GALLUP, N.M. (CNN) – COVID-19 is hitting the Navajo Nation Particularly hard. There are now more than 1,000 cases and more than 40 deaths. CNN’s Gary Tuchman looks at how medical professionals are dealing with the pandemic.

A nurse in yellow is being suited up, the protective mask she is wearing is a welder’s mask. Personal protective equipment is such a premium that this hospital has bought 60 masks from a welding company. This is one of the many challenges for the Gallup New Mexico Indian Medical Center, which sits adjacent to the remote splendor of America’s Navajo Nation.

“This is the largest ICU, in Navajo Nation,” said Dr. Jonathan Iralu of the Indian Health Service. An infectious disease expert for the Federal Indian Health Service takes CNN’s Gary Tuchman inside the intensive care unit.

“We’ve transformed this kind of regular ICU into a covid unit. We’re doing things we never would have thought were proper, like put the IV pulls out here on the doorway. We’re trying not to trip over them. This is the best way for the nurse to be able to manage the medications without having to put on PPE every time the nurse goes into the rooms.” In that room, a very sick woman who has been on a ventilator for about a week. And in a nearby room, a woman who appears to be in even more dire shape, about to get what’s known as a fresh frozen plasma transfusion. “Yeah, it’s an FFP transfusion to prevent bleeding problems at this time, so it’s part of a resuscitation. You’re going need (a) deep breath,” said Dr. Jonathan Iralu.

Reporter: “How seriously ill?

“That’s a very critical person right now,” said Dr. Jonathan Iralu.

While this is the largest ICU of the four Indian Health Service Hospitals in the Navajo area, it is much smaller than you would likely think. There are six rooms right now. They’re all full. Often what happens when people come in and have to go into the intensive care unit and there are no rooms is that they have to be flown 130 miles to Albuquerque. It’s very upsetting for members of the Navajo Nation to leave their nation, unfortunately that’s become a necessity

Patients are also flown to larger hospitals who have COVID-19 already in the ICU and need special surgery or procedures that aren’t able to be done in such a rural area. “The Navajo people live between four sacred mountains and in general people prefer to stay in this area. They’re basically their Homeland,” said Dr. Jonathan Iralu. “Many of our staff speak Navajo, so it’s a, it’s, it’s very comfortable for them here on Navajo Nation.”

When members of the Navajo Nation feel they might have COVID-19 they are initially seen outside the hospital in tents that have been set up. Those suspected COVID patients are first brought to the emergency room. Patients are evaluated and might go to a coronavirus ward.

The Navajo Nation, with about 175,000 residents has more cases of COVID-19 than nine entire states. More deaths than 13 states. According to the chief medical officers of the Navajo Area Indian Health Service, “I do not believe we have hit our peak yet,” said Dr. Loretta Christensen the Chief Medical Officer of the Navajo Area Indian Health Service.

Authorities believed there are enough ventilators but the PPE shortage is very concerning. “I try to tell him to be strong… and try to get some rest so that they stay healthy,” said Dr. Jonathan Iralu/ Indian Health Service

Gary Tuchman/Reporter: “But it weighs on you.”

Dr. Jonathan Iralu/ Indian Health Service: “It does.”

This day decision is made. The woman in a room who needed a transfusion also needs critical care she can only get in a bigger city. She is brought out on a stretcher and will be taken by ambulance to a plane for a flight to a bigger city hospitals where doctors will try to save her life.

Last month’s $2 trillion stimulus package included $500 million for Indian affairs and $8 billion for tribes but community leaders say it isn’t enough to meet supply shortages and infrastructure shortcomings like broadband and drinking water. Many Native American communities like some Alaskan rural villages lack basic infrastructure to adequately deal with the pandemic in the first place.

New Mexico Coronavirus Resources