We want to thank you for all that you do. This pandemic hit us so fast and so hard that everyone is reeling and scrambling just to get a basic handle on how to manage patients, provide testing and treatment, supplies, staffing, tending to the needs of workers’ families and all of the other demands you are meeting right now. We see what you are going through and we can imagine how busy you are. We know we ask so much of you already and there is one more thing that we need you to do.
We need you to ask your patients about their race.
Because we are dying.
- Black and Hispanic people are contracting the disease at higher rates than any other races.
- Black and Hispanic people are dying of COVID-19 at higher rates than any other races, accounting for more than 50% of fatalities in New York, Louisiana and Detroit.
We know that data drives process. Unlike other states, Vermont is not currently collecting or analyzing data on the racial identity of patients who present for COVID-19 testing. Without more information about who is getting infected and dying, it will be impossible to target preventative measures and treatment. The profound lack of data puts our communities at extreme risk and ties your hands as committed healthcare providers. There is another reason we are asking you to solicit racial information from your patients. Accurate information about transmission and death rates means that we can dispel myths that are leading to the rise in racist attacks against people of color. From racist taunts and harassment, to the March 14th attack and stabbing of an Asian man and his two children ages 6 and two, COVID-19 is not the only threat we face. Vermont is not immune, as the rise in racist attacks and harassment is also on the rise.
We, as your patients, are more likely to trust you if we see that you are acknowledging and taking race into account when you develop treatment protocols and vaccines because we know that race plays a role in every system and the most respectful thing we can do is to be honest about that. Race is a sensitive subject in this country for good reason, but you must put aside whatever hesitation you have and do what is needed to collect information that will help shed light on the patterns and help save lives. Understanding both the importance of asking about race and also the difficulty, here are some guidelines to help guide you:
- Ask every patient, every time regardless of their skin color. Often only “not-white” patients are asked for racial identity which confounds racial data and makes it as useless as a contaminated blood sample.
- Practice how you ask. It can be as straightforward as any other question you ask: Height? Weight? Religion? Race?
- Develop an elevator speech or explanation. Put it into your own words. Why are you asking this information? What happens when we don’t have it? “We collect demographic data to help us get a better idea of how COVID 19 is affecting different groups. From age to health and race to gender, we want to gain a clear picture of how this disease is spreading so that we can target our interventions so we can to heal those who are sick and prevent this illness from spreading further, or from disproportionately impacting certain groups.”
- Develop a white people elevator speech. Some people are going to look at you funny when you ask, especially those who aren’t used to talking about or being asked about race (read: white people). Some may say things like “Isn’t it obvious?” or “White, duh.” Have a 2-3 sentence response ready to go. Like, “We ask about race because we need to gather information so we know who this is affecting. We know that there are racial disparities and we need to track how those disparities look in Vermont.”
- Be empathetic. Those of us who experience racism are more likely to be wary of you asking, especially if you are white. Understand that there is a long, complicated and painful history of racism in the medical system, and other systems of government, too. Being aware of this reality and acknowledging it with kind words, validating language or just slowing down for a moment (if you can) to really see us is something we rarely experience. Consider it good bedside manner.
- Support your staff. Supervisors and administrators should make time to check in with front-line staff. How are you doing? Have you had time to develop your elevator speech? Do you need support? How are you being treated? This last question is especially important right now in the time of increased anti-Asian rhetoric and attacks. Check in with people of color on staff to see what, if any, experiences they are having that you may need to address.
- Reach out. There are plenty of race-related organizations and resources across Vermont. And many of us are more than happy to help. This is not an easy subject to broach. We are here to talk to and provide you with guidance. The NAACP, ACLU, Migrant Justice, Justice for All and the Association of Africans Living in Vermont are just a handful of Vermont’s racial justice groups out here serving communities of color.
- Urge the Vermont Department of Health to set standards that require providers to solicit and document racial identity on all patients tested for COVID-19 AND to initiate responsive analysis and consideration of this data when implementing public health strategy. We understand that there are barriers to frontline HCPs asking and documenting demographic identity. You have tremendous power and with your influence we can change the standard approach in our state and create a safe medical approach to this pandemic.
We get that it isn’t easy. But what about your job is? You ask some of the most difficult questions—and tell people some of the most heartbreaking news. You do it with tact and grace and you care what happens to the people who walk into your clinics and hospitals. If you can do that, you can ask about race.
This virus is upending life for all of us in different ways. We must work together from our respective places to heal and protect our communities. Thank you again for all that you do.
Tabitha Moore & Steffen Gillom
Presidents of the Vermont Branches of the NAACP