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Racial health inequities are “preventable, they're avoidable, they're unjust:” 1,678 COVID-19 cases in Cuyahoga County, 86 deaths

May 1, 2020
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The Cuyahoga County Board of Health holds press conference updating citizens on the coronavirus pandemic on Friday mornings.  

Cuyahoga County Board of Health (CCBH) commissioner Terry Allan, began his comments on the May 1 briefing by thanking the staff at the county’s donation center where medical supplies and personal protective equipment (PPE) can be donated. He thanked the Cuyahoga County Public Works Department, the Highway Patrol, the county sheriff’s department and the county’s staff who have filled in with critical roles throughout the pandemic.  

“The work we've done around contact tracing around quarantine and isolation and response in this community together with the telehealth lines has really flattened the curb and really created a plateau that has helped to buy us time to save lives,” said Allan.  

Allan reiterated that people can still make donations of unopened boxes of things like gowns, disinfecting wipes, hand sanitizers and masks at the drop site located at the Cuyahoga County Public Works garage at 2501 Harvard Avenue in Newburgh Heights from 9:30 a.m. to 2:30 p.m.

 One of the common themes you’ll find is wearing a mask…to protect others

The health commissioner then touched on something else people in the community may be thinking about right now – graduation ceremonies. He said the county has been working with the state health and education departments to come up with innovative ways to celebrate graduation this year including virtual ceremonies and drive-through graduation events.  

“I wish that we didn't have to make these types of decisions however right now we're all making sacrifices that are difficult to accept but are central to the safety and health of our community,” said Allan. “Data has guided us throughout this pandemic and it will continue to guide our decisions going forward. This is about saving lives and protecting people and we all share in that sacred responsibility. As a health commissioner I can't recommend easing restrictions and placing countless people at risk.”  

He said we have to reduce the spread of the virus and also said we don’t decide the virus’ timeline, the virus decides its own timeline.  

Allan then touched on new guidance from the Ohio Department of Health on returning to work.  

“One of the common themes you’ll find is wearing a mask…to protect others,” said Allan. He highlighted that wearing a mask protects you from other people and other people from you.  

“If you wear a mask we protect each other. We must all do our part to protect our family, friends, neighbors, co-workers and even people that we've never met. These people are part of our community and these public health strategies have clearly served as well,” said Allan.

 Five hundred seven people have recovered from COVID-19

CCBH medical director Dr. Heidi Gullett then started her remarks, beginning as she usually does with gratitude. She thanked those who work with the homeless and medical students from the Case Western Reserve University (CWRU) School of Medicine.  

Gullett shared that in Cuyahoga County, excluding the City of Cleveland, there are 1,678 cases of COVID-19 in patients ranging from one-week old to 101 years old. The date of illness onset ranges from February 28 through April 28 which, Gullett said highlights that the virus is still being spread in he community.  

Five hundred seven people have recovered from COVID-19, Gullett said the majority of these clearances were handled by CWRU’s medical students.  

“We continue to have great joy and seeing people moving past this infection in our community but we still continue to have new infections and they're very similar in the frequency of new infections as compared to last week,” said Gullett.  

As far as contact tracing. Gullett said the CCBH has identified 3,256 contacts of people who have tested positive for COVID-19. She then moved on the share that 86 people have died in Cuyahoga County due to COVID-19, with the age of victims ranging from 53 years old to 97 years old.  

Eighteen percent of people who contract COVID-19 are hospitalized in the county, and 6 percent of patients spend time in the intensive care unit (ICU). Twenty-three percent of COVID-19 cases are people who work in the health care industry, 43 percent of COVID-19 cases are in those who have a pre-existing condition.  

Gullett then went on to break down the racial and ethnic makeup of COVID-19 victims. Thirty-two percent of cases are in people who identify as Black, 55 percent of cases are in those who identify as white, .8 percent of cases are in those who identify as Asian and 8.5 percent of cases are unknown. More than three-quarters of the cases are in people who do not identify as Hispanic, 2.4 percent do identify as Hispanic and 21.4 percent it is unknown if they identify as Hispanic.  

In terms of hospitalizations, patents who identify as Asian make up 1 percent of hospitalizations, those who identify as Black make up 37.9 percent of cases, those who identify as white make up 52.6 percent of cases, those who identify as other make up 3.6 percent and 4.9 percent are unknown.

