Much is still unknown about the coronavirus pandemic that has caused a world wide emergency. With “stay-at-home” orders, we watch the briefings from our living rooms that grimly report the numbers of cases and deaths each day. The numbers are alarming, and the information from our Mayor and Governor is vital, as they emphasize that we all must take heed to the warnings about this invisible but deadly virus.
Still, too many people aren’t receiving information.
Ethnic communities in particular are at risk for receiving inaccurate information, according to Dr. Tung Nguyen, endowed chair in General Internal Medicine and a professor of medicine at the University of California, San Francisco.
“Minority communities in particular, due to lack of access to culturally and linguistically appropriate information and reliance on social networks for communications, are at a high risk for misinformation,” Nguyen said.
The doctor points out that there is still much unknown about this virus and information is changing day to day. “And in this particular pandemic, bad information is deadly,” he said.
Nguyen explains that COVID-19 is a coronavirus, which is a large family of viruses that cause respiratory infections, going all the way from the common cold to more serious diseases such as MERS, SARS, and now COVID.
“Because COVID-19 is a new infection, the exact way in which it infects and spreads, and the way in which our bodies respond, is currently unknown,” Nguyen said. “But the research community is mounting a rapid response,” and he hopes that we will learn much more in the coming weeks.
“Just to be clear, there is currently no vaccine against COVID-19. There is one that has been approved to get started in Phase 1, but Phase 1 is a very preliminary state, which is to see whether or not it’s safe. Typically, it would take 12-18 months before we even get to an effective vaccine if everything goes well.”
As of March 27, “there were currently 500,000 people infected, and in the US it’s 81,000 cases, among the highest in the world,” Nguyen said.
Nguyen also assures that many people who get infected with COVID-19 don’t have any symptoms, and most will get over the infection without any treatment. However, that increases the importance of staying home in order to avoid unwittingly transmitting the virus.
Those experiencing no symptoms are advised to stay home and not seek testing, as testing kits and medical supplies are very limited and hospitals must be focused on those who are in critical need. Our medical systems cannot be overwhelmed by unnecessary calls and visits.
Immigrant Communities At Risk
Immigrant communities are at greater risk from COVID-19, which disproportionately impacts communities of color.
Dr. Daniel Turner-Lloveras, an assistant professor of medicine at the Harbor-UCLA/David Geffen School of Medicine, has also been a primary care physician and hospitalist in South Central LA. He says now is the time to plan for the possibility of you or a family member becoming ill by asking yourself, “Who am I going to call, [and] what am I going to do if I get sick or if my family members get sick?”
He recommends that people call ahead before seeking medical care so that an emergency department or the hospital can triage you appropriately, and if it’s revealed that you do have COVID-19, precautions are taken so that you aren’t exposed to others.
Turner-Lloveras also expressed his concern for those who may not seek care because of concern with losing their immigration status due to their fear of the Public Charge rule. Those in need but not seeking care or getting tested may interfere with attempts to contain the spread of the virus.
“I think ‘Public Charge’ is a public health threat. One cannot contain a virus outbreak by providing care to only some of the population,” Turner-Lloveras said. “We cannot successfully contain an outbreak if there are those among us who are afraid to seek care. It’s going to break down.”
Having served in communities where residents may be at-risk of apprehension from ICE, Turner-Lloveras knows the importance of supporting the vulnerable members of the community when they seek medical assistance.
“Some of us have [contributed to] an article that we’re submitting to a journal as we speak. We’re asking to ensure access to publicly funded health insurance for everyone, including undocumented immigrants,” Turner-Lloveras said.
“Only 8% of citizens were uninsured, but 23% to 45% of all undocumented immigrants have no health insurance. We want to stop detaining immigrants that are seeking health care. Every healthcare site should be an ‘ICE-free’ zone.”
Although ICE is supposed to consider hospitals and medical centers as “sensitive locations” and avoid conducting “enforcement actions” such as arrests, searches, interviews, or surveillance, Turner-Lloveras says there are multiple cases of ICE officials entering an establishment and detaining undocumented immigrants who were seeking care.
“We need to stop that, otherwise we’re not going to stop this outbreak. Twenty percent of adults from low-income immigrant families have reported avoiding public benefit programs for fear of risking future green card status. That’s not compatible for containment,” the doctor said.
Turner-Lloveras also calls for the elimination of overcrowding in detention centers, and the dismantling of the “Remain in Mexico” program. The Trump-supported policy requires asylum seekers to wait in Mexico for their day in US Immigration court, which has forced tens of thousands of migrants back across the border to live in makeshift camps with unsanitary and dangerous conditions.
“Historically we’ve always seen pandemics as a time where we all come together — by caring for others, you’re caring for yourself. And that’s really the only way to address the outbreak of a pandemic,” Turner-Lloveras said.
Risks of COVID-19 Spread for Communities of Color
Dr. Rishi Manchanda, public health innovator and founder of Health Begins, warns of an increased risk of spread of COVID-19 among communities of color.
Immigrant communities face a greater risk of exposure and infection and are also affected disproportionately due to limited access to testing, along with any additional risks they may take economically and socially because they feel they have little choice but to continue working. They are unlikely to have a cushion to fall back on and may not qualify for any kind of assistance.
“First, it’s hard not to work for many in communities of color, who receive lower wages and have insufficient insurance coverage. That limits their access to treatment, which often forces them to work even while ill. This increases the risk of exposure due to community transmissions,” Manchanda said.
“That’s why it’s so vital to make sure that everybody — but especially communities of color who have increased risks of getting exposed — stay at home.”
He said there can be many factors that create an increased risk of exposure for communities of color, such as the disproportionate rate at which people of color live in cities, dense neighborhoods and public housing, and the rate at which people of color experience housing insecurity or homelessness. There is also the tendency for communities of color to be composed of larger or multi-generational families living in one home, putting vulnerable family members such as the elderly, children, and teenagers at risk of exposure.
The common jobs of working-class communities of color include jobs that require close contact with the public — “face to face and forward facing” service jobs that include transportation, health care, grocery store workers, cashiers and farmworkers, which put many workers on the front line, forcing them to make the difficult choice: staying home or abstaining from work, which could possibly cause them to lose their jobs, or continue to work and risk being exposed to COVID-19.
Language barriers can add another layer of complexity for individuals seeking testing or attempting to apply for insurance. Compared to white populations, people of color are more likely to lack coverage with Native Americans and Latinos being the most likely to lack health coverage. In addition, those who are independent contractors and day laborers often don’t have health insurance.
COVID-19 Hate Crimes
In addition to the serious health risks the virus itself poses, the Asian American community has been facing harassment, threats, and violence due to fear-mongering and panic caused by the virus.
Manju Kulkarni, executive director of the Asian Pacific Policy and Planning Council A3PCON, a coalition of 40 community-based organizations serving and representing 1.5 million Asian-American and Pacific Islanders in LA county, said A3PCON has been making a concerted effort to support the growing number of families that have been targeted by anti-Asian American hate.
“This is obviously a very challenging time for all Americans. Unfortunately it’s been made worse by the racism and xenophobia that is targeting our Asian-American communities. We began working on this issue in early February when a child at a local [Los Angeles] middle school was physically attacked and verbally assaulted because he was Asian-American,” she said.
“Another kid at the school accused him of having the coronavirus and said, ‘Go back to China!’ When the child said, ‘I’m not Chinese,’ the bully proceeded to punch him 20 times in the head on the schoolyard.”
Hate crimes against Asian Americans have been reported across the country, and in some cases video has been taken by witnesses who’ve posted the occurrences on social media. One video shows an Asian American woman wearing a mask being chased by a man through an underground subway area. She attempts to get away but he catches up with her and starts to physically attack her.
“We are getting about 100 reports a day, most of the cases involve verbal harassment. And now that we’re in ‘shelter-in- place’ across most of the country, we are seeing [harassment] at grocery stores, big box retail, on public streets, in Metro and public transit,” Kulkarni said.
“All of these things are preventing Asian American families from getting groceries, filling their prescriptions, even just going on a short walk around the block in their neighborhood because they’re worried about their safety. This is such a challenging time, and to now be fearful of your neighbors, your coworkers, colleagues, is honestly morally reprehensible. This is a time for us to be our better selves and it’s our hope that communities will come together rather than being apart.”
To find COVID-19 testing and screening locations, visit http://www.findcovidtesting.com. To report anti-asian-american/pacific islander incidents related to Coronavirus, visit http://www.a3pcon.org/stopaapihate.