“ ‘But what will my children do if we die?’ asked my patient’s mother in Spanish. With three other children at home, she had used her limited funds for a taxi to bring her child with COVID-19 symptoms to the hospital. Her husband was hospitalized with COVID-19. She was sick herself, and worried about getting sicker due to underlying health conditions.
“Through my N-95 mask and face shield, I yelled so the interpreter on the phone could hear me. When she started sobbing, I could not comfort her from six feet away, but I could feel her fear. I felt helpless. I listened, cried with her, and provided her and her child COVID-19 testing. I wanted her to know that I saw her, and I saw her suffering.”
— Elizabeth Keating, M.D.
As frontline physicians, we are seeing this pain in real time. It is feeling all too common these days. We attempt to acknowledge this invisible suffering that stems from a deeper need. We write united to address Utah’s racial health disparities surrounding COVID-19.
Although the overall positivity rate of 4.11% indicates Utah is on track to safely reopen, this rate is not uniform between groups. The Latinx population makes up 14.2% of Utah’s population, yet accounts for 37.9% of confirmed cases. This represents the highest case rate of any race/ethnicity in Utah. Social conditions like household density, limited access to health care, pre-existing medical conditions, unemployment, and pervasive discrimination can all set people up for exposure to the virus and worse outcomes.
Many of our public-facing essential workers in the U.S. and in Utah are Latinx. As we lift restrictions, the risk of infection will likely increase for this already heavily impacted population. For many families, the need to feed their children outweighs the risk of returning to work. Staying at home to stay safe could risk losing prior employment.
Given the risks many families are taking, it is imperative that we prioritize reporting more COVID-19 outcomes by race/ethnicity, so that we are prepared as a community to address needs in a proactive manner.
We have much to be proud of as Utahns. Organizations, supported by citizens like you from across the state, have risen to the occasion to support our most vulnerable residents. The Utah Food Bank (UFB), for example, has worked hard to meet the “over 1000% increase in need,” according to Julie Adams-Chatterley, food drive specialist. She encourages families in need to call 211 to be connected to resources in 150 languages, and to check the UFB site for upcoming mobile pantries. COVID-19 is disproportionately affecting a vital minority population in Utah. What can we do?
The first step is to better understand the scope of the problem by consistently reporting infection rates by race/ethnicity, not only confirmed cases. This allows us to strategically expand testing, enhance contact tracing, tailor education, and, most importantly, better signal when our community is truly safe for further transitions.
Second, we must understand who is becoming critically ill and who is dying by reporting ICU and mortality data by race/ethnicity. Without this, we cannot evaluate how COVID-19 and our policies affect our vulnerable populations.
Third, we need to continue to physically distance. Do this by staying home if able, wash hands, and wear masks in public.
Finally, we must make sure that state, federal, and non-profit resources are accessible to families who need them most. This is our community, our collective health, and our collective economy — we are all in this together.
Reena Tam, M.D., is a pediatric hospitalist.
Katie Gradick, M.D., MHS, is a fellow in pediatric hospice and palliative medicine and a primary care pediatrician.
Elizabeth Keating, M.D., MSPH, is a fellow in pediatric emergency medicine and global health.
Vicki Wilkins, M.D., MPH, is a Pediatric Hospitalist.
Margie Diaz-Ochu, M.D. is a General Pediatrician.