Category: Health

by Nomin Ujiyediin, Kansas News Service

Lawrence, Kansas — The more Kansas tests people for the coronavirus, the clearer it becomes that black Kansans are being disproportionately affected — a sobering trend that is true in communities across the United States.

Black Kansans are three times more likely to test positive for COVID-19 than white people, and more than seven times more likely to die from the virus. Latinos are also about three times as likely to test positive for COVID-19.

The data mirrors trends seen in across U.S. cities like New York, Chicago and Detroit, as well as other states.

Kansas’ data points also follow the lines of racial disparities in health care treatment and access. Black Americans have higher rates of obesity, diabetes, asthma and other health conditions.

“These disparities are nothing new,” said Crystal Lumpkins, an associate professor at the University of Kansas Medical Center who studies public health communications.

The Kansas Department of Health and Environment has cautioned that its coronavirus race data is incomplete, because of “the high number of individuals tested with no race and ethnicity reported.”

In an email, spokeswoman Kristi Zears said the agency needs more data on race and ethnicity from test providers.

“KDHE is working to expand testing in areas throughout Kansas,” she said.

But outreach to black communities should have happened earlier, Lumpkins said. State and county governments, health departments and medical providers hadn’t spent much time reaching out to black communities even before the pandemic.

‘We don’t feel like we’re included’

Lumpkins said her community in Wyandotte County, which has one of the largest black populations in the state, didn’t get much information about the pandemic early on. Now, the county has the most cases in Kansas, and nearly half of its COVID-related deaths are black individuals.

Things could have been different, Lumpkins said, if officials had more proactively consulted her community in the preceding years.

“One of the things I’m hearing from my community members is that many times, we don’t feel like we’re included,” she said. “It comes across as very tangential or something that is done after the fact.”

Lumpkins also said the lack of communication had allowed rumors to spread — such as a myth that African Americans couldn’t get the coronavirus.

“African Americans, because of history, have been more likely to not trust the information from those types of organizations,” she said. “It is really incumbent upon these entities to recognize that.”

Black communities across the country tend to have less access to amenities that improve health, like grocery stores and outdoor recreation. Many black Americans also have to travel farther to access hospitals and pharmacies.

That can lead to poorer health outcomes overall, said Rashawn Ray, a fellow at the Brookings Institute and sociology professor at the University of Maryland.

“Structural factors undergird pre-existing health conditions — and people’s exposure to COVID-19,” Ray said.

‘There’s not been any urban renewal’

Broderick Crawford, who’s the president of the New Bethel Church Community Development Corp. in Kansas City, Kansas, believes “80 to 90% of a person’s health does not occur inside of a medical facility at a clinic. It happens outside of that.”

Crawford said the response from health officials and hospitals has been inadequate, partially due to discrimination against the black community. His neighborhood doesn’t have a grocery store, which means less access to healthier foods. There aren’t many jobs nearby that people can walk to, and some may not feel safe walking or exercising outside at all.

“There’s not been any urban renewal in this particular area,” he said. “It’s those kinds of things that have negatively impacted our community.”

Data from the Bureau of Labor Statistics shows that higher percentages of black people work in the service, transportation, production and shipping industries than other groups.

“We put these factors together and it leads to blacks being more exposed,” Ray said. “We also know that black Americans are more likely to be in these new ‘essential service’ jobs.”

Overall, Kansas needs to obtain and provide more demographic information when it comes to coronavirus testing, Ray said, including gender, age and location.

“We need to collect more data,” he said, “then be able to funnel resources, testing and triage centers to predominantly black neighborhoods that are under-resourced.”

Nomin Ujiyediin reports on criminal justice and social welfare for KCUR and the Kansas News Service. You can follow her on Twitter @NominUJ.
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy. Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.
See more at https://www.kcur.org/news/2020-04-23/black-kansans-at-least-7-times-more-likely-to-die-from-coronavirus-than-white-kansans.

U.S. Rep. Sharice Davids, D-3rd Dist., emphasized the importance of addressing health disparities in Wyandotte County Wednesday afternoon during a Facebook Live with a Unified Government of Wyandotte County and Kansas City, Kansas, Health Department official.

