些问题的努力是由遥远的团体领导的， 知情或同意不仅会导致促进无效的解决方案，而不是当地的需求，而且还可能 使对健康、社会和经济问题的持续危害永久化。因此，旨在解决 在资源不足的环境中，COVID-19公共卫生能力必须包括当地资源、当地同意， 并确保参与者的长期能力，共享公平和数据控制。在这里，我们建议利用 斯坦福大学医学院与部落附属机构之间的现有资源和伙伴关系， 现有的实验室基础设施，用于进行COVID-19诊断测试，健康咨询， 公共卫生数据管理和政策。这充分利用了原生生物数据构建的现有资源 联盟（NBDC）-一个由土著人领导的研究小组-从其与SPHERE项目1美国印第安人能力，教育，法律，经济和技术生物库（BRAICELET）中心的合作。 这里提议的工作旨在使部落管理的保健资源在6年内投入运作， 持续进行COVID-19诊断测试和监测，以改善公共卫生。

The spread of COVID-19 across the world and throughout the United States has brought extant disparities in health care resources and capacity into new focus as the various health, economic, and social harms of COVID19 disproportionately fall upon under-invested communities. Ongoing limitations in testing capacity, medical infrastructure and resources, and strong community partnerships are leading to greater spread of COVID-19, more difficulty in balancing precautionary isolation vs economic decisions, and a lack of data to guide public health policies. At the same time, efforts to overcome these issues that are led by faraway groups without local knowledge or consent can not only result in the promotion of ineffective solutions over local needs, but can also perpetuate ongoing harms to health, social, and economic concerns. Therefore, solutions that aim to address COVID-19 public health capacity in under-resourced environments must include local resources, local consent, and ensure long-term capacity, shared equity, and data control for participants. Here, we propose to leverage pre-existing resources and partnerships between the Stanford School of Medicine & tribal affiliates to upgrade existing laboratory infrastructure for conducting COVID-19 diagnostic tests, health consultations, and tribe-wide public health data management and policy. This capitalizes on existing resources built with the Native BioData Consortium (NBDC)—an Indigenous-led research group- from its collaboration with the SPHERE Project 1 BioRepository for American Indian Capacity, Education, Law, Economics, and Technology (BRAICELET) center. The work proposed here was designed to result in a tribe-governed health resource being operational within 6 months to conduct COVID-19 diagnostic tests and monitoring on an ongoing basis for improved public health.