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Impact of the Pandemic on Minorities

  • Marilyn Perez
  • Nov 10, 2021
  • 2 min read

How has COVID-19 affected you? For many, the answer could include quarantine, working from home, virtual schooling, and more subtle changes in their daily routine. However, some populations have been more adversely affected by the changes the pandemic has brought, including several ethnic minority groups.

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For that matter, the hospitalization and deaths for minority populations has been up to 3 times the rate of white and non-minority identifying populations1. In the Durham community alone, the Hispanic/Latinx population has accounted for 27.01% of COVID cases in the previous months while Black/African American communities accounted for almost 39.55% of COVID cases2. However, the Hispanic/Latinx community accounts for only 14% of the total Durham County population, while Black/African American communities account for 37% of Durham County. This discrepancy in numbers demonstrates how minorities are more profoundly affected by COVID in the county that we reside in.

So why do these discrepancies occur?

There are many factors and not a perfect way to answer this question, although it could be broadly answered by the impact of social determinants of health. For instance, minority groups are most likely to be employed as “essential workers”. These occupations include “farms, factories, grocery stores, and public transportation” 3. By working in these essential jobs and interacting more frequently with the general public, minority groups may be more susceptible to contracting the disease.

Moreover, institutional and lifelong racism can also play a part in the health risks for minorities. The long-term experience of racism is associated with tangible biological impacts on a person’s health.4 In particular, chronic inflammation has been linked to “race-related stressors”. This demonstrates the detrimental impacts of racism to the health of humans and the importance of eliminating institutional racism from our social spaces.

In addition, more than half of the uninsured population are from minority groups. This is important to consider because this is another way in which social determinants are associated with worse health outcomes for minorities who contract COVID, since the high costs of hospital bills discourage those without medical insurance to go to the hospital, which contributes to worse health outcomes than people that are insured. We also have to keep in mind that those without medical insurance could face even more health disparities because they do not have the security of going to medical providers or getting yearly check-ups. Furthermore, people who have been diagnosed with obesity or diabetes are more vulnerable to contracting COVID-19, which has also been linked to social determinants and institutional racism, creating an additional barrier for minorities who live with these diseases.

COVID-19 still continues to affect minorities today in a myriad of economic, social, and psychological ways, and as the pandemic continues on, we may still discover more of the adverse effects that minority groups continue to experience.


Edited by: Madi McMichael

Graphic Designed by: Heiley Tai


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Hospital Overflow is Far From Over: Patients Are Returning to Regular Care on Top of COVID-19 Influx

  • Abby Cortez
  • Nov 10, 2021
  • 3 min read

For nearly two years, the COVID-19 pandemic has overwhelmed hospitals across the country. The mass influx of patients took its toll on things like resources and nurses. But coronavirus patients weren’t the only people sick in 2020; they were just the only ones seeking care. The CDC reported that 41% of American adults delayed or simply avoided medical care due to the pandemic. Some even avoided basic care and screenings. In Austin, Texas mammograms were down 90%, and according to TIME, about 15% of Americans skipped specialist appointments like cardiologists. These are concerning numbers considering cancer and heart conditions are deadly; what’s further concerning is that as many as 12% of those patients did not seek emergency care.

Even though it might seem counterintuitive to avoid seeing a doctor in an emergency, there was, and remains, a very real fear of infection. Especially prior to the development of a vaccine, COVID-19 posed a great and virtually unpredictable risk to patients, especially those with underlying conditions. Hospitals, though working to keep everything sterile, were full of patients capable of spreading the infection. If fear of a life-threatening virus wasn’t enough to keep people out of hospitals, finance also played a role. Quarantine put a lot of people out of a job, and with that, left many without health insurance. So even if people mustered the courage to risk an appointment, many would have a hard time affording it.

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Unfortunately, but perhaps predictably, this kind of concern adversely impacts low-income and ethnic or racial minority groups. These groups are not only more likely to have underlying conditions that need repeated care, but they are also more likely to be unable to afford it. Families barely able to afford the treatment they already need are not going to want to risk having to pay for coronavirus care on top of their usual medical expenses. Telehealth options are often presented as a way to help people worried about going in person for medical services, but this solution isn’t perfect. Not only is there a certain intimacy and connection that telehealth lacks, but for low income groups, telehealth may not be a viable option.

A TIME study also revealed that the number of patients seeking care for mental health has also decreased. And though suicide rates didn't appear to increase during the pandemic, depression and anxiety rates certainly did. According to the Kaiser Family Foundation, 4 in 10 adults experienced anxiety or depression during the COVID-19 outbreak, a fairly dramatic increase from the 1 in 10 it was prior to 2020. It’s concerning that a number of adults had to let go of mental health as a priority. The effect of this still remains to be seen as the pandemic continues.

