By: EMS Staff Reporter, Sunita Sohrabji
SAN FRANCISCO, Calif. — The United States, currently leading the world in the number of people infected with coronavirus, is at the crest of fully experiencing the pandemic, a panel of medical experts and community health advocates told reporters March 27.
The U.S. has registered more than 136,000 infections and approximately 2,400 deaths, according to March 26 data from the World Health Organization.
The telebriefing — organized by Ethnic Media Services and sponsored by the Blue Shield of California Foundation — featured two physicians speaking from the front lines of the global health crisis: Tung Nguyen of the University of California, San Francisco, and Daniel Turner-Lloveras of the Harbor UCLA Medical Clinic.
A large percentage of the immigrant community relies on public health facilities, Turner-Lloveras said, but fear to seek care because of the new public charge rule the Trump administration rolled out Feb. 23. The rule says immigrants who seek any form of federal public aid could be denied permanent status in the U.S.
About 43% of undocumented immigrants have no health insurance, said Turner-Lloveras. “We cannot contain a virus outbreak by providing care to only some of the population. We cannot successfully contain an outbreak if there are those among us who are afraid to seek care,” he said.
Public health innovator Rishi Manchanda, founder of HealthBegins, said the pandemic disproportionately affects immigrants and people of color. Psychiatrist Sampat Shivangi, currently serving on the Trump administration’s Council for Mental Health and Substance Abuse, spoke about the psychological effect of self-isolation and the possible surge in substance abuse.
Veteran activist Manju Kulkarni, executive director of the Asian Pacific Policy and Planning Council (A3PCON), briefed reporters on the rise of hate crimes against the Asian American community in the wake of the pandemic.
Nguyen said he has “never seen doctors so scared by an infection. We could be looking at a million infections by next week and four million by next month.”
The virus is deadly: 15 to 45 of every 1,000 infected people will die of a COVID-19 related illness, Nguyen said, noting that the elderly are particularly vulnerable. No vaccine exists for the disease, and the U.S. is still 12-18 months away from developing one. No cure exists, said medical experts on the panel, cautioning against spreading misinformation about using hydroxychloroquine, a malaria drug President Trump has touted as a possible cure for coronavirus-afflicted people.
“You need to just stay home,” Nguyen stressed. The most effective methods to steer clear of the virus are social isolation and avoiding touching objects and surfaces. For communities of color and immigrants, who tend to live in multigenerational households, it’s imperative that people who must leave the household for work wash up and change clothes afterward, before engaging with their families again. The virus may be in the air for up to three hours. It can live on cardboard for up to 24 hours and on plastic and steel for 72 hours, the UCSF physician said.
New York City is currently experiencing the worst of the pandemic, Turner-Lloveras said, and its overloaded hospitals lack medical supplies to treat all ill patients. California hospitals, which had an extra week to prepare, may be better-equipped to manage the surge. They are trying to triage appropriately, using telemedicine and other resources to avoid a crush of people coming in at once.
Turner-Lloveras has worked in low-income communities in Los Angeles and advocates for hospitals to be “ICE-free zones” that limit immigration agents’ access so they cannot arrest and detain people seeking medical care. He also spoke out against the overcrowding at ICE detention centers that can increase the community spread of the virus.
Manchanda also has worked in South Central Los Angeles’ low-income communities. He told reporters that the pandemic disproportionately affects the economic well-being of people of color and the immigrant community as well as their health.
“It’s hard to not work for many communities of color. Lower wages and insufficient insurance coverage limits their access to treatment and often forces them to work even while ill, increasing the risk of exposure to the community,” he said. Also, many minorities live in large cities, frequently in public housing, placing them at a greater risk for infection. And members of ethnic communities often work in front-facing jobs, such as grocery-store clerks, and take public transportation to get to jobs, resulting in higher rates of exposure.
Manchanda added that limited access to testing, language barriers, and underlying illnesses, such as diabetes and heart disease that disproportionately affect certain minorities, put immigrants and minorities at greater risk of infection and death.
The rise of xenophobia against Asian Americans is real, Kulkarni said, citing the case of a child who was punched in the head 20 times at school because a bully thought he was Asian. A3PCON has received 750 reports of COVID-19-related hate crimes in the past month, she said.
10 QUESTIONS ?
1. Can Covid-19 strain mutate and if so, how many types have been identified? Would the strain in the US be different from the original strain from China?
TN: so far, the evidence is that there are mutations with COVID-19 virus. As the scientific data is being gathered, it’s hard to say about different strains. This article gives a good update in plain language, and the other link shows graphically what is happening as far as the COVID-19 genomes.
2. Staying at home and staying healthy are two ways people can do to help themselves and to stop the spread. How can one stay physically and mentally healthy while spending much of time at home?
