SCHENECTADY — “This may feel unpleasant,” a registered nurse told a local resident right before she inserted a long plastic swab deep into his nasal cavity and twisted it for 15 seconds.
The man grimaced and sped away from Mont Pleasant Middle School, clutching a packet of tissues and a spray cylinder of rubbing alcohol.
Coronavirus testing ramped up in the city’s neighborhoods this week.
Officials hope the effort will reach symptomatic people in underserved communities, which will help contain the spread.
But the testing will also paint a clearer picture of how hard the virus is hitting minorities, who have been disproportionately affected by the pandemic based on emerging state data.
“We know that the majority of the ethnicities affected are African-Americans and Latino and that’s been shown also from the statistics in New York City,” said Leslyn Williamson, chief operating officer of Ellis Medicine. “So it was imperative for us to do this.”
Upstate, black people constitute just 9 percent of the population, but preliminary state data show they have accounted for 18 percent of upstate coronavirus deaths.
Fourteen percent of fatalities were Hispanics, who constitute 11 percent of the population.
Local officials want to see if those trends are reflected in Schenectady County, which has the largest Hispanic population in the region, the second-largest African American population in the region and second-largest Guyanese concentration in the U.S.
“We know from cases throughout the country that the virus has disproportionately been impacting people of color,” said Schenectady NAACP President Dr. Odo Butler. “But we haven’t gotten any hard data in Schenectady about how it’s affecting people here.”
As cars crept through a series of checkpoints Tuesday, nurses asked patients to disclose their race, ethnicity and zip code.
About 70 percent of the 146 people tested at Ellis Medicine’s McClellan Street Health Center on Monday were people of color, Williamson said. On Tuesday, 164 were tested.
The disease has hit the black community harder for numerous reasons.
African-Americans are predisposed to diabetes, hypertension and kidney disease, all factors that increase their vulnerability to the virus.
Longstanding disparities have reduced access to health care, insurance and preventative screenings.
“This is just another example of the negative health impacts of structural racism,” said Shannon M. Monnat, associate professor of sociology and senior research associate at the Center for Policy Research – Maxwell School at Syracuse University. “Across all institutions, blacks are disadvantaged.”
Living paycheck-to-paycheck means more frequent trips to the store, magnifying the risk of exposure.
And minorities also constitute a higher percentage of front-line workers who have to report from work.
“You see how these two factors come together and make a bad situation worse,” said Gov. Andrew Cuomo, who has pledged to step up testing in minority communities.
While the growth of the virus has flattened statewide and deaths and hospitalizations are lessening, officials warn of pending waves upstate, including Schenectady, which has a large percentage of poor people, is more racially diverse and has a large population of people in poor health.
The county ranked 55 out of New York’s 62 counties for overall health in 2018, according to the Robert Wood Johnson Foundation’s County Health Rankings & Roadmaps program.
African-Americans constitute 21 percent of the city’s population, which is slightly above the state average of 17.8 percent. Hispanics make up 10.4 percent, which is about half the state average.
But Schenectady’s minority populations are disproportionately more economically distressed than their white counterparts.
At 34 percent, the poverty rate for African-Americans is twice as high as that of whites, which is 15.8 percent, according to a 2018 report by Schenectady County Action Program.
The poverty rate for Hispanics is even higher is 41.6 percent, and Native Hawaiian/Pacific Islanders is nearly 71 percent.
Neighborhood leaders say information gaps transcend race.
While widespread services are available to inner-city residents, many remain unaware of how to access them.
“A lot of people rely on word of mouth,” said Eddie Polanco, a health navigator with City Mission who helps connect people to healthcare services. “Their world is no bigger than the block they live on.”
Polanco, who is Hispanic, pointed at his own experiences navigating inequities in the healthcare system.
He recently had a tooth pulled. But a friend with better insurance was able to obtain a crown and save the tooth.
“Not all of us have the resources to have better healthcare,” he said.
ANTIBODY TESTING EMERGES
Nearly 845,000 New Yorkers have been tested as of Tuesday, roughly 36 percent testing positive.
The state has been tracking fatality numbers by ethnicity, but not the number of everyone being tested, or even all positive diagnoses.
