Public health experts have battled with testing labs on reporting of race and ethnicity, arguing that they should note that information whenever they test a patient for any virus. | Justin Heiman/Getty Images
Preliminary data shows that minority patients are disproportionately at risk of being hospitalized or dying from Covid-19. But health professionals say the numbers that have been released aren’t telling the whole story.
Gross underreporting of tests, hospitalizations and deaths related to Covid-19 has plagued racial and ethnic data at both the state and federal level. Nearly half of all states have not included any data on the race or ethnicity of those affected by the coronavirus. Figures released by the Centers for Disease Control on Friday list the race and ethnicity of 75% of all cases as unspecified. None of the race and ethnicity statistics for deaths have been reported nationally.
The incomplete figures have made it more difficult to respond to the crisis in the neediest communities, which are majority-minority, advocates and health professionals of color say. The data — particularly related to testing outcomes — is crucial to both treating the virus and stopping its spread in these communities.
And the information that is available, they say, paints an even grimmer picture for African-American and Latino patients, who are already over-represented among the hospitalized or dead in a majority of state data sets.
Kristen Clarke, executive director of the Lawyers’ Committee for Civil Rights Under Law, called the CDC’s data “astounding” and the federal government’s response to lawmakers’ initial call for racial and ethnic data “woefully anemic.”
“The department of Health and Human Services has not offered a concrete plan about how it intends to tackle the problem in front of us,” Clarke said during a press call on Monday. “The fact [is] they do not have race information tied to all of their data. We know that our communities are being ravaged by Covid and the federal government has a role to play.”
Clarke called on HHS to release data on testing and testing outcomes by race. So far, only two states, Kansas and Illinois, have made public their testing data broken down by race and ethnicity. Half of all U.S. states have released some racial and ethnic data outlining deaths from Covid-19 and 34 states have recorded cases.
In Kansas, African Americans comprise less than 6% of the state’s population but make up 15% of its positive cases and 32% of deaths, according to data released by the state’s health department on Monday. Nearly 400 of the 1,705 total cases are listed as having an “unknown” racial or ethnic identity.
A similar pattern has emerged in Georgia. The race and ethnicity of 47% of the state’s cases are unknown. African Americans make up 27% of the remaining cases and 54% of all deaths, more than any other racial or ethnic group in the state.
Janet Hamilton, head of the Council of State and Territorial Epidemiologists, said that while federal standards do call for the collection of racial and ethnic data, it’s not always provided when clinicians are strained. Shortcomings in reporting are a longstanding problem that public health professionals have warned about for years.
Public health experts have battled with testing labs on reporting of race and ethnicity, arguing that they should note that information whenever they test a patient for any virus. If a testing lab doesn’t catalog racial and ethnic data, their state’s health department may never get that information.
Hamilton added that the reporting that does occur is mostly on paper rather than electronically, and many physicians are simply “not faxing and providing that paper.”
“That’s why we need an information superhighway,” said Hamilton, who put the onus on the private sector and federal government. “We have consistently relied on piecemeal approaches to gather that information as well as sluggish approaches.”
Representatives from the CDC attribute the incomplete data in part to an overwhelmed health care system. The rush to treat patients, they argue, has stunted some demographic reporting.
“Health departments try to get complete information on every case, but during a large-scale pandemic it is understandable that these health departments may not be able to gather all the information about each case,” said Kristen Nordlund, a spokesperson for the CDC. “We are exploring using other avenues to supplement this information when possible.”
Still, other issues with the data abound. In states that have released race and ethnicity figures, the mediums by which they do so are inconsistent: Some measure only the number of hospitalizations by race and ethnicity, while others have only taken account of deaths. Some states have not released their racial and ethnic data while major cities within them have: Milwaukee’s county health department released the number of African-American, Latino and Native American people to be hospitalized or die from Covid-19 weeks before Wisconsin’s state health department. In Florida, the number of cases in which the race or ethnicity is categorized as “unknown” outnumbers cases of black and ‘other’ patients combined.
Some states are not reporting racial and ethnic data at all. Among them are South Dakota and Nebraska, which have yet to institute stay-at-home orders and have some of the largest concentrations of Covid-19 cases.
States that are not independently reporting their data are reliant on figures from the CDC, which have big holes.
“We have the categories and we know what questions should be asked, we just know that not everybody is using them,” Dr. Lisa Cooper, a professor at Johns Hopkins School of Medicine and Bloomberg School of Public Health.
Marc Morial, president of the Urban League, said he and his organization have been advocating for both increased testing in black communities and relief for black-owned businesses, which the Urban League projects will be hit hardest by the economic damage caused by the coronavirus.
“This is nothing new,” Morial said. “The disparities in American life are being pointed out.”
In response to growing calls from medical professionals, lawmakers and legal advocates to release racial and ethnic data, more states are making the figures they do have available. But Clarke and medical professionals maintain that the incomplete numbers are not enough.
Dr. Taison Bell, an assistant professor of medicine at the University of Virginia’s division of Infectious Diseases, argued during Monday’s call that securing accurate data is just as important as ventilators or personal protective equipment.
“If these agencies are overwhelmed and they need support, then provide them the support that they need,” Bell said. “If there are problems collecting data, I need them to be fixed. I need the issue to be acted on, but most importantly, I need the excuses to end.”
Laura Barrón-López contributed to this report.
Black doctors blast "woefully anemic" data on minority coronavirus cases
0 Comments: