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COVID-19 is killing black residents of Polk County at a much higher rate than white residents, although the rate of infections appear to be similar, according to data from the Florida Department of Health.
A panel of three medical experts addressed that and other health disparities Tuesday afternoon during a Zoom teleconference meeting of the African American Chamber of Commerce Polk County.
Joy Jackson, M.D., who is the director of the Department of Health in Polk County, said that while blacks make up 16 percent of the county’s population, they accounted for 20 percent of the confirmed cases (87 among 441 cases as of Monday); 30 percent of the 123 hospitalizations to date and 39 percent of the deaths (7 among 18 deaths as of Monday).
Daniel Haight, M.D., who is medical director of infection prevention and vice president of community health for Lakeland Regional Health, said disparities that may be contributing to the higher hospitalization and death rates include:
- Less access to health care
- The state of Florida not extending Medicaid coverage to all low-income adults
- Pre-existing health conditions that are complicated by COVID-19
- Increased exposure to the virus because of employment in essential functions
- Increased use of public transportation
- Delay in getting treatment
The head of Lakeland’s public transit service took exception to the remark about public transportation.
“Absolutely ridiculous. Citrus Connection hasn’t had one positive COVID test. Our vehicles are sanitized approximately 20 times a day,” Citrus Connection Executive Director Thomas Phillips posted on Facebook.
He continued: “We had three drivers self quarantine due to concerns and all three returned to work after two weeks. Our paratransit department suspended service to all senior living facilities that have positive COVID results. 87% of our riders are transit dependent and do not have access to a personal use vehicle. Citrus Connection is following 100% of the CDC recommendations for public transit. The continued stigma of public transit use, without proper supporting local data isn’t helpful or appropriate.”
Because of lack of primary health care, a person may not be aware that he or she has one of the underlying health conditions, such as high blood pressure, diabetes, lung disease, heart disease, or cancer “that impacts how sick you get with COVID-19,” Haight said.
Lakeland Regional Health’s hospital has plenty of ICU beds and ventilators to treat COVID-19 patients and an emergency department that isolates people with infections but staff is finding that too often people are delaying getting treatment, he said.
“We see people coming to the hospital late,” Haight said. “COVID-19 can change blood clotting, which can lead to stroke. A person may develop weakness on one side of the body, slurred speech or slurred vision, all signs of stroke, that can be treated if caught early.”
While it is vital that anyone exhibiting signs of a stroke get to an emergency department immediately, it is even more critical if any of these signs are combined with symptoms of COVID-19 – coughing, fever, trouble breathing, persistent pain, Haight said.
State’s role
Dr. Shamarial Roberson, who has a doctorate in public health and is deputy secretary of the Florida Department of Health, gave a rundown of the state health department’s role in combating the pandemic, symptoms of the virus and resources.
She said that in addition to chronic health conditions, older age is a major risk factor. Statewide, as of Tuesday, 26 percent of confirmed cases but 85 percent of deaths, had been among people over age 65.
Roberson said it is important people at high risk continue to be vigilant and recommended they use telemedicine, if available, for routine doctor visits, keep up with their medications, if diabetic keep monitoring blood-sugar levels, and if dealing with high blood pressure issues, keep monitoring it.
“We want to make sure we provide resources so our COVID-19 call center is open 24 hours a day at 866-779-6121,” Roberson said.
In addition, the Florida Department of Health’s COVID-19 web page has a wealth of information. including data that is updated daily at 11 a.m., recommended safety measures, and resources – including pickup sites by zip code for food distribution to children 18 and younger, she said.
Roberson recounted the now-familiar prevention advice: frequent handwashing with soap and water for 20 seconds; if water is not available frequent use of hand sanitizer with at least 60 percent ethyl alcohol; sneeze or cough into a disposable tissue or into the elbow, not hands; if sick, stay home and consult a doctor if conditions worsen.
In response to a question, Roberson said, “Social distancing remains one of the most important mitigators we have. The National Centers for Disease Control and Prevention recommends wearing a mask and maintaining six feet of distance from other people,” she said.
While the virus is mostly spread by droplets in the air from an infected person’s coughing, sneezing or even talking, it can also live on surfaces from two hours to 10 hours, depending on the surface, she said.
“We recommend you clean and disinfect on a regular basis, and there is a link to EPA-approved cleansers on the Department of Health website,” Roberson said.
