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Reports across the country are emerging that African Americans are disproportionately getting sick and dying from Covid-19. But it will likely be some time before Vermonters know whether there are racial disparities in testing and treatment for the virus in the state.
The Vermont Department of Health has not consistently collected race data about the state’s coronavirus patients. This has raised concerns among activists and lawmakers who say the information is necessary to identify inequities or disparities that may emerge as Vermont responds to the pandemic.
Health Commissioner Mark Levine said it wasn’t until last week when clear racial disparities began to emerge in other parts of the country that he realized the state hadn’t been consistently collecting race data on patients who tested positive for Covid-19.
“We’re all doing this very quickly on very rapid timelines,” Levine said. “It’s not an excuse, but it’s very challenging to address everything to everyone’s satisfaction.”
Levine also said that if the data had been collected by the state, it likely wouldn’t be released because the information could inadvertently identify a patient, which is in violation of federal medical privacy laws.
The health department does collect race data on death certificates. Recently released documents show that all but one of the 21 first people to have died from the virus in Vermont were white, non-Hispanic. One individual who has died was identified as Asian.
But Levine said ensuring health equity in the state is a priority for the department, which is why moving forward, he’s ensuring that the state epidemiologists who collect demographic information on Covid-19 patients report race data in all cases moving forward.
That still could be challenging. State Epidemiologist Patsy Kelso said there are two forms where demographic data is collected. The first is a lab requisition form which takes down information about a patient who is getting tested for the virus. The second form, called a case report form, collects data on those who tested positive.
Until now, the state had inconsistently collected data for the second form. Kelso said that epidemiologists were dependent on what the provider or next of kin knew about the patient, which was sometimes inaccurate. In the hectic flood of patient information, sometimes the question just wasn’t asked, Kelso said.
On the first lab requisition form, there isn’t a question about race, Kelso said. It is not a high priority of the health department to redesign the form and share it with all Vermont providers right now, she said.
Tabitha Moore, president of the Rutland area branch of the NAACP, said the lack of race data collection “speaks to the larger problem here in Vermont.”
“People make assumptions about race. They aren’t comfortable asking about it,” Moore said. “Because they don’t see it as important.”
But even if Covid-19 race data was available, Moore was skeptical of the state’s patient privacy explanation for why it likely wouldn’t be released.
She said she doesn’t think numerical data about how many people of color are getting sick or dying from Covid-19 would violate HIPAA, the federal law that ensures all medical information about a patient is kept private.
“We don’t know what the landscape looks like here in Vermont,” Moore said. “To not know that means that our efforts to support the Department of Health to have a racially just, appropriate response, we can’t help them. And they can’t help themselves.”
While she hasn’t heard any anecdotal complaints about people of color being treated inequitably in Vermont’s hospitals, she said the patterns popping up in other states, and also the history of structural racism in healthcare systems, are cause for concern.
Multiple studies have found that black people in the United State are more likely to die from disease than white people. The Centers for Disease Control and Prevention found that black mothers are three to four times more likely to die in childbirth compared to white women.
New preliminary data from New York shows that African American and Hispanic people are dying from Covid-19 at much higher rates than their white counterparts. This trend mirrors other data emerging in Florida counties, Michigan and Louisiana that shows that black people are disproportionately getting sick with Covid-19.
A CDC study released Wednesday found that African Americans have been hospitalized for treatment for the virus at a disproportionate rate.
But, as Politico reports, many other states are also not releasing ethnic and racial data about coronavirus patients, leading health experts to worry that communities of color will be hit especially hard by the disease.
Hundreds of doctors and activists are calling on the CDC to enforce the collection and release of race data as it pertains to Covid-19 infections and deaths, according to the Washington Post.
Mark Hughes, executive director of Vermont racial justice organization Justice for All, sent a letter to lawmakers and Levine requesting the release of race data of Covid-19 patients before finding out that a complete analysis didn’t exist.
“We can’t have an empirical discussion unless data is available. We can only make assumptions,” Hughes said. “People are dying. This is a global pandemic and people are dying. We need the data so we can figure out how to save lives.”
Hughes said that in a state that has documented the presence of racial disparities in its communities, and made similar mistakes about inconsistent race data collection in its police departments during traffic stops, he doesn’t understand how this could have happened.
“I’m having a really difficult time understanding how this slipped somebody’s mind,” Hughes said.
Sen. Debbie Ingram, D-Chittenden, who sits on the Senate Health and Welfare Committee, said she is also concerned that the state doesn’t have race data on Covid-19 patients.
She said she’s “sympathetic to a point” to the DOH’s explanation that disaggregated race data could inadvertently identify someone. “But we use that too often as an excuse to not be diligent about the racial inequities that exist,” Ingram said.
She said her committee would like to invite the Department of Health to testify about its lack of race data collection, which would likely happen next week.
