News 

Testing Criteria, Health Disparities likely cause for higher COVID 19 cases among Blacks in Mecklenburg

Thestimulus

In press conference held earlier today Gibbie Harris [ the Public Health Director in Mecklenburg County North Carolina ] officially confirmed that both current COVID 19 testing criteria, and racial / ethnic disparities in chronic disease, are more likely the cause for the higher number of  COVID 19 cases among African Americans in Mecklenburg County.

 

A press release issued by the Mecklenburg County Health Department today reads in part:

At this time, we do not believe the racial/ethnic differences observed in our data are related to the spread of COVID-19 or differences in the susceptibility of certain groups to being infected by COVID-19.  These differences are more likely related to the current testing criteria, which is focused on symptomatic patients, and underlying racial/ethnic disparities in rates of chronic conditions that increase severity of illness with COVID-19.”

 

 

 

This is a significant development in the fight against COVID 19 since a growing number of doctors across the country are voicing concerns about how current COVID 19 testing criteria and bias in the delivery of healthcare may be disproportionately affecting vulnerable populations during this pandemic.   For example, yesterday NPR released the article “The Coronavirus Doesn’t Discriminate, But U.S. Health Care Showing Familiar Biases” and that article reads in part:

 

In one analysis, it appears doctors may be less likely to refer African Americans for testing when they show up for care with signs of infection.  The bio-tech data firm Rubix Life Sciences, based in Boston, reviewed recent billing information in several states, and found that an African American with symptoms like cough and fever was less likely to be given one of the scarce coronavirus tests.  Delays in diagnosis and treatment can be harmful, especially for racial or ethnic minority groups that have higher rates of certain diseases, such as diabetes, high blood pressure and kidney disease. Those chronic illnesses can lead to more severe cases of COVID-19.”

 

 

In another article, “The Coronavirus Doesn’t Discriminate, US Health Care May Be a Different Story“, also published by NPR Dr. James Hildreth president of Meharry Medical College and an infectious disease specialist highlights that:

We cannot afford to not have the resources distributed where they need to be because, otherwise, the virus will do great harm in some communities and less in others.”

 

In the same NPR interview Dr. Georges Benjamin emphasized the need for the release of demographics that reveal who is getting tested and who is not:

We want people to collect the data in an organized, professional, scientific manner and show who’s getting it and who’s not getting it and recognize that we may very well see these health inequities.”

 

 

 

Recently both the North Carolina Department of Health & Human Services and the Mecklenburg County Health Department released additional racial and ethnic demographics re: the impact of COVID 19.

 

Still there’s the elephant in the room:  Current testing criteria.   While the CDC has provided guidance on their website there is currently a highlighted caption at the top of their page that reads:  “CDC guidance for COVID-19 may be adapted by state and local health departments to respond to rapidly changing local circumstances:”

 

PRIORITY 1  Ensure optimal care options for all hospitalized patients, lessen the risk of nosocomial infections, and maintain the integrity of the healthcare system

  • Hospitalized patients
  • Symptomatic healthcare workers

PRIORITY 2  Ensure that those who are at highest risk of complication of infection are rapidly identified and appropriately triaged

  • Patients in long-term care facilities with symptoms
  • Patients 65 years of age and older with symptoms
  • Patients with underlying conditions with symptoms
  • First responders with symptoms

PRIORITY 3    As resources allow, test individuals in the surrounding community of rapidly increasing hospital cases to decrease community spread, and ensure health of essential workers

  • Critical infrastructure workers with symptoms
  • Individuals who do not meet any of the above categories with symptoms
  • Health care workers and first responders
  • Individuals with mild symptoms in communities experiencing high COVID-19 hospitalizations

NON-PRIORITY

  • Individuals without symptoms

 

Again, notice the caption at the top of their page says “CDC guidance for COVID-19 may be adapted by state and local health departments” – not must be adopted.  Keep in mind the definition of adapted is:  make (something) suitable for a new use or purpose;  modify;  adjust to new conditions; and  alter (a text) to make it suitable.  In other words the guidance appears to suggest that user discretion is advised.  Therefore,  can current testing criteria in and of itself be used as a scapegoat?   So within this context and given the statement made by the Mecklenburg County Health Department today,  it will be interesting to see if  states and local health departments across the country – as well as the CDC – will modify, adjust, or alter the application of CDC guidance for COVID-19 testing criteria as a result of rapidly changing  circumstances.   After all the application of the current testing criteria doesn’t just affect African Americans without symptoms, but all individuals without symptoms.

At this time, we do not believe the racial/ethnic differences observed in our data are related to the spread of COVID-19 or differences in the susceptibility of certain groups to being infected by COVID-19.  These differences are more likely related to the current testing criteria, which is focused on symptomatic patients, and underlying racial/ethnic disparities in rates of chronic conditions that increase severity of illness with COVID-19.”

 

PBS Video:  COVID-19 may not discriminate based on race, but U.S. health care does

Health officials have stressed that novel coronavirus doesn’t discriminate based on race or ethnicity.  But disparities long present in the U.S. medical system are now driving what some call a crisis within a crisis: black and brown communities across the country are being hit harder, and with fewer resources to save them. Amna Nawaz talks to Dr. Uché Blackstock of Advancing Health Equity.