TN: This depends on the person. We always recommend exercise. Walk outdoors if you are able to do while keeping physical distancing. If not, try exercising indoor, from calisthenics to yoga to aerobic exercise using assistance from TV or Youtube. It is important to take frequent breaks from watching things on TV or the computer, and not to do it a couple of hours before sleep. Try to keep regular hours as our mood is dependent on cycles and getting enough sleep (8 hours or more). Keep in touch with others through whatever works best—text, phone calls, FaceTime or other similar. When it feels like the news or other social media sources is overwhelming or making you anxious, take a break and walk away.
Lower your expectations during these difficult times. We will not be able to accomplish as much. Things will not be as nice. People may be unhappier, but not necessarily because of us. Try to be grateful if you can—if you still have a job, if you still have everyone you love being healthy, that’s the best.
For those without a job right now, that is very stressful. Apply for unemployment. Ask for rent/mortgage reductions/deferral/forgiveness. Wait for the stimulus bill. Learn new skills online.
Most importantly, acknowledge that these are incredibly stressful conditions and it is ok to feel stressed. Forgive yourself and others. Tell your loved ones how you feel (by using “I feel” not “You make me” phrasing). Understand that everyone is stressed out, so try not to escalate the stress by being short tempered. Remember that stress = fight or flight, and fighting makes things worse, so walk away if you can’t be nice. Domestic violence goes up during these times. Use hotlines for significant concerns.
3. Dr. Fauci said flu-like virus tend to be most potent during winter, cold weather season. And the opposite is true that virus tend be less potent in warmer climate, hotter temperature environment. So keeping the home really warm while staying at home during this period might be one of the ways for prevention?
TN: seasonal spread of viruses depend on a variety of factors, from how the virus survives in different environment to how human beings behave in different environment. For example, one reason why there are more colds in the winter may be because people are clustered closer together, making it easier to spread infections. It is true that some viruses do not survive as well in warmer weather. At this time, because COVID-19 is a new virus, we do not know what will happen when the weather warms up. It is likely that the change won’t be enough to stop the pandemic—it will be human behavior change. As far as the temperature in a home, there’s no evidence that keeping a home warmer decreases infection as far as I know.
4. Would be great to hear someone talk more about Public Charge and if there is evidence this threat is preventing people from getting tested or getting other help. And since it exists, what do professionals recommend undocumented immigrants do – ignore the threat of public charge.
TN: to be clear, public charge affects only legal immigrants who do not have a green card yet. We already know from before the pandemic that legal immigrants have been reluctant to use the healthcare system before the public charge rule went into effect end of February, so it would be expected here.
For ongoing public charge info: https://www.onenationaapi.com/
5. How long could you expect the pandemic will last? until May or August?
TN: the projection is this may last 12-18 months, likely with multiple peaks, depending on how we handle the containment strategies.
6. What will the curve of the pandemic look like on April 12?
TN: this depends on the country. In the US, each hotspot will have a different curve, depending on when it started and what the containment policies there are.
7. One of the speakers mentioned that California is more prepared than other states because we have more time to prepare. Does it mean that the peak of the out break hasn’t arrived yet in CA? If not when it’s gonna be and is there any thing people can do other than staying home and stocking up?
TN: we are probably not at the peak in California, but the peak may be lower in California due to early action. Besides staying home, if you can participate remotely in efforts (including policy and advocacy) to ensure that there are enough personal protective equipment (masks, gowns, gloves, etc..) for our healthcare workers and enough ventilators for the sick, that would help.
8. With the African American community suffering in great numbers from most-if not all- of the high risk conditions resulting in the most severe form of COVID-19; what else can be done to raise the alarm in these high risk communities?
TN: I think working closely with the local department of public health, churches, community organizations, and ethnic media would be good.
9. Although many minority households are multi-generational, there also remains a representative number of African American seniors and other seniors who live alone—many in their 80s and 90s. While cities/states are sheltering in place, is there any thinking/planning to take an organized government/public approach to some kind of daily/weekly organized effort to assure these seniors are taken care of, recognizing that many of them may have outlived their relatives and friends and may not have anyone looking out for them.
TN: as far as I know, there isn’t any organized governmental approach yet for this
10. Mental health is a taboo topic among many ethnic communities. During this period, those with mental issues may get worsen and exhibiting angers that would affect family members who are now staying at home. How would you advice these individuals and their families in taking steps to be open about mental illness to cope as a family and even seeking professional help?
SS: Thank you for your question on Mental health, you are absolutely right on question of taboo on issue of mental health in ethnic communities. My take on this would be follow the strict regime on medication, make sure there are enough medications in hand and medical and Psychiatric follow up as scheduled and good old TLC.