(CNN)The Navajo Nation has extended its lockdown for three more weeks to try to slow the growth of Covid-19 cases in the community that has already filled nearly all of their ICUs to capacity.
Navajo Nation implements another three-week lockdown as ICUs reach capacity amid coronavirus surge
"We are near a point where our health care providers are going to have to make very difficult decisions in terms of providing medical treatment to COVID-19 patients with very limited resources such as hospital beds, oxygen resources, medical personnel, and little to no options to transport patients to other regional hospitals because they are also near full capacity," Navajo Nation President Jonathan Nez warned in a statement issued Sunday.
A public health order issued by the Nation said it is "experiencing an alarming rise in positive COVID-19 cases and uncontrolled spread in 75 communities across the Navajo Nation."
The Navajo Department of Health has reported 17,915 confirmed cases in the Navajo Nation, and 667 deaths as of Monday morning. It has a population of 173,667, according to Census data.
"Navajo Area IHS has reported that nearly all ICU's beds are at full capacity and other bed space is also filling up quickly due to the rapid rise in COVID-19 cases," Nez said in a statement Sunday.
Starting Monday the extended Stay-At-Home Lockdown order will require all residents to "remain at home 24-hours, seven days a week, with the exceptions of essential workers," according to a statement from Navajo Nation leaders.
This lockdown comes as Covid-19 cases continue to surge across the United States, with record numbers of daily new cases and hospitalizations reported every day the first six days of December.
While some states have opted not to order additional restrictions, this is one of several lockdowns that the Nation has ordered over the course of the pandemic, as resources in the area are scarce and even small increases in cases among the community can have catastrophic results.
The Navajo Nation was a prominent hot spot for Covid-19 in the United States earlier this year. In May, it surpassed New York and New Jersey for the highest per-capita infection rate. Nez cited multi-generation living situations, a lack of running water, and fewer places to purchase food as causes for increased spread of the disease in May.
"This second wave of COVID-19 is much more dire and much more severe than the first wave we had in April and May," Nez said Sunday.
Under the new lockdown, only essential businesses are permitted to operate, and only between the hours of 7 a.m. to 7 p.m. MT Monday through Friday. The previous lockdown, which was issued on November 13, permitted businesses to be open daily from 7 a.m. to 3 p.m.
Essential businesses include gas stations, grocery stores, laundromats, restaurants and food establishments that provide drive-thru and curbside services, as well as hay vendors, the statement said.
The order also re-implements full 57-hour weekend lockdowns for three additional weekends from 8 p.m. local time through 5 a.m. local time, starting next weekend and lasting through the weekend following Christmas.
Outdoor activity such as walking or hiking is allowed, but residents are encouraged to stay within five miles of their homes, the public health order said.
Members of the Navajo Nation are being urged not to gather or travel off the reservation land to keep them safe from possible contamination and prevent further spread of the virus among the community.
Clusters withing the community have been identified as "a direct result of family gatherings and off-Reservation travel," the public health order said, leading to "an outbreak and a second surge in cases on the Navajo Nation."
"The Navajo Nation's health care system is in a state of major crisis," Navajo Nation Vice President Myron Lizer said in the statement issued Sunday. "We, as citizens of the Nation, have to step up and do more to protect ourselves and our loved ones. We cannot be careless and we have to stay the course."
The Navajo Nation spans parts of Arizona, New Mexico and Utah. All three states are seeing increases in cases and deaths associated with the virus over the last month.
In New Mexico, 202 people died from the virus last week, Gov. Michelle Lujan Grisham said in a tweet on Friday.
"We have lost 202 of our fellow New Mexicans to COVID-19 in the last week alone, a number that took 46 days to reach at the outset of the pandemic," the governor wrote. "Please do your part to slow the spread."
In Arizona, the percentage of positive tests for the most recent full week jumped to 18% from 15% the week before, Gov. Doug Ducey said in a tweet on Sunday.
ICU bed usage by Covid-19 patients increased to 714 and the number of ventilators in use by Covid-19 patients increased to 462 Sunday, Ducey tweeted.
The entire state of Utah has 215,407 confirmed total coronavirus cases as of Monday morning, according to the state's health department Covid dashboard, and many regions are currently listed as having a a "very high rate" of transmission.