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| Black Coronavirus Patients Land in Hospitals More Often, Study Finds | Black Coronavirus Patients Land in Hospitals More Often, Study Finds |
| (about 11 hours later) | |
| As the coronavirus spread across the United States, sweeping through low-income, densely populated communities, black and Hispanic patients have been dying at higher rates than white patients. | As the coronavirus spread across the United States, sweeping through low-income, densely populated communities, black and Hispanic patients have been dying at higher rates than white patients. |
| Crowded living conditions, poorer overall health and limited access to care have been blamed, among other factors. But a new study suggests that the disparity is particularly acute for black patients. | Crowded living conditions, poorer overall health and limited access to care have been blamed, among other factors. But a new study suggests that the disparity is particularly acute for black patients. |
| Among those seeking medical care for Covid-19, the illness caused by the coronavirus, black patients were hospitalized at nearly three times the rate of white and Hispanic patients, according to an analysis of patient records from a large health care system in Northern California. | Among those seeking medical care for Covid-19, the illness caused by the coronavirus, black patients were hospitalized at nearly three times the rate of white and Hispanic patients, according to an analysis of patient records from a large health care system in Northern California. |
| The disparity remained even after researchers took into account differences in age, sex, income and the prevalence of chronic health problems that exacerbate Covid-19, like hypertension and Type 2 diabetes. | The disparity remained even after researchers took into account differences in age, sex, income and the prevalence of chronic health problems that exacerbate Covid-19, like hypertension and Type 2 diabetes. |
| The finding suggests that black patients may have had limited access to medical care or that they postponed seeking help until later in the course of their illness, when the disease was more advanced. | The finding suggests that black patients may have had limited access to medical care or that they postponed seeking help until later in the course of their illness, when the disease was more advanced. |
| Black patients were also far less likely than white, Hispanic or Asian patients to have been tested for the virus before going to the emergency room for care. | Black patients were also far less likely than white, Hispanic or Asian patients to have been tested for the virus before going to the emergency room for care. |
| Black patients “are coming to us later and sicker, and they’re accessing our care through the emergency department and acute care environment,” said Dr. Stephen H. Lockhart, the chief medical officer at Sutter Health in Sacramento and one of the authors of the new study. | Black patients “are coming to us later and sicker, and they’re accessing our care through the emergency department and acute care environment,” said Dr. Stephen H. Lockhart, the chief medical officer at Sutter Health in Sacramento and one of the authors of the new study. |
| The study, which was peer reviewed, was published in Health Affairs. | The study, which was peer reviewed, was published in Health Affairs. |
| Delayed care may give the virus more time to spread through households and neighborhoods, Dr. Lockhart and his colleagues concluded. The delays also suggest that minority patients continue to face barriers despite California’s broad expansion of health insurance under the Affordable Care Act. | Delayed care may give the virus more time to spread through households and neighborhoods, Dr. Lockhart and his colleagues concluded. The delays also suggest that minority patients continue to face barriers despite California’s broad expansion of health insurance under the Affordable Care Act. |
| “How soon you access care, even supportive care, affects how you experience illness and how much pain and suffering you have,” said Kristen M.J. Azar, a research scientist at Sutter Health who was the study’s lead author. | “How soon you access care, even supportive care, affects how you experience illness and how much pain and suffering you have,” said Kristen M.J. Azar, a research scientist at Sutter Health who was the study’s lead author. |
| She added, “While we don’t necessarily have treatments at this point, there are therapies being developed, and identifying people early on as these treatments become available will be important in order to prevent poor outcomes, like death and being put on ventilators.” | She added, “While we don’t necessarily have treatments at this point, there are therapies being developed, and identifying people early on as these treatments become available will be important in order to prevent poor outcomes, like death and being put on ventilators.” |
| Dr. Clyde W. Yancy, chief of cardiology at Northwestern University’s Feinberg School of Medicine, said the granular study of patient records bolstered cruder public health reports of higher Covid-19 death rates among black Americans. | Dr. Clyde W. Yancy, chief of cardiology at Northwestern University’s Feinberg School of Medicine, said the granular study of patient records bolstered cruder public health reports of higher Covid-19 death rates among black Americans. |
| The data confirm that socioeconomic factors play an outsize role in influencing health status and vulnerability to infection, he added. | The data confirm that socioeconomic factors play an outsize role in influencing health status and vulnerability to infection, he added. |
| “Where and how we live contributes greatly to our health,” said Dr. Yancy, who has written about health disparities and the pandemic. | “Where and how we live contributes greatly to our health,” said Dr. Yancy, who has written about health disparities and the pandemic. |
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| The new study analyzed the electronic health records of 1,052 confirmed Covid-19 patients who sought care between Jan. 1 and April 8 at Sutter Health, a health system serving 3.5 million patients in Northern California. | The new study analyzed the electronic health records of 1,052 confirmed Covid-19 patients who sought care between Jan. 1 and April 8 at Sutter Health, a health system serving 3.5 million patients in Northern California. |
| Updated June 16, 2020 | Updated June 16, 2020 |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. |
| More than half of the 61 black patients who tested positive for the coronavirus were admitted to hospitals, compared with about one-quarter or fewer of the Hispanic, white and Asian patients who tested positive. | More than half of the 61 black patients who tested positive for the coronavirus were admitted to hospitals, compared with about one-quarter or fewer of the Hispanic, white and Asian patients who tested positive. |
| Black patients were also more likely than the others to be so sick that they required treatment in an intensive care unit. | Black patients were also more likely than the others to be so sick that they required treatment in an intensive care unit. |
| Even after the investigators factored out a number of differences between patient groups, black patients were still 2.7 times more likely than others to require hospitalization when they sought care. | Even after the investigators factored out a number of differences between patient groups, black patients were still 2.7 times more likely than others to require hospitalization when they sought care. |
| “The important thing we found in this study is that even when we were accounting for all those things, race mattered,” Dr. Lockhart said. “That’s a message that’s incredibly important as we think about going forward.” | “The important thing we found in this study is that even when we were accounting for all those things, race mattered,” Dr. Lockhart said. “That’s a message that’s incredibly important as we think about going forward.” |
| The study was too small to detect differences in death rates among the patient groups, the authors said. In California as a whole, however, black residents are bearing a disproportionate burden of Covid-19 deaths. | The study was too small to detect differences in death rates among the patient groups, the authors said. In California as a whole, however, black residents are bearing a disproportionate burden of Covid-19 deaths. |
| Black residents make up 6 percent of the state’s population and roughly the same percentage of the state’s Covid-19 cases. But black patients represented 10.3 percent of Covid-19-related deaths as of May 13, according to the California Department of Public Health. | Black residents make up 6 percent of the state’s population and roughly the same percentage of the state’s Covid-19 cases. But black patients represented 10.3 percent of Covid-19-related deaths as of May 13, according to the California Department of Public Health. |
| One limitation of the study was that researchers did not make adjustments for obesity. Rates of obesity are somewhat higher among black people, and obesity has emerged as a risk factor in patients with more severe complications from Covid-19. | One limitation of the study was that researchers did not make adjustments for obesity. Rates of obesity are somewhat higher among black people, and obesity has emerged as a risk factor in patients with more severe complications from Covid-19. |