Berks County Medical Society Medical Record Summer 2020 - 6

Editor's Comments

What We Owe One
Another Now
by Lucy J. Cairns, MD, Editor

T

he novel coronavirus pandemic that has washed over our
world like a 360-degree tsunami has killed many, sickened
many more, and upended lives and livelihoods. We have
been forced to reassess our obligations to family and friends, to
work or school, and to the larger community we are part of-both
across our country and around the world. This reassessment has
been complicated in a most devilish fashion by the fact that in many
cases these obligations conflict. There are probably few so-called
"essential" workers who have not struggled with the fact that simply
continuing to show up on the job involves placing not just their own
health at risk, but also the health and possibly the lives of any loved
ones they are in close contact with.
Physicians and the many others who work in hospitals, medical
offices, long-term care facilities, and other institutions providing
care to the sick and vulnerable are among those who have carried
the burden of increased stress resulting from this conflict-a burden
added to that of the natural anxiety accompanying exposure to a new
and deadly pathogen. The failure of the wealthiest country on the
planet to ensure that front-line healthcare workers had early access
to an adequate supply of the equipment designed to keep them
safe will surely be a black mark in the history books. This failure
has unnecessarily magnified the risk of disease for such workers
and therefore their anxiety, and has contributed to our losing some
healthcare workers to death by COVID 19 disease and others to a
decision to stay home to protect their loved ones.
What do we now owe to front-line healthcare workers? We owe them
a debt of gratitude that can only be repaid by using every means at our
country's disposal to ensure that such a dire shortage of PPE never occurs
again. Equally important, we owe it to them to conscientiously follow
the guidance of public health and infectious disease experts designed to
minimize future spikes in the disease.

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As COVID 19 disease has spread through our country, it has
become painfully apparent that the burden of disease and death is
falling much more heavily on certain groups. Among the groups
affected most disproportionately are African Americans and nursing
home residents. In Berks County, data released in late May by
state health officials revealed that nursing home residents accounted
for more than half of the 254 deaths from COVID 19 recorded at
that time in Berks. An analysis by the Philadelphia Inquirer posted
online on May 21 came to a similar conclusion for deaths in that
city: 54% of 1,152 deaths were of residents of nursing homes.
What do we owe now to our community members who reside in
long-term care facilities? Only what they have been due all along: a
safe place to be cared for, ensured by adequate resourcing, regulation,
and enforcement.
Data on the impact of the pandemic on specific racial and ethnic
groups is incomplete and imperfect at this time, but multiple reports
provide strong evidence of the disproportionate impact on African
Americans. In a CDC MMWR report posted online on April 18,
an analysis of 580 hospitalized COVID 19 patients for whom racial
data was available found that 33% were African American, whereas
only 18% of the surrounding community was black. Analysis of
data from a large, integrated health system in northern California
which included 1,052 confirmed cases between January 1 and early
April revealed that African Americans were hospitalized at twice
the rate of non-Hispanic whites and were more than twice as likely
as whites to require care in an ICU. A report out of Louisiana
indicated that while African Americans make up only 33% of the
population in that state they accounted for 70% of deaths from
COVID 19. Michigan and Chicago are among a number of other
localities reporting similar disparities, and we can expect more as
racial and ethnic data are included in reporting.
Berks County Medical Society Medical Record Summer 2020

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