BCBST News Center, Amanda Haskew, July 24, 2020
In recent weeks, COVID-19 cases have been rising in Chattanooga. The Hamilton County Health Department reports that nearly half of patients diagnosed with COVID-19 in the area are Hispanic, even though they make up only 6% of the county’s population, according to 2019 census data. And the virus has become another example of the health disparities minority groups face.
Dr. Kelly Rodney Arnold operates Clinica Medicos, a BlueCross community partner and local medical center serving uninsured and underinsured patients. More than 90% of the clinic’s patients are Latinx and often don’t speak English. Dr. Arnold employs a staff of 35. Each team member is bilingual in Spanish and English, breaking one of the primary barriers to care for these populations – language. No one has to have an appointment or insurance to visit. And the clinic is open seven days a week to accommodate patients’ schedules, as many cannot afford to miss work.
Dr. Arnold and her staff have found their clinic on the front lines helping one of the city’s most vulnerable and at-risk populations in the fight against this dangerous new virus.
The coming storm
As COVID-19 made its way to Chattanooga, Dr. Arnold saw the signs on the horizon and knew that her clinic needed to be prepared. Around the end of February, she was asked to serve on the Chattanooga Mayor’s Council.
“I quickly realized we were facing an uphill climb in terms of providing equitable testing, care and education for already marginalized Chattanoogans,” she says.
At the clinic, she and her staff were discussing what the virus and a large-scale outbreak in the Chattanooga community could mean for their patients. “Our team took a leadership role right from the beginning in terms of trying to manage patients and vulnerable communities inside the pandemic,” she adds.
Dr. Arnold, a member of the Chattanooga and Hamilton County COVID-19 joint task force, approached the Hamilton County Health Department to request that Clinica Medicos be able to test its patients, including those who are uninsured and/or undocumented. “They quickly obliged with the needed supplies and thankfully so, because at the time, we had no idea how severely this virus would affect our patients and community,” she says.
A community at risk
Across the country, Latinx communities are at greater risk of contracting COVID-19. That’s true for a number of reasons, and Dr. Arnold says most of them highlight issues that existed even before the pandemic. Some of the societal and cultural factors that put Latinx populations at higher risk include:
- Multi-generational housing
- Essential work and financial dependence on daily wages
- Decreased access to care
- Underlying health conditions that are more common within minority communities (obesity, asthma, diabetes, etc.)
Dr. Arnold adds, “National outlets reported from the onset that low-income neighborhoods, especially those of color, were going to be more heavily hit by this novel coronavirus than other communities, and Chattanooga has been no exception.”
Clinica Medicos routinely serves patients with these underlying health conditions and complicated social needs. “Elevated cholesterol, obesity, diabetes, hypertension – the whole cardiovascular metabolic syndrome – we see that all the time, on top of food insecurity, difficult housing situations and fragile mental health.”
“This pandemic added an entirely new layer of complexity to many preexisting struggles. But we are here, as best as we can be, to stand by our patients and help them wade through it all,” Dr. Arnold says.
And she says there’s still a lot that is not understood about the virus itself and how it operates. “I believe this period of time will be under study for years to come before we feel any sense of finality about how and why the virus disproportionately affected certain pockets of the population,” she notes.
Putting testing in place
Clinica Medicos is located south of downtown Chattanooga – near the ZIP code with the highest number of confirmed COVID-19 cases in Hamilton County.
To handle the influx of COVID-19 patients, the clinic team set up a special unit at the back of their property. Staff members use this space for drive-through testing and patient education.
Since 2016, the BlueCross BlueShield of Tennessee Foundation and Community Trust have awarded Clinica Medicos $205,000 in grants to expand health care access for the Latinx community. Earlier this year, the foundation provided $50,000 to the Hamilton County Health Department to assist with COVID-19 testing. And the county allocated these funds to Clinica Medicos to set up its special testing unit.
“We have been extremely grateful for the support from the BlueCross Foundation and Community Trust over the years, and this contribution was especially meaningful given the imminent challenges we faced,” Dr. Arnold says. “Not only did it lift us off of the ground in supporting testing for our uninsured community, but it also helped establish our COVID-19 unit geared toward accessible, equitable testing for those in need.”
“Throughout this pandemic, both inside our clinic and through our drive-through unit, we have seen thousands of patients,” she adds. “Some were sick and many were not ill at all but sought testing for multiple reasons. We’ve never closed our doors because we recognize that our patients need us now more than ever.”
The team at Clinica Medicos is actively educating patients about the virus using online information, webinars, texts and social media posts. Dr. Arnold recognizes that many patients are suffering physