The coronavirus spread rapidly throughout crowded cities in the country. But one rural area has more COVID-19 cases per capita than nearly any other place in the United States: the Navajo Nation.

The Navajo reservation is almost as big as the state of South Carolina. And on much of it, there aren't paved roads or running water.

Speaking with Morning Edition host Rachel Martin on Wednesday, the president of the Navajo Nation, Jonathan Nez, said that out of the more than 20,250 Navajo people tested for the coronavirus, 3,245 have tested positive for COVID-19. "We have 103 deaths on the Navajo Nation," he said.

While the Navajo Nation's case rate may seem high, said Nez, it is due in part to what has been an aggressive approach to testing.

Here is more from the conversation:

Can you help us understand why the infection rate has been so high within the Navajo Nation? ... Just 175,000 people live there. People are spread out, presumably. Why is the infection spreading?

Well, Rachel, we're testing very aggressively here on the Navajo Nation. ... We have tested about 8% of our population compared to 2%, a little bit over 2% of the U.S. population. So we are testing very aggressively. I know that people are saying per capita we're higher than New York and New Jersey. But we need to also keep in mind that we have been getting a lot of test kits here on the Navajo Nation and testing our citizens with the Abbott ID NOW analyzers and the older type of rapid test kits, the swab tests. Those swab tests ones take about 48 hours before we get the results, while the Abbott ID NOW takes less than 15 minutes to give us a result.

So you're getting quick results, which is putting your numbers up. The federal government has agreed to provide $8 billion to tribes. That was in March. Your portion of that money was $600 million. How did you spend it?

We just got that a week ago. We had to take the federal government to court so that they can release those dollars. The Cares Act was approved and signed into law over seven weeks ago while the rest of the country, municipalities and townships and counties and states have been utilizing those dollars, tribal governments, 574 tribes just last week received their money. And of that $8 billion, only 60% of that total amount was given to tribes. So we're still going to be waiting for the 40%.

... We are in the process now here on the Navajo Nation to do an expenditure plan of how these dollars are going to be spent. We're going to be putting it into personal protection equipment. We're going to also put money for hazard pay, we're hoping. And we're also looking at the immediate needs of food and supplies to our Navajo people. You know, clear across the country you have seen food distributions happening and we want to do something similar here on the Navajo Nation.

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