My brother who is a pulmonologist in Philadelphia is an easy-going guy. In our frequent chats, he usually starts off with a quip, often about our 87-year-old mother’s daily complaints of boredom and her refusal to accept her severe hearing loss. But for two weeks now, he’s been uncharacteristically serious. The situation is pretty dire, he admitted to me, mentioning that he’s seen people in their forties and fifties on ventilators. Some with underlying conditions and some without. He feels overwhelmed by the trajectory of the virus, he said.
“In truth, there’s a lot about the deadly coronavirus that is unknown,” remarked Dr. Tung Nguyen, professor of medicine at the University of California, San Francisco (UCSF), at an Ethnic Media Services telebriefing with health care professionals.
Despite our continued investment in cutting edge technology and science, we don’t quite know why this virus has such diverse effects on the human body from some people showing little to no symptoms and others having severe issues.
One thing’s for sure: communities of color aren’t any less susceptible to the virus.
Dr. Rishi Manchanda, founder of Health Begins, said that the pandemic disproportionately affects immigrants and people of color. He attributes this to the “type of work” they do as well as the barriers to access health insurance and get tested.
Apart from those in the healthcare industry, many of us are privileged enough to practice and maintain social distance by deploying video technology for our work. Not so the hourly wage earner at the local pizza shop, or the Amazon warehouse employee, or the grocery store checkout clerk or the Central Valley farm worker. Immigrants and members of minority communities are doing the jobs that keep our lives humming along even while quarantined. And that fresh, crispy kale and spinach that you bought at Whole Foods wasn’t picked through Zoom.
As Peggy Noonan said in her Wall Street Journal column, about undocumented immigrants, “’They worked through an epidemic and kept America going. Some in the immigration debate have argued, ‘They have to demonstrate they deserve citizenship’—they need to pay punitive fines, jump through hoops. ‘They need to earn it.’ Ladies and gentlemen, look around. They did.”
When Noonan talks about deserving citizenship, I believe she’s partly referring to the misguided public charge policy that went into effect on February 24. The public charge rule denies legal admission or permanent residency to those who are determined to have accessed public benefits, such as Supplemental Security Income, Temporary Assistance for Needy Families, SNAP, Section 8 Housing and Medicaid.
Dr. Daniel Turner-Lloveras, an assistant professor of medicine at Harbor-UCLA, called the public charge rule “a public health threat,” since it has sowed the seeds of anxiety among immigrants preventing some from accessing health care.
The U.S .Citizenship and Immigration Services has issued several memos since March 13, attempting to control the damage done by this policy in the midst of a health care crisis. The latest update states that “USCIS encourages all those, including aliens, with symptoms that resemble Coronavirus 2019 (COVID-19) (fever, cough, shortness of breath) to seek necessary medical treatment or preventive services. Such treatment or preventive services will not negatively affect any alien as part of a future Public Charge analysis.”
It remains to be seen if these memos will mitigate the fear harbored by legal immigrants of losing the homes and careers they built in this country. “We already know from before the pandemic that legal immigrants have been reluctant to use the healthcare system before the public charge rule went into effect,” Nguyen said, adding that this fear could persist.
And as Turner-Lloveras said, “we cannot successfully contain a virus outbreak if there are those among us who are afraid to seek care.”
If we keep underinvesting in and undervaluing our immigrants, especially during a pandemic, we are going to harm all of us.
Take the fiscal relief packages passed by Congress recently. According to analysis by the California Budget and Policy Center, while federal relief legislation does go a long way to ensure that COVID-19 testing is available to Californians free-of-charge with and without health care coverage, the cost of treatment for people who are diagnosed with COVID-19 could amount to tens of thousands of dollars and “Californians who are uninsured would be responsible for 100% of these costs.”
According to Manchanda, “blacks, Latinos and Native Americans are more likely to be uninsured or underinsured and 22 percent of Native Americans lack coverage.” And 43% of undocumented immigrants lack health insurance, asserted Turner-Lloveras. Those who don’t have the resources to seek care are going to be harbingers of the virus, he warned. “You are only as strong as the weakest link.”
In The City, we are not seeing the kind of raging manifestation of the virus that New York is currently enduring. But since there are still a lot of unknowns about the virus, let’s not draw comfort from this. What we do know is that the shelter-in-place directive has helped us shelter from the virus for the time being.
And, so I worry about people like the Doordash delivery person, the trash collector, the mass transit worker, the gas station employee and Dr. Turner-Lloveras who was called away from the briefing to attend to another patient.
And I worry about my brother, hoping he has a healthy stock of defensive gear to get through another work day in the hospital battling an invisible enemy.
Jaya Padmanabhan can be reached at firstname.lastname@example.org. Twitter: @jayapadmanabhan. She is a guest columnist and her point of view is not necessarily that of The Examiner.