The Coronavirus Doesn't Discriminate. U.S. Health Care May Be A Different Story

The coronavirus doesn't discriminate in who it infects. But some doctors say the U.S. health care system's pandemic response is already showing familiar patterns of bias.

MARY LOUISE KELLY, HOST:

The coronavirus does not discriminate, but some physicians say the public health response is already showing familiar patterns of bias. Racial disparities and economic disparities are beginning to emerge in the testing and treatment of COVID-19. Blake Farmer of member station WPLN starts the story from the campus of a historically black college in Nashville.

BLAKE FARMER, BYLINE: Meharry Medical College is staffing some of the drive-through testing centers in Nashville. But this one here on its campus took a long time to open because the school wasn't able to acquire the protective gear they needed.

JAMES HILDRETH: There's no doubt that some institutions have the resources and clout to maybe get these materials faster and easier.

FARMER: Dr. James Hildreth is president of Meharry and an infectious disease specialist. His college is in the historically black heart of Nashville, where there were no screening centers until this week. Across town, Vanderbilt University Medical Center is screening as many as a thousand people a day, primarily in the most affluent areas. Hildreth says that's just proof of a disparity in access to medical care that has long persisted. He says he's seen no overt bias. But if anyone should be prioritized, Hildreth says, it's minority communities, where people already have more risk factors for complications from the coronavirus, like diabetes and lung disease.

HILDRETH: We cannot afford to not have the resources distributed where they need to be because, otherwise, the virus will do great harm in some communities and less in others.

FARMER: In the majority black city of Memphis, a heat map shows where coronavirus testing is taking place. It reveals the most testing is happening in the predominantly white and well-off suburbs.

Rev. Earle Fisher has been warning his African American congregation that the response to the pandemic may fall along the city's usual divides.

EARLE FISHER: I pray I'm wrong. I think we are about to witness a inequitable distribution of the medical resources, too.

FARMER: There's already some evidence of that. In Milwaukee, African Americans made up all of the city's first fatalities. Wisconsin Gov. Tony Evers says he wants to know why black communities seem to be hit so hard.

(SOUNDBITE OF ARCHIVED RECORDING)

TONY EVERS: It's a crisis within a crisis.

FARMER: Nationwide, it's difficult to know how minority populations are faring because the Centers for Disease Control and Prevention isn't reporting any data on race. Dr. Georges Benjamin has been pushing the CDC to start monitoring race and income in the response to COVID-19. He leads the American Public Health Association.

GEORGES BENJAMIN: We want people to collect the data in an organized, professional, scientific manner and show who's getting it and who's not getting it and recognize in that we may very well see these health inequities.

FARMER: Benjamin says until he's convinced otherwise, he assumes the usual disparities are at play.

BENJAMIN: Experience has taught all of us if you're poor, if you're of color, you're going to get services second.

FARMER: Even for those African Americans who are symptomatic, it appears doctors are less likely to refer them for testing. Rubix Life Sciences analyzed recent billing information in several states. They found an African American with a cough and fever was far less likely to be given one of the COVID tests that have been so scarce. That's what worries Dr. Ebony Hilton most - the subjectivity of coronavirus symptoms.

EBONY HILTON: The person comes in. They're complaining of chest pain. They're complaining of shortness of breath. They have a cough. I can't quantify that.

FARMER: Hilton is an anesthesiologist at the University of Virginia Medical Center. She's also been raising concerns, for example, the way drive-through testing has expanded. She notes that requires having a car.

HILTON: If you don't get a test, if you die, you're not going to be listed as dying from COVID. You're just going to be dead.

FARMER: Hilton says the country can't afford to overlook race, even during a swiftly moving pandemic.

For NPR News, I'm Blake Farmer in Nashville.

KELLY: And this story is part of NPR's partnership with WPLN and Kaiser Health News.

Copyright © 2020 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.