Although black residents make up around 23 percent of Wyandotte County’s population, they represent more than half of the people testing positive for COVID-19, as well as two-thirds of COVID-19-related deaths. Wyandotte County currently has the most confirmed positive cases of coronavirus in the state.

“The data presented by public health officials in Wyandotte County shows a stark reality: black residents are disproportionately impacted by the coronavirus pandemic. While there are complex, systematic issues that absolutely need to be addressed, right now we need to focus on getting as much help to Wyandotte County as possible. This includes increasing access to testing and supplies, supporting Community Health Centers, and expanding Medicaid right away,” Rep. Davids said.

Rep. Davids voted to pass the CARES Act, which provided $100 million for health services through Community Health Centers that support smaller health clinics across the country in under-served urban and rural areas.

To watch the livestream, visit https://www.facebook.com/watch/live/?v=762211897644166&ref=watch_permalink.

Kansas reported an additional 186 positive COVID-19 cases today, bringing the state total to 2,211 cases.

The state reported a total of 110 deaths, up three deaths from Tuesday, according to Gov. Laura Kelly.

Wyandotte County, as of the 4:30 p.m. April 22 report, had two more deaths than the 8:25 a.m. report April 21, according to the Unified Government COVID-19 webpage. There were 47 more cases, for a total of 473 positive cases in Wyandotte County.

The UG Health Department stated that two new deaths were reported today at Riverbend Post-Acute Rehabilitation facility in Kansas City, Kansas, for a total of 27 deaths at that facility.

At a news conference today, Gov. Kelly said she had signed an emergency order to allow the temporary easing of licensing requirements for advanced practice registered nurses, physician’s assistants and licensed practical nurses. The order allows those who were recently inactive to practice, and allows enrolled students to volunteer or work within facilities, she said.

The order will help the health care system have more flexibility to make sure hospitals are not overwhelmed by the COVID-19 pandemic, she said.

Dr. Lee Norman, Kansas secretary of health, said the new order would not necessarily increase the number of health care workers, but it would allow some to work without direct supervision. It would particularly help rural areas, he said.

Gov. Kelly said there will be a gradual rollout for reopening the Kansas economy.

“There is no blueprint for what comes next,” she said. It is far more complicated than flipping a switch or rescinding an emergency order, she added.

Gov. Kelly said public safety must be paramount. The Trump administration stated last week the transition couldn’t take place until the state passes its peak and the number of cases begins to decline.

Gov. Kelly said while there are many reasons to be optimistic, Kansas is not yet at the point it needs to be to reopen. COVID-19 will need to decline, she said.

The governor has been meeting with county and local health departments to identify the needs of health care workers to reopen the economy and protect public health before a vaccine is developed.

She said specific benchmarks must be identified for Kansas to reopen safely.

The recovery timeline will be determined by testing capacity, hospital surge capacity, personal protection equipment supply and contact tracing, Gov. Kelly said. There will be benchmarks attached to these categories in the next week, she added.

The governor also said that reopening must be regionally targeted and industry specific. She said she has held discussions with the Kansas City Chamber and the Sedgwick County Chamber of Commerce. This afternoon, she planned to have discussions with the Kansas Chamber of Commerce.

Gov. Kelly said all discussions with the business community have indicated that safety will be paramount in reopening. Their response will weigh heavily in this process, she said.

The governor also said she will collect responses from sectors such as the hospitality industry, retail and barbers and hairstylist, among others.

In the next five days, the governor said she plans more discussions with health care providers, local units of government, labor leaders and the faith community.

In addition, she said she is coordinating the state’s efforts with neighboring states of Missouri and Colorado, and also will talk with Kansas City, Missouri, Mayor Quinton Lucas about working together.

Gov. Kelly said she would release more comprehensive information about the next phase by the end of next week.

Dr. Norman said the state currently is monitoring 45 clusters of COVID-19 cases.

Seventeen were in long-term care facilities, including 348 cases and 58 deaths, he said.

Other clusters included two group living facilities with 27 cases and no deaths; one correctional facility, Lansing Correctional Facility, with 82 cases and no deaths; two health care facilities with 16 cases and no deaths; five religious gatherings with 85 cases and seven deaths; 19 private companies with 81 cases and no deaths; and six meatpacking facility clusters with 168 cases and no deaths.

