About half of the 2,361 people in Richmond who’ve tested positive for coronavirus are Hispanic, but only 14 workers hired recently to investigate cases and curb the spread of the virus in the city and Henrico County speak Spanish.
Public health officials in the city and state say they are still working to ramp up hiring of Spanish-speaking contact tracers among other targeted moves designed to combat the debilitating surge among Latinos in Virginia, where Hispanic people account for 10% of the population but 44% of the state’s coronavirus cases.
Health workers, advocates and politicians say the barrier to care compounds existing challenges facing Latinos, who are more likely to work essential jobs, less likely to have access to health services and continue to outpace all other race and ethnicity groups in contracting the disease.
“Additionally, many community leaders have voiced concern that undocumented immigrants are not seeking care for fear of being deported, leading to significant underreporting in COVID-19 cases,” Del. Jennifer Carroll Foy, D-Prince William, wrote to Gov. Ralph Northam in a letter last week asking that he ensure 45% of contact tracers are bilingual, to match the state case percentage.
A core part of the state’s effort to limit spread relies heavily on case investigators — people who identify patients with confirmed or probable diagnoses — and contact tracers, who warn those potentially exposed to the virus on what steps they can take to contain the infection.
More than four months have passed since Virginia recorded its first case. As of July 8, the Virginia Department of Health has hired a total of 388 contact tracers and 531 total contractors but has more than 1,200 people working on case investigations and contact tracing, said department spokeswoman Julie Grimes.
The Centers for Disease Control and Prevention recommends a core group of 15 to 30 contact tracers per 100,000 people. In Virginia, that would mean between 1,275 and 2,550 tracers.
Of the recent hires, 113 are bilingual and 66 speak Spanish, the second-most spoken language in the state. The VDH does not have a breakdown of the languages or numbers of existing VDH staff, Grimes added.
With its current containment strategy, the VDH reported Friday that staffers are reaching five out of six COVID-19 cases within 24 hours to begin the process of tracing who they’ve been in contact with, and talk through minimizing spread.
The recommendations to all diagnosed remain the same: stay home for two weeks, isolate from others in the same household and monitor symptoms. But for the Hispanic population, following those guidelines may not be easy.
Many Latinos work front-line jobs, as farm workers, cleaning staff, construction or in poultry plants, with limited protective equipment. They can’t work from home without losing wages; many also live in cramped households where isolation is nearly impossible.
The Richmond Health Department has made efforts to shelter people in these situations in hotels, but not everyone has that luxury, said Anna Cerrato, social work program coordinator at Crossover Healthcare Ministry, a clinic with a patient population that is 50% Hispanic.
In Richmond, where Latinos are 7% of the population, they have remained the most affected, even as the city ramps up free community testing sites regardless of insurance status; door-to-door efforts explaining safety measures; and the translation of materials into Spanish.
Low-wage workers often don’t have paid sick leave or health care benefits and, for many Latino families, their industries never shut down, Cerrato said. Risking loss of wages by staying home could mean loss of food for their family and rent payment.
Some solutions to managing this, Cerrato said, include educating Latinos on labor laws, employee rights and safety practices.
Latino outreach relies on a combination of pre-existing relationships with nonprofits and clinics such as Crossover that already catered to the community and mitigating distrust by bolstering the Spanish speakers and cultural competency among health department staff, said Dr. Danny Avula, director of the Richmond and Henrico health districts.
As of Monday, the health districts have hired 53 people, 14 of whom speak Spanish. The districts had recorded 5,145 combined total cases by Friday morning. Richmond and Henrico combined trace 30 to 40 cases per day.
Avula said they’re “pretty well-equipped to meet the current demand.”
The first wave of contact tracer hires for Richmond was on May 30 and included two bilingual contact tracers. The goal is to have 40, with some who are fluent in Indigenous languages, and a staff of 80 within a month, said Joanna Cirillo, a public health nurse who leads contact tracing efforts at the Richmond City Health Department.
Hospitalization numbers for Hispanics are slightly lower than the number of cases, albeit by a smaller percentage, a factor Avula said could also be attributed to how many cases among the Hispanic community tend to be younger.
Cerrato, the social work program coordinator at Crossover, said Latinos are also less likely to seek medical attention if they’re uninsured due to fear of receiving a bill they can’t pay.
Building that support — hiring bilingual contact tracers, building a layer of community health workers and raising money for these efforts — is vital in making sure the virus doesn’t continue to stalk Latino populations, but there’s work to do, Avula said.
“This pandemic is not going to be done in a few months,” he said. “We’re looking at a year to 18 months of ongoing social needs that are just going to take funding.”