LINCOLN, Neb. -- President-elect Joe Biden is considering canceling the permit for the Keystone XL pipeline project as early as day one of his term, which could be good news for Native American communities in Nebraska living near crowded worker camps during the pandemic.

Wesley Furlong, staff attorney for the Native American Rights Fund, said Indian Country is at greater risk of illness and death from COVID-19 due to a systemic lack of access to quality health care, which has led to higher incidences of heart disease, diabetes and obesity.

"Because there's been generational lack of adequate health care in Indian Country, you have very vulnerable populations who have pre-existing conditions, who have the co-morbidities that make this virus especially deadly if you catch it," Furlong contended.

He said the Rosebud Sioux Tribe on Nebraska's northern border has less than five respirators for its 15,000 residents, and zero respiratory therapists.

The Petroleum Equipment and Services Association told High Country News it was initially concerned about testing, quarantining and other COVID-related safety measures for workers, but the group now is confident that most operators have "gotten the hang of things."

Furlong is skeptical, pointing to a lawsuit involving TransCanada, now called TC Energy.

While the company had announced safety measures including mask wearing and social distancing, when construction started, Furlong said those protocols went out the window, people were grouped together and not wearing masks.

"I think if industry was really doing what it could to keep their employees and the people in the communities that they are operating in safe, they wouldn't be bringing in hundreds or thousands of people to live in very close quarters," Furlong asserted. "It's the exact opposite of what should be happening during a pandemic."

A TC Energy spokesperson responded by email, saying the safety of its crews and the public are core company values.

Furlong noted one challenge protecting tribes from outbreaks at transient work camps is that official COVID case counts are recorded in a workers' home state, not in the county where they are working.


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As the new year unfolds, rural health providers in North Dakota and other states will continue to have extra latitude in using telehealth technology. But a temporary extension of key rules still leaves uncertainty.

When Congress avoided a government shutdown in late December, it approved a funding resolution that runs through mid-March. For the next few months, that plan keeps in place relaxed telehealth regulations for people on Medicare that started during the pandemic.

Even though telehealth use has declined since the COVID emergency ended, said Brad Gibbens, deputy director of the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences, this option is still useful in remote areas.

"People can not only stay in their own community and interact with a physician or another type of provider and not having to travel," he said, "they can actually, in many cases, do this right out of their home."

He added that because these interactions are timelier, telehealth cuts down on health-care costs by reducing hospital admissions. A number of health organizations want the relaxed rules made permanent, so providers can better plan for them and patients don't lose continuity.

Telehealth access has bipartisan support, but skeptics have voiced concerns about privacy breaches and lower quality of care.

Gibbens stressed that telehealth should not be seen as a replacement for in-person visits. When the situation allows, he said, doctors still prefer having a patient come see them.

"They feel they get more of a review of the patient by seeing their body language and how they react," he said, "and it's kind of the nature of medicine."

However, Gibbens disagreed with assertions that there's a dropoff in the level of care when the visit happens online. He said that for patents in areas with very limited provider access or transportation gaps, telehealth is better than no care at all. He added that broadband investments have helped smaller clinics overcome technology barriers in enhancing online appointments.


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Holidays are traditionally a slow time for blood donations, but recent events have made the need for people to give blood and plasma in the Magnolia State even more urgent.

Following the deaths and injuries from a terrorist attack in New Orleans in the early hours of New Year's Day, Mississippi officials have pitched in to supply blood for victims of the violence. As a member of the Blood Emergency Readiness Corps, Mississippi Blood Services is supporting the efforts of the Blood Center of New Orleans.

Kasey Dickson, Mississippi Blood Services' director of public relations and marketing, said they have immediate needs.

"We are desperately looking for individuals that are eligible to donate platelets," she said, "as well as individuals with the blood types of O, negative or positive, and B, negative or positive."

Dickson said the agency is contacting its list of regular donors as well as putting out a call for new ones. Donations can be made at the blood centers in Flowood, in Cleveland and Oxford, and at mobile vans around the state. To find one, look online at MSBlood.com or call 888-90-BLOOD (888-902-5663).
Dixon said donors need to be at least 17 years old, be in general good health and complete a health history questionnaire. Approved individuals can donate about every two months, platelets every seven days, and plasma once a month.

"Fortunately, the donors of Mississippi helped get our supply ready, and we were able to ship enough products to assist the Blood Center of New Orleans ahead of time," she said. "And now, we're wanting to replenish our supply, so we can continue those efforts to help them."

Dickson said it was an honor to help another state with blood in its time of need, but added that it's equally important to care for Mississippians. She said people need to remember that blood isn't created, it's given.

"Blood itself can only be donated," she said. "It cannot be manufactured in a tube or re-created in a tube, so it has to be given from person to person."


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With the 2025 legislative session around the corner, the nonprofit advocacy group Alabama Arise said it plans to take aim at poverty and systemic challenges that hit families the hardest.

Big issues like health care access, public transportation and unfair court fines often weigh on lower-income families.

Robyn Hyden, executive director of Alabama Arise, said it is time for state leaders to step up and tackle the concerns.

"Our state, because we underfund state government and we underfund our court systems, we heavily rely on fines and fees that really disproportionately hurt low-income families and working families," Hyden contended.

Hyden believes cutting court fines and fees could be life-changing for some, freeing up money for essentials like food and health care. She highlighted the need for Medicaid expansion, removing the grocery tax and protecting voting rights as top priorities for 2025. State legislators have so far refused to expand Medicaid.

One of the most pressing issues Alabama Arise wants to see addressed is health care during and after pregnancy since the state has among the highest rates of maternal and infant mortality. A new report from Pregnancy Justice shows Alabama led the nation with 104 prosecutions of pregnant people in the year following the Dobbs decision.

Hyden stressed she wants to see an end to the state criminalizing pregnancy-related issues and instead, improving access to prenatal care.

"We don't think that women should be prosecuted because they have a miscarriage," Hyden emphasized. "We believe that health care providers should be able to provide lifesaving care to women in those situations. And we believe that when women are given drugs during labor, which does happen, they should not then be incarcerated or have their children removed."

The legislative session begins in February. Hyden added Alabama Arise is planning an advocacy day in March to unite voices in support of low-income and working families.