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The Pandemic

Lack of information on race hinders efforts to find, fight COVID-19 outbreaks

Local officials hampered by CDC’s failure to require race, ethnic data

The task force aims to test 1,000 people a day at “safety-net” clinics, mobile testing facilities, and added Tiger Lane-style sites. UTHSC staff and students (in an April 1 photo) work at Tiger Lane with the Shelby County Health Department. (Mark Weber/The Daily Memphian)

Efforts to expand COVID-19 testing in underserved parts of Memphis are ramping up but are doing so slowly in a city that is majority African American.

The sparse racial data available on those testing positive for the virus is a reflection of a national problem, largely because that information has not been made widely available. The Centers for Disease Control and Prevention, for example, isn’t including racial and ethnic background data.

Still, the information is more readily available in some places than here.

opens in a new windowThe Washington Post reports, for example, that data from eight states that do include a demographic breakdown with race indicates a clear racial disparity in infections as well as deaths.

Asked when such data may be available in Shelby County reporting, Shelby County Health Department director Alisa Haushalter said she plans on having a racial breakdown of COVID-19 deaths in Shelby County and is working on a similar breakdown for confirmed cases.

The problem is that while the Health Department gathers data on race on paper forms, the CDC reports don’t include data on race.

“Where the race data is not included is in the actual report of the case. As we are completing the contact information, we are gathering race,” Haushalter said Tuesday at the daily briefing on the pandemic. “But we are still on a paper chart.”

From that chart, the information is entered into data bases used for modeling the spread of the virus locally.

“That’s really where the glitch is. We really do ask that information as much as possible,” she said. “It is not included on the CDC report form because it is not viewed as a critical factor for COVID-19.”

Questions about the race and locations of outbreaks and individual cases are getting more attention from the coordinated local task force as the group seeks to expand testing and trace contacts to isolate hot spots for the virus and prevent its spread. Some activists are also raising questions about access to health care in poorer parts of the city that traditionally has less access than other parts of Memphis after the earlier release of a map of cases by ZIP code.

“The virus is indiscriminate in its spread,” said Rev. Stacy Spencer of the social justice group MICAH – Memphis Interfaith Coalition for Action and Hope. “It is an equal opportunity enemy but the way we will be affected by the virus is not at all equal – not in health care, not in policing. This is what our communities need to know.”

At an afternoon briefing Tuesday, April 7, Spencer also mentioned the racial disparities in infection and death rates in other cities.

“We want to make sure that there is more testing,” he said. “That the poor and most vulnerable get tested so we can know how those disparities play out.”

Initially, the health department didn’t release numbers it had on the total number of people tested early in the response to the pandemic. There was data on that, but the health department said the number of those who tested positive was more important. Other health care professionals with access to the total numbers tested were also told not to release the figures.

But having such information is critical to testing since independent research gleaned from local data nationally suggests that a disproportionately high percentage of minority populations are infected by the coronavirus. Culling local data in Chicago, opens in a new windowmedia reports found that more than 70% of those who had died from COVID-19 were African American. The black population of Chicago is about 30%, compared to about 65% in Memphis.

Local officials say they know having such information is critical and that’s why they’re working to get the local information.

The state also is preparing to provide COVID-19 testing information related to race and ethnicity, possibly as early as Wednesday, Health Commissioner Lisa Piercey said.

Reports also could be released on deaths by age range stemming from the pandemic, the commissioner said.

“We try to be very sensitive for patient privacy and balancing that with transparency recognizing that this is a gray area and this is new territory for all us, and so we want to approach it cautiously but with the public’s interest in mind,” Piercey said.

State Rep. G.A. Hardaway said Tuesday test results broken down by factors such as race and economic condition are vital to helping the state stem the spread of the coronavirus.

The Memphis Democrat said universal testing is crucial, as well, to “managing the coronavirus crisis effectively” and providing a “true picture” of the disease’s impact.

“It’s like driving without a map. It’s like driving without hands. All you have are a gas pedal and brakes,” Hardaway said. “You don’t know which way to go because you don’t have enough information.”

The local COVID-19 Task Force is developing a comprehensive coronavirus testing strategy to widely expand testing to more under-served areas and vulnerable populations of Shelby County.

The plan seeks to test 1,000 people a day at “safety-net” clinics, mobile testing facilities, and added Tiger Lane-style sites for the next six months, then transition to primary and urgent care settings by November. Testing will be free.

The expanded testing would be phased in, starting with all who are showing symptoms of COVID-19, regardless of whether they have insurance or other means to pay.

“The goal isn’t so much to expand the volume of testing but the equity of testing, both demographically and geographically,” said Jenny Bartlett-Prescott, chief operating officer of Church Health who is leading the task force’s testing subgroup.

The task force plans to use data collected by the health department that breaks down those who have tested positive for COVID-19 by race, gender, age and ZIP code. Mobile testing sites would be dispatched where more testing is needed. 

In the second phase, testing would expand to all healthcare workers, first responders, and staff and residents of homeless shelters, nursing homes/assisted living facilities, large housing complexes, and other high-density populations, regardless of whether they are symptomatic.

The third phase would involve serological testing, so-called “immunity testing,” that could identify those with immunity to the virus. That would allow healthcare workers, first responders, and other essential workers who are no longer at risk to return to work sooner.

This story first appeared at dailymemphian.com under an exclusive use agreement with The Institute. Photos reprinted with permission of The Daily Memphian. Bill Dries and Sam Stockard of the Daily Memphian contributed to this story.

David Waters
Written By

David Waters is Distinguished Journalist in Residence and assistant director of the Institute for Public Service Reporting at the University of Memphis.

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