COVID-19 has proven time and again that it isn't an equal opportunity virus
A mystifying characteristic of our country’s health system is the level of disparities among different groups. This is reflected in how long people live and how sick they are.
These disparities have been linked directly or indirectly to several factors like neighborhood and physical environment, access to quality health care, occupation and job conditions, income and wealth, and education.
Disparities by race and ethnicity are the most stunning. For example, Hispanic/Latinx have three times the rate of uncontrolled diabetes than whites. Black women die from pregnancy-related deaths more than three times more often than white women. And Black babies in Kansas die more than twice as often as white babies.
It is not surprising therefore that COVID-19 is following the same pattern, and racial and ethnic health disparities that started back in the early days of the pandemic have been documented.
Black and brown individuals are more likely to: be exposed to the virus, often because of their occupation and housing situations (with a rate of contracting COVID-19 in Kansas 30% higher for Hispanics than for Whites); have difficulty accessing testing; develop severe illness if infected (with a risk of hospitalization over 3.5 times greater than for white individuals in the U.S.); and die from the virus (with a risk of death for Blacks 2.5 times greater than for whites in the U.S.).
As we all know, the availability of multiple vaccines is likely to change the course of the pandemic in many ways. However, early data suggest that the vaccine is not helping close the COVID-19 racial gap.
In Kansas, the rate of vaccination for whites is over twice as large as that for Blacks, and 1.7 times greater than that for Hispanics, despite the fact that Blacks and Hispanics are disproportionately affected by the virus.
Offering the same opportunity to be vaccinated to high-risk individuals must take into account race and ethnicity. Consider for example the approach of targeting older individuals first with the vaccine.
While it is true that seniors can become sicker and die more often than younger individuals, many Blacks die on average at younger ages. Using an age cut-off criterion for vaccine eligibility for everybody may disqualify some Blacks from receiving the vaccine even though their risk of severe disease at just about any age is higher than that of older whites.
It does not need to be like that, and we are still in time to change it. The first step is to collect, analyze and publish data on race and ethnicity at every step of the coronavirus pathway (from exposure to testing, disease, hospitalizations, deaths, and vaccination).
COVID-19 immunizations started at the end of December. The first data was published by KDHE on number of vaccinations (including a breakdown by race and ethnicity) at the end of February, and only for the entire state.
A much more detailed analysis of local data is necessary to guide targeted, local interventions. The Shawnee County Health Department should be commended for developing creative interventions aimed at reaching minority populations in the county, but without good data at the county and neighborhood levels, they will not be able to monitor the results of their programs and adjust their activities accordingly.
In addition, we need to craft vaccination policies and plans that openly acknowledge and address the COVID-19 racial gap.
We have a unique opportunity to stop COVID-19 from creating even more health disparities in a country where we already have too many. Let’s make sure we don’t waste it.
Gianfranco Pezzino is a public health physician, formerly Shawnee County health officer, who works at the Kansas Health Institute.