“We’re talking about people who, during this pandemic, have been essential in working in meatpacking plants and manufacturing. They have been involved in cleaning, maintenance, construction jobs,” Dr. Viviana Martinez-Bianchi, a primary care doctor and associate professor in family medicine and community health at Duke, said during the discussion Wednesday.

“While the rest of the country did quarantine or was able to stay home to flatten that curve … the Latinx community continued to go to work,” Martinez-Bianchi said.

“So what we’re seeing is now all these people who have been essential workers, who worked without even the masking and the protection that was legally required during the time of their jobs, are now becoming infected by the virus,”

Rosa Gonzalez-Guarda, an associate professor at the Duke University School of Nursing, agreed that Hispanics are getting infected at disproportionate rates by “simply going to work.”

Covid-19 infections have outsized impact

The US Centers for Disease Control and Prevention’s National Center for Health Statistics is reporting almost 17% of Covid-19 deaths are among the Latino population. It’s not out of proportion on the surface, because Latino people make up just over 18% of the US population.

However, data collection on race and ethnicity has been lacking since the beginning of the pandemic and the CDC’s numbers are based on death certificates. The reporting can be delayed up to eight weeks, which means it’s not a fully accurate statistic at any given moment.

North Carolina, where Duke is located, is seeing a spike in Covid-19 cases recently.

“In the state we see approximately 42% of the cases of Covid-19 are among the Latinx community. Across the state, the community only represents 10%,” Gonzalez-Guarda said.

In the Durham area, for example, Hispanics represent about 10% of the population but accounted for 70% of positive Covid-19 cases in the past month, Gonzalez-Guarda said. “A key driver here is really the exposure that’s innate in the kinds of work, the essential work that the Latinx community does and so we’re also seeing disparities that are a result of the nature of that work.”

The state is one of many that does not have a specific breakdown in coronavirus infections and deaths by race.

“But we do have qualitative data,” Martinez-Bianchi said. She said surveys from assisted care units at the Duke Regional Medical Center and Duke University show a disproportionate number of patients with Covid-19.

“They have never really seen so many people in the intensive care units who spoke Spanish,” she said.

Choosing between working or staying home

Also leading to the high number of infections in Hispanic communities: multigenerational homes. People of varying ages often live together, go to jobs as essential workers and bring home infections, Martinez-Bianchi said.

Gonzalez-Guarda said people need better on-the-job protections.

“This means not only providing mask and social distancing measures in the workplace, but also putting pressure on business owners to provide paid sick leave to workers so that people don’t have to make the decision between going to work while they’re sick and potentially infecting others, or paying rent or providing food at home,” she said.

Another problem is access to testing, the panelists said. Barriers to testing include financial issues and access to insurance.

“We need more investment of resources and attention from leaders and government and healthcare institution and business owners,” Gonzalez-Guarda said.

When it comes to containing the spread of Covid-19 within the Hispanic community, experts believe it will be a difficult challenge.

“People are fearful of seeking out any help, whether it’s information, whether it’s testing or medical care, if they need it,” Gonzalez-Guarda said.

“And people are afraid that their immigration status might be compromised. They’re afraid about the possibility of having to pay bills, particularly if they don’t have insurance,” she said.

“So it’s really uncovering some of the structural and fundamental drivers about this population. It’s going to be critical for us to address as we continue to see a growth in this population in the future.”

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