Page 19 - Florida Sentinel 5-22-20

Coronavirus Equity
Coronavirus And Health Equity - Again This (Too) Is Predictable
Part I
The current COVID-19 pandemic represents the most unprecedented health event to occur across the globe in over a generation. Initial indicators of the severity of the emerging pandemic were revealed when the Wuhan, Hubei province, China ceased all daily and economic activity within their region in Janu- ary 2020 to attempt to con- tain the spread of a novel Coronavirus, now identified as SARS-CoV-2 (WHO 2020).
Human infections were quickly detected in dozens of countries outside of China, with the first confirmed identification inside of the United States on January 20, 2020 (N Engl J Med
2020; 382:929-936). The spread across the United States has been dramatic; at the time of this writing there are 321,762 confirmed cases in the United States, and 1,237,420 worldwide (Johns Hopkins University COVID- 19 map).
The most affected state has been New York, with 114,996 cases, and 3,568 deaths. New York City has the highest infection and death counts, with 63,307 cases, and 2,254 deaths. For the past two weeks, New York and New York City have been the epicenter of SARS-CoV-2 in the United States. It makes geographi- cal sense that New Jersey has the second highest infec- tion and death counts. Ac- cording to the University of Washington Institute for
BY KEVIN B. SNEED PharmD, FNAP, FNPHA, Sr. Associate Vice-President, USF Health Dean and Professor, USF Health Taneja, College Of Pharmacy
Health Metrics and Evalua- tion (IHME), peak utiliza- tion of hospital resources were expected to occur in New York by April 8-9, with nationwide peak resource utilization expected to occur
by April 15 .
While the most attention
to the COVID-19 outbreak has been focused on Wash- ington state (early out- breaks) and New York (most severe outbreaks), newly emerging hotspots in Michi- gan, Louisiana, and Illinois begin to reveal another pat- tern. The outbreaks are fo- cused in densely populated cities, with the most affected areas concentrated in coun- ties and neighborhoods with higher racial and ethnic pop- ulations. This is particularly concerning as the highest rates of chronic illnesses, and particularly cardiovas- cular chronic illnesses, are also concentrated in these areas.
It has become widely ac- cepted that COVID-positive patients with comorbid con-
ditions such as hyperten- sion, diabetes, and diag- nosed cardiovascular disease also experienced the highest mortality rates (Wu Z, et al JAMA. doi:10.1001/jama. 2020.2648). These locations likely represent patients that are dependent on public transportation, may be clas- sified as essential workers, and reside in socially dense housing (Associated Press, Wire Service Content-April 3, 2020, at 4:25 p.m.).
Population density, while not the final factor, must be considered and identified as a significant factor for spread of SARS-CoV-2. And people of color and identi- fied ethnic groups may dis- proportionately represent the largest burden to the healthcare systems.
(To be continued)
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