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In March, the Rev. Curford Dixon and his wife, Deborah, became sick after attending a funeral in Missouri. Dixon, who is Black, is the pastor of the Trinity Missionary Baptist Church in Kansas City, Missouri. Within a few days of the funeral, Deborah asked to go to be taken to a doctor, where she had a 99.7 degree fever and was diagnosed with a “viral syndrome.” Dixon started feeling sick a few days later, suffering from diarrhea, loss of taste, chills and extreme fatigue.
At the end of the week, they went to their doctor to be tested for COVID-19.
The results? Positive.
While the Dixons were sick, others who attended the funeral also contracted COVID-19. At least eight people who attended the funeral tested positive for COVID-19 and several died, Dixon said.
“All of that time, I was going through wondering what was next for me. Because I was getting the word that one guy passed, another friend passed,” Dixon said. “It was messing with my mind.”
In Kansas City — and similarly across the U.S. — racial and ethnic minorities face worse outcomes and greater disparities when it comes to catching, surviving and being tested for COVID-19. In both Missouri and Kansas, Black people are contracting COVID-19 at rates higher than their share of the state population. On both sides of the state line, Black people are dying at a rate over two times their population share. Hispanic populations have also been disproportionately affected, especially in Kansas, where they account for more than half of all cases.
“Unless we change our health care systems and how health care is delivered, we will continue to see these disproportionately high rates,” said Jannette Berkley-Patton, director of the Health Equity Institute at the University of Missouri-Kansas City.
“Three things have to happen: We need to be able to communicate in ways that are digestible for people of color on prevention. Testing has to be done continuously in the communities that are hard hit by this virus. Contact tracing is going to be really important.”
Inequalities in Testing
While Dixon’s symptoms were gone within about eight days, he still tested positive on his next COVID-19 test, even though his wife’s was negative. Because health officials are still unsure if someone who has had COVID-19 can catch it again, Dixon was quarantined in the basement of his house for weeks, unable to use the same bedroom or bathroom as his wife. He had to be tested three more times, 10 days apart, before he finally tested negative twice in a row and could be free from quarantine.
In total, Dixon had to take five different COVID-19 tests throughout the course of his illness. Without access to tests through his primary care physician, he wouldn’t have known to quarantine himself, especially once he still had the virus but was asymptomatic.
So far, COVID-19 testing data by race is widely unavailable. Kansas is one of only four states that includes race in its testing breakdowns, but 36% of those tests are missing race data, likely making the data inaccurate.
Wyandotte County — which has the highest COVID-19 case rate on the Kansas side of the core Kansas City metro and the highest percentage of Black and Hispanic populations — has very few permanent COVID-19 testing sites to serve the high numbers of people in the county hit by the coronavirus. Kansas Gov. Laura Kelly recently announced that the state’s health department will dispatch its Mobile Testing Unit to provide COVID-19 tests to underserved areas of the state.
To further address this, the Wyandotte County Health Department started an initiative in April called the Wyandotte County Health Equity Task Force, which includes leaders from the Black, Latinx and Asian communities. The task force has been working on outreach, testing and contact tracing, and establishing pop-up testing sites at community locations. These sites are usually open for one day, generally three hours at a time.
“We have been able to test more than 1,000 people at pop-up sites, with 185 people testing positive,” said Nicole Garner, COVID-19 project manager at the Unified Government of Wyandotte County and Kansas City, Kansas. “Those people might not necessarily have been tested if we hadn’t had those locations.”
Task force member Mariana Ramirez said that while the team is limited by its resources, they are working together to create an impact.
“We’ve been able to maximize the limited funding that our county had, and doing a lot of testing and outreach,” she said.
On the other side of the state line, the Kansas City, Missouri, Health Department began offering pop-up community testing targeting racial and ethnic minorities at the end of April, with most of the temporary testing sites located east of Troost Avenue, a major socioeconomic and racial dividing line. However, the Health Department recently reported that they do not have enough testing resources and have filled all appointments at their test sites, offering only 20 walk-up spots for each location.
The department has faced challenges with the community testing sites, said Frank Thompson, its deputy director.
“There are staffing limitations. There are also limitations in terms of the actual test kits that are available to use at those sites, so that has been a challenge,” he said.
Thompson added that Kansas City did not receive direct funding under the federal Coronavirus Aid, Relief, and Economic Security Act and is instead depending on surrounding Missouri counties to distribute funding to the city, which has happened slowly.
“We have mobile sites that are good, but the flip side of having a mobile site is that you really need to be paying attention in order to figure out where those sites are. We need to think about how to stabilize these mobile sites,” said Melissa Robinson, 3rd District councilwoman for Kansas City, Missouri. “The sheer number of testing and asymptomatic testing needs to improve.”
What are other states doing?
In the past few months, multiple governors have established health equity task forces at the state level, including Pennsylvania, Louisiana, Colorado, Virginia, Ohio, Michigan and Tennessee. These task forces receive independent funding to address and reduce racial health disparities related to COVID-19. Louisiana’s governor distributed $500,000 from the Governor’s COVID-19 Response Fund to the state’s COVID-19 Health Equity Task Force in April.
After one month of operation, the Pennsylvania COVID-19 Response Task Force of Health Disparity announced that it was able to get health providers to more often include race and ethnicity information for patients tested for coronavirus and work on creating more accessible testing. The group in Pennsylvania includes members from Latino Affairs, Asian Pacific American Affairs, Commission for Women, African American Affairs and LGBTQ Affairs.
“We convened this (task force) but have stepped back because they are the voices. They are the ones closest to the issues and have the best understanding of what is necessary,” said John Fetterman, the lieutenant governor of Pennsylvania. “It is critical to have a buy-in from every level, otherwise it becomes window dressing.”
The Pennsylvania task force influenced the governor to allocate federal stimulus funds for health care providers to be reimbursed for COVID-19 testing for uninsured patients. This ensures that patients can be tested for free at any health center and not just designated free testing sites provided through county health departments.
Neither Kansas nor Missouri has a similar policy in place.
Meanwhile, people like Dixon are continuing to use word of mouth to support increased testing in their Kansas City communities. Although free pop-up testing is available at nearby churches, he said many of his parishioners are nervous about being tested.
“They don’t want to know if they have it or not, and they are scared of how taking the test is going to feel,” Dixon said.
“You can have this ordeal and not have the symptoms. That’s my fear, even now.”
Brittany Callan is the health and environment reporter at The Beacon and a Report for America corps member. You can reach Brittany at firstname.lastname@example.org. Funding for this reporting was provided in part by the Health Forward Foundation.