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Reducing COVID-19’s impact on racial and ethnic minorities

Written by Tanya Terry

As of 3 p.m.  April 4, there had been an alarming 14, 225 confirmed COVID-19 cases in Michigan alone, with 540 deaths within the state! Four hundred sixty four of those cases and 15 of the deaths had occurred in Genesee County.

Dr. Joneigh Khaldun said racial and ethnic minorities tend to have higher rates of chronic medical conditions in the United States, which, along with other factors, makes them at higher risk of becoming very ill if they get COVID-19.

The Michigan Department of Health and Human Services’ (MDHHS) Public Health Administration and Office of Equity and Minority Health recently held a virtual COVID-19 town hall for community organizations that provide services to racial and ethnic minorities, in which Khaldun; the MDHHS chief deputy for health and chief medical executive, and other experts spoke about reducing the impact of COVID-19 on Michigan’s racial and ethnic minority communities.

“We also know that racial and ethnic minorities are more likely to be socioeconomically disadvantaged in this country, which we know has an impact on the general health of a community. Finally, we know that based on the realities of the history of the healthcare system in this country and how it has affected racial and ethnic minorities, we understand there is sometimes an understandable mistrust or distrust of the medical community,” Khaldun said.

MDHHS is the lead state agency in regards to aiding with the COVID-19 crisis. MDHHS coordinates resources, tracks data and implements policies that support the response. Local governments, as well as the federal government, play a critical role in helping to stop the spread of the virus. Local health departments play a role in setting policy at the local level and work with communities to identify who may have been exposed.

Sarah Lyon-Callo, director and state epidemiologist, said phone calls made by volunteers from the state health department within the past week made to more than 2,400 people identified 359 settings in which an investigation needs to happen to prevent further spread. Wayne, Oakland, Macomb, Washtenaw and Genesee counties have the largest number of people infected. Those 65 and older are more concerning in terms of risk of hospitalization and mortality, according to Lyon-Callo.

“We’re missing data on race for about 30% of case records and about 30% of deaths,” Lyon-Callo said.

She said the state was trying to improve that information. Based on the information the state does have, about 35% of those infected with coronavirus are African-American and 25% are Caucasian.

“Healthy people can use a homemade mask if they wish to, but it’s very important that we save medical masks, surgical masks, things called N-95s for people who are ill and for our healthcare workers and our first responders,” Lyon-Callo said.

She said it was important healthcare workers and first responders are able to stay healthy so they can care for people with severe illness.

She also said though the flu and pneumonia vaccination will not prevent the virus, it is important to get influenza vaccinations, when a person is eligible.

“You don’t want to be in a situation where you’re infected with both coronavirus and an influenza virus because it makes it such harder for your body to fight off those infections. It’s very important we not only clean surfaces with soap and water, but we’re able to disinfect high touch surfaces in bathrooms and kitchens so that we’re killing the virus whenever possible if it has entered our homes or workplaces.”

The appropriate use of bleach is to put five tablespoons (or 1/3 cup) per gallon of water. Lyon-Callo said bleach can still work when it can’t be smelled.

“It’s important you don’t overuse bleach because you can trigger asthma attacks in people who have asthma, and it’s no good for you to be breathing in bleach either.”

The administration is working with distilleries to improve the supply of hand sanitizer. In the meantime, there are ways to make hand sanitizer at home. It is important to follow the recipe supplied by the World Health Organization when doing so.

Use 12 fl. ounces of alcohol with two teaspoons of glycerol, which can be purchased online in big jugs. The glycerol will help prevent damaging the skin on the hands. A moisturizer should also be used.

“Unfortunately there have been cases of people burning themselves when they’re trying to use other sorts of substances.”

Those with coronavirus symptoms (fever, a new cough, shortness of breath) are urged to stay home, rest and drink plenty of fluids.

“If you’re someone with morbid conditions (i.e. congestive heart failure or diabetes), it’s important if you get these symptoms you call your physician because you may be more at risk of severe disease. It’s also important that no matter who you are, if you’re experiencing severe symptoms (i.e. severe trouble breathing or lips turning blue), that you call for assistance immediately. This is a serious virus and healthy people are getting very serious infections as well.”

Lyon-Callo said her sister is a physician and her mother lives with her sister and her family. Her mother has a number of conditions that put her at risk of coronavirus or severe disease if she becomes infected. Her mother and sister agreed they are only going to talk on the phone once her sister has been in the emergency room and been exposed. They have also had conversations within the household on how they will manage mealtimes and disinfecting the home.

Elizabeth Hertel, chief deputy director for administration for MDHHS, said the number of workers who can work from home is lower for Hispanics and African-Americans than for White Americans.

Hertel said MDHHS was in the process of loosening income requirements in regards to eligibility for food benefits.

“Part of that is also some of the agreement on the Disaster Supplemental Nutrition Program. So, we’re actually working with the federal government in order to do that. I am hoping we will be able to announce something fairly soon,” Hertel said.

Phil Chase is the assistant director in the office of health and nutrition services with the Michigan Department of Education.

“Toxic stress weakens the immune system and a lack of nutritious meals and the inability to interact with peers and guiding adults are two significant sources of stress that students face at a time of extended school closure,” Chase said.

He said students in grade 12 would graduate and students in grades K-11 would move on to the next grade, despite executive order 2020-35, which calls for all K-12 schools to remain closed the rest of the school year unless restrictions are lifted.

“Schools will likely be asked to provide some form of remote learning to students the remainder of the school year. It’s still unclear whether that learning is going to earn course credit and how,” Chase said.

Schools are now being asked to work on plans to provide home-based instruction for specific items laid out in the executive order for submission by April 28. However, equitable access to technology at home and a reliable internet connection remains in question.

The Meet Up and Eat Up program is the state’s summer food service program. Signs that would normally indicate summer feeding mean the summer food service program is also operating at this time of school closure.

“The non congregant waiver allowed us to allow meal providers to allow children not to have the stay in a group to eat at designated meal time.”

Up to two free meals are available through the Meet Up and Eat Up program for all kids 18 and under. In addition, students with disabilities ages 18-26 are eligible for these meals when they have an active individual education program on file.

Debra Pinals, medical director of behavioral health and forensic programs for MDHHS, said racial and ethnic minorities tend to live with more chronic stress on a regular basis due to hardships and inequitable outcomes in normal areas of living. According to Pinals, in a crisis it is important to continue to prioritize one’s mental and emotional well being to try to manage it as effectively as possible.

“Families with different racial and ethnic backgrounds have strengths they can rely upon in terms of closeness to community and faith that one can rely upon for support,” Pinals said.

Individuals can be active in staying connected through using a variety of technological needs.

Making sure one puts time for fresh air in their schedule is crucial as a way of using calming strategies to help reduce stress, according to Pinals. She suggests people schedule time to keep up with news but not watch the news all day.

People coming in and out of correctional environments, a group which racial and ethnic minorities are overrepresented in, will have additional challenges as they are dealing with the responsibilities of reporting probation or returning home from a correctional setting, according to Pinals.

“It is important to understand there are crisis lines available and that people should be connected to their medical provider and their behavioral health care provider to support their needs along the way.”

Tips are offered daily at michigan.gov/coronavirus to help individuals manage their stressors. Pinals suggests individuals read these tips over time and not overwhelm themselves by trying to learn it all at once.

 

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