The data isn’t available due to the patchwork approach of how medical facilities collect data on race and ethnicity.
“It’s actually been quite tricky to track,” said Carrie Dunn-Herrera, a county public health systems administrator.
Not everyone opts to disclose their race and ethnicity, and even if they do, hospitals and medical agencies don’t automatically transmit that information to county health officials.
And facilities from outside the county may not convey data on people testing negative to Schenectady County officials.
“We may not get that information,” Dunn-Herrera said. “There’s no reason for them to transfer that information and it’s not part of the policy.”
State officials acknowledged the gaps.
“The nature of this public health emergency is constantly evolving and we will continue to evolve with it,” said a state Department of Health official on Tuesday.
Early results of antibody testing, however, have sketched out the basic contours of the virus’ spread and confirms minorities are experiencing higher infection rates.
About 32 percent of Latinos tested as part of the state’s 7,500-person survey were found to have the antibodies, and blacks, 16.9 percent.
The state average is 14.9 percent.
Hard data is also starting to emerge in Albany County, which launched a dashboard last week tracking the virus by age, gender and race.
To date, whites make up the 49 percent of positive cases and blacks, 20 percent.
But 76 percent of the county’s population is white compared to 14 percent for blacks, according to 2019 U.S. Census estimates.
Monnat, the senior research associate, said she wasn’t surprised at the disparity.
“This is a story that keeps repeating itself across the U.S.,” she said.
Albany County has been aggressively testing people at sites that rotate around low-income neighborhoods for the past week.
“I made a priority to get into these communities to see if there is an issue, and if so, to address it,” said Albany County Executive Dan McCoy last week.
As of Tuesday afternoon, 455 people in Schenectady County have tested positive.
While the county hasn’t launched a dashboard, nor are they releasing data publicly, they did make preliminary figures available to The Daily Gazette.
To date, African-Americans constitute 12.9 percent of positive diagnoses; whites, 48.5 percent, and those who identify as Hispanic, 6.8 percent.
Asians account for 5.2 percent.
But the true number remains vague because one-third of people who tested positive declined to disclose their race or ethnicity or identified themselves as “other.”
There is no indication of how many Guyanese, who tend to identify as “Indian-Asian” or “East-Indian” in U.S. Census surveys, have tested positive.
City Council President John Mootooveren declined to speculate without access to hard data, but acknowledged some Guyanese may have checked off “other.”
“I have not heard a lot in the Guyanese community,” he said. “It could be a cross, not specifically Guyanese.”
Guyanese leaders have been aggressively pushing social distancing, he said, and those efforts appear to be working.
Mootooveren welcomed the expanded testing efforts and the gradual emergence of data.
But a more detailed analysis would be useful, he said.
“We want to see neighborhood-to-neighborhood rather than zip code, which would be more specific,” he said.
City Councilwoman Marion Porterfield agreed and hoped the county will also release racial and ethic data publicly available via regular updates.
“I commend the county for providing the food deliveries, but people also want information on how this very serious crisis is impacting the African-American community,” Porterfield said.
Porterfield called the lack of detailed information from the county “troubling,” citing multiple calls from constituents.
“I wish the county would be forthcoming with that information,” she said.
The county’s breakdown also only reflects only those who have tested positive — not the entirety of people who have received testing, which amounted to roughly 3,000 as of late-Tuesday.
County officials say they are mindful of the gaps.
“We’re going back through our data because we know it’s so important to not only capture that data, but also in terms of prevalence and terms of community mitigation and being able to address it appropriately,” Dunn-Herrera said.
County officials are “acutely aware” that minorities, especially African-Americans, are not only under-tested, but also suffer the most serious complications from the virus, said Erin Roberts, a county spokesperson.
“This has driven Schenectady County Public Health Services and our partners to do what we can to address this disparity,” Roberts said.
The testing, which continues Wednesday at Washington Irving Education Center in Hamilton Hill (for symptomatic people only), is a partnership between the county, Ellis Medicine, MVP Health Care and Hometown Health Centers.
County officials are reliant on the state for testing supplies and hope the collaborative approach will result in more testing supplies.
“We’ll do this, demonstrate that it works and that way, more testing supplies may come our way,” said Philip Schwartz, Ellis spokesperson.