Haight added, “Realize that if something is cleaned, it can be a matter of minutes before someone who is infectious touches it. So it is important that after you touch objects you don’t touch your face, your nose or your eye.”
Haight explained why it is so important not to touch your eyes: “If you look at your lower eyelid, there is a hole that tears come out of. Every time you blink, those tears moisten your eye. The hole goes down to the nose and back of the throat. That is where the infection starts.”
Testing
Pastor Eddie Lake of Lakeland asked if the lack of testing and the slowness of getting results back is impacting how accurate the data is.
“Back on March 25, a young man went to the hospital with strep throat,” Lake said. “It was assumed he had COVID and a test was given. He was told the waiting time was 7 to 10 days. Then he was released from the hospital and never got the results back.”
Roberson, Jackson and Haight said that the long backlog of testing is mostly over and such a situation is unlikely to happen now. The three state Department of Health laboratories are processing PCR tests (the type that uses a nasal swab) for critically ill hospitalized patients and for nursing home patients, with results back in 24 hours. Commercial labs have also improved their turn-around time, although it may take longer to get test results back through doctors’ offices and clinics, they said.
Haight said that Lakeland Regional is still limiting testing to mostly those who are critically ill or who have underlying conditions and symptoms or who have had contact with an infected person. A limited number of rapid tests, which take about two hours, are also available for patients with specific issues, such as pregnancy, he said.
“If you are relatively healthy and have mild symptoms, if you venture out to get tested, you can spread the disease,” Haight said. “It is best to stay home to make sure that you don’t spread it.”
If you start getting sicker, call your doctor about being evaluated or call Lakeland Regional’s respiratory clinic set up for COVID-19 patients at its Pablo campus off South Florida Avenue, Haight said.
Anyone with shortness of breath, painful breathing, fingers turning blue from lack of oxygen, stroke symptoms or other serious symptoms needs to call their doctor or go to the emergency department.
“Our goal is to get more testing in the county,” Jackson said. And as access to testing supplies and processing continues to improve, the availability of testing will continue to improve, Jackson said.
Currently, Lakeland Regional Health is providing drive-through testing at the RP Funding Center for those with appointments, and AdventHealth is providing testing at Posner Mall in Davenport, for all comers, even those without symptoms, Jackson said. (Consult the AdventHealth.com website for details, she advised.) Those with insurance are billed through their insurance but there is no charge for the uninsured, she said.
Targeted testing
Leah West, an assistant to U.S. Rep. Darren Soto, D-Kissimmee, said that Central Florida Health Care has agreed to provide mobile testing to several low-income, minority neighborhoods where transportation may be an issue.
Central Florida Health Care is a federally funded community health clinic that has 13 primary care centers serving low-income, under-insured and uninsured residents of Polk, Highlands and Hardee counties.
The testing will be free, West said, at the following times and places.
- From 10 a.m. to 2 p.m. Friday, the mobile clinic will be set up at the Oakland Community Center in Haines City.
- On May 8, also from 10 a.m. to 2 p.m., testing will be available in Lake Wales outside Central Florida Health Care’s former dental clinic building at 225 Lincoln Ave.
- On May 15, the mobile site will be set up in Winter Haven to serve the Florence Villa and Inwood neighborhoods. Details will be announced later.
Following the Zoom meeting, Ann Claussen, president and CEO of Central Florida Health Care, said that the agency already has been providing testing to symptomatic clients but because of requests from Soto’s office it is extending that to providing assessments and free testing to anyone in the targeted neighborhoods.
“The problem is we only have about 300 tests within Central Florida Health Care so we have to be careful,” Claussen said.
Nurses wearing protective gear will be set up with tables in the parking lots and will assess anyone who shows up, she said. If testing is warranted, it will be performed while the patient remains in their vehicle, she said.
The clinic has been sending testing kits to LabCorp for processing and lately the turn-around time has been three or four days, she said.
Central Florida Health Care has more tests ordered and is exploring ways to procure more tests, she said.
Circulars have been printed and social media notices are being posted about the free testing, Claussen said.
West appealed to members of the African American Chamber of Commerce Polk County to also help spread the word, especially among the elderly and others who may not have access to social media.
Doris Bailey, president of the chamber asked, “How can we get testing in the black community northwest Lakeland?”
Jackson said she would see what she could do to get it set up.
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