New data show that minorities and low-income earners are more susceptible to COVID-19

Yet another article on racial disparities, based upon Toronto Public Health census track-level data:

When the public image of Pearson International Airport turned from travel hub to petri dish in March, Rajinder Aujla’s friends and colleagues felt they had no choice but to drive toward it every day, again and again. As airport taxi and limo drivers, this is their livelihood.

A month later, Mr. Aujla, president of the Airport Taxi Association, started hearing about what may have been the consequences of all those trips. By his count, 10 drivers have died in the past month, at least six of whom tested positive for COVID-19. One was Karam Singh Punian, a close friend of Mr. Aujla, who died May 4.

He estimates that about 20 drivers contracted the virus since April. Most of the 1,500 drivers who make their living ferrying passengers to and from the airport are immigrants from places such as India, Pakistan and Egypt, he said.

“They’re all self-employed. They don’t have access to health benefits,” Mr. Aujla said. “Some of the people are the only breadwinners. Some of them have others in their family working, but their spouses are mostly out of jobs now. Everyone is staying at home.”

Preliminary data support the idea that COVID-19 is hitting marginalized communities harder than others. The situation will only worsen as provinces reopen, according to front-line health care workers and experts who study health inequities.

Public-health messages about staying home, which are aimed at curbing the spread of COVID-19, have largely ignored the realities faced by low-income workers, people who are homeless or other at-risk groups, said Andrew Boozary, a doctor who is executive director of health and social policy at University Health Network. He also works with Toronto’s Inner City Health Associates, a group that provides care to people living on the street and in shelters.

“Physical distancing is a privilege by postal code,” he said. “We’re seeing a public-health message that is speaking to a certain part of the population. There’s a completely separate curve that is … facing most of the cases and deaths now.”

A recent Toronto Public Health analysis of COVID-19 cases in the city showed that neighbourhoods in Toronto with the lowest incomes, highest rates of unemployment and highest concentrations of newcomers consistently had twice the number of cases of COVID-19 and more than twice the rate of hospital admissions.

That analysis was based on COVID-19 cases tracked up until May 10. It looked at census tracts throughout the city and divided Toronto into five groups for each category of analysis: income, proportion of newcomers and unemployment.

While the lowest-income group had 205 cases of COVID-19 and 34 admissions to hospital per population of 100,000, the highest income group had only 94 cases and 15 admissions.

Neighbourhoods that had the highest concentration of immigrants recorded 194 cases of COVID-19 and 31 admissions per 100,000 people, compared with the ones with the lowest number of immigrants, which had 93 cases and 12 admissions.

The same pattern emerged when it came to unemployment: Areas with the highest levels of unemployment had 198 cases and 30 admissions per 100,000, versus those with the lowest unemployment, which had 98 cases and 15 admissions.

Toronto Public Health is now tracking demographic data (including race and income) to give an even more accurate picture of who is getting infected.

Arjumand Siddiqi, Canada Research Chair in population health equity, said many of the essential workers keeping society going during COVID-19, including janitors, long-term care workers, grocery clerks and transit operators, fall into the at-risk categories.

“They tend to be lower wage, and they tend to consist of black and brown people,” said Dr. Siddiqi, an associate professor at the University of Toronto’s Dalla Lana School of Public Health. “Every time we see a long-term care worker on TV, it’s almost invariably a black woman.”

In Montreal, Canada’s hardest-hit city, many of those workers live in Montréal-Nord, which has the highest concentration of COVID-19 cases and has become the epicentre of the outbreak.

This low-income enclave is a “springboard” for immigrants from places such as Haiti and North Africa, many of whom live in close quarters in high-rise apartment buildings and work in the vulnerable health and service sectors. All these factors have contributed to its high rate of infection, said Bochra Manai, executive director of Parole d’excluEs, a social-services organization that works in the neighbourhood.

The area had 2,593 cases per 100,000 residents as of May 21, by far the most of any borough and well over double the city average. (In part because of its government structure, made up of 19 boroughs, Montreal has more precise neighbourhood data on cases and deaths.)

In Canada’s largest cities, points out Kwame McKenzie, the CEO of health-policy think thank the Wellesley Institute, accommodation is expensive, “and we know that people with lower incomes tend to be in more concentrated or overcrowded places where it is more difficult to physically isolate.”

That was precisely the challenge Fahim Sultana Rigi faced in late April.

After breathing difficulties landed her in hospital and she tested positive for COVID-19, Ms. Rigi was told to self-isolate at home for two weeks.

This was no small feat: She shares a three-bedroom apartment in an 11-floor housing co-op in the densely populated St. Lawrence neighbourhood in Toronto with her husband, Emad Hussain, and four children. Her eldest son was temporarily moved to a room with a sibling, Mr. Hussain shared a room with two of his other children, and Ms. Rigi was in a room on her own.

As his two-year-old cried and begged to see his mother, Mr. Hussain tried his best to help maintain the quarantine. His work ground to a halt as he took on the job of parenting his children solo.

His wife is only 41 but had pre-existing health conditions – thyroid problems and diabetes – so he worried about her recovery.

Research suggests immigrants and low-income earners are more likely to suffer from diabetes, high blood pressure and other chronic illnesses, and those with these pre-existing conditions can face higher rates of hospital admissions and worse outcomes if they are infected with COVID-19.

Just a few days into isolation, Ms. Rigi woke early one morning struggling to breathe. She summoned her husband to her side and frantically gestured to call 911. After spending nine hours in hospital and receiving oxygen, Ms. Rigi was discharged again, continued to isolate and has since recovered – though she still suffers from body pain and exhaustion.

Still, Mr. Hussain can’t forget the fear he felt in those first days that spurred some grim research.

“If I got infected, or if I passed away or my wife passed away, how could we manage those children? Those were the legal things I was looking for,” he said.

Source: New data show that minorities and low-income earners are more susceptible to COVID-19 ‘Physical distancing is a privilege by postal code,’ one doctor says of the dichotomy of infection rates between marginalized communities and wealthier neighbourhoods

Data linking race and health predicts new COVID-19 hotspots

While more of the same in terms of argumentation, some better data analysis than other commentary although the researchers should have made more explicit the correlation with lower socioeconomic outcomes which is largely the main driver:

Anecdotal stories about the COVID-19 pandemic suggest that Black, racialized and immigrant people in Canada have been disproportionately affected by COVID-19. This narrative tells the story of immigrants and racialized people pushed to the front lines of the economy, working in settings with greater exposure to the COVID-19 virus.

It tells the story of immigrant groups clustered in city neighbourhoods with high population densities who cannot practise physical distancing. It tells the story of temporary migrants who live in tightly packed communal quarters.

Reports have shown that Black and immigrant communities in the U.S. have been disproportionately affected by COVID-19. But many believe that Canada is different.

After all, Canada has universal health insurance coverage; the U.S. does not. Canada adopted a multiculturalism policy decades ago and racial discrimination is frequently — though wrongly — believed to be absent in Canada.

Under this narrative, many government officials in Canada have not seen a need to collect COVID-19 data on race. They have also excluded racial minorities and immigrants from their list of populations vulnerable to COVID-19.

