How Latinos In North Carolina Are Disproportionately Affected By COVID-19
Sunday, June 21, 2020, was the saddest Father’s Day that Eliana and Daniel Kusak’s family has ever had, as they suspected that they had already been infected by the coronavirus. The symptoms progressed day by day: chills, body aches, headaches, nausea.
“Every day that passed, we were getting worse and we were losing strength,” recalls Eliana, who has worked as an interpreter in health services for 18 years. “We were afraid of not waking up.”
On Wednesday, Daniel was gasping for air. He was short of breath. Eliana had to call an ambulance to take him to the hospital. While having access to medical attention helped them, it was the support they received from the community that played a fundamental role in their recovery.
“If it hadn’t been for our friends, our relationships and our family, I don’t know if we would have survived to tell about it,” says Daniel, who works in construction but is known in his community for the children’s radio and TV programs that he produces. Eliana and Daniel have a Ministry called Los Soldaditos de Jesús (The Little Soldiers of Jesus) and have traveled all over the world sharing the gospel. During their 14 days of strict quarantine and slow recovery, the community brought them food, flowers and messages of hope.
The Argentinean husband and wife, who have lived in the United States for more than two decades, are among the thousands of Latinos who have been affected by the spread of the pandemic in Mecklenburg County. Latinos account for 55% of the county’s infections (of those cases in which ethnicity is known), according to data from the North Carolina Department of Health and Human Services (NCDHHS), although Census figures show that they only make up 14% of the population. The pandemic’s disproportionate impact on Latinos is being felt across the state of North Carolina-- which has already reported more than 100,000 positive cases -- as well as across the country. It is an issue that has generated a public debate about the factors that are exposing the community to the virus and the inequalities that are allowing this to happen.
But there are some areas in the state where the impact has been even more extreme.
La Noticia conducted a comparative analysis of three databases in order to identify North Carolina’s most vulnerable Latino communities, which are suffering the most from the advance of COVID-19 and need additional support and resources.
The analysis found that there are 30 counties that meet the three criteria indicating they have been hit the hardest by the pandemic. First, in these areas, the Latino population has the highest rates of infection per 10,000 people, which shows that the virus is spreading rapidly. In Duplin County, for example, 1,100 Latinos have been infected according to the NCDHHS count. The most up-to-date Census data indicate that about 12,900 Latinos live in the county, which means that one in 10 could have been infected. McDowell, Burke and Yadkin also have high rates of infection.
Second, these are the counties where COVID-19 disproportionately impacts the community when comparing the percentage of infected Latinos with the percentage of Latinos living in the area. In Durham County, for example, Latinos account for 65% of the cases in which the ethnicity is known, although Latinos only make up 13% of that county’s population.
Third, and most concerning, is that many of these counties have a high Social Vulnerability Index (SVI) according to the Centers for Disease Control and Prevention. The SVI measures the capacity of a community to respond to a hazardous event, such as a tornado or a disease outbreak, or to an event such as a chemical spill. In these 20 counties, the inhabitants have greater socioeconomic challenges, high poverty rates, crowded households and large minority populations whose native language is not English. Duplin and Sampson counties (in North Carolina) are the most vulnerable according to the national CDC SVI metric, and Latinos account for more than 60% of infections in those counties.
Poverty, Lack Of Information In Spanish And Large Families
State authorities and community leaders have pointed out that these unfavorable socioeconomic conditions are the main reason why the Latino population is more vulnerable to contagion, as they have fewer resources to face the pandemic.
“When the COVID-19 epidemic began in March, we already suspected that there was going to be an outbreak in the community,” said Dr. Gabriela Maradiaga Panayotti, who is of Honduran origin and has been in North Carolina for 11 years. Through her work with the Latino and immigrant community at the Duke University Health System in Durham County, the doctor knew that vulnerable conditions clearly threatened Latinos. “Many families have challenges, and some even depend on the school system for food,” she explains.
Durham County is on the list of most vulnerable areas and has more than 5,200 cases to date, 60% of which are Latino. Last year, Dr. Maradiaga Panayotti formed a coalition called LATIN-19 alongside a group of medical professionals, activists and community leaders. The coalition was re-launched in March, and it has carried out an in-depth communications campaign in the community about prevention methods.
In April, Latinos accounted for only 8% of cases statewide. In June, the number was up to 44%. It was only then that Gov. Roy Cooper signed an executive order to reduce the obstacles faced by minority communities. Since then, NCDHHS has coordinated a series of initiatives that focus on the most vulnerable communities. Among the most recent announcements is an agreement with providers to establish more than 300 free temporary testing sites, alliances with community organizations for prevention measures and a group of 250 community health workers who will assist people in the areas most affected by the pandemic from August to December.
Asked about lessons learned and what happened in those first two months before a decisive policy was made, North Carolina’s Deputy Secretary for Health Services Benjamin Money said the state was one of the first in the country to share demographic information about the race and ethnicity of those infected. They saw the greatest risk to the Latino community was that many Latinos are employed in certain occupations and are front-line essential workers in areas where social distancing is not possible, Money explained in an interview with La Noticia. Lack of access to affordable housing and overcrowded conditions also make it difficult for Latino families to isolate themselves if necessary, added Money, who has led the state department’s communication with minorities.
Jenice Ramírez, director of the educational and community organization ISLA, agrees that a key factor is that many Latinos “do not have the option of staying home and not going to work.” Workers have complained that at the beginning of the pandemic, and even today in some cases, the businesses, restaurants and large industries where Latinos work, such as in meat-processing plants and in construction, were not taking precautionary measures.”