 "We don’t want people to avoid addressing emergency situations because they’re afraid to go to emergency departments so please seek care if you need it"

In terms of those who are admitted to the ICU, 1 percent identify as Asian, 45 percent identify as Black, 46 percent identify as white, 5 percent identify as other and 2 percent are unknown.  

“Those who are hospitalized and those who are ICU admissions and identify as Black have a higher percentage compared to the general percentage of cases of individuals who identify as Black for their race,” said Gullett.  

She then shared a ZIP code map that shows that the infection is everywhere in the county, and the map shows that parts are getting darker green meaning there are more cases than before.  

 

Romona Brazile, CCBH’s deputy director of Prevention & Wellness then addressed the briefing. She gave a special acknowledgement to nursing students graduating from her alma mater, Kent State University.  

She then said that the county has seen a significant decrease in emergency room visits, from an average of 1,200 to 1,400 visits a day to about 400 visits a day. She attributed the decrease to a variety of things including people being home more and possibly not having as many accidents and telehealth services. She stressed though that “emergencies are emergencies.”  

“We don’t want people to avoid addressing emergency situations because they’re afraid to go to emergency departments so please seek care if you need it,” said Brazile.  

She then addressed “complicated relationship African-Americans have with the health care system.” She mentioned the Tuskegee Experiment, saying that is really only one example in a long history of neglect and maltreatment of African-Americans.  

“Poverty and lifestyle behaviors are often pointed out as the causes of disparities but even when those socio-economic factors are equal, or even better, African-Americans still fare worse in most health outcomes. Over the years our hospital systems and our community organizations have worked to build trust and to challenge both explicit and implicit biases that exist and that work is not over, and more has to be done. So what this leads to is a vacuum in trust in institutions and what often fills that space is what is being spread through other sources such as social media that are trusted more but are not accurate.” She urged people to get their medical information from reliable sources like the CCBH website.  

She said that the CCBH knows that the coronavirus is disproportionately impacting the African-American community. She said that members of the African-American community are also less likely to be able to work from home or they are essential workers. She also addressed that some people may not feel comfortable wearing masks or they may fear they will be stigmatized.  

“You are in the right when you wear a mask. Be aware that stores may require you to wear one. Find something that you feel comfortable wearing and don't let fear stop you from helping to protect our communities,” said Brazile.  

She reiterated social distancing includes distancing physically from friends and family members.  

“What we don't want to see happen is that the people that you love the most are the ones who get sick,” said Brazile.  

Responding to a question, Brazile reiterated that testing continues to be an issue, so it’s still very difficult to give a broad statement about the data. Gullett echoed the sentiment about testing being an issue by saying that they don’t have “negative tests” -- meaning since the county hasn’t been able to test enough people the data isn’t a reliable snapshot of the overall community.  

“We're committed to ensuring equity with testing, but these data do not represent equitable testing they represent very targeted testing of the sickest and mostly hospitalized folks,” said Gullett. “A combination of testing will eventually tell us the story of what is happening and has happened here, but I still believe we need a lot of testing to understand active, current infection so that we can identify, isolate and then get contact tracing done.”  

Responding to a question about why Black members of the community may have higher hospitalization or ICU rates, Gullett pointed to a “long history of structural determinants of health policy determinants such as redlining which have created unequal opportunity for people.”

 “What we don't want to see happen is that the people that you love the most are the ones who get sick,” said Brazile.

“When you hear us talk about disparities or differences in health outcomes which are complex they're related to underlying health problems which are related to unequal opportunities around housing and jobs, related to structural racism. Because of that, you'll see that there are a lot of differences which many describe as disparities, but we often go the next step to say these are inequities, because they're preventable, they're avoidable, they're unjust and so that's why we try to help everyone understand the context,” said Gullet.  

Responding to a question about testing, she said CCBH recently received more test kits from MetroHealth, saying there are only a few thousand test kits for a very large population. She said “as more test kits come our way, we are deploying in an intentional strategy to ensure we're getting people tested who haven't been tested yet, and who are really high-risk congregate setting workers deploying back into the community, critical infrastructure workers, so I hope by next week I can report to you even more test kits and even more about a community testing strategy.”  

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