Which of the two narratives reflect the realities of racial minorities and immigrants in Canada during the COVID-19 pandemic?

Until recently, there was no data to address this question. By making creative use of health and census data, we now know that Black and immigrant communities in Canada are disproportionately affected by COVID-19.

Combining COVID-19 and census data

Our research team based at the department of sociology at Western University tested these competing narratives by creatively combining existing data. We used COVID-19 data released by the Public Health Agency of Canada and census data about the racial and socioeconomic composition of health regions, units set up by provinces in Canada to administer health care.

Using these data, we assessed how racial and socioeconomic factors have shaped COVID-19 infection and death rates. Our findings paint a picture closer to the anecdotal stories

The COVID-19 pandemic is not the “great equalizer.” Black and immigrant communities in Canada are disproportionately affected by COVID-19.

Our findings showed COVID-19 infection rates are significantly higher in health regions with a higher percentage of Black residents. A one percentage point increase in the share of Black residents in a health region is associated with the doubling of coronavirus infection rates. We also found that a one percentage point increase in the share of foreign-born residents is associated with a three-per-cent rise in COVID-19 infection rates.

This may explain why Montréal, where Black residents make up 6.8 per cent of the population, has emerged as one of Canada’s COVID-19 epicentres. The same is also true of other cities with high immigrant and Black populations, like Toronto and Vancouver.

We also found the number of COVID-19 deaths tend to be higher in communities with higher shares of residents who are 65 and older. Many studies have shown COVID-19 is more lethal in older adults and we have seen the tragically high COVID-19 death rates in long-term care facilities.

COVID-19 hotspots

Health regions are large administrative units responsible for the health care of roughly 420,000 residents. They are too large geographically and too socially heterogeneous to adequately tell a story about local communities. So for our study, we subdivided health regions into smaller areas and predicted the spread of COVID-19 in local communities based on their racial, demographic and economic profile. This approach helped us identify several potential COVID-19 hot spots.

Black and immigrant communities like Hamilton, Vancouver and Montréal were particularly vulnerable. Also, other localized communities may be more vulnerable than originally thought.

For example, the oilsands in northeast Alberta, where the petroleum industry hired large numbers of temporary migrant workers who reside in crowded living quarters, may be a potential COVID-19 hotspot. Similarly, another potential COVID-19 hotspot may be found in western Québec, which includes mining sites that employ large numbers of temporary migrant workers.

Public health workers may have overlooked the higher infection rates in Ontario’s towns bordering Michigan, partly reflecting their geographic proximity to U.S. cities like Detroit.

Who is the most vulnerable?

Communities are home to different types of people. With the existing data, we cannot address questions like: are white residents who live in Black communities less vulnerable to COVID-19 than their Black neighbours?

Our study highlights the importance of collecting individual data about COVID-19 patients as well as for smaller geographic units. Having individual data is essential for determining how to direct scarce resources and how to contain the spread of the virus.

With our study, we underscore the importance of acknowledging the challenges of Black and immigrant communities in Canada, including their vulnerability to COVID-19. Without this acknowledgement, we risk exacerbating inequality between them and other groups.

For example, Blacks and immigrant groups were not classified as “vulnerable populations” in the Ontario government’s COVID-19 Action Plan for Vulnerable People. They were excluded even though their risks of infection and death are significantly higher than those of some groups identified as vulnerable under this plan.

Policies aimed at mitigating the consequences of COVID-19 target individuals as well as communities. If we do not address this oversight, the future health disadvantages of Black and immigrants groups may become more pronounced.

Closing one’s eyes to inequality along racial lines will not eliminate disparities. It just eliminates ways to address it.

Source: New COVID-19 hotspots predicted by data linking race and health

Canada’s COVID-19 blind spots on race, immigration and labour

Yet another article on racial and economic disparities and COVID-19. Nothing new here and perhaps a sign that governments just need to get on with collecting the data. Should be a role for CIHI in this:

The low-paid and precarious positions in industries that are considered essential during the COVID-19 pandemic (sanitation, health care, and those in the food supply chain) are filled with women, recent immigrants, and racialized Canadians. Many of these workplaces are notoriously plagued with exploitative labour practices that, in many ways, contributed to the spread of the virus in the first place. Recent immigrants and racialized Canadians, notably Filipinos and Sudanese Dinka, who work in these industries, for example, meat-packing plants in Brooks, High River and Balzac, Alberta, are at great risk of negative health outcomes during this pandemic.

And, yet, we do not collect the necessary data in Canada on the social determinants of health for racialized minorities. Stories from across the country paint a bleak picture. In April, a 40-year-old Haitian asylum seeker contracted COVID-19 while working as a personal support worker. He died in his home after having been denied refugee status. In Toronto, researchers have recently connected positive COVID tests to neighbourhoods characterized by a higher proportion of visible minorities and recent immigrants, poor housing and low income.

There have been numerous calls to gather disaggregated data on COVID-19, health and race. After initial reluctance, the federal government and some provincial jurisdictions are now considering collecting more demographic data. We join our voices to the call and argue that Canadian governments need data not only on race and health, but also on immigration status during this COVID-19 crisis and beyond.

While collecting data on race will show that people of colour are disproportionately affected by COVID-19, we know that not all racialized Canadians are equally vulnerable to being exposed to this disease. From our work in community health, and gender and politics, we know that despite the best intentions of epidemiological approaches to the pandemic, marginalized groups face barriers to accessing and benefiting from public services. In fact, recent research by the University of Lethbridge’s Eunice Anteh shows that in places like Brooks, newcomers’ health profiles will vary based on numerous factors, including gender, race, language barriers, and the health and social infrastructures in their settlement locations.

We need longitudinal data that intersects the usual factors – gender, age, education, income, for example – with race and immigration profiles to enable policymakers to better understand the pathways and structures that create hierarchies of vulnerabilities within racialized and newcomer communities. This will enable public health officials to work with other stakeholders in eliminating the institutional barriers to health equity for all within our borders.

Intersecting reasons why some are more vulnerable to COVID-19

In Quebec, disparities in COVID-19 infection rates are shaped by the intersection of race, gender, immigration, labour, and public health. Health care workers account for 20 percent of infections, and in the hard-hit Greater Montreal area, up to 80 percent of the aides in long term care facilities are racialized women, mostly Black and Maghrebi. Industries of care are feminized and undervalued despite being critical to preserving the health and safety of the population.

For years workers have complained about these institutions’ chronic understaffing, high patient-to-aide ratios, and unsafe working conditions. As occurred in other provinces, the government subcontracted public services to private entities, with limited public oversight, enabling these institutions to avoid paying employment benefits by privileging part-time over full-time work. This left many health care aides with no other choice but to work at multiple sites to make ends meet. These are the conditions that upended Quebec’s response to COVID-19.

In Alberta, the links between race, immigration, labour, and public health manifested themselves in the food supply chain. Over 1200 COVID-19 cases were linked to the Cargill meat plant. Seventy percent of employees are of Filipino descent, most of whom work as general labourers amongst the lowest-paid employees, and some who have spouses working as health-care aides in Calgary. Public health officials named carpooling and crowded living arrangements as contributing factors to the rapid spread of the virus but overlooked labour practices and socioeconomic conditions that lead to shared living and transportation arrangements in the first place.