Not only does putting off medical care negatively impact patients, who may miss out on early diagnosis and treatment, but it also hurts hospitals. Much of hospital revenue comes from the procedures and appointments they have on a daily basis. When the pandemic put a stop to those kinds of patients, many hospitals saw their profits plunge. The financial losses to healthcare systems, in addition to the shortage of nurses and resources associated with COVID patients, is likely to have long lasting effects even as the pandemic begins to subside.

Hospitals and patients have not had adequate time to recover from the effects of putting off medical care. A lack of vaccination rates and resurgence in coronavirus cases following the delta variant have once again put stress on hospitals. And even if more Americans get vaccines, there’s still a chance hospitals will remain overwhelmed, this time not with COVID patients, but patients now desperate for the care they put off.


Edited by: Olivia Ares

Graphic Designed by: Eugene Cho


References

 
 
 

The Future of Immunization - a look at RNA Vaccines

  • Abby Cortez
  • Oct 31, 2021
  • 3 min read

Updated: Nov 1, 2021

Polio, measles, smallpox. Many people today don't give these deadly diseases a second thought. Since the development of the polio vaccine in the 1950s, immunizations have prevented many devastating viral infections.​​

Humans have been creating vaccines for years, and we get at least one every year when flu season comes around. What’s special about the COVID shot?

Traditional vaccines are developed using a deactivated part of the targeted virus. Essentially, the vaccine tricks your body into thinking that you are infected. When the body detects the deactivated virus, it sends an immune response to fight off the “infection”. As a result, your body produces antibodies specific to that antigen, so that if an actual infection takes place, your body can initiate a much quicker immune response. The COVID-19 vaccine is different because it’s an RNA vaccine. The process used to develop this shot is drastically different from that of prior vaccines, and it could be the future of immunizations.

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So what the heck is RNA?

Every person has a unique set of DNA that codes for genes. Genes determine everything from the color of your eyes to any allergies you might have. RNA is produced from DNA, and instead of being a code for genes, it codes for proteins. Your body uses proteins to do pretty much everything. RNA is a set of instructions that tells your body exactly how to make all these proteins. When you get an RNA vaccine, it gives your body a set of instructions to make a protein found on the surface of the targeted virus. Upon detection of that protein, the body initiates the same immune response as the one traditional vaccines generate, providing you with antibodies.

So if both types of vaccines have the same end result, antibodies, then why does the difference matter?

Before COVID-19, the fastest record for vaccine development was in the 1960s when the mumps vaccine was rolled out in just four years. Typically, traditional vaccines take up to a full decade to get developed and approved for clinical use. RNA vaccines are both faster and cheaper to develop. The COVID-19 vaccine was created in a year, at a record-breaking speed. Developing an RNA code is easier than deactivating a virus. In comparison to traditional vaccines, RNA vaccines can be adapted to different viruses much more easily. All researchers have to do is change the code and tell the body to make a different protein, as opposed to finding and deactivating a whole new virus. This can make the whole development cheaper and more efficient since the process does not require animal cells to hold deactivated viruses. The production takes only a few minutes as opposed to weeks.

If RNA vaccines are so much better, why haven’t we seen them before?

The short answer is we had, but they were overlooked. Labs have been researching RNA vaccines for years, with many ready to start human trials when the pandemic began. The newfound urgency gave rise to much greater research efforts. The demand and funding increased virtually overnight; the research paid off, and the COVID-19 vaccine was approved. RNA vaccinations are safe, and they work. The success of the Pfizer and Moderna vaccinations could mean a new future for the RNA vaccine and the development of vaccines in general.

It's worth noting that there were some special circumstances around the coronavirus vaccine. Due to the tremendous pressure for the speedy development of a vaccine, researchers had access to far more funding than they usually did. Congress gave the Department of Health and Human Services around 6 billion dollars for research on the coronavirus, in contrast to the 23 million they designated in 2019 for the Ebola vaccine. Additionally, COVID-19 is part of a family of viruses, the Coronaviridae. Scientists already had some understanding of how this family worked, which would have made the whole process easier. These factors likely contributed to the speed the COVID-19 vaccine was approved, but still, if the RNA method could lower development time to anything less than ten years it’s an improvement.

The COVID-19 vaccine has been saving lives, and those vaccinated are less likely to contract or spread the disease. And even if they do get it, their symptoms are likely to be significantly less severe. Regardless of the circumstances that set COVID-19 apart, the success of the vaccine shows that RNA vaccines can be developed faster and more efficiently without risking the health of patients.


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DMEJ

   Duke Medical Ethics Journal   

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