COVID-19 could have been a death sentence for Gisele Fetterman and her family, if the virus had struck when she was a child.
“If this pandemic had happened while I was growing up, my family wouldn’t have made it. I lose sleep over that,” Fetterman told LebTown.
Fetterman’s mother fled a strife-torn Brazil in 1990 to raise her children in the United States.
“My mother was undocumented. She worked as a housekeeper,” Fetterman said. “She wouldn’t have been working during this pandemic. We wouldn’t have survived.”
Fetterman, who tried to keep a low profile as a child, is now Pennsylvania’s second lady. Her husband is Lt. Gov. John Fetterman.
Last week, the second lady held a conference call with leaders and media representatives from the Latino community to address concerns that COVID-19 is hitting their population harder than most.
“I’m concerned about it impacting all Pennsylvanians,” she told LebTown. But with the Latino community particularly, she said, “they are working frontline jobs, and only about 50 percent of Latinos have access to private healthcare. They already see mass inequities, and it only gets worse during a pandemic.”
Details regarding the ethnicity of coronavirus victims has been difficult to obtain, as those statistics have not been widely disseminated by government and healthcare sources. However, York Mayor Michael Helfrich recently said Latinos account for nearly 81 percent of the COVID-19 cases that have been reported in the city.
Latinos make up a third of York’s population, according to local media.
The Department of Health does not break out Latinos in its breakdown of cases.
“Anecdotally speaking, we know that the Latino community in Lebanon County has also been impacted pretty hard by the coronavirus,” said Nicole Maurer, executive director of the Community Health Council of Lebanon County.
“People are talking about all of their friends and their family being impacted. The community is being hit really hard,” she said.
There are many reasons being given for the impact on the Latino population, from their concentration in low-paying, high-risk jobs to lack of healthcare and genetic predispositions for certain health risks that can be aggravated by the virus.
“There’s a lot of fear” among the Latino population, Fetterman said.
Dr. William Calo, a professor and Latino health researcher at Penn State College of Medicine, said this week there are three major factors putting the Hispanic population at risk from the virus: exposure, vulnerability, and access to healthcare.
Calo co-leads REACH (Racial and Ethnic Approaches to Community Health), a national grant program administered by the Centers for Disease Control and Prevention, in Lebanon and Berks counties. He’s investigating the three differentials (exposure, vulnerability and access to healthcare), all of which make the Hispanic population “more susceptible to getting COVID-19,” he said.
“Many of the Hispanics work in low-wage—and what are now considered ‘essential’—jobs,” Calo explained. Whether they’re working in waste management or stocking grocery-store shelves, he said, “these people are constantly being exposed to others who might have the virus. These aren’t doctors or nurses, but they are frontline workers all the same.”
The Latino population is more vulnerable, Calo said, because of a number of underlying conditions for those who are infected. For instance, someone who is infected with COVID-19 has a higher chance of dying if they already have diabetes or heart disease—both of which occur in higher-than-average levels among Latino population.
“Hispanics are the population with the highest prevalence of diabetes in the United States, and they are second only to blacks in the U.S. for heart disease,” Calo said. And, he added, “Hispanics often don’t have good access to healthcare.”
Combined, he said, that means Hispanics who are exposed to the virus are more likely to have negative outcomes.
However, health agencies have not been releasing much data on the age and ethnicity of people who have contracted COVID-19.
While specific data isn’t available, Calo said it’s likely Lebanon is following the national trend that sees a disproportionate impact on the Latino population.
“I would like to emphasize how important it is to get reliable data,” he said. “We need a better understanding of who’s getting sick, and where.”
Solid data on ethnicity is not currently available from the medical community, said Community Health Council’s Maurer, whose position is sponsored by WellSpan Health. She said the state Department of Health is beginning to push providers to provide ethnicity data in their findings.
