1/ Q. I hear that communities of color are experiencing more severe illness and death from #Covid_19. How does the healthcare system contribute to worse outcomes?
A. One way to think about the #healthcare system is "links in a chain."
2/ Researchers have used a framework like this (“cascades of care”) to improve clinical outcomes for other diseases.
The following are a few of the links in the chain of care for #COVID, which can shed light on weaknesses that put communities of color at greater risk
3/ HEALTH INSURANCE: Even before the pandemic, Blacks and Latinos were more likely to have inadequate #health#insurance (or none at all). When the #pandemic came along, millions lost their jobs—and, along with that, their health insurance. (pewsocialtrends.org/2020/04/21/abo…).
4/ Without insurance, families often put off seeking care, so that when they do show up, their disease is so far advanced that treatment is less effective.
5/ TESTING: In many cities, predominantly Black and Latino neighborhoods have fewer testing sites (npr.org/sections/healt…) Many states also require a referral from a doctor to get tested. This further limits access for individuals that don’t have a regular care provider.
6/ ACCESS TO CARE FACILITIES: Access to ambulatory care and pharmacies is more limited Black and Latino neighborhoods (jamanetwork.com/journals/jaman…). People of color are also less likely to have a usual place of care or regular provider, which leads to more delays in seeking care.
7/ TREATMENT: Once in care, communities of color face a myriad of other challenges to quality of care and treatment. For example, implicit prejudices of healthcare professionals are proven to impact patient-provider interactions and treatment decisions (pubmed.ncbi.nlm.nih.gov/26469668/).
8/ In emergencies when seconds count, language issues have also led to delays in administration of care: propublica.org/article/hospit…
9/ A “cascades of care” approach can be a useful tool to visualize the gaps along the healthcare chain that contribute to more severe illness and death from #Covid_19 in communities of color. However...
10/ It’s also important to stay mindful that healthcare is just ONE component of a broader array of social factors that place Blacks and Latinos at higher risk of death from #COVID19 and other diseases.
1/ Q: Has almost everyone been infected with COVID by now?
A: Recent estimates suggest around 58% of the population in the US and over 70% in England have been previously infected, with BIG increases during the Omicron wave.
3/ ➡️ During the Omicron wave from December 2021-February 2022, this estimate increased from 33% to 58%.
➡️ Rates vary a lot by age, ranging from 33.2% for those over age 65 to 75% for those under age 18.
2/ Not likely. If your kids are suddenly getting sick a lot, this is likely due to “catching up” on exposures rather than a weakened immune system.
3/ Many families w/ young kids have been hunkered down for the better part of 2 years– a good % of a young child’s entire life. While isolation had *many* downsides, we can agree that not having to suction snot out of infant noses or clean up norovirus puke was a happy upside.
1/ Q: Are cases peaking? That means it’s all downhill from here, right?
A: Sort of…. Remember that even if cases come down as quickly as they rise, there will be as many cases *after* the peak as before (think area under the curve).
2/ ➡️ And if the downward slope is *slower* than the rise, we will see *more* cases during the decline from a surge.
3/ Burning fast could be a silver lining of super transmissible #Omicron. Cases rose & fell quickly in S. Africa (w/ hospitalizations & deaths still lagging). The UK appears to have turned the Omicron corner. Many US states appear past their peak in cases, w/ regional variation:
Unfortunately, this includes New Year’s Eve plans. The perfect storm of a new variant & holiday get-togethers is hitting communities & health care w/ FORCE! Testing is in short supply.
3/ Health care is under extreme pressure with surging cases. If you can avoid even one additional contact, you are helping. This is a temporary and urgent request (from a health care provider).