Becker's Clinical Quality & Infection Control

45 QUALITY IMPROVEMENT & MEASUREMENT COVID-19 is 13 times deadlier than flu, study suggests By Mackenzie Bean C OVID-19 may kill about 1.3 percent of symptomat- ic patients, an infection fatality rate that is 13 times higher than the flu, according to study published in Health Affairs. Researchers analyzed 40,835 confirmed cases and 1,620 deaths across 116 U.S. counties using GitHub data from Baltimore-based Johns Hopkins University and The New York Times through April 20. Based on mathematical modeling, researchers esti- mate the national infection fatality rate for symptomatic COVID-19 patients is 1.3 percent, with county-specific rates ranging from 0.5 percent to 3.6 percent. For refer- ence, the fatality rate for seasonal flu is about 0.1 percent. If 35.5 million U.S. residents contract COVID-19 this year (which is how many people were sickened last flu season), about 500,000 deaths would occur in the absence of any mitigation strategies. Researchers noted their estimate does not factor in asymptomatic COVID-19 patients, which would lower the fatality rate. n 4 reasons COVID-19 disproportionately affects black communities By Gabrielle Masson C OVID-19 appears to be affecting black Americans at a disproportionately high rate, with the majority of black counties reporting triple the infection rate and nearly six times the rate of deaths as majority white counties, according to an April analysis by e Washington Post. Below are four main reasons black Americans are dying at a faster rate than other groups, as explained by e Fix. 1. Higher rates of underlying health conditions and less access to care. Black Americans have higher rates of hypertension, heart dis- ease, diabetes and lung disease, data shows. COVID-19 exacerbates complications of these illnesses, experts say. In predominantly black neighborhoods, hospitals are more likely to shut down compared to those in predominantly white neighborhoods, according to a 2014 National Institutes of Health study, meaning it may be difficult for black Americans to access healthcare nearby. Studies have also found a bias among healthcare workers toward white patients over patients of color, said Uché Blackstock, MD, as- sociate professor at New York City-based NYU School of Medicine. 2. More likely to work in 'essential' jobs. Disproportionately high numbers of black people work in the food service, hotel and taxi industries, according to data from the U.S. Bureau of Labor Statis- tics compiled by the Center for American Progress. Such jobs make social distancing difficult and put workers in close contact with others who may be sick. 3. Insufficient information. Inconsistent and inadequate informa- tion from government leaders has influenced black people's experi- ences with COVID-19, said Keneshia Grant, PhD, assistant political science professor at Washington, D.C.-based Howard University. Nearly 60 percent of black Americans live in Southern states, where governors' messages on how to stay safe were oen inconsistent with federal guidelines. e needs of black communities should be better addressed, U.S. Surgeon General Jerome Adams, MD, said at the White House's daily briefing April 10. 4. Housing disparities. Racial disparities in housing put black res- idents at a much greater risk for contracting illnesses, said Vedette Gavin, investigator for the Conservation Law Foundation's Healthy Neighborhood Study. Black children are more likely to live in older buildings with poor air quality, contributing to their higher rates of asthma, according to a 2017 Princeton University study. People with asthma may be at a greater risk of dying from COVID-19, the CDC said. Housing affordability can also be a factor in COVID-19 transmission. "Black and Latino families in urban centers tend to double and triple up when rent is unaffordable, making distancing in the home impossible," Ms. Gavin said. April data from New York City showed the impact COVID-19 has had on communities of color, according to NPR. e Latino population constitutes about 29 percent of the city's population, but make up nearly 34 percent of COVID-19 patient deaths as of April 13. Almost 28 percent of the city's known deaths were among black people, who represent about 24 percent of the population. n

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