Ramírez points out another key factor related to vulnerability: the language barrier. “When COVID-19 started, there was not enough information in Spanish. The Latino community was not hearing the rules, the changes or the stay-at-home order,” she said. In recent weeks, the state government has had to expand its staff of bilingual professionals in order to offer information on its website and to be able to communicate with immigrant communities. ISLA and other organizations have organized forums and talks on social media to inform the community, with the participation of Dr. Mandy K. Cohen, the N.C. Secretary of Health and Human Services.
There is still work to be done. Spanish-speaking residents continue to report difficulties in finding easily accessible resources and information in Spanish. Ramírez warns that a lack of reliable resources makes Latinos easy targets for scams and fake news. A few weeks ago, one of the messages that circulated in the community through the social media platform “WhatsApp” asked immigrants to give some personal data in exchange for information about COVID-19. Activists recommend reporting these suspicious messages directly and reaching out to organizations for support before sharing this type of content.
In addition to having limited access to health care and medical insurance, Latinos face discrimination due to the language barrier or immigration status. Last week, Dr. Viviana Martinez-Bianchi, a member of the LATIN-19 coalition, publicly denounced cases of immigrants who were turned away from emergency rooms -- another place with a shortage of Spanish-speaking professionals.
Dr. Maradiaga Panayotti indicated that this is yet another example of the importance of having more diverse teams in all organizations and entities, both public and private. Not only can they collaborate to help identify community problems early on, but they can also come up with appropriate actions and provide solutions. “Powerful institutions and organizations -- including schools -- need a logistics plan for these crises that includes community leaders and specialists who are connected to the community members they are supporting,” she explains.
The Strength Of The Community
“The community was safe at first [from COVID-19],” says Pastor Maudia Meléndez, president of the Federation of Christian Churches of North Carolina. That was the feeling. But since May, the cases began to multiply, and many members of the religious community had to be hospitalized. At the same time, there was a network of social support. “In the midst of the pandemic, a brotherhood has developed,” Meléndez said.
In recent months, organizations and foundations across the state such as Amexcan, Siembra and the Latin American Coalition of Charlotte also have launched food distribution programs, housing support and information outlets in Spanish.
The story of Eliana and Daniel, the Argentinean couple who received the support of their family and friends while they were in isolation, is repeated in testimonies from the community. For example, Sandra (who prefers to use her first name only to protect her identity) says that she found peace in prayer and support in the faith community when she was coping with the illness of her mother, who was hospitalized with COVID-19 and serious pre-existing conditions but survived.
“There has been a lot of pain for those who have lost their family members. But on the other hand, it has brought out the best in people, who have donated food and money and offered help,” Meléndez emphasizes. “It has taught me a great lesson: what people need most is to connect with family and spiritual leaders and to know that everything will be alright. It is something that helps by directly touching the soul.”
The Challenge: Prevention
The Charlotte Open Air Market is a weekend destination for hundreds of families, including many Latinos, where they can get a variety of items such as clothing, sunglasses, cleaning supplies, hats and more. It is one of the businesses and social gathering spaces allowed in Phase 2 of Gov. Cooper's statewide reopening plan. A large percentage of those in attendance at the market have been wearing masks, but many are still not wearing them.
“We made the decision to always wear masks to protect the family. We also disinfect everything and respect social distancing,” says Maetzin, whose last name is being omitted at her request. Maetzin, who is a native of Mexico and has been in Charlotte for 20 years, enjoys visiting the market with her husband, Sergio, and their 4-year-old daughter, Sofia. They all wear colorful masks with children’s designs that they bought from a large supermarket chain. Maetzin says that when a relative became ill, she realized the importance of wearing masks.
It was only a month ago, amid local and national political debate on these types of measures, that Gov. Cooper mandated the use of masks -- currently the most effective method known to prevent the spread of the virus -- in public places and in businesses such as restaurants and construction sites. In his interview with La Noticia, North Carolina’s Deputy Secretary for Health Services Benjamin Money explained that it is a good example of how scientific knowledge about the virus and its transmission has been advancing and changing rapidly, along with the situation regarding resources. At the beginning of the pandemic, there was a shortage of personal protective equipment in North Carolina and general mask use was not recommended.
Going forward, all levels of government and community organizations should focus on the use of masks, social distancing and other measures that will help prevent the most vulnerable populations from facing another wave of infections this winter, officials say. Polls have shown that the majority of Latinos in North Carolina and throughout the United States support the use of masks.
However, the challenge is even greater for many essential workers, especially those who work in difficult outdoor conditions or in extreme temperatures. Sergio Asdrubal Ruiz, who came to this country from Mexico 19 years ago, has spent at least 13 of those years in construction and is now the team lead for a major contractor in North Carolina. The company provides masks, but the workers generally wear them only when they are working in close proximity. “The heat suffocates us,” he says, but he still makes the effort.
Multiple times throughout their interview, the Kusaks emphasized the importance of that effort, of wearing masks, washing hands and maintaining social distance. “I want people to be aware of the coronavirus. It is no joke. It is not a game or a myth. It is not the flu,” Eliana says. She and her husband survived the coronavirus but realize that the pandemic is continuing to claim more and more lives in the Latino community. To date, more than 1,720 people in North Carolina, including 168 Latinos, have died from COVID-19. “Take care of your family. Take care of your children,” concludes Eliana, who has two children and a grandson.
Read this story in Spanish: Cómo el COVID-19 impacta desproporcionadamente a los latinos en Carolina del Norte
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