“Across the nation, we’ve had difficulty gathering data that’s specific to ethnicity,” Maurer agreed. “A lot of people are starting to report on race—we know, for instance, that African-Americans are also being disproportionately affected by the coronavirus.”
In mid-April, she said, WellSpan created a task force made up of local health officials and community leaders to help get information out to the Hispanic and Latino community.
“We’ve really been working on pushing out a wide variety of communications,” she said, including social media and local Spanish-language print and radio outlets.
Her organization is also working on materials that can be distributed by mail or door-to-door.
“We need to work to ensure that communication is provided in both English and Spanish as much as possible,” she added. “Being attentive to cultural differences is important. In certain populations, it’s easier for people to stay apart. That’s the nature of community in different cultures.”
The Community Health Council is planning a “Latino-focused event” from 10 a.m. to 2 p.m. on Monday, May 11, which will include the distribution of masks and sanitizers as well as an option to check symptoms with a health worker and discuss options for working and carpooling during the pandemic.
Although the REACH grant has specific parameters, such as helping establish healthy nutrition standards and improving opportunities for physical activity in the community, Calo said the CDC has granted them “some flexibility … to deploy some of our resources for COVID-19.” That includes using community health workers to make calls to members of the Latino community and doing webinars with Latino leaders to help spread information about the virus.
“We are developing education resources in Spanish for the community,” he said. “We are making these resources available to the community, we’re doing a lot of PSAs and putting out a lot of flyers, which we’re delivering to grocery stores, corner stores, places where people can see them.”
One of the best tools against the disease, Calo said, is information. Unfortunately, he added, information evolves and changes very easily, and at a rapid pace.
“Six weeks ago, we were listening to the news and everyone was saying you don’t need to use masks,” he said. “Four weeks later, the data changed. We got better information about the transmission of the disease. Then the states started encouraging people to use masks.
“Now, we’re requiring people to wear masks to go out to public places. In six weeks, the guidelines for using masks changed three times. However, people aren’t always up to speed on the latest information.”
Because not all Latinos are not proficient in English, Calo said, they can be limited in how much new information they are able to receive and process.
“We need to disseminate straightforward information, especially in Spanish,” he said. “We are trying to help the communities understand more about COVID-19.”
Cornell Wilson, a former Lebanon City councilman who serves on the Lebanon County Democratic Committee and the Governor’s Advisory Commission on Latino Affairs, said he is “very concerned” about the pandemic because Latinos “seem to be the highest group that’s being affected here in Lebanon. They’re the highest percentage in the hospital.”
Wilson agreed the lack of good information is one of the big problems for the community, particularly the “mixed messages” they’ve been receiving.
“They hear one thing from the governor, they hear something else from the president. They don’t know who to follow,” he said. “I think some of the groups and organizations are starting to do more to provide more information, to hold events to help educate and spread the word.”
He encouraged everyone to stay home if they can, to wear a mask and to follow rules and guidelines if they have to go out or go to work.
Fetterman agreed that messaging is key in helping curtail the spread of COVID-19 among the Latino community.
The government’s role includes ensuring that vital information is readily available, through multiple channels and in Spanish as well as English, Fetterman said. It’s also important to make sure resources are available to vulnerable populations, that wages are fair for essential workers and that health insurance is affordable and easy to obtain.
Many Latinos are employed in manufacturing and meat processing plants that have continued to work through the pandemic.
“In those work environments, it’s very difficult to create social distancing and provide the proper protective equipment,” Maurer said. “We know at a national level that the meat packing industry is being hit very hard.”
The Latino population is also being hit at home, where family units tend to be bigger and urban housing tends to be crowded.
“One of the things that makes our community so special, so beautiful, is that we live with our grandparents, we live in big families,” Fetterman said. “But, during a pandemic, that makes social distancing difficult.”
Maurer agreed. Cultural emphasis on family, specifically how it relates to home environments, can accelerate the spread of contagious disease.
“The city has been hit pretty hard,” Fetterman said. “Where people live closer together, it’s often difficult to create the proper social distance.”
