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Failing Another National Stress Test on Health Disparities [jamanetwork.com]

 

By William F. Owen Jr, Richard Carmona, and Claire Pomeroy, JAMA Network, April 15, 2020

The African American daughter of one of us called from New York City in early March, worried about her Hispanic partner’s health. Did his high fevers, worsening shortness of breath, and painful cough indicate coronavirus disease 2019 (COVID-19) infection? Given his history of asthma and hypertension, was he at high risk? What should they do? Urged to seek medical attention, he resisted. The nearby affordable and accessible urgent care clinics were staffed by physicians who, based on his previous experiences, “just didn’t get it,” and he anticipated that his concerns would be dismissed. When he relented and requested a coronavirus test, he was asked about international travel, but not about their small apartment or his use of public transportation. He was told “no test,” once again confirming his impressions of an uncaring system. He decided to stay at home and tough it out.

But he got worse. The fevers were unrelenting, and it was hard to breathe. He was finally cajoled to try a different clinic. There, the African American receptionist conveyed their concerns and the staff agreed to provide a COVID-19 test. The patient was handed a flyer with home care instructions, but no one asked about financial consequences of staying home and no follow-up plans were provided.

And then good news—the clinic called and reported that the test was negative. Yet, a week later, the high fevers continued. They reached out to the clinic again and were reassured that “there [was] nothing to be done for coronavirus.” When they asked why the nurse was labeling him a “COVID patient” when his test was negative for coronavirus, the response was an unapologetic “Oops, you got the wrong result.” Now a month later, he is still recovering from COVID-19 and from another painful health care encounter.

[Please click here to read more.]

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