Dr. Norman said the state Health Department and Kansas Department for Aging and Disability Services are working together with the Centers for Medicare and Medicaid Services to review infection control practices, patient safety and staff safety. He said the facility should be able to go back to a full and normal existence once there is cleaning and a number of days have passed.

Testing in Kansas now has been broadened, he said. Previously, a fever and cough were a requirement to be tested. As of Tuesday, the state no longer requires fever for testing, nor a cough. Instead, the patient must have two symptoms, which can be fever, chills, body aches, sore throat or other symptoms listed on the state’s website.

Dr. Norman said the CDC has acknowledged that as more testing is done, they are finding COVID-19 cases that did not have fever or cough.

Some additional testing is taking place in Wyandotte County and other areas.

Over the next few days, Kansas may see a jump in cases, he said. The state probably is right about at the peak right now, although that won’t be certain until more time passes, he said.

Increased testing around meatpacking plants in southwest Kansas are finding more and more cases minimally symptomatic or asymptomatic, he said. Some of the smaller counties may have manual entry of test results that may mean the state’s totals are lagging a few days, he added.

Dr. Norman said he doesn’t see more testing as negative. Wider testing will result in increased numbers, and it will help the state target where they need to be, he said. The health departments are doing contact tracing on positive cases, in order to isolate them, while they get ready to reopen.

Dr. Norman said the state received a batch of 3,000 swabs for testing this afternoon, from a third printing that started April 18. Local dentists are producing 10,000 swabs a week. By the end of the week there will be an increase of 7,000, so that swabs won’t be a limiting factor for testing in the future.

On the topic of how COVID-19 deaths are recorded, Dr. Norman said the cause of death is reported by the attending physician. The physician follows guidelines based on guidance from the CDC. There are some cases where there are comorbidities, and doctors will use their best judgment to determine the cause.

Dr. Norman is issuing a caution about serology tests for COVID-19.

He said there were more than 100 serology testing platforms before the FDA, and the tests do not have FDA approval.

The tests should not be used alone to say if a person has had COVID-19 or not. The serology tests should be combined with one of the molecular tests being given throughout the state, he said.

According to Dr. Norman, some of the serology tests might indicate that a person had coronavirus, but not the novel coronavirus COVID-19. That test could show a positive result for just a cold. If a decision is made to put someone on a COVID-19 ward because of a serology test result, and relax personal protective equipment requirements, then that person would be very vulnerable to COVID-19, and it would not serve them well, he said.

Self-administered tests at home, approved by the FDA, are a good idea, he said, especially if they keep people who have symptoms out of the doctors’ offices and emergency rooms and away from other people. At home, they can continue to isolate, he said.

Dr. Norman said he was certain that there would be a second wave of COVID-19 into the fall and winter. If it follows the patterns of past epidemics, there would be a higher peak than there is at the first peak.

Health officials have done a lot of things to push down the number of cases, he said, and broader testing will help them target certain areas where there are higher problems. They can go to problem areas and work there, he said.

Gov. Kelly said there were three phases under the White House guidelines. If they get to the third phase and a new wave hits, they would start pulling it back, she said.

A county commission in the Wichita area has discussed herd immunity as the solution, and Dr. Norman said that would be a bad idea.

Herd immunity is when a sufficient number of people in the population get a virus, and don’t transmit it because everybody has already had it. It’s a good idea if it is a minor illness without a lot of deaths associated with it, but a bad idea for COVID-19, he said. The nation would have deaths in the six or seven figures if that were done, he said. The more modern approach would be to do the other mitigating efforts, push as many cases into the future as possible, then have a vaccine and get herd immunity through the vaccine, Dr. Norman said.

To view the governor’s news conference, visit https://www.facebook.com/GovLauraKelly/videos/233133637768654/.

The Kansas COVID-19 resource page is at https://govstatus.egov.com/coronavirus.

The UG’s COVID-19 webpage is at https://alpha.wycokck.org/Coronavirus-COVID-19-Information.