Fearing that Los Angeles County African-American and Latino communities may be hit harder disproportionately by the coronavirus pandemic, a move to gather more data to track such cases kicked into gear countywide on Tuesday, April 14.
For weeks, county public health officials have been pushing for more racial and ethnic data points from hospitals, labs and clinicians with a goal of understanding to what extent underserved populations across the county are being affected.
But that process has been slow to develop, caught up in slow and glitchy reporting processes from providers who are handling cases and tests, prompting Public Health Director Dr. Barbara Ferrer to write a letter to the county’s hospital CEOs to ensure that such data is included.
The data is vital, officials say. It is key in understanding the spread of the virus, how to contain it and move resources such as virus testing sites, they say.
But the information also highlights inequities in the healthcare system that could be underserving people of color, who long before the pandemic erupted were dealing with higher rates of illness such as diabetes and asthma.
Those conditions are among the “underlying conditions” that have made people — no matter what age — more vulnerable to the coronavirus, which is more lethal and contagious than the regular flu.
The Board of Supervisors on Tuesday instructed Ferrer to break down the county’s COVID-19 cases by age groups and socioeconomic status, and to perform an analysis on COVID-19 testing data “to include information on those who have tested positive by race and ethnicity, when available and socioeconomic status, and an analysis of fatalities by race and ethnicity.”
“Racial and ethnic data are needed to address health disparities and help ensure that resources are distributed equitably in areas,” said Supervisor Hilda Solis, calling the apparent disparities not just a public health issue but a “civil rights” issue.
Ferrer now needs come back with an assessment of the data within 14 days. And the board’s action formally asks the public health director to work with the county’s coroner to report back to breakdown COVID-19 fatalities by race, ethnicity and age group.
Faced with limited data now, the board also sought on Tuesday to ensure that immediate measures could be taken to get such data. They include requesting demographic data such as race and ethnicity when people sign up for testing on the city/county web testing appointment portal or through the region’s 211 phone service.
Ferrer said that some such actions had already been taken, and more were coming.
Ferrer and other public health officials had already been pushing for a more accurate picture of what is happening in underserved communities. And officials have been looking to ramp up virus diagnostic testing in potentially underserved areas.
A COVID-19 drive-up testing site at the Charles R. Drew University of Medicine and Science in Willowbrook became the first in L.A. County to collect detailed demographic data from its inception, said Supervisor Mark Ridley-Thomas, who wanted to speed up Ferrer’s report to seven days.
Another testing site will open Wednesday in Bellflower, adding to a network of about two dozen sites across the county, from Lancaster to Pomona to Redondo Beach.
You can make an appointment to get to these sites via a web portal started weeks ago through the city of Los Angeles, which the county has partnered on, at https://lacovidprod.service-now.com/
When public health officials look at the number by population in the region, Ferrer said African Americans have a slightly higher rate of death than all others. But 43% of the cases still need to be assessed, she added, warning against drawing conclusions so early.
As of Monday, of those who died, information about race and ethnicity was available for 262 people. Of those, 33% of deaths occurred among Latino residents, 33% among White residents, 18% among Asian residents, 14% among African American residents, and 2% among residents identifying with other races, according to the L.A. County Department of Public Health, which stressed that the information was still very preliminary.
While the number of 14% may seem small in the series, African Americans in L.A. County make up 9% of the county’s population, according to Census estimates.
“The community is bearing the brunt of this an there’s still a lot for us to learn about the virus and the inequity that is so alarming to many of us,” Solis said, noting that issues such as hypertension and diabetes, prevelant among blacks and Latinos “are not an accident.”
The numbers have been changing, and it’s still early, officials say, to make any definitive conclusions regarding the numbers.
But it was clear on Tuesday that the region’s public health chief was concerned about the signs of “disproportionality across the board.”
She said efforts to dig down on demogrophic data are focusing on three areas:
- hospitalizations
- testing
- mortality
“We’ve had very little success on gathering information around testing,” she said, calling it “a significant lift for us to really create a sort of backend system that collects this system appropriately.”
Disconnects between the public and private providers, labs and the county haven’t helped.
And the testing itself, she said, has so far been more likely to occur in more affluent areas, where people have more access to healthcare.
Two weeks ago, the county issued an order to health providers to provide accurate and timely data, and Ferrer said she sent a letter to all area hospital CEOs, reminding providers to do so.
Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, and a top adviser to President Donald Trump, said last week that there is a troubling trend in communities that already are dealing with healthcare challenges.
“We have known, literally forever, that diseases like diabetes, hypertension, obesity and asthma are disproportionately afflicting minority populations, particularly the African-Americans,” Fauci said at a White House briefing. “Unfortunately, when you look at the predisposing conditions that lead to a bad outcome with coronavirus, the things that get people into ICUs … and that often lead to death, they are just those very comorbitities that unfortunately are disproportionately prevalent in the African-American population. So we’re very concerned about that.
“There’s nothing we can do about it right now. except to give them the best possible care to avoid those complications.”