The second-largest meat packaging plant in Canada, JBS, is also facing an outbreak. It is the main employer in the city of Brooks, Alberta. A third of the population there are visible minorities, mostly from East Africa, South Asia, and Latin America. Today, JBS employees account for approximately 26 percent of Alberta’s active cases, and over 6 percent of Brooks’ population, one of the highest rates across Canadian municipalities. These outbreaks revealed mistakes and oversight linked to concerns around the food supply chain and showed the price that racialized and marginalized workers pay due to neglect and prioritization of profit over safety.

Temporary foreign workers are also at risk

As the agricultural season enters in full swing and concerns grow about Canada’s food supply chain, we must take stock of employment inequities in how we treat temporary foreign workers (TFWs) and the implications for overall community health and wellbeing. For decades TFWs from the Caribbean and Latin America have taken on work that Canadian often refuse to do, generally because of long working hours, unsanitary bunkhouses, and low wages. Many of these workers are reluctant to speak out about their work conditions given the precariousness of their employment and residency status, which are both tied to their employers.

These conditions, like those of personal service workers or meat plant employees, are not new or even unique to Canada. Across the world, industrialized countries depend on temporary migrant workers to sustain their basic infrastructures. Around the world and in Canada, it is clear that the temporary migration of racialized individuals serves as the backbone of essential services in Canada. From the West Indian Domestic Scheme (1955) and the Caribbean Seasonal Agricultural Workers Program (1966) to our modern TFW program, the utilitarian approach to immigration and the neglect of these populations have resulted in systematic and deep-rooted inequities that weaken health and safety institutions.

A lack of political will to address neglect

Why do Canadians tolerate these types of working conditions that can become public health issues during a crisis like COVID-19? Is it because of who is overrepresented in these fields: female, racialized, and immigrant workers who struggle to get substantive political representation? Some in the broader society rationalize these challenges by saying that newcomers are better off here than where they came from. Others turn a blind eye altogether to these conditions.

In reality, we ignored the working conditions of racialized and immigrant workers who help sustain our health and food supply infrastructures, and way of life.

Yes, we need to gather COVID-19 related data on race and immigration to better address the needs of vulnerable communities that also tend to work in essential sectors. But going forward, we also need long-term changes to what we consider to be health-relevant demographic data.

Provincial healthcare professionals need to pay as much attention to collecting data on race and immigration profiles as they do in collecting data on gender, education, and income. This data needs to feed into national environmental population surveys that will allow public health officers to tie specific demographic markers to health status over time. It will paint a clearer picture of social, economic, and health disparities between various communities and point to needed improvements and progress. This will also enable provincial health officials to identify variations and gaps between federal and provincial jurisdictions. For example, while refugees are resettled and supported by the federal government, their access to health services is the responsibility of the provinces.

Finally, this data should then be the starting point for engagement between public health officers, immigration and labour policy-makers, and relevant stakeholders from relevant industries. Together, they can help develop more robust social and labour protection for racial minorities, newcomers and migrants. We need to be invested in the health and work conditions of racialized and immigrant populations in Canada, not only because, as COVID-19 has demonstrated, safety for them means safety for all, but most importantly because this is what this country says it stands for.

Source: Canada’s COVID-19 blind spots on race, immigration and labour

Why Have Britain’s Ethnic Minorities Been Hit Harder by COVID-19? It’s Hardly a Mystery

Another example of denial of the links between minority status and socioeconomic factors as a way to minimize the influence of systemic and other issues affecting socioeconomic outcomes and thus health. Not an either/or but an and:

COVID-19 is a disease that can strike anyone. A recent study of 5,700 sequentially hospitalized COVID-19 patients in a New York City health network, for instance, found that patients’ ages ranged from single digits to 90-plus. Roughly 60 percent were male. About 40 percent were white. Nine percent were Asian. And 23 percent were black.

As Coleman Hughes recently noted in Quillette, black people are overrepresented among American COVID-19 fatalities overall. In Chicago, for example, black people account for more than 70 percent of COVID-19 deaths, despite comprising just 30 percent of the local population. But this doesn’t necessarily tell us much about the disease itself, because “black people are more likely than white people to die of many diseases—not just this one. In other cases, the reverse is true. According to CDC mortality data, white people are more likely than black people to die of chronic lower respiratory disease, Alzheimer’s, Parkinson’s, liver disease, and eight different types of cancer.”

In the UK, too, COVID-19 has had a disproportionate effect on communities that get lumped in under the (somewhat dated) term “BAME”—black, Asian, and minority ethnic. The Intensive Care National Audit and Research Centre has reported that 34 percent of a studied group of 6,720 critically ill COVID-19 patients self-identified as black, Asian or minority ethnic. By way of comparison, the comparable figure for a group of 5,782 patients with non-COVID-19 viral pneumonia tracked between 2017 and 2019 was about 12 percent. Moreover, as the Telegraph reports, “despite only accounting for 13% of the population in England and Wales, 44% of all [National Health Service] doctors and 24% of nurses are from a BAME background. Of the 82 front-line health and social care workers in England and Wales [who] have died because of COVID-19, 61% of them were black or from an ethnic minority.”

The release of these numbers prompted an official inquiry. And last week, the Labour Party appointed civil-rights campaigner Doreen Lawrence to head up its own review of the issue. A BBC article entitled “Coronavirus: Why some racial groups are more vulnerable” informs readers that the issue might be rooted in the “physiological burden from the stresses caused by racism and race-related disadvantage, such as the frequent secretion of stress hormones.” London Mayor Sadiq Khan recently wrote an article in the Guardian, demanding that more data be collected. However, he didn’t wait for such data before suggesting that the issue is rooted in “the barriers of discrimination and structural racism that exist in our society.”

I’m a refugee from Afghanistan who came to England as a child in the back of a refrigerated truck. So I know a little bit about these issues. I also know that the above-described statistical disparities may well be related to factors that have nothing to do with racism. Firstly, as everyone in the country knows, BAME communities are disproportionately urban. Specifically, they tend to live in Britain’s larger cities, such as London, Birmingham, and Manchester—often within populous urban wards. Contagion rates are high in these areas, in part because it’s easier for an epidemic to spread in a big city than in the country’s sparsely populated (and disproportionately white) countryside.

Secondly, BAME groups in the UK tend to have more aggravating health conditions, known as comorbidities. Given the epidemiological data, this is of enormous importance. In the aforementioned study of 5,700 COVID-19 patients in New York City, for instance, the leading comorbidities were found to be hypertension (57 percent of all patients), obesity (42 percent), and diabetes (34 percent). Overall, a stunning 94 percent of patients in the study had at least one comorbidity. And 88 percent had more than one.

According to 2006 data, South Asians in the UK are up to six times more likely to develop type-2 diabetes as compared to white people, and black people were up to five times more likely. Similarly, as the BMJ has reported, people of South Asian and Black ethnicity “are known to have worse cardiovascular outcomes than those from the white British group”—in large part because of the “significant” effect of differences in average hypertension levels.

