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Federal Action Should Clarify COVID-19 Racial Impact

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James A. Bacon
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by Carol J. Bova

Discussion of the percentage of black COVID-19 hospitalized patients in Virginia is based on the known racial identification of all COVID-19 cases. The breakdown of all cases shows this is a false narrative. We don’t know what the true racial percentages are because currently 32% of all COVID-19 cases have no racial identification.

From here forward, that problem should be reduced by new federal guidance announced on June 4 requiring labs to report demographic data like race, ethnicity, age, and sex.

Today, the U.S. Department of Health and Human Services (HHS) announced new guidance that specifies what additional data must be reported to HHS by laboratories along with Coronavirus Disease 2019 (COVID-19) test results. The Guidance standardizes reporting to ensure that public health officials have access to comprehensive and nearly real-time data to inform decision making in their response to COVID-19. As the country begins to reopen, access to clear and accurate data is essential to communities and leadership for making decisions critical to a phased reopening.

“The requirement to include demographic data like race, ethnicity, age, and sex will enable us to ensure that all groups have equitable access to testing, and allow us to accurately determine the burden of infection on vulnerable groups,” said ADM Brett P. Giroir, MD, Assistant Secretary for Health. “With these data we will be able to improve decision-making and better prevent or mitigate further illnesses among Americans.”

It’s good that solid information will be available. It’s a shame that the Commonwealth failed to require the same information sooner. We can hope public health officials will support the effort now.

Carol J. Bova is a writer who lives in Mathews County.

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13 responses to “Federal Action Should Clarify COVID-19 Racial Impact”

  1. Steve Haner Avatar
    Steve Haner

    https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm

    The CDC data I’ve been monitoring through all this is up to 88,000+ death certificates filed, and they seem to be more complete with demographic data.

    Table 2A shows that both black and white non-Hispanics are dying at rates higher than their proportion of the affected population, while Asians and Hispanics are very much underrepresented in deaths. “Affected” population is key – keep reading.

    The baseline population distributions initially threw me – only 42.2% non-Hispanic white? But a close examination of the footnotes reveals that CDC is only tracking areas of the country, individual jurisdictions, where the infection has taken a good hold. Large swaths of rural, sparsely populated areas with little or no disease (fewer than 100 reports) are excluded. Included mainly within the data are denser urban areas, and outer jurisdictions with prisons, old age homes and densely packed work places which were kept open as essential (packing plants, for example.) Clearly that’s not the same as all of the USA.

    I suspect what they see with deaths would also be true with all cases. You have to start with your baseline being the demographic in those affected jurisdictions. As with all infectious diseases, population density accelerates and eases the spread. A subtle point, but I think a valid one to consider before jumping to conclusions about demographic disparities.

  2. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    I think we really need to be careful about this. It is important to know that some racial groups are more affected by the coronavirus than others, but we run the risk of tending to identify it as a “black disease”, just as some commenters on this blog tend to see COVID-19 as a “nursing home” or “elderly people” disease.

    It is just as, or more, important to collect data on the other health conditions of those with COVID-19, such as heart problems, diabetes, obesity, etc. It seems at this point that such conditions have weakened the body sufficiently to make those people more vulnerable. Of course, that would be true for just about any communicable disease.

    There is so much that we do not know about this disease that we should not jump to conclusions. For example, why do some people who contract COVID-19 show no, or only mild, symptoms, while others progress to very serious respiratory problems? Some scientists in Europe are engaged in genetic tests and coming up with some intriguing results. One is that people with Type A blood, who contract COVID-19, seem to be more likely to need oxygen or ventilators than those with other blood types. (That is sobering news for me.) https://www.nytimes.com/2020/06/03/health/coronavirus-blood-type-genetics.html

  3. Nancy_Naive Avatar
    Nancy_Naive

    What a shock when AIDS jumped into the heterosexual community. Who saw that coming? Not the President. Complacency in the belief that the victims are in the margins? History repeating.

  4. TooManyTaxes Avatar
    TooManyTaxes

    Wouldn’t it make sense to attempt to find out why there are different impacts on different demographics using testing and studies as Dick suggests? Can DNA databanks help? This is more important than headlines.

    1. Steve Haner Avatar
      Steve Haner

      I see nothing in the data to challenge the idea that underlying factors explain the deaths — age being the main one, but also obesity and resulting conditions, smoking and resulting conditions, and other chronic diseases. Are those medical problems more common in certain populations because of systemic racism? That’s another question. Many would say yes. I agree it’s important, TMT, but the narrative unfortunately is set so (as with other things) data won’t change perceptions now. And any analysis has to go beyond the US and look at what has happened in Europe, which still has far higher fatalities per capita than the US.

      More than one PhD in all this, I’m sure.

      1. Reed Fawell 3rd Avatar
        Reed Fawell 3rd

        Yes, and we watch the claim of systemic racism continually popping up, which increasingly goes into the hopper to add to the strong evidence of the systemic racism of its chronic proponents. As the most fragile in face of virus by far are black and white males living unhealthy lifestyles, while perhaps there are some other folks genetically near bulletproof against virus.

