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Even before Utah had its first case of the coronavirus, the state had created a task force to coordinate its response and, shortly after, added a group to focus on the economic impacts of what soon would become a life-altering pandemic.
Silvia Castro, executive director of the Suazo Business Center, wasn’t part of those early efforts. Hardly any people of color were. She found that not only frustrating but also shortsighted.
“From the beginning, there was never a thought to include people of color,” said Castro, who is now one of the 23 members of the state’s COVID-19 Multicultural Subcommittee, which launched in late April.
By then, it was all too clear the coronavirus was disproportionately affecting Utahns of color and, in particular, the Hispanic community.
By May 27, the cases among Hispanic Utahns surpassed those of white residents. And week after week, that disparity has grown. It is now more than 1,000 cases. With Hispanics accounting for 5,904 positive tests and white people at 4,836 as of Saturday.
Another way to look at it is that Utah’s population is 78% white and yet that demographic now accounts for only 34.6% of the COVID-19 cases. Conversely, Utah is 14.2% Hispanic and yet 42.2% of all of the cases are among that group.
Health officials, current and former government officials, and leaders of community organizations say Utah reacted too slowly to the virus’s impact on Hispanics, failing to provide the necessary health information in effective ways.
“I’m just going to say we are playing catch-up,” said former state Rep. Rebecca Chavez-Houck, who is also on the subcommittee. “Because we knew that something like this could happen. It would have been optimal if that awareness had been recognized sooner rather than later by individuals [who] were making decisions at a statewide level."
There now are a variety of efforts aimed at stopping the spread among Hispanics, with others still in the works. This includes more testing in areas with larger Hispanic populations, grants to nonprofit groups to hire community health workers, Spanish language podcasts and online forums, and even talk of shifting funding to help Hispanic families hit by the virus.
These efforts may make an impact, though that hasn’t yet been reflected in the state’s coronavirus statistics.
How jobs and living situations play a role
What underlies Utah’s slow initial efforts and the rush to make up for them is the realization that the same public health tactics are not effective with every community. Utah’s Hispanics have their own demographic realities, economic hardships and a general distrust of the government.
Lorena Riffo Jenson, a strategic adviser for Salt Lake County in communicating with diverse communities, said many Hispanics have jobs considered essential during COVID-19 — such as work in a construction field or at supermarkets and restaurants. And oftentimes an individual is working two or three jobs.
“If they don’t go to work, there’s not going to be food on the table,” Jenson said. “There’s no three months or six months of savings that is recommended in middle-class America. That doesn’t exist.”
The state’s largest single outbreak is at the JBS meatpacking plant in Hyrum, where at least 287 employees tested positive for the virus. Several people who work there said they were forced to go to work despite a positive test. The plant has 1,400 workers and is largely staffed by minorities, many of whom are immigrants from Latin America, Asia and Africa.
The way some Hispanic families live may also contribute to higher numbers of infections. It is more common to have multiple generations living under the same roof. And some hop from temporary living situation to temporary living situation for a couple of weeks at a time.
These circumstances make following social distancing and quarantine protocols — such as keeping 6 feet apart or not sharing a bedroom or bathroom with someone showing symptoms — virtually impossible.
“What we see is the guideline is a good guideline,” said Edwin Espinel, Spanish-language spokesman for the Utah Department of Health. “But is it considerate of individuals that have less means ... or [that] live under tighter conditions?”
Liliana Benavidez, an epidemiologist at the Salt Lake County Health Department, said roughly 46% of Salt Lake County residents who identify as Hispanic or Latino got the virus from interacting with a family member who was positive.
Still, Benavidez said there isn’t enough data to make sweeping conclusions.
“We’ve been looking at trying to identify any one specific reason or any specific factor as far as the data goes,” Benavidez said. “There’s nothing glaring at us that tells us, ‘This is why it’s affecting specifically these communities.’”
The barriers and fears that stop some
What appears evident is that Utah wasn’t prepared to reach out to its Hispanic residents when the virus struck.
Almost none of the government health websites offered Spanish translations. Those that did often included inadequate information.
Maria Montes, community engagement and advocacy coordinator for Comunidades Unidas, said her organization spoke to the state health department and each of the local health departments about the poor translations and lack of information in Spanish.
"It doesn’t matter what precautions our governor and our state promotes if our people don’t know it,” Montes said, reiterating that Hispanics account for one out of every seven Utahns.
Montes said they’ve had to resort to social media to get adequate information out to people, and have collaborated closely with Spanish TV stations like Univision and Telemundo.
Benavidez, who said several of her family members and a couple of her friends tested positive for the coronavirus and have since recovered, often wonders if those close to her are “truly aware of the situation” and “actually getting the correct information.” Many people she knows don’t have access to the internet because they deem it an unnecessary extra expense.
And the very nature of how COVID-19 spreads has complicated educating the community. Sending people door to door or holding community events is highly discouraged.
