NAVAJO & APACHE COUNTIES — Rural Arizona counties are preparing for the apocalypse.

Well – providing they get the grant.

To be specific, Navajo County along with Apache and Gila counties are all lining up for state and federal money to plan a comprehensive response for the kind of pandemic that killed 50 million people after World War I, as a virulent strain of the flu drifted across the world.

The Navajo County Board of Supervisors at its last meeting approved the application for a $250,000 grant from the State Department of Health Services and the federal Centers for Disease Control to establish a system to rapidly distribute antibiotics, vaccines and newly developed drugs in the event a pandemic rips through Arizona. The grant application will come before every county in the state in the next several months, courtesy of the Arizona Bureau of Public Health and Emergency Preparedness.

It sounds like science fiction spawned by a dark mind, but public health experts warn that the nation remains woefully unprepared for fast-spreading, potentially incurable diseases. A recent case in point is Ebola, now once again rippling through the Congo. The fast-spreading viral disease has a 65 percent mortality rate. The Congo has had 10 outbreaks in the past 40 years, with the most recent spread killing 1,800 people.

Most Americans think of the threat of such pandemics as a Third World problem, held at bay here by modern sanitation and healthcare systems.

However, the Bill and Melinda Gates Foundation has been battling AIDS, malaria and other diseases for more than a decade through the world’s largest charity. At a conference, he recently warned that the world remains woefully unprepared for deadly viruses and bacteria incubated by overcrowding, poor sanitation, overuse of antibiotics and global travel patterns.

Medical researchers have developed only a handful of effective vaccines against viral diseases. Tragically, many poor countries can’t afford the vaccinations and in many rich countries exaggerated fears of vaccine side-effects have left much of the world vulnerable to even well-known viral disease like measles.

The Navajo County Board of Supervisors at its last meeting approved the development of a Public Health Emergency Preparedness program, to train county workers to receive, distribute and stockpile critical items – like vaccines, antibiotics and other medications needed to cope with a pandemic or “outbreak event.”

The program would also help local hospitals to set up protocalls and systems to handle the huge number of potentially infectious patients such an outbreak could generate.

Each county will have to provide a detailed budget to qualify for the state and federal support. The county will establish a point-person in the event of such a medical emergency, train workers to handle the crisis and pull together local coalitions of healthcare workers and public safety officials.

The state has set up four regions to coordinate responses. Navajo and Apache counties are in the Northern region, along with Coconino and Yavapai counties as well as the Hopi, Kaibab-Paiute and Navajo reservations. Gila County’s in the Central Region, along with Maricopa and Pinal counties and the Gila River, San Carlos Apache, White Mountain Apache and Salt River Pima-Maricopa tribes and communities.

Each county and tribe can apply for state and federal money to pull together its public health emergency plan.

Rural counties have lower population densities, which reduces the speed with which a pandemic can spread. However, rural areas in Arizona also have less access to healthcare – including vaccines. One survey showed only 51 percent of people living in rural America have job-based healthcare coverage, compared to 57 percent in urban areas. The Affordable Care Act drove down the percentage of Americans without health coverage to the lowest levels in decades, but rural areas still lagged. About 30 percent of rural residents get their healthcare covered through the Arizona Affordable Health Care System (AHCCCS), but the state-run healthcare system for low income workers has far fewer healthcare clinics and facilities in rural areas.

Vaccination rates lag even for established diseases easily preventable with safe vaccines. It requires a 95 percent vaccination rate to acquire “herd immunity” from common viruses like measles, mumps and rubella. But statewide, the vaccination rate has fallen to 93 percent, according to the state department of health resources.

Only about 40 percent of the state’s kindergarten students have a vaccination rate high enough to prevent the spread of a measles outbreak – much less still-incurable diseases like Ebola or the kind of flu strain that proved so lethal worldwide in 1918.

The vaccination rate by county for kindergartners in 2019 stood at 92 percent in Apache County and 93 percent in both Gila and Navajo counties, according to the State Department of Health Resources. All three counties fall below the 95 percent threshold for “herd immunity,” which dramatically slows the spread of a virus through the population.

The potential for lethal damage from a new viral threat like AIDS, Ebola or a version of the 1918 flu virus is potentially even greater, since such a virus would spread quickly without an effective vaccine and only limited drug options for treatment. That’s why the state is scrambling to get each county to set up an emergency response system in case such a virus does get loose.

Peter Aleshire covers county government and other topics for the Independent. He is the former editor of the Payson Roundup. Reach him at

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