- At least 27 states are reporting an increase in confirmed COVID-19 cases as businesses and public facilities reopen.
- As cases surge in multiple states, people of color and particularly Black Americans may be at heightened risk.
- Health experts have said we’re still in the first wave of COVID-19 and may be reaching a second peak.
After several months of stay-at-home orders, all 50 states are now starting to loosen their lockdown guidelines and recommendations.
However, as restrictions are lifted, states are seeing an alarming increase in cases.
Already, at least 27 states are starting to report an increase in confirmed COVID-19 cases with businesses and public facilities starting to reopen.
In Arizona the number of confirmed cases of COVID-19 have more than doubled over the previous 2 weeks, and Florida recently reported its largest single-day increase in cases since the state’s most recent record on June 4.
Texas also reported over 5,000 new cases in a single day.
As cases rise, people of color including Black and Hispanic Americans, especially those working in essential jobs or unable to work from home, will be at increased risk for severe cases of COVID-19.
Recent statistics from the Centers for Disease Control and Prevention (CDC) show that Black Americans have made up 23 percent of all COVID-19 deaths, however, they only constitute approximately 12.5 percent of the U.S. population.
According to data from the Brookings Institution, Hispanic and Latino people are more than twice as likely to die from COVID-19 compared to white Americans, after adjustments made for age.
In some states such as Michigan, Black Americans account for about 40 percent of cases despite making up less than 14 percent of the state’s population.
These disparities have caused an increased concern in many Black communities.
COVID-19 spotlights health inequalities
A study published Wednesday in the Journal of Public Health found that rates of severe COVID-19 cases were far higher for Black, Asian, and other minority groups.
The researchers from Queen Mary University of London looked at over 4,000 people, of whom 1,326 tested positive for COVID-19.
The team determined that socioeconomic, cardiovascular disease rates, and vitamin D rates couldn’t explain the disparity and that more needs to be done to understand why these groups are at such high risk.
“There is increasing concern over the higher rate of poor COVID-19 outcomes in BAME [Black, Asian, and Minority Ethnic] populations,” Dr Zahra Raisi-Estabragh, BHF clinical research training fellow at Queen Mary University of London, who led the analysis, said in a statement.
“Understanding potential drivers of this relationship is urgently needed to inform public health and research efforts,” Raisi-Estabragh said. “This work goes some way in addressing some of these pertinent questions.”
According to Dr. Matthew Heinz, a hospitalist and internist at the Tucson Medical Center in Tucson, Arizona, health disparities aren’t new for minority populations.
Structural problems in our health system have meant many people of color and especially Black Americans face difficulty accessing quality healthcare.
Studies have found that medical providers have the same levels of bias as the wider population which could put people of color at risk of facing prejudice when getting medical care.
“Many minority communities throughout the U.S. have lack of access to healthcare, and while there are services and clinics available, there is still a disproportionate lack of services available to African Americans,” Heinz said.
The study found that people of color faced sustained stress from racism, which one researcher called a “social toxin” that can lead to premature cellular aging.
The U.S. Department of Health and Human Services Office of Minority Health indicates that the death rate for Black Americans is generally higher compared to white populations for a variety of diseases including “heart diseases, stroke, cancer, asthma, influenza and pneumonia, [and] diabetes.”
The comorbidities that create the worst outcomes for COVID-19 are these conditions.
Combining these risk factors with COVID-19 only worsens health outcomes and can increase a person’s chance of hospitalization, and as a result, can even lead to death when combined with COVID-19.
“African Americans are less likely to have consistent access to healthcare overall, primary care, and insurance coverage,” Heinz said. “That already is going to affect how likely someone is going to go see a doctor and to seek medical care.”
Danger at work and at home
New reports from the Economic Policy Institute suggest that Black Americans are not only experiencing additional risk factors on their health, there’s also inequality in the job market.
Black Americans are reportedly least likely to be able to continue to work from the safety of their home, and are disproportionately found among the essential workers of today’s economy — meaning they continue to go into their workplace to help and service others.
According to the report, Black Americans make up 1 in 9 workers in the overall general population. However, in the frontline industries, they make up 1 in 6 workers. This means increased exposure to COVID-19.
They’re more likely to pass it along to family members or loved ones as well.
Studies found that living in multigenerational homes can increase the risk of transmission. In the United States, people of color including Black, Hispanic, and Asian Americans are more likely to live in multigenerational homes than white Americans.
Research published on June 18 from Columbia University found that one reason New York was hit so hard early in the outbreak was likely due to multiple generations living in the same household.
The researchers looked at 400 pregnant women who were tested for COVID-19 during delivery. They found that those who lived with many family members were most likely to contract the virus.
Researchers said since Black and Hispanic people were more likely to be living in households with many family members, it may explain why they disproportionately were diagnosed with the disease.
“One may think that because New York City is so dense, there’s little that can slow the spread of the virus, but our study suggests the risk of infection is related to household, rather than urban density,” Dr. Cynthia Gyamfi-Bannerman, a professor of women’s health in Columbia’s department of obstetrics and gynecology said in a statement.
The mental toll of COVID-19
There’s no doubt that the United States is not out of the woods yet, and that can also take a mental toll on Americans.
With increased death rates and cases in minority communities, people in those communities may be at higher risk for anxiety and depression.
Those that are forced to go back to work aren’t only experiencing their own anxieties related to the virus, but may be coping with loss of a family member or fear of losing a friend or family member.
Brittany LeMonda, PhD, senior neuropsychologist at Lenox Hill Hospital in New York City, said that the pandemic has meant not only concentrated loss for people in certain areas or in certain ethnic groups but an inability for people to be with their loved ones in the hospital.
Many hospitals have restricted visitation and adjusted daily practices, so there are additional anxieties of not being able to see a sick relative in the hospital.
“These important aspects of coping have not been able to happen during the pandemic due to social distancing/stay-at-home orders, making coping with loss and grieving especially hard,” said LeMonda.
The traditional means of closure for families during this pandemic have been limited and many times nonexistent. Funerals have had to have a limited number of attendees in certain cases to avoid the chance of spreading the virus.
Shifting advice in recent months — such as recommendations for face masks — can also contribute to mental strain for all Americans.
LeMonda said this sudden shift can be “very confusing and can result in significant anxiety.”
As cases again increase across the country, people who cannot work remotely and have to take public transportation may face mental strain from taking these risks.
“We didn’t know what to expect, when the peak would hit, how many people would pass, if we/loved ones would fall ill — all of this can be a very traumatic experience,” LeMonda said.
Dr. Rajiv Bahl, MBA, MS, is an emergency medicine physician, board member of the Florida College of Emergency Physicians, and health writer. You can find him at RajivBahlMD.com.