Thirdly, immigrant households are far more likely to contain more than two generations living under one roof. (The authors of a 2017 report found that 70 percent of surveyed white households in the UK containing people aged 70-plus didn’t contain younger individuals. The comparable figure for black households was about 50 percent. For South Asians, it was 20 percent.) In such circumstances, social isolation is more difficult, and grandparents are put at risk of catching infectious diseases from (possibly asymptomatic) younger relatives. From the beginning of this pandemic, intra-household contagion has been a leading form of COVID-19 transmission. The bigger the household, the more people get infected in each cluster.

Fourthly, the problem of getting public-health information to citizens is compounded in the case of those immigrants who have limited English abilities. There is much less official information in Somali, Hindi, Farsi, or Pashto, for instance. There is lots of “fake news” circulating on WhatsApp groups, which is especially problematic in the case of those who don’t understand information coming from official channels in English. Much of this fake-news information flow flies under the radar of public officials.

Finally, as noted above, BAME workers make up a disproportionate share of National Health Service medical staff. A fifth of nurses and midwives, and a third of doctors, are from BME backgrounds. In many cases, these actually represent employment success stories. But as one would expect, these cohorts also tend to be younger, and so are disproportionately employed in entry-level roles and front-line care, as opposed to working in specialized clinics or managerial positions.

An objective assessment of such issues is welcome. But the government’s fact-finding project should take into account the underlying factors, as opposed to simply echoing some of the unhelpful generalizations that now have become common currency in the media.

The public-health policies that are put in place in coming years will affect our ability to withstand the next pandemic. And we should be mindful of the manner by which they impact different communities in different ways. Such a discussion would not only help save lives, but also help spark a larger discussion about why such differences continue to exist, and, more generally, what factors have prevented BAME communities from sharing in the benefits that come with social integration.

Source: Why Have Britain’s Ethnic Minorities Been Hit Harder by COVID-19? It’s Hardly a Mystery

For background:

Kamrul Islam doesn’t dare visit his local supermarket. Over the last few weeks, he said three of his closest friends fell ill with the coronavirus shortly after shopping there. One friend’s mother became seriously unwell after contracting the virus and died.

The 40-year-old former cab driver says a day doesn’t go by when he isn’t aware of a death or infection of someone he knows. While the coronavirus has spread widely across the UK, the pandemic has taken a huge toll on the area where Islam lives, the east London borough of Newham, which has recorded the worst mortality rate in England and Wales.

The borough’s rate – 144.3 deaths per 100,000 people – is closely followed by Brent in north London (141.5), and Newham’s neighbour Hackney (127.4), according to figures published by the Office for National Statistics. The data confirms what Islam has suspected all along: people living in the poorest parts of the country are dying from Covid-19 at a much higher rate than those in the richest.

On Islam’s road and neighbouring street, 22 people have died after contracting coronavirus. “Every day I get a message from someone in my community telling me of people who have died. They are young and old. It’s been really tough,” Islam said. His wife, who wished to remain anonymous, said: “You hear sad stories of people dying and no one was with them. It does affect people mentally.”

The deaths from the coronavirus include Betty and Ken Hill, who were together for more than 40 years and died hours apart; Dr Yusuf Patel, who was the fifth GP to succumb to the virus in the UK; “exceptional” secondary school English teacher Dr Louisa Rajakumari; and Abdul Karim Sheikh, the former ceremonial mayor who founded one of the first mosques in the area.

Islamophobia row over choice of consultant for UK Covid role

Trevor Phillips continues to court controversy in this appointment. Suspect there were others the UK government could have called on for the analysis given the communications difficulties this has raised:

The appointment of a prominent consultant to investigate why Covid-19 is killing a disproportionately high number of minorities in the UK has sparked a backlash because of his involvement in an Islamophobia row.

Trevor Phillips, a former head of an equality watchdog, was suspended from the opposition Labour party this year over claims of Islamophobia but has been chosen to advise the UK’s main public health body on coronavirus death rates.

Data suggests that 34.5 per cent of critically ill patients were from black, Asian and minority ethnic backgrounds.

The 2011 census suggested that less than 11 per cent of the population was from a black or Asian background.

Mr Phillips was suspended from the Labour party over comments he made about the outlook of the British Muslim community and a case in which Pakistani men abused children.

“To appoint someone who is being investigated for racism is inappropriate and deeply insensitive,” said Yasmin Qureshi, an MP, in a letter to the head of Public Health England.

Ms Qureshi said that the appointment undermined the integrity and credibility of the review.

“It is critical that this review is independent and has the confidence of all communities, and so I urge you to reconsider this appointment as a matter of urgency,” she said.

Dr Zubaida Haque, deputy director of the Runnymede Trust, a race equality think tank, also criticised the appointment.

“Covid 19 is not a culture war It’s the difference between life and death,” Dr Haque said in a tweet.

“The fact that Public Health England have appointed Trevor Phillips, someone with concerning attitudes towards Muslim communities as the main adviser into the racial disparities review is highly concerning.”

Mr Phillips claims to have introduced the term Islamophobia to Britain when he commissioned a 1997 report into discrimination.

He later said a “chasm” had opened between the thinking of Muslims and non-Muslims on social issues. He suggested that multiculturalism in the UK had failed.

The research consultancy run by Mr Phillips and Prof Richard Webber, a demographics expert, was appointed because of the large-scale studies it carries out on ethnicity.

Initial work conducted by his consultancy suggested that washing before prayers may have helped to curb the spread of the disease in some places, he said.

The investigation found that 13 of 17 Covid-19 hotspots in England and Wales had non-white populations above the national average.

“Everyone should be contributing anything they can to tackling this crisis,” Mr Phillips told the Huffington Post.

“Anyone can see the research Richard and I have already done on our website, which explains why we’ve been asked to help.”

Source: Islamophobia row over choice of consultant for UK Covid role

How Canada’s crucial data gaps are hindering the coronavirus pandemic response

Good long read on data gaps. Have excerpted the intro and the section on the lack of visible and ethnic minority data:

Gaps in key health and economic data are hindering Canada’s response to the COVID-19 pandemic, leaving Canadians in the dark about who is being infected or struggling with the devastated economy, say researchers, politicians and scientists.

These blind spots could blunt the federal economic rescue effort, hide inequities in deaths from the disease and slow our emergence from self-isolation in the months ahead. Experts are urging provincial and federal leaders to open up more streams of data immediately, as doing so might save lives and livelihoods.

Canada has a long-standing problem of information gaps, The Globe and Mail found in a year-long series, and that has left us vulnerable during public health crises before. A government audit found that during the 2009 swine flu pandemic, data deficiencies left the Public Health Agency of Canada “unable to answer basic questions such as the rate of spread” of the virus.

….

Nationally, the ethnicity of those who have been infected or have died is unknown. Because of data gaps, the death toll likely is being underestimated.

On the economic front, Canadians don’t know how many in each province are applying for employment insurance every week (as the United States does by state). They don’t have up-to-date numbers on bankruptcies, mortgages in arrears, how workers in the gig economy are faring, the extent of layoffs or the degree to which the federal government’s plan for an enhanced wage-subsidy program has spurred rehiring.

