Two weeks ago, as the coronavirus was spreading across the U.S., Shanna Yazzie loaded the bed of her gray Toyota Tacoma pickup truck with as many empty, five-gallon containers as she had in her house and drove 25 miles on unpaved desert roads looking for a place to fill them with water.

This is a routine for Yazzie, 38, one of the 2 million Americans who live without access to running water. She lives in Cameron, Arizona, a town of fewer than 900 on the edge of the Navajo Nation, where one-third of the reservations 350,000 residents lack running water and sanitation.

Native Americans are 19 times more likely to lack indoor plumbing than white Americans, according to a report published last November by the human-rights group DigDeep, where Yazzie works, and the nonprofit U.S. Water Alliance.

Keeping water stocked in the home she shares with her 10-year-old son, 17-year-old daughter and 79-year-old mother is a chore on a good day. But as confirmed cases of COVID-19, the respiratory disease caused by the novel coronavirus, surged from two to 39 on the reservation this week, the Navajo phrase t water is life took on a warped new meaning. Yazzie has struggled to tamp down a nauseating sense of dread.

The anxiety is sickening, she said by phone Tuesday. Your mind keeps racing with what ifs. You cant eat. You lose your appetite. Youre shaking. Youre sleepless. Your mind, it just constantly races with negative thoughts. Thoughts like, Were gonna die.