Letter to San Diego County’s Public Health Officer Regarding Advancing Equity Issues Pertaining To The Pandemic Response

The following is a letter addressed to Dr. Wilma J. Wooten, M.D., M.P.H. regarding advancing equity issues pertaining to the pandemic response. A PDF copy of the letter can be found here.

April 9, 2020

Dr. Wilma J. Wooten, M.D., M.P.H.
Public Health Services Health Services Complex
3851 Rosecrans Street
San Diego, CA 92110

Sent via e-mail

Re: Advancing equity issues pertaining to the pandemic response

Dear Dr. Wooten:
We wish you and your family health and wellness as you grapple with the COVID-19 virus firsthand. We write to lift-up key concerns pertaining to issues of equity, which are too often cast aside during emergencies. We believe that under your leadership, San Diego can lead the state in protecting public health while upholding our shared values throughout the response.

Increasing transparency regarding COVID-19 testing, positive cases and deaths in San Diego County

We request that the County provide additional demographic data (in a way that protects privacy) associated with COVID-19 testing, positive cases, hospitalizations and deaths disaggregated by race, ethnicity, gender identity, sexual orientation, primary language, disability status, socioeconomic status and whether or not the person was an essential worker (broken down by industry). In response to requests from advocates, we were glad to see that the County started to provide zip code and racial data as a part of the daily updates and believe this additional information we are requesting will help to provide a clearer picture about how COVID-19 is impacting our communities. We also request that the County begin to collect additional data if any of the requested information is not available.

This past week we have seen experts from around the Country sound the alarm about how the response to COVID-19 is revealing biases in our healthcare system and the need for agencies to track and share data that will allow for informed responses. As you may have seen, last week Senator Elizabeth Warren and Congresswoman Ayanna Pressley called on the federal Department of Health and Human Services to focus on racial equity in its COVID-19 response by requesting that state and local governments collect data to make it possible to discern whether there are racial disparities in access to COVID-19 testing in communities nationwide. Recent reporting from the New York Times also highlights the need to understand the impact of COVID-19 on communities of color before it is too late. UN human rights experts in a statement urged governments to commit to racial equity and racial equality because of the threat posed by structural racial discrimination and the potential for it to exacerbate inequality in access to health care and treatment.

While we know that anyone can contract the virus, we also know that the impacts on communities of color and other vulnerable populations could be severe. We’ve already begun to learn about these disparities in other parts of the country, for example, Milwaukee’s African American community has been hit particularly hard, leading the numbers of deaths in the state. People with disabilities are among those at the greatest risk during this crisis because of several factors including: being more likely to have underlying health conditions, being economically disadvantaged, being dependent on others for care, or simply because people with disabilities are disproportionally placed in institutions, incarcerated, or homeless.

Understanding the impact of COVID-19 on essential workers can also help to inform responses. This includes our hardworking first responders, healthcare workers, restaurant and grocery store workers, farmworkers, and all other essential workers. The COVID-19 pandemic has placed a spotlight on the important role that essential workers have in our day-to-day lives and the fact that they are at greater risk of becoming infected with the virus.

It’s crucial that our county government do everything in its power to ensure equitable access to testing and treatment during this pandemic. We cannot manage what we do not measure.

Ensuring an equitable response to COVID-19 in San Diego County

Another key equity issue pertains to the distribution of personal protective equipment and
ventilators across the county. Given the potential for a lack of adequate resources, it is important for the County to focus on equity when determining which hospitals obtain equipment. Distributions must be based on need determined by a consistent, fair, and transparent process, not economic or any other social status. To the extent that need will be determined by testing, the county must ensure that test kits are equitably distributed, taking into account the ability of people with limited English proficiency to advocate for themselves.

We seek information relevant to the Department’s plans for distributing equipment. Please provide us with any directives, guidance, or other records pertaining to how the Department will make determinations about which hospitals, regions, or people will receive personal protective equipment and ventilators. If necessary, please consider this a public records request.

Thank you for your tireless work to respond to this crisis and for your assistance in helping us and the public better understand the County’s response to this crisis. We look forward to your response.

Sincerely,
Norma Chávez-Peterson
Executive Director
ACLU of San Diego & Imperial Counties

Henry N. Tuttle
President and Chief Executive Officer
Health Center Partners of Southern California

Darrah DiGiorgio Johnson
President and CEO
Planned Parenthood Action Fund of Pacific Southwest

Caroline Dessert
Chief Executive Officer
The San Diego LGBT Community Center

cc:
Board Chair Greg Cox
Board Vice-Chair Jim Desmond
Supervisor Dianne Jacob
Supervisor Kristin Gaspar
Supervisor Nathan Fletcher