Arjumand Siddiqi, the division head of epidemiology at the University of Toronto’s Dalla Lana School of Public Health, said she and her colleagues are eager to help analyze the fast-moving crisis to a greater extent, but have been stalled by a lack of detailed figures on the demographics and locations of confirmed cases, among other things.

“We have the will, we have the expertise, but we don’t have the data,” she said. “It would be good to know what is actually happening.”

One of the most pressing gaps, Dr. Siddiqi said, is information about the ethnicity of those who have tested positive for COVID-19 or died of the disease. No Canadian province makes this data available, in keeping with a long-standing national aversion to publishing statistics about racial disparities in health. (Toronto’s Medical Officer of Health, Eileen de Villa, has announced that the city is exploring ways to collect race-based coronavirus data on its own.)

But there is reason to suspect race may be a factor in determining who is being infected and dying from the virus, Dr. Siddiqi said, both because of the prevalence of various underlying health conditions in some racialized communities, and their over-representation in low-wage jobs such as nursing, delivery and retail, which make them highly prone to exposure to the virus. Early U.S. data indicate that black Americans are being admitted to hospital and dying from COVID-19 at a disproportionate rate.

“We are very clear that we want to know who is at risk,” Dr. Siddiqi said. “But we’re just very hesitant – and that’s kind of putting it mildly – to add race to the set of dividing factors that we’re willing to entertain.”

This blind spot extends to Indigenous people, whose health care is largely provided by the federal government. NDP MP Charlie Angus would like to change that. In a letter to Health Minister Patty Hajdu last week, he urged the government to start keeping data on COVID-19 cases among Indigenous people, saying, “It would be irresponsible at this time to turn a blind eye to the movement of COVID through vulnerable populations.”

“It seems bloody obvious that you would want to track this and make policy based on this information,” he said in an interview. “I think there’s a naive arrogance in the principle of saying: ‘We’re not the United States, we don’t have their problems, we don’t discriminate like that.’ ”

Even government-funded groups such as the Canadian Institute for Health Information (CIHI) have begun calling for race-based data around coronavirus cases. The organization now supports the idea of health care providers asking a common question about the race of COVID-19 patients and says it would be willing to compile the data.

“The COVID pandemic is certainly exposing gaps in important data flows within and between health care systems in Canada,” CIHI spokeswoman Alex Maheux said.

Source: How Canada’s crucial data gaps are hindering the coronavirus pandemic response ‘We have the will, we have the expertise, but we don’t have the data’: Nationally, the lack of coronavirus-related health and economic data is stalling efforts to analyze the fast-moving COVID-19 crisis

COVID-19 takes unequal toll on immigrants in Nordic region

More on racial disparities:

The first person in Sadad Dakhare’s two-bedroom apartment in Oslo, Norway, to show symptoms was his 4-year-old niece. Next, his mother, his sister and he himself fell ill. Then, about a week after his niece became sick, Dakhare heard his 76-year-old father coughing heavily.

Sadad Dakhare (R), his father Mohamed Dakhare Farah and niece Safa Mohamed Hassan (L) who fell ill with the coronavirus disease (COVID-19) but have now recovered pose in a photo taken in Oslo, Norway April 23, 2020. Picture taken April 23, 2020. Samsam Muhammed Dakhare/Handout via REUTERS. THIS IMAGE HAS BEEN SUPPLIED BY A THIRD PARTY

He found his father lying in bed, gasping for air. “Just call an ambulance,” the father told Dakhare.

At an Oslo hospital, Dakhare’s father tested positive for COVID-19 and was treated for a few days before he was discharged to finish his recovery at home.

The Dakhare family’s story is a familiar one among Somalis in Norway and other Nordic countries, where the pandemic is taking a disproportionate toll on some immigrant groups. Governments in Sweden, Norway and Finland are taking extra steps to try to slow the spread of the disease in these communities.

Across Europe, little is known about who is affected by the virus because governments are releasing limited demographic information about the sick and those who die. But a Reuters examination of government data in three Nordic countries where more details are available shows that some immigrant groups are among those affected at higher rates than the general populace.

“WORRYING” DISPARITY

In Norway, where 15% of residents were born abroad, 25% who had tested positive for COVID-19 by April 19 were foreign-born. Somalis, with 425 confirmed cases, are the largest immigrant group testing positive, accounting for 6% of all confirmed cases — more than 10 times their share of the population.

Somalis are the most overrepresented immigrant group among Sweden’s confirmed cases, as well. Their 283 positive tests account for about 5% of the nearly 6,000 cases documented between March 13 and April 7. That’s seven times their share of the population. Iraqis, Syrians and Turks also made up disproportionately large shares of positive cases.

In Finland’s capital city of Helsinki, the mayor said it was “worrying” that almost 200 Somalis had tested positive by mid-April. They accounted for about 17% of positive cases — 10 times their share of the city’s population.

More than 100,000 Somalia-born live in the three countries, mostly in Sweden and Norway, one of the largest Somali diasporas in the world. Many arrived as refugees of war in the 1990s, 2000s and 2010s. Several factors place them more at risk of getting sick, public health officials and researchers say.

VIRUS OUTPACES RESPONSE

It is common in all three countries for multiple generations of Somalis to live, like the Dakhares do, in crowded apartments, making it easier for the virus to spread from one family member to the next. They also tend to work in high-contact jobs — healthcare workers, drivers and cleaners, for example — with a higher risk for exposure.

Language barriers also are at play, and some have criticized governments in Sweden and Norway for failing to move fast enough in communicating about the virus to immigrant groups.

“By the time information translated to different languages was spread sufficiently, the infection rate among minority groups was already very high,” said Linda Noor, a social anthropologist who is managing director of Minotenk, a think tank focused on minority-related politics in Norway. She said a lot of information in Norway was distributed through national health authorities’ websites that are unfamiliar to many people in immigrant communities.

Public health officials in both Norway and Sweden pointed to COVID-19 information they published in multiple languages, including Somali, in early to mid-March. But they acknowledged that they did not reach some immigrants fast enough.

GETTING THE WORD OUT

“I think it is clear from the epidemiological situation, especially looking at the high proportion of Somalis with COVID-19, that we did not reach this group in time,” said Hilde Kløvstad, department director at the Norwegian Institute of Public Health.

Once the virus started to spread, officials realized they needed to be more focused in their outreach, she said, adding that the spread of the virus among immigrant communities is slowing.

In Oslo, officials contacted leaders in immigrant communities, who helped them get the word out via social media, word of mouth, posters and online videos targeting Somalis, said Hanne Gjørtz, head of communications for the city. Health alerts in Somali aired on the radio, and text messages with translated information were sent to Somali residents.

“We saw that this led to increased traffic on our websites,” she said.

“But we are constantly learning,” she added. “It would definitely have been an advantage to have videos and posters in place earlier in this crisis. This has been and still is a crisis of great speed, and it took some time for us to find the right ways to reach different groups.”

