The Navajo Nation has surpassed New Jersey and New York for having the highest per-capita coronavirus infection rate in the US.

The Navajo Nation that spans part of Arizona, New Mexico and Utah has an estimated population of 173,667. As a result, with 4,002 cases, the Native American territory has 2,304.41 cases of Covid-19 per 100,000 people. By comparison, according to data from Johns Hopkins University, currently New York state has a rate of 1,806 cases per 100,000 and New Jersey is at 1,668 cases per 100,000.

In a recent interview, Navajo Nation President Jonathan Nez said Sunday that the nation has one of the strictest stay-at-home orders in the country. The order mandates residents not leave their homes unless there is an emergency or they are essential workers. Those who leave home for work must have documentation on company letterhead with a verifiable contact number for a manager in order to go.

For the last few months the nation has been on weekend lockdowns to prevent members from being out and risking infection but case numbers have continued to rise.

Nez said there has been a huge spike in cases among the population, resulting in 140 deaths for the entire nation as of this past weekend.

Part of the reason for the spike is increased testing capacity. More than 23,791 members, or 11% of the population of the Navajo Nation, has been tested for the virus, Nez said.

Another reason for the large number of cases on the Navajo Nation is living accommodations. ”Multiple generations live in one home. When one person gets Covid, goes home, they turn to infect the rest of the family,” Nez said.

In addition, 30% to 40% of residents do not have running water, Nez said. That prevents everyone from being able to wash their hands as often as recommended.

Another challenge: the nation is described as a “food desert,” meaning that more people are at the few grocery stores, convenience stores and gas stations to purchase food. Fewer options of businesses, increases the odds of exposure.

“When we run out of food or supplies we have to go to the stores and there is a lot of people there and I believe…the spread is happening there as well as at home,” Nez said.

Nez is urging residents to continue to stay in lockdown as much as possible and maintain good hygiene practices.

“With every passing day, we are a day closer to beating COVID-19. Whether we realize it or not we are winning the war on this virus,” Nez said. “We have to stay the course when it comes to staying home as much as possible, wearing masks in public, washing our hands often, and taking every precaution to ensure our health and safety especially for our elders and children.”