Duke professors: To fight COVID-19, health officials need to build trust in government
To effectively stop the spread of COVID-19, health officials need convince some communities that they can trust the government, according to two Duke University professors.
And that will be more important when a vaccine is available, said Dr. Oluwadamilola Fayanju, a Duke assistant professor of surgery and population health sciences. He was joined by Dr. Kevin Thomas, an associate professor of medicine, at Thursday’s Duke-sponsored media briefing on COVID-19 health disparities. Mistrust of the government may make it more difficult to quickly inoculate people if and when a COVID-19 vaccine is created.
Among Black people, particularly in the South, the memory of the Tuskegee Experiment looms large, while deportation efforts are frequently cited as causes for mistrust among Hispanic residents.
Health officials should, Fayanju said, be trying to build trust around a vaccine now.
Fayanju said, “I do know of individuals who will say, ‘You know what? I just don’t feel like I live in a country right now that I trust enough to give me a vaccine that will not hurt me.’”
The Duke professors specifically addressed how to spread information about the most up-to-date steps against COVID-19 to Black and Hispanic groups in North Carolina, as well as the importance of making sure testing is broadly available in those communities.
In North Carolina, the virus has hit the Hispanic population particularly hard, with the group making up 45% of the cases for which there is a recorded ethnicity. That is almost five times the group’s 9.8% share of North Carolina’s population.
Many cases in Hispanic communities throughout North Carolina have been linked with working conditions that allow the virus to spread. COVID-19 outbreaks have been tied to meat packing plants, farmworker lodging and construction sites, in addition to nursing homes.
“There may be explicit or implicit pressure to continue coming to work at a daycare center as a housekeeper as a bus driver as a utilities worker. Because frankly, there aren’t enough people to do the work,” said Fayanju.
Once someone does go to work and is developing symptoms, they may not be able to find testing, Thomas said, specifically pointing to Durham as a place where testing is difficult to find for vulnerable groups.
According to Rodney Jenkins, the county’s health director, the ZIP codes of 27703 and 27704 in East Durham had the highest rates of COVID-19 and lacked testing as well.
Thomas said the location of test sites is critical, but that it is also important to consider who is limited in other ways.
“Drive-up testing has become a very popular way to test individuals. That really doesn’t consider who has transportation and who doesn’t,” Thomas said. “For those who potentially can access testing sites but are reliant on public transportation, that really promotes some challenges as well.”
Earlier this week, DHHS officials announced they’ll bring free testing to more than 100 underserved ZIP codes throughout North Carolina during July. Some of the sites will, DHHS announced, have walk-up testing.
Fayanju noted that transportation is not the only barrier to testing, with work hours making it hard for some to get to a testing location in time. One possible solution, she suggested, is for workplaces that are still operating to offer testing, a step that has been taken at some of the state’s meat processing plants.
Those living in underserved communities may have other needs if they receive a positive test, Thomas said. For instance, if they live in a multi-generational home, it could be difficult to social distance and conditions could allow for the quick transfer of COVID-19 to an older person.
“I think what’s incumbent us and incumbent upon the communities and the governmental agencies and the public health agencies is to be able to provide the necessary infrastructure for people who are challenged with these situations to be able to social distance properly,” Thomas said.
DHHS officials also announced Thursday that they’ll station 250 community health workers in places that have high COVID-19 caseloads and historically marginalized populations. Once deployed in August, DHHS said, the workers will help link people with testing, primary care and mental health services, among other services.
It is also important, Fayanju noted, to reiterate messages about wearing a face covering, frequently washing hands and physically distancing in underserved communities where the most up-to-date information about COVID-19 may not yet be widely disseminated.
Regarding wearing masks, Fayunju said, ““If we had a drug that we knew would reduce transmission of the disease by a factor of five, we would all be jumping to do that. It’s kind of amazing that we know that masks actually significantly decrease the likelihood of transmission, but yet there are people unwilling to wear it.”