Sadad Dakhare (R) and his niece Safa Mohamed Hassan who fell ill with the coronavirus disease (COVID-19) but have now recovered pose in this photo taken April 22, 2020 in Oslo, Norway. Picture taken April 22, 2020. Samsam Muhammed Dakhare/Handout via REUTERS THIS IMAGE HAS BEEN SUPPLIED BY A THIRD PARTY.

HITTING THE STREETS

In Rinkeby-Kista and Spånga-Tensta, two Stockholm boroughs where immigrants and their children make up most of the population, rates of infection are more than two times higher than in the city overall. Trying to slow the spread of the virus in these areas, where Somalis are the biggest minority group, the government is offering temporary furnished rental apartments to at-risk-groups, such as elderly people who live in multi-generational housing, said Benjamin Dousa, chairman of the Rinkeby-Kista district council.

Government workers who speak a variety of languages, including Somali, have hit the streets in immigrant-heavy neighborhoods — near libraries, religious buildings, municipal offices, metro stations and grocery stores — to warn people about COVID-19, said officials from government body Region Stockholm.

In a statement to Reuters, Region Stockholm said it could have been faster in distributing multilingual information before the virus began spreading disproportionately among immigrant groups.

“However, we are working in the middle of a situation which is before unseen,” the statement said. “Therefore, it is difficult to be as fast as is needed and to foresee all needs.”

The statement added that the infection rate is slowing in Spånga-Tensta and Rinkeby-Kista.

“SITUATION DEMANDS TEAMWORK”

Helsinki is gearing up for similar outreach.

“The situation demands enhanced teamwork, continued development of multilingual services and effective targeted communications,” said Mayor Jan Vapaavuori. “We have entered into discussions with the Finnish Somali League about new measures to improve the situation.”

Somalis themselves also are trying to spread the word about how to stay safe.

Ayan Abdulle posted an informational video on Facebook, but she found she wasn’t reaching the people who needed the information most.

Abdulle, 29, who was born in Somalia and came to Norway at age 9, heads a non-governmental organization in the city of Bergen called Arawelo, which usually focuses on helping young immigrants apply for jobs and find friends. After the coronavirus outbreak, Abdulle started to focus on the elderly as well, helping them with grocery shopping. When she spoke with elderly Somali women out shopping last month, she learned they were not getting enough information about the coronavirus because they weren’t using social media and not all of them understood Norwegian.

“In Somali culture, most information is spread by word of mouth,” Abdulle said. “Now we are going from door to door and hanging posters informing people about the symptoms and how dangerous the disease can be.”

Job Losses Higher Among People Of Color During Coronavirus Pandemic as are Nursing Home Deaths

Two related articles on racial disparities regarding COVID-19, starting with job losses:

Until a few weeks ago, Melissa St. Hilaire worked the night shift taking care of a 95-year-old woman for a family in Miami.

“I help her to go to the bathroom, use the bathroom, and I watch TV with her, and I comb her hair sometimes in the night,” she said.

But one day in March, the woman’s daughter told her not to come back, saying she wanted to protect her mother during the coronavirus pandemic.

St. Hilaire is black and a Haitian immigrant. And her situation is an example of what early data from this crisis shows: People of color have lost work at greater rates than white workers.

The March jobs data show a number of racial and ethnic disparities in the economic impact of the coronavirus. For example: the share of white people who are employed fell by 1.1% last month. That rate fell by substantially more for black people (a 1.6% drop), Asian Americans (1.7%), and Latinos (2.1%). Economist Christian Weller highlighted this data and more at Forbes earlier this month.

In addition, a survey from the left-leaning Data for Progress found that 45% of black workers have lost jobs or had their hours cut, compared with 31% for white workers. (Samples were not large enough to break out other racial and ethnic groups.)

Losing her job landed St. Hilaire in dire straits. She was able to delay her rent payment after she talked to her landlord.

“​I said to her my situation. She said, ‘OK.’ She understood my situation. She gave me more days,” St. Hilaire said, but she added that shelter isn’t her only concern. “Two weeks before [that], I was out of food. That’s crazy.”

She ended up getting some food supplies from a local aid group. She plans to apply for unemployment and also has a GoFundMe whose proceeds she plans to share with fellow domestic aides.

A big reason for these racial and ethnic gaps has to do with the workplaces that have been hurt most by the economic crisis.

“We know which industries are being hit the hardest,” says Gbenga Ajilore, senior economist at the left-leaning Center for American Progress. “So we look at leisure and hospitality, transportation, utilities, industries that are first ones were hit really hard. We also know service — think hairdressers, salons. We know which ones are getting hit hard, and we know who’s in those occupations.”

People of color — and in the case of domestic workers like St. Hilaire, women of color — are disproportionately in those occupations. Nearly three-quarters of domestic workers were out of work the week of April 6, according to a survey from the National Domestic Workers Alliance.

Similar patterns turn up in other industries hurt most by the coronavirus slowdown. The latest jobs report showed more than 450,000 job losses in leisure and hospitality — a category that includes hotels and restaurants. Black, Asian and Latino workers are all disproportionately represented in the hotel industry, and Latino workers have heavy representation in restaurants.

That includes Erick Velasquez, who is Mexican American and who until recently was head bartender at a Greek restaurant in Houston.

“Everything just happened so quick. We’re watching the news, and they talk about COVID-19, and nobody really thought much about it,” he said. “And then a few days after then that’s when they — the city or the county — closed down dining rooms for restaurants everywhere.”

Velasquez has managed to find a temporary job — helping his fellow laid-off workers. He’s a case worker now at the Southern Smoke Foundation, a nonprofit that supports people in the restaurant industry. And he sees racial and ethnic gaps among the people he’s helping.

“​Everybody in the restaurant industry is hurting, but more so, it’s the people that you don’t really see when you go into a restaurant,” Velasquez said. “It’s like the back of the house workers, the immigrant community, the people of color.”

There’s also evidence of disparities in who is able to work from home during this crisis: 30% of white people and 37% of Asian Americans could work from home in 2017 and 2018, according to the Labor Department. Meanwhile, only 20% of black people could. In addition, only 16% of Latinos could work from home, compared to nearly twice as many non-Latinos.

The March jobs report that much of this analysis is based on only captured the start of the economic crisis created by COVID-19. The April report, which will be released May 8, will show if racial gaps have persisted.

If those gaps do continue, it could make existing inequalities worse. The unemployment rates for blacks and Latinos, for example, are always higher than the broader national unemployment rate. Wages for blacks and Latinos are also lower than for other groups.

Ajilore thinks it was easier to ignore these types of gaps when the economy was humming along with record-low unemployment. Now, the economic crisis brought about by the pandemic is holding a magnifying glass to those gaps.

​”Once this pandemic hit, then it’s like you see the cracks in the structure,” he said.

Source: Job Losses Higher Among People Of Color During Coronavirus Pandemic

And nursing home deaths in NYC:

There’s one thing that distinguishes the nursing homes in New York that have reported patient deaths from COVID-19. According to an NPR analysis, they are far more likely to be made up of people of color.

