MILWAUKEE (AP) — Coronavirus cases among American Indians in Wisconsin have tripled since Sept. 1, far surpassing the growth rate among other races.

Data from the state Department of Health Services as of Wednesday showed 59 new cases and one additional death among American Indians in Wisconsin. That raised the total to 2,333 Native Americans testing positive, up from 775 cases as of Sept. 1. Twenty-three American Indians have died due in Wisconsin to COVID-19 this year, the agency said.

“The numbers are outrageous,” Shannon Holsey, president of the Stockbridge-Munsee Mohican tribe, told the Milwaukee Journal Sentinel. “It’s scary.”

The figures include Native Americans who live on reservations and those who live elsewhere.

“The disease is catching up with everybody now,” said German Gonzalez, director of the Great Lakes Inter-Tribal Epidemiology Center. “It was just a matter of time.”

Several races tracked by the department also have seen significant increases since Sept. 1. The number of cases among whites was up 167%, while cases among Asians or Pacific Islanders rose 91% and the increase among blacks was 47%.

The COVID spike in Indian country occurred even though each of Wisconsin’s 11 tribes have enacted orders aimed at stemming the outbreak. The orders included closing casinos, limiting access to some reservations, safer-at-home rules and curfews. Some limited or banned visitors to nursing homes. Some have delivered food and medical supplies to elders.

“The tribes were extremely, extremely cautious,” said Matthew Dellinger, an epidemiologist at the Medical College of Wisconsin and a co-investigator at the Great Lakes Native American Research Center for Health.

Through the summer, several tribes reported just modest impacts thanks to the location of the tribes in remote areas and protective measures. The numbers in Indian country started jumping in the fall, when cases started skyrocketing throughout northern Wisconsin.

“The numbers would be a lot worse if the tribes didn’t take ... the measures that they have,” said Thomas Boelter, administrator of health and wellness for the Forest County Potawatomi.

Of particular concern is the high rate of risk factors such as diabetes, heart disease and asthma among Native Americans.

“A lot of my tribal members have compromised immune systems,” Boelter said. “Thank the Creator it hasn’t been worse than it is.”