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COVID-19 Crisis Highlights Disparities in Access to Care

Patti Singer

Dr. Michael Mendoza, commissioner of the Monroe County Department of Public Health, at a news conference March 12, 2020, about the area’s first confirmed COVID-19 case. File photo

COVID-19 is highlighting what people of color – and the medical community — knew about access to health care.

Preliminary data on who is being sickened by COVID-19 needs to get everyone’s attention, according to the county’s top doctor.

“I think this condition is shining a light on the disparities,” said Dr. Michael Mendoza, commissioner of the Monroe County Department of Public Health. “If we don’t heed the opportunity to address disparities in care and disparities in health as a result of this unfortunate epidemic, we will have missed a giant opportunity as a community.”

One day after Rochester Mayor Lovely Warren announced that the city and county would increase messages to communities of color about social distancing, Mendoza held an online news conference to give perspective on the first local data released about the effect of COVID-19 on Blacks and Latinos.

Mendoza cited data that Blacks make up 16.2% of the local population and Latinos make up 9%.

As of April 8,

  • Blacks made up 27.9% and Latinos made up 18.6% of all hospitalizations for COVID-19.
  • Blacks made up 53.8% of hospitalized patients on ventilators, and Latinos made up 5.1% of patients on ventilators.
  • Blacks made up 18.2% percent of people who died, and Latinos accounted for 9.1% of fatalities from COVID-19.

Mendoza said Monroe County still is in early stages of the pandemic and he continues to parse the data, so he did not want to draw major conclusions.

But the disparities weren’t a surprise.

“We know in this community there are ZIP codes separated by four miles where life expectancy differs by almost nine years.

Blacks and Latinos are more at risk for chronic conditions such as heart disease, high blood pressure and lung disease. Mendoza said that his own and other research shows that minorities tend to seek care later in an illness. He said the health department is working with Trillium Health, Anthony L. Jordan Health Center and St. Joseph’s Neighborhood Center on identifying people earlier in the course of COVID infection. He said earlier intervention may reduce the need for hospitalization.

He also acknowledged that people may not be able to isolate themselves. The county previously announced it would use the 43-room Clarion Pointe Hotel in Brighton to isolate people who could not otherwise manage that on their own. Mendoza said that as of April 9, there were fewer than 10 people at the site. He said he urged officials at Jordan to contact the health department if they had clients who could benefit.

“I would much rather have that hotel filled,” he said. “I believe there are going to be challenges in achieving a quality isolation across our community.”

Mendoza also talked about:

Antibody testing. In his daily emails, Gov. Andrew Cuomo said the state Department of Health was working on an antibody test. Such a test could show whether a person has been exposed and has immunity to the current strain of virus.

Mendoza said no test has been shown to be valid. He said when one is available, he would make sure it is available in minority communities. “When we think of minorities, structural racism has put people of color on the front lines disproportionately. I think we should want to screen those individuals more aggressively for immunity because I think it matters. …”

When the county can reopen. Mendoza does expect Monroe County to have a surge in cases, although the severity depends on how well residents follow instructions to stay home and if they have to be out, staying six feet from another person. “How we behave today will predict how we do in two to three weeks and two to three months.”

If that passes and everything reopens at once, the county risks seeking a second spike in cases. “We want to be very careful about how we return to normalcy.”

Mendoza said that health experts suggest waiting six weeks after the peak number of cases before considering that the crisis has passed. He gave no indication that this week marked the spike, but if it did, six weeks would mean it’d be Memorial Day before officials could safely start thinking about relaxing restrictions.