Fetterman also said some Latino people “hesitate to seek care, either because of a language barrier, a lack of insurance or fear of being found out, if they’re here illegally.”
WellSpan, Maurer said, is trying to push the fact that all COVID-related care is free.
“Testing is free, urgent care is free,” she stressed. “No questions asked.”
Amaury Abreu, a native of the Dominican Republic and writer for the bilingual newspaper La Voz Latina Central, participated in Fetterman’s conference call last week. He said he was impressed with the state’s efforts Fetterman described during the call.
“They are working as hard as they can to translate the information in a timely fashion, and to put the information out on social media channels,” Abreu said. “It also sounds like they are also looking to help Hispanic business owners across the state by providing the funding they need—some didn’t know they were qualified or were having trouble getting connected.
“They really care, they’re just overwhelmed with everything that’s going on across the state. They’re doing the best they can to help minorities because they’re the most vulnerable.”
He, too, worries that people in the Latino community are not getting information in a timely fashion. By the time they get it, he said it’s already too late.
“It’s not that the information isn’t available, but how do we get that information in front of them?” he asked. “People are going to the hospitals, when the hospitals are saying that, unless you’re in a really bad state, stay home. People are still getting together in groups … culturally speaking, the Latino is most comfortable in groups. They have families in New York, they’re coming down and staying together, definitely having more people in the house than they should have.”
Immigration, he said, is another barrier to getting care for many in the Latino community, due in part to fear.
“They are afraid of seeking assistance. They are afraid if they go to the hospital, they’ll be reported to ICE [Immigration and Customs Enforcement],” he said. “There’s a lot of fear. They go to work, because they don’t want to lose their jobs … if I’m sick, but the boss says I have to come to work or he’ll report me, I have to show up. There’s a lot of that going on.”
There are solutions, Abreu said, in local initiatives like food banks and free healthcare services for patients with COVID-19.
“We have to inform people from the Hispanic community that, if they go to the hospital, they’ll get the assistance they need, and ICE is not going to be informed,” he added. “No one is coming for them.”
Conversely, Calo said, there are widespread financial issues that are impacting the Latino community particularly hard during the shutdown: unemployment, housing, and difficulty receiving public benefits, for example.
“A good percentage of people in Lebanon are immigrants, and they do not qualify for the government’s economic benefits or unemployment compensatio,” he said. “So these people are completely unprotected.”
Guadalupe Barba, a leader with Juntos de Lebanon, said people working locally at factories and other essential businesses are concerned about putting their families at risk by continuing to work.
The crisis creates a conflict, she said, between job loyalty and concern over losing their income.
“Coronavirus is no easy time for Hispanics and other essential workers,” she said Monday. “Factories must take care of their employees. There are employees who feel protected and others do not. We should not feel bad about taking care of ourselves.”
People should not die for going to work, Barba said.
“There’s a lot being done,” said Maurer. “One of the things that we’re hearing is that the Latino community feels abandoned. We are working on it. The question is, what is the best way to get information into people’s hands, what is the best way to get equipment into people’s hands, and what is the best way to advocate with employers, and with the government? We also need to advocate for employees, and make sure that people have access to protective equipment—make sure they have enough disinfecting wipes and hand sanitizers, enough masks, enough thermometers.”
Other inequities must be addressed, Fetterman noted, such as the federal decision disqualifying U.S. citizens from receiving stimulus checks if their spouse is an immigrant.
“We have to look at a bigger level—at how we can support these families. Not only through nonprofits, but looking on them as neighbors,” she said. “How many people can we reach? Can we call 10 people, check in on them?”
Calo also said it’s important for people to stay active during this period of isolation.
“These days, you look outside and you see so many families being physically active. People are taking the time to go outside,” he said. “If you want to keep good physical health, good mental health, go outside and do things.”
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This article was updated to clarify some quotes that were previously ambiguous as to who said them.