    2. ksmith8953 Avatar
      ksmith8953

      You would think that someone in the health field of data collection would have thought of this from the onset. I agree, the why is as important as the “how many”. I also agree with Dick above, this shouldn’t be looked at as a black disease, it sends a false narrative. I am over 65 and know I am more at risk. If I we’re black and 40, I need to know if I am more at risk. It makes a difference as we open things up. At 65+, I am not growing shopping quite yet. I am wearing a mask around people for their safety and mine.

  5. James A. Bacon Avatar
    James A. Bacon

    I don’t know a single person who has characterized COVID-19 as a “black disease” — only people who have said the disease has impacted blacks disproportionately. The implication is that the healthcare system or America generally is racist.

    For some reason, the people who emphasize how severely blacks are being impacted fail to observe that Hispanics are less likely to be hospitalized or die from the virus, or that Asians are even less likely to be.

    1. Nancy_Naive Avatar
      Nancy_Naive

      There was a pool full of them in the Lake of the Ozark. No one said it, but as they say, “Why listen to what you say when I can see what you do.”

      If a disease is seen as a threat to just the “others”, whoever they are, then it may not be dealt with as effectively.

      Asians? You mean like in residents of Wuhan?

      The healthcare system isn’t racist. The system for paying for healthcare is.

      1. Steve Haner Avatar
        Steve Haner

        As a 65 year old with underlying cardiac issues, I don’t see it as a threat just to “others.” But if I were 45 and otherwise healthy, I wouldn’t have much chance of dying. Still would rather not get sick. I still don’t trust the numbers out of China, but why did other Asian nations have lower impacts? I’d say they were culturally more accepting of masks and the other mitigation strategies. Lots of future PhDs to be earned on this.

        1. Nancy_Naive Avatar
          Nancy_Naive

          Well, how about this. Prevailing opinion is that this COV2 is a result of the virus doing a cross species thing. The Spanish flu was a chicken-pig thing. COV2 is currently believed to be a bat-pangolin combo. From where did the bats and pangolins come? Bats, well, they’re everywhere, but I doubt you could find a pangolin in Wuhan except the wet market. So, maybe, the other SE Asian countries, where pangolin are, were a bit immune because of their exposure to the animals?

          BTW India is getting hit hard, no?

  6. Reed Fawell 3rd Avatar
    Reed Fawell 3rd

    Recall Northam’s press conference (around May 8th as I recall), and how Virginia was going to be World Class cutting edge on the racial impact of the virus. The suggestion was he was going to get to the bottom of this racism & make sure it never happened again, akin to his infamous campaign ad that his spokesperson did not deny, then did disclaim.

  7. cjbova Avatar
    cjbova

    Steve Haner: CDC says not to try to compare the death counts across states. So I used the information from the Virginia death certificates from Table 2C, the unweighted version. Table 2A is weighted to give a better national picture by focusing on areas with outbreaks and more than 100 deaths in an area.

    Unlike the VDH numbers, CDC includes two additional groups besides COVID deaths alone; COVID and pneumonia; and COVID, Pneumonia OR Influenza. I combined those 4014 for the list below. (Influenza by itself only had 67 deaths reported.) Pneumonia alone had 1507 deaths.

    Race and Hispanic ————— Percentage of COVID-19
    Origin Group ———————-or possible COVID-19 Deaths*
    Black Non Hispanic 23.1%
    Hispanic or Latino 6.6%
    Asian, Non-Hispanic 5.1%
    More than one Race, Non Hispanic 0.0%
    White, Non Hispanic 65.2%
    Unknown 0.0%

    * Used total of COVID-19 Deaths; COVID AND Pneumonia Deaths;
    Deaths listed as COVID, Pneumonia or Influenza

    Pneumonia Deaths Alone
    Black Non Hispanic 21.6%
    Hispanic or Latino 4.3%
    Asian, Non-Hispanic 3.8%
    More than one Race, Non Hispanic 0.0%
    White, Non Hispanic 70.3%
    Unknown 0.0%

    And if anyone wants to see COVID-19 death percentages alone of the CDC 1204 (VDH had 1375, but it can take 7-10 days to get the info into the CDC numbers.):
    Black Non Hispanic 23.9%
    Hispanic or Latino 8.4%
    Asian, Non-Hispanic 6.6%
    More than one Race, Non Hispanic 0.0%
    White, Non Hispanic 61.0%
    Unknown 0.0%

    2019 Census Bureau Quick Facts Racial Breakdown in Virginia
    Black 19.9%
    Hispanic or Latino 9.6% (census also includes in applicable race categories)
    Asian 6.9%
    More than one Race 3.1%
    White 61.5%
    American Indian and Alaska Native 0.5%
    Native Hawaiian/Pacific Islander 0.1%

    cdc info is from 2-1 to 5-30-20.

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