NPR looked at 78 nursing homes in New York in which six or more residents have died of COVID-19. In one facility, 55 people have died as of April 20. Ten others report 30 or more deaths.

Seven of the 11 nursing homes with the highest number of deaths report that 46 percent or more of their residents are “non-white.” Most of these “non-white” residents are black and latinx. At one facility, the Franklin Center for Rehabilitation and Nursing in Queens, which reported 45 deaths, 80 percent of the residents are minority, including 47 percent who are Asian.

NPR filed a public records request with the Centers for Medicare and Medicaid Services and collected data on every nursing home in the United States. We focused our analysis on New York because that state has the most deaths of COVID-19, by far.

Fifty-eight percent of the deaths in the state happened in nursing homes in New York City. Those nursing homes, the NPR numbers show, are notable for their high percentages of residents of color.

But even most of the residents who died in facilities in other parts of the state were living in nursing homes that had a high percentage of residents of color. The population in those facilities tend to reflect the demographics of the counties where they were located.

The racial imbalance in the deaths in New York nursing homes reflects another national trend: That among all fatalities, across the country, from COVID-19, black and Hispanic people make up a disproportionate share of the dying.

NPR analyzed other data too, including the federal government’s system for rating nursing homes that gives each facility a star rating from one to five.

In New York state, nursing homes that recorded deaths actually had better quality scores than other nursing homes. Half of the facilities that report deaths get four or five star ratings from Medicare’s Nursing Home Compare website, indications of “above average” or “much above average” quality.

On other indicators, there was little difference between nursing homes with deaths reported and other facilities in the state. Staffing levels were about the same. Their reliance on Medicaid patients — who bring lower reimbursements — was similar, too. Their occupancy rates — which can indicate problems at a facility if low — also were roughly the same.

But the nursing homes with outbreaks were often larger facilities. Three of those facilities have 700 or more residents. Almost half — 38 out of the 78, including some of the largest in the state — are in New York City.

Nationwide, people living in nursing homes and other long-term care facilities make up close to one out of five deaths nationwide from COVID-19, according to The New York Times.

“It is not surprising that this is exaggerated,” Dr. Clyde Yancy, chief of cardiology at Northwestern University’s Feinberg School of Medicine, said of NPR’s findings of the racial imbalance in deaths at nursing homes. He wrote in the Journal of the American Medical Association about the long history of racial disparities in health care and how it plays out now in this pandemic.

For “someone living in a nursing home who has suffered more extensive complications to a disease process because of already embedded health disparities,” says Yancy, “one can only imagine what happens when that individual now is facing coronavirus infection, potential COVID-19 complications.”

Years of inequality can lead to less access to health care, to hard lives and jobs, to a greater likelihood of developing diabetes, asthma and other conditions that now put people in those nursing homes at greater risk.

Nursing homes are now being recognized as one of the front lines of the pandemic. The residents are often frail, they have underlying health problems.

Nurse aides — who work for low wages — do the hands-on care. They get people out of bed, bathe them and take them to the toilet. They and other staffers were some of the last to get masks, gloves and other personal protective equipment. That made it easier for the virus to spread, notes Dr. Dora Hughes, of the Milken Institute School of Public Health at George Washington University.

“For all of our pandemic response, much of our attention has focused, appropriately, on hospitals. But I think for what we’ve seen with the nursing home is a fairly stark reminder that we need to really expand our thinking in terms of essential workers,” says Hughes. “The direct care staff, should have been a greater priority.”

Source: In New York Nursing Homes, Death Comes To Facilities With More People Of Color

Opinion: U.S. Must Avoid Building Racial Bias Into COVID-19 Emergency Guidance

Another angle and concern regarding racial disparities in healthcare:

Across the United States, we are seeing alarming statistics about the disproportionate toll of COVID-19 on Latino and black people. In New York City, the New York Times tells us, coronavirus is twice as deadly for these minorities as for their white counterparts. In both Chicago and Louisiana, black patients account for 70% of coronavirus deaths, even though they make up roughly a third of the population.

At Massachusetts General Hospital, where we practice, an estimated 35% to 40% of patients admitted to the hospital with the coronavirus are Latino — that’s a 400% increase over the percentage of patients admitted before the outbreak who were Latino.

In the emergency room, conversations about a patient’s end-of-life wishes are taking place in broken Spanish, seconds before they get intubated. In the intensive care unit, doctors barely have time to update family members, because they’re too bogged down by patient-care tasks to call an interpreter. For patients healthy enough to go home, our usual script around social distancing falls short, as many of our black and Latino patients are unable to self-isolate within large multigenerational households. In addition, many of these patients either are essential workers or live with one — they cannot simply “stay home”.

In a pandemic that has stretched U.S. health care resources thin, it’s not surprising to see a worsening of already existent health care disparities. Several states and organizations have started to release Crisis Standards of Care guidelines in recent weeks — these are meant to help hospitals ration critical resources like ventilators and intensive care unit beds, if and when the need is dire.

The overall aim of such guidelines, which can vary in their specifics from state to state and hospital to hospital, is to allocate limited resources to the people who are most likely to benefit from them.

To determine which patients get priority in treatment, several of the CSCs published so far, such as guidelines from Colorado and Massachusetts, recommend that the hospital use frameworks that include the patient’s age and “SOFA” score (a measure of how critically ill the patient is at arrival, based on objective laboratory values). Importantly, they also include what we doctors call “comorbidities” — other, underlying medical conditions that can put patients who are infected with this virus at a higher risk for worse outcomes.

We know that historically disadvantaged populations — including black and Latino patients — have a higher burden of the comorbidities traditionally used by hospitals to stratify patients by risk. This is largely because of structural and socioeconomic factors. Studies and statistics suggest that, compared to their white counterparts, black patients are 40% more likely to have high blood pressure, twice as likely to have heart failure, three times as likely to die from asthma-related complications, three times more likely to have chronic kidney disease, twice as likely to be diagnosed with colon and prostate cancer, and represent 44% of the HIV positive population. Similarly, Latino patients are twice as likely to both have and die from diabetes, and twice as likely to have chronic liver disease than non-Hispanic whites.

Although the foundational principle of Crisis Standards of Care guidelines are utilitarian and aim to benefit the greatest number of people while treating “individual cases fairly,” a system that penalizes on the basis of comorbidities will undoubtedly and unfairly penalize the populations that are already more vulnerable to those conditions.

Furthermore, given the novelty of COVID-19, we still don’t have a complete picture of which factors lead to worse outcomes. While some data suggest that patients with severe COVID-19 are more likely to have hypertension or respiratory or cardiovascular illnesses, there are also findings suggesting that men have more severe disease than women. Yet, the Crisis Standards of Care are not factoring sex into their scoring system. This means that we are arbitrarily choosing metrics to guess which patients will do better, and we’re doing so at the expense of populations that have historically been marginalized by the health care system.

COVID-19 is already affecting and killing a disproportionate number of black and Latino patients across the United States. Using comorbidities as a proxy for disease severity to allocate resources, without taking into account race and ethnicity, will almost certainly mean that racial and ethnic minorities will be placed in the “back of the line” for critical care resources.

In order to do the greatest good for the greatest number of people ethically and fairly, standards of care must be informed by the existing inequalities in our country.

While we’re not suggesting that comorbidities be removed from crisis standards of care altogether, we urge states to reevaluate current guidelines and include only major comorbidities with a known short-term impact on a patient’s prognosis.

States should also track and make publicly available demographic data — including race and ethnicity — for patients hospitalized with COVID-19 in order to ensure that people of color are not being denied resources disproportionately. Lastly, states should ensure that the committees designing crisis standards of care are composed of a racially and ethnically diverse group of individuals in a way that is representative of their population.

It was devastating enough to have to tell my African American patient’s young son that his dad’s illness was so life-threatening we needed to place a breathing tube down his throat and send him to the intensive care unit. I can only imagine how he would feel if, in some unfortunate circumstance, we would have to tell him that his father would need to be taken off the ventilator to conserve resources.

Dr. Jossie Carreras Tartak and Dr. Hazar Khidir are residents in Emergency Medicine at Massachusetts General Hospital in Boston.

Source: Opinion: U.S. Must Avoid Building Racial Bias Into COVID-19 Emergency Guidance

Racial divide of COVID-19 patients in U.S. grows even starker as new data suggests disproportionate black patients

Yet more evidence and advocacy:

As a clearer picture emerges of COVID-19’s decidedly deadly toll on black Americans, leaders are demanding a reckoning of the systemic policies they say have made many African Americans far more vulnerable to the virus, including inequity in access to health care and economic opportunity.

A growing chorus of medical professionals, activists and political figures are pressuring the federal government to not just release comprehensive racial demographic data of the country’s coronavirus victims, but also to outline clear strategies to blunt the devastation on African Americans and other communities of colour.

On Friday, the Centers for Disease Control and Prevention released its first breakdown of COVID-19 case data by race, showing that 30% of patients whose race was known were black. The federal data was missing racial information for 75% of all cases, however, and did not include any demographic breakdown of deaths.

The latest Associated Press analysis of available state and local data shows that nearly one-third of those who have died are African American, with black people representing about 14% of the population in the areas covered in the analysis.

Roughly half the states, representing less than a fifth of the nation’s COVID-19 deaths, have yet to release demographic data on fatalities. In states that have, about a quarter of the death records are missing racial details.

Health conditions that exist at higher rates in the black community – obesity, diabetes and asthma – make African Americans more susceptible to the virus. They also are more likely to be uninsured, and often report that medical professionals take their ailments less seriously when they seek treatment.

“It’s America’s unfinished business – we’re free, but not equal,” civil rights leader Rev. Jesse Jackson told the AP. “There’s a reality check that has been brought by the coronavirus, that exposes the weakness and the opportunity.”

This week, Jackson’s Rainbow PUSH Coalition and the National Medical Association, a group representing African American physicians and patients, released a joint public health strategy calling for better COVID-19 testing and treatment data. The groups also urged officials to provide better protections for incarcerated populations and to recruit more African Americans to the medical field.

Jackson also expressed support for a national commission to study the black COVID-19 toll modelled after the Kerner Commission, which studied the root causes of race riots in African American communities in the 1960s and made policy recommendations to prevent future unrest.

Daniel Dawes, director of Morehouse College’s School of Medicine’s Satcher Health Leadership Institute, said America’s history of segregation and policies led to the racial health disparities that exist today.

“If we do not take an appreciation for the historical context and the political determinants, then we’re only merely going to nibble around the edges of the problem of inequities,” he said.

The release of demographic data for the country’s coronavirus victims remains a priority for many civil rights and public health advocates, who say the numbers are needed to address disparities in the national response to the pandemic.

The AP analysis, based on data through Thursday, found that of the more than 21,500 victims whose demographic data was known and disclosed by officials, more than 6,350 were black, a rate of nearly 30%. African Americans account for 14.2% of the 241 million people who live in the areas covered by the analysis, which encompasses 24 states and the cities of Washington D.C., Houston, Memphis, Pittsburgh and Philadelphia – places where statewide data was unavailable.

The nation had recorded more than 33,000 deaths as of Thursday.

In some areas, Native American communities also have been hit hard. In New Mexico, Native Americans account for nearly 37% of the state’s 1,484 cases and about 11% of the state’s population. Of the 112 deaths where race is known in Arizona, 30 were Native Americans.

After Democratic lawmakers introduced legislation this week to try to compel federal health officials to post daily data breaking down cases and deaths by race, ethnicity and other demographics, the CDC released only caseload data that – similar to the AP’s analysis of deaths – show 30 per cent of 111,633 infected patients whose race is known were black. African American patients in the 45-to-64 and 65-to-74 age groups represented an even larger share of the national caseload.

The lawmakers sent a letter last month to Health and Human Services Secretary Alex Azar urging federal release of the demographic data. And Joe Biden, the former vice-president and presumptive Democratic presidential nominee, also called for its release.

Meanwhile, some black leaders have described the Trump administration’s response to COVID-19 as inadequate, after what they said was a hastily organized call with Vice-President Mike Pence and CDC Director Robert Redfield last week.

According to a recording of the call obtained by the AP, Redfield said the CDC has been collecting demographic data from death certificates but that the comprehensiveness of the data depends on state and local health departments, many of which are overburdened by virus response. No plan was offered to help health officials in hard-hit communities collect the data, leaders who were on the call said.

Kristen Clarke, president of the Lawyers’ Committee for Civil Rights Under Law, which took part in the call, said African Americans “have every reason to be alarmed at the administration’s anemic response to the disproportionate impact that this crisis is having on communities of colour.”

Mistrust runs deep among residents in many communities.

St. Louis resident Randy Barnes is grappling not just with the emotional toll of losing his brother to the coronavirus, but also with the feeling that his brother’s case was not taken seriously.

Barnes said the hospital where his brother sought treatment initially sent him home without testing him and suggested he self-quarantine for 14 days. Five days later, his brother was back in hospital, where he was placed on a ventilator for two weeks. He died April 13. Barnes’ brother and his wife also were caring for an 88-year-old man in the same apartment, who died from the virus around the same time.

“Those people are not being tested. They’re not being cared for,” Barnes said.

Eugene Rush lives in one of the areas outside large urban cities that have been hit hard with coronavirus cases. He is a sergeant for the sheriff’s department in Michigan’s Washtenaw County, west of Detroit, where black residents account for 46% of the COVID-19 cases but represent only 12% of the county’s population.

Rush, whose job includes community engagement, was diagnosed with COVID-19 near the end of March after what he initially thought was just a sinus infection. He had to be hospitalized twice, but is now on the mend at home, along with his 16-year-old son, who also was diagnosed with COVID-19.

“I had a former lieutenant for the city of Ypsilanti who passed while I was in the hospital and I had some fraternity brothers who caught the virus and were sick at the hospital,” Rush said. “At that point, I said, ‘Well, this is really, really affecting a lot of people’ and they were mostly African American. That’s how I knew that it was really taking a toll a little bit deeper in the African American community than I realized.”

Source: Racial divide of COVID-19 patients in U.S. grows even starker as new data suggests disproportionate black patients