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COVID Slams Ethnic Minorities

As the COVID-19 vaccination program rolls out erratically across the US, research increasingly shows that health inequities underlying who gets infected will also affect who gets vaccinated.

In telling statistics reported by the CDC and KFF, people of color are more likely to be infected or hospitalized, and more likely to die from the coronavirus.

The numbers are stark.

Compared to whites, American Indians are 1.9 times more likely to be infected, African Americans nearly 3 times more likely to be hospitalized, and Latinx people 2.4 times more likely to die.

Asian Americans are the highest risk for hospitalization and death among any ethnic group. In San Francisco, it’s reported that  Asian Americans consistently account for nearly half of COVID-19 deaths.

It’s impossible to ignore the disproportionate toll of the pandemic on racial and ethnic minorities. Even though all communities are at risk for COVID-19, the socioeconomic status of people of color, and their occupations in frontline, essential and infrastructure jobs puts them at greater risk of exposure to the coronavirus.

For minority communities, it means that where you live and where you work shapes how the virus impacts your health, while inadequate access to healthcare makes you more vulnerable to its consequences.

“The pandemic has exposed the “underlying health disparities, social determinants of health, systemic inequalities and discrimination contribute to the disproportionate impact the virus has had on all communities of color,” said Adam Carbullido of AAPCHO, at an EMS press briefing on February 12, about health inequities in the pandemic.

Health advocates predicted that an inequitable distribution of vaccines was inevitable, given the high rates at which Blacks, Latinos and other ethnic groups were being infected and dying in each wave of the pandemic.

This is borne out by data from the Kaiser Family Foundation (KFF) which is tracking vaccine distribution. For example, fewer black people are getting vaccines despite a higher rate of COVID 19 cases. In Delaware only 6% of Blacks were vaccinated though 24% were infected, and in Louisiana, only 13% of Blacks received vaccines though 34% were infected, while in Mississippi, 38% of Blacks were infected but only 17% got the vaccine.

However, the lack of disaggregated racial data at the state and national level is hobbling equitable distribution of the COVID-19 vaccine, noted Dr. Daniel Turner-Lloveras of the Latino Coalition Against COVID-19. Currently only 20 US states are reporting racial data.

Given that it’s primarily Black and Latino workers in essential jobs,  it’s imperative to consider who’s at high risk when making decisions about reopening the economy, he added.

If we cannot quantify racial disparity in vaccine distribution, warned Lloveras, it will be difficult to develop interventions to ensure vaccines are given to those who need it most.

Health disparities between whites and people of color that are impacting vaccine distribution, are “gaps that have become chasms,” said Lloveras. The vaccine roll out “inherently prioritizes a population that is not reflective of the people who are disproportionately affected by the coronavirus”, added Virginia Hedrick, of the California Consortium for Urban Indian Health.

In American Indian country, inequitable vaccine distribution is merely a reflection of the historical trauma inflicted on indigenous communities that has negatively impacted their health and wellbeing over the long term, said Hedric resulting in the highest rates of diabetes, heart disease and substance use disorders. Its only because of advocacy that the Indian Health Service has a separate vaccine reserve allocated to urban and tribal Indian American communities.

Barriers to Better Health  & Vaccines

Several other factors create barriers to better health and getting a vaccine among people of color.

Ethnic minorities tend to live in densely populated areas which makes social distancing difficult, and often in multi generation family homes which put elders at risk. They may use public transportation which could expose them the virus, and lack health insurance or healthcare access.

Farmworkers and the elderly face similar barriers in the form of digital literacy, language barriers and internet access, said Lloveras.  With stay at home orders in place, telehealth depends on who has access to technology. He suggested providing Internet access hotspots and community classes on computer literacy to expand digital access for underserved minorities.

The lack of a robust public healthcare system requires that we provide the technology to help people see a doctor and register for vaccines.

In Asian communities, added Carbullido, patients of Asian descent report fear in getting help they need because of emotional trauma caused by racism and xenophobic attacks associated with the virus.

Yet, many ethnic minorities are reluctant to get their shot because they mistrust the government. Kaiser Family Foundation’s vaccine tracker data reports ‘fear of side effects” prevents people from obtaining the vaccine.

Lloveras proposed ‘a gigantic digital patient engagement project’ to address vaccine hesitancy to set the path to herd immunity and a semblance of normal life .

Missteps in California

Each state’s scramble to acquire and distribute vaccines signaled an unpreparedness for a public health crisis like the coronavirus, said Dr.David Carlyle, President and CEO of the Charles R. Drew University of Science and Medicine, calling California’s missteps in the pandemic a “failure of public policy.”

When MLK Community Hospital, a 130-bed facility at the epicenter of the pandemic in Los Angeles County tried to transfer its sickest patients to nearby tertiary hospitals for oxygenation, they were repeatedly refused because because their patients did not have health insurance. When the vaccine roll out flatlined mid-February, high volume vaccine centers (LA Forum, Dodgers Stadium) in LA county closed mid -February, because supplies of vaccine doses ran out. Commercial pharmacies placed vaccination sites in smaller, less diverse towns like Huntington Beach, Irvine and Newport Beach, while Los Angeles, a city of 8 million was allotted just one site.

“In my estimation we weren’t prepared for COVID 19.” Carlyle concluded.

A Robust Rescue Package

Given the lack of a robust public health system, panelists urged Congress to bolster the public health infrastructure with a bold COVID 19 rescue package for testing, treatment, vaccine distribution.

They called for increased investment in public health and community-based organizations (CBOs) that serve marginalized communities which have more chronic medical issues and higher risk factors for complications of COVID19.  CBOs are vital in reaching communities of color and other hard hit communities, by providing culturally and linguistically appropriate services where government and private institutions have fallen short. Supporting CBOs could mitigate the health inequities of the COVID19 crisis, said Carbullido.

The pandemic overwhelmed most healthcare systems which were not prepared or adequately funded creating crises like the MLKCH that Carlyle called “a  perfect example of the inhumanity of equities in healthcare.”

But “the pandemic has not created these inequities,” concluded Hedrick, “it’s simply highlighting them.”

More information is available at:
https://bit.ly/vaccines-race-data
https://ccuih.org/


Meera Kymal is the Contributing Editor at India Currents
Photo by Ivan Diaz on Unsplash

We Are as Strong as Our Weakest Link

Coronavirus has overtaken how people are living their lives and is now controlling their psyche – as it should.

Reaction has ranged from indifference to paranoia. On one end of the spectrum, reckless students from University of Austin chartered a plane and flew to Mexico for spring break. 44 of them contracted coronavirus. On the other, fake news circulates, conspiracy theories go viral on WhatsApp, and people self-medicate with chloroquine, leading to paranoia.

What is fact and what is fiction?

Ethnic Media Services video briefing on Coronavirus

Ethnic Media Services held a video briefing last Friday, March 27th, with a panel of medical health professionals and advocates who are on the forefront of coronavirus research, work, and policy. The panelists addressed current information about the virus, safety measures, and effects on marginalized communities.

Dr. Daniel Turner-Lloveras, Harbor UCLA Medical Center, and Dr. Rishi Manchanda, Health Begins, spoke about overlooked populations and how their health will actually determine the efficacy of COVID-19. Turner-Lloveras pressed that we need to ensure access to public health for those that are undocumented or without health insurance. 43% of undocumented immigrants are without health insurance and are high risk populations if they contract the virus. 

Additionally, the pandemic has the potential “to disproportionately affect communities of color and immigrants,” Dr. Manchanda confirmed. He expanded that the reason for this is that these populations are at a “greater risk for exposure, have limited access to testing, and have severe complications.”

Dr. Rishi Manchanda briefing community media outlets

Many frontline staff for essential services belong to such communities and are at a higher risk of exposure because of their contact with the public. People on the frontline are unable to take time off due to the nature of their job and their dependency on the income; many continue to work while sick. Infection can spread from work to home and into these communities due to the density of housing.

Once exposed, vulnerable populations have limited access to testing for a multitude of reasons – fear of the healthcare system, lack of health insurance, inability to communicate their needs, and underlying racism. 

Infection from this virus can cause complications leading to chronic illness. The risk of developing chronic illness is higher for communities of color. Research shows that African American, Latinx, and Asian Americans have an increased probability of having chronic illness, over white populations; “Asian Americans, Native Hawaiians, and Pacific Islanders are at twice the risk of developing diabetes than the population overall.”

The nascence of a pandemic brings with it a pressing need to address the gaps within the structural framework of the public health system in America. If we are unable to effectively help disenfranchised communities, then we are ineffective in controlling the spread of the virus. 

“By caring for others, you’re caring for yourself,” Dr. Turner-Lloveras urges. 

Public health is not an economic drain or a privilege, it is a right. Dialogue around healthcare has long forgotten the systemic racism embedded in it; the wealth gap limits the accessibility to health care or good health care. NAACP studies have found connections between coronavirus and negative impacts on communities of color. 

But racism has moved beyond just health…

Asians and Asian Americans are experiencing racism at higher rates. Manju Kulkarni, Executive Director of Asian Pacific Policy and Planning Council, recounted a story of a child experiencing verbal and physical assault for being of Asian descent at a school in LA. Since then there have been around 100 reported cases a day of hate towards AAPIs on public transit, grocery stores, pharmacies. Kulkarni and her team at A3PCON are doing everything in their power to legislate and educate.

That said, it is our social responsibility to stay informed and updated. “Bad information is deadly,” states Dr. Tung Nguyen, University of California, San Francisco, as he gives quick rundown of what is known about COVID-19 thus far:

  • Currently there is no known vaccine or immunity from COVID-19. 
  • Vaccines are 12-18 months out, if the vaccine was approved for phase 1 testing today.
  • COVID-19 has exponential spread; if there are 200,000 cases this week, there will be 400,00 cases next week, 1 million cases the next week, and 4 million cases by the end of the month.
  • COVID-19 is an infection that leads to sepsis and those with sepsis require ventilators; this has led to a national shortage of ventilators.
  • There is a 1.5% – 4.5% death rate from COVID-19.

Information to keep you safe:

  • Have the healthiest person leave the house to get essentials.
  • Have a room to disinfect in before entering primary areas of the house.
  • COVID-19 is in the air for 3-6 hours, lasts 24 hours on cardboard, and on steel and metal for 72 hours.
  • Clean commonly touched objects – faucets, handles – with disinfectant.

If you are sick, call your hospital or provider in advance. Hospital resources are currently limited and telehealth measures have been put in place to assess patients from a distance. You can find more on the CDC website

Dr. Tung Nguyen and Dr. Daniel Turner-Lloveras, both gave one big takeaway – the best thing one can do during this pandemic is STAY AT HOME

Abide by the shelter in place regulations and continue to keep the dialogue about the pandemic open. The coronavirus pandemic has reminded us of the need for awareness, the importance of early containment, and the accessibility of health care to colored communities/immigrants. 

Srishti Prabha is the current Assistant Editor at India Currents and has worked in low income/affordable housing as an advocate for children, women and people of color. She is passionate about diversifying spaces, preserving culture, and removing barriers to equity.