The novel coronavirus is terrorizing Indian country. The Indian Health Service (IHS) reports 7,244 confirmed cases of covid-19. Since March the Navajo Nation, with homelands stretching over Arizona, New Mexico and Utah, has emerged as a hot spot.

The virus has taken the lives of 142 Navajos and the covid-19 infection rate is at 2,304.41 per 100,000 people, giving the Navajo Nation a higher per capita infection rate than both New York and New Jersey. The situation has spurred Doctors Without Borders to send a team to Navajo Nation, a signal of the magnitude of the disaster.

The coronavirus is the latest epidemiological invasion in a long history of unwelcome foreign pathogens for indigenous people of the Americas. Since Columbus reached the Americas for the first time in 1492, foreign diseases have reshaped native communities. According to one recent study, the Americas were home to 60 million people before European colonization, only fractionally less than Europe’s population in the 1600s. Yet, between 70 and 90 percent of Native American populations were killed by diseases brought from overseas, like mumps and smallpox, between 1492 and the opening decades of the 20th century.

This data makes for grim reading. But such high death tolls were due not only to diseases themselves. Europeans brought viruses like smallpox, but their presence also led to deaths of indigenous people due to cholera and typhus. These ailments arose from transatlantic commerce, for example from the lice, ticks or fleas brought on trading and slave ships, and from contaminated drinking water that resulted from polluted waterways due to European settlements.

In short, European colonialism changed local ecosystems at unprecedented speeds, accelerating the effects of climate change and disrupting the ability of indigenous healers to treat the sick. These same vulnerabilities continue to exist today, showing why covid-19 is so deadly in Indian country as indigenous people once again fight disease amid today’s climate change crisis.

Before Columbus’s invasion of the Americas, indigenous people grappled with an extended period of warming, which scientists call the medieval warm period. Between 900 and 1300, some regions of the Americas experienced higher temperatures and drought, leading to crop failures, hunger and displacement. Other regions, such as Southeastern North America, experienced warmer, wetter conditions and improved crop yields of corn and other staples.

While the people of this region fared well during this period, they contended with illness and disease. Native people dealt with tooth decay, a marker of a diet high in carbohydrates, for example. Others suffered broken bones, anemia, osteoarthritis or spondyloarthropathy. And in other cases, tuberculosis invaded the lungs and brought life to a premature end.

But native communities developed social systems and medical and spiritual traditions to treat the sick and care for the dying. Those traditions proved adaptive, as spiritual leaders and healers worked to balance the health of human communities with larger ecological considerations with the onset of the Little Ice Age in the 14th century. As Southeastern Native Americans adapted to fluctuations in local ecosystems, they eventually established permanent towns along riverbanks. The healers in these communities oversaw “going to water” ceremonies to cleanse the body and nourish the souls of tribal members, while administering ginseng to people suffering from stomach ailments.

The delicate balance of human and natural ecologies came under sustained assault when European colonizers began intruding on native homelands during the mid 1500s. Across Indian country, the scale, speed and duration with which Europeans altered local ecosystems and became vectors for diseases like smallpox, measles, mumps, chickenpox, influenza, cholera, diphtheria, typhus, malaria, leprosy and yellow fever caused epochal shifts in balance and harmony throughout Indian country.

For the Diné people, popularly known as the Navajo, achieving a balance between the local ecology and human health and harmony — a principle known as hózhó — became that much harder. As historians and epidemiologists have pointed out, the antibody responses of Native Americans to diseases like smallpox proved no less efficient than that of early modern Europeans.

What changed was the way colonialism rapidly altered local ecosystems and exposed native communities to zoonotic diseases — those that pass from animals to humans. This proved the case for the Diné and tribal communities throughout the West. From the late 16th century, European colonizers introduced livestock and placed humans and animals in much closer proximity, resulting in increased fatalities from zoonotically transmitted diseases. In the 1780s and 1790s, smallpox brought Comanche communities to their knees, and a half-century later, tribal nations confronted the Great Plains smallpox epidemic that lasted from 1836 to 1840.

When the Diné adapted and eventually incorporated livestock into their economies, colonial policies disrupted their ability to adapt to changing ecologies and epidemiological threats. Coerced onto reservation lands at the four corners of Arizona, Utah, Colorado and New Mexico by the United States government in the late 1860s, Dinés also came into conflict with settler communities who then urged federal officials to remove Navajo sheep from federal lands. This devastated the Diné economy, ultimately leaving people impoverished and ill-equipped for the influenza pandemic of 1918-19, which killed almost 2,000 Navajo people.

Health disparities experienced by native communities grew during the 20th century as colonial incursions on local ecosystems intensified. The construction of the Hoover Dam and the diversion of rivers to supply coal mines and provide electricity to suburban homes, combined with the pesticide pollution of the Navajo aquifer to exacerbate social, economic and health disparities for the Navajo Nation.

Many of those assaults continue today. The chronic shortages of freshwater in the Navajo Nation is a direct result of 20th-century mining and dam construction that diverted water away from the Diné. This shift in the local ecology makes combating coronavirus difficult; it’s not easy to wash your hands with soap and water, or perform traditional healing ceremonies, when there’s no water.

After more than five centuries, European colonialism and capitalism continue to test the health and resilience of native communities, which are acutely vulnerable to pandemic disease as well as the effects of climate change. In 2009, the H1N1 pandemic saw much higher rates of mortality in Indian country than in the general population. Covid-19 is the latest chapter in that history, a history defined by non-indigenous powers transforming landscapes, damming rivers and engaging in the ecologically unsustainable pursuit of endless economic growth.

As Dina Gilio-Whitaker (Colville Confederated Tribes) argued recently, “We must change the way we inhabit the planet.” If we don’t, covid-19 won’t be the last pandemic we see in our lifetimes. And it may not be the worst.