“I wonder, with us trying to avoid people being out in the community, how that information is getting out to them,” Benavidez said. “Is it just the news? Is it just word of mouth? Is it just what they’re seeing on their phones or on social media?
“What is it, and what's the best way to make sure that we implement a process to get the good information out to them so they understand the reality of the virus and how to prevent it from passing it on to each other?”
For some Hispanics, there’s fear of getting tested because they distrust the government.
José Borjón, the Mexican consul stationed in Utah, believes the issue, at least with those Hispanics who aren’t U.S. citizens, stems from not knowing what would happen if someone needs to be hospitalized due to COVID-19. It raises questions, such as if they’d be able to call their children.
Another fear Hispanics harbor, particularly those who are undocumented, is that information they give while at a testing site could be sent to immigration officials. Others have feared identification is a prerequisite for getting tested.
Borjón, along with health officials, say that is not the case.
“There was, and there's been still, a lot of this information [on] social media, especially in our community,” Borjón said. “And that has been a real need and concerted effort, I guess, to fight [that] misinformation. And there hasn't been a lot of trusted voices out there to give [these] messages consistently, repeatedly.”
What ends up happening, Borjón said, is some people don’t want to know if they have the virus, refusing to get a test even if they have symptoms, because they can’t risk losing work or don’t want to be separated from family.
And that means people who have the disease are interacting with others and spreading it, especially as the economy continues to reopen.
“That is unfortunate,” Borjón said. “But that's a situation that is certainly happening.”
A scramble to help
Efforts to help Hispanics and other communities of color have ramped up in recent weeks.
More testing sites have popped up to address hot spots, some in areas believed to have a high percentage of Hispanic residents, including Salt Lake City’s west side, West Valley City, Orem, Glendale and Mexican Hat, said Castro, with the Suazo Business Center.
The Mexican Consulate held a testing event at the Centro Cívico Mexicano, located in downtown Salt Lake City on May 15, roughly a week after a similar event was held at the fairpark.
Another focus has been boosting the number of documents and websites translated into other languages, Espinel said. He called it a “monumental” undertaking.
The state’s coronavirus website added a chat feature May 11 in Spanish, almost two months after the original chat feature in English became available, Espinel said.
Other education initiatives have popped up. Latino Behavioral Health Services has offered workshops in Spanish. A coalition has started to raise mental health awareness among communities of color. The Utah Division of Multicultural Affairs started a video podcast called “Centering Diversity: COVID-19 Conversation” and weekly virtual chats for Spanish speakers.
Rylee Curtis, University of Utah Health’s director of community engagement, said her office is creating double-sided mailers in Spanish, which will be sent soon, that offer guidelines from the Centers for Disease Control and Prevention.
Utah’s Office of Health Disparities gave $250,000 to divide among 11 community organizations to fund Promotoras, community health workers who screen people at testing sites for social needs, provide more personal help and do follow-ups. One example: making food deliveries to families so they can comply with quarantine protocols.
Sen. Luz Escamilla, D-Salt Lake City, who tested positive for the virus and has since recovered, has assisted in that effort and said she’s trying to secure more funding.
There’s also an ongoing attempt by the state to hire contact tracers who speak Spanish. Contact tracers talk to a person infected with the coronavirus in an attempt to learn the names of everyone that person came into contact with to help stop the virus from spreading.
Espinel said having to translate a contact tracing interview makes a conversation that usually lasts 15 to 20 minutes go for longer than an hour. The state health department recently hired 12 part-time Spanish speaking contact tracers, Espinel said, and hopes to get 37.
What the future holds
The state’s Division of Multicultural Affairs released a report in April that surveyed nonprofit organizations serving communities of color. The report revealed specific issues that Utah’s people of color face when it comes to COVID-19 and gave recommendations on how to address them.
The subcommittee’s priorities include, but are not limited to, increasing translated information and getting it to the public, expanding outreach in underserved communities, collaborating with health care organizations, and encouraging the collection and reporting of equity data.
Castro said that report was a “wake-up call” to the deeply rooted health disparities that exist.
“This could be an opportunity to address these inequalities,” Castro said. "Because you cannot ignore them. Frankly, I think a lot of people were not aware. A lot of people had no clue.”
Escamilla said the state can definitely do more than is currently being done, and there’s an appetite to do so.
“There's an understanding that there's this huge gap and we're seeing it in the numbers,” Escamilla said. “The numbers speak for themselves. And we need to just have real interventions that are effective.”
Some of those interventions will require funding, which may be difficult to obtain because of the economic crisis tied to the pandemic. Escamilla and Castro said families who can’t afford to quarantine will need financial assistance. Castro also said funding would be better served going through nonprofit organizations, where it might stretch further.
The state seemed slow in seeing the danger for Utah’s Hispanics, and the virus continues to spread rapidly among them. The question remains: Is the state doing enough?
Castro, who was frustrated with the early response, now has a glimmer of optimism. “At least," she said, "we’re catching up.”