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Diabetes leader: COVID-19 test access is needed for high-risk groups

Tracey D. Brown, CEO of American Diabetes Association
Tracey D. Brown, CEO of American Diabetes Association

Low-income residents and high-risk groups need better access to COVID-19 tests, said a national diabetes group leader.

Tracey Brown, American Diabetes Association CEO, has backed a recent federal bill introduced by U.S. Rep. Bobby Rush to fund more testing and access for low-income and minority communities, which she said have higher numbers of residents with serious underlying health issues including diabetes.

Brown, who also has Type 2 diabetes, co-wrote an op-ed with Rush in support of “COVID–19 Testing, Reaching, and Contacting Everyone (TRACE) Act” for a program run by the Centers for Disease Control and Prevention to mobilize testing and contact tracing efforts.

Grantees would include community health centers, school-based health centers, academic medical centers and nonprofits to hire and train individuals as part of mobile testing units. Other outreach would go to hot spots and medically underserved areas.

“Diabetes was an epidemic before this COVID pandemic hit,” said Brown in a recent phone interview with The Spokesman-Review. “What this has done has shone a bright light on an existing problem. In addition, there are a disproportionate number of people of color who are actually living with diabetes.”

About 115 million Americans live with diabetes or prediabetes, according to the association.

The ADA says that among rates of diagnosed diabetes in adults, nearly 15% are Native Americans or Alaskan Natives, about 12% are African Americans, 12.5% are Hispanic Americans, about 9% are Asian Americans and 7.5% are non-Hispanic white Americans.

“Add this pandemic and what we’re finding is twofold,” Brown added. “One is if you’re living with an underlying condition like diabetes and if you contract COVID-19, there is a higher likelihood that the outcomes that you face will be poorer, meaning more hospitalizations, more complications, and if you look at the numbers, there is a disproportionate amount of people who have died from COVID-19 who had diabetes or an underlying condition.

“If you double-click on that information, what you will find in many of the cities is a disproportionate amount of people who have died have also been people of color.”

The CDC says people of all ages seem to be at higher risk of severe COVID-19 symptoms if they have serious underlying chronic medical conditions such as lung disease or a weakened immune system.

That’s particularly true if underlying serious medical conditions aren’t well-controlled, the CDC says, including for diabetes, moderate to severe asthma, severe obesity and chronic kidney disease.

Brown offered examples in Chicago and Philadelphia, where she said African American residents are dying of COVID-19 at far higher rates than other groups. “Chicago’s one of the first to report about 72% of deaths from COVID were African Americans. In Georgia, 80% of COVID patients were African Americans.”

She cited “inequities linked to diabetes and other underlying conditions,” and other issues such as air pollution and access to health care. Adding to that are such issues as unemployment because of the pandemic, costs for diabetes care and complications from unmanaged diabetes, Brown said.

“I could go on, but the point being, you start seeing there is something going on with underlying conditions and worse outcomes. Diabetes already disproportionately affects people of color and disproportionately affects low-income communities, and now you see the magnitude of the problem.”

Brown said she and others are encouraging state leaders to offer continuity of health care insurance if someone loses a job because of the pandemic.

Returning to the issue of COVID-19 testing, she said it’s key because states are starting to open back up.

“We know that in many places, COVID-19 cases have not plateaued, so for people living in these underserved communities, two things could be happening. One is they can’t afford to not go to work, so they’re going to work and potentially being exposed, and again there are many asymptomatic people walking around.

“Or two, they are in essential jobs, and they have to go to work and could be at risk of more exposure and then potentially bringing COVID-19 back into community.

“That’s a reason why you need to get into underserved communities so testing can happen. There are pop-up drive-thru testing sites, but again if you don’t have a car, your ability to get through drive-thru testing is limited.”

She said if people don’t have testing nearby their homes or going into neighborhoods, access can be limited. They might lack a vehicle or can’t leave work.

“That’s why it’s so important to take the testing into the communities that need the testing, so we can identify and understand, and if you have it, you can quarantine,” she said.

Locally, at the Spokane County Fair and Expo Center, a drive-up testing option for COVID-19 ended on June 9. Providence Health Care, MultiCare, Kaiser Permanente, Native Project and CHAS offer testing sites at various locations for their patients throughout the Spokane area.

Brown said many databases are available that can help identify underserved neighborhoods with higher numbers of residents who have income below the federal poverty line to ensure mobile testing or tests offered through a community center, public health, churches or nonprofits.

For overall support and resources, Brown encourages people living with diabetes to reach out to the ADA’s phone number at (800) 342-2383 or online at diabetes.org .

The group offers COVID updates as well as information if someone is struggling to pay for insulin at its page insulinhelp.org . Leading manufacturers are reporting that COVID-19 isn’t having an impact on their current manufacturing and distribution capabilities for insulin and other supplies at this time.

The ADA’s “insulin help” page lists that four insulin manufacturers offer immediate assistance and long-term resources.

“If people are struggling to pay for insulin, we have a page, insulinhelp.org , where we encourage everyone to go. We don’t want people not having access to the very drugs they need to live.”

Treva Lind can be reached at (509) 459-5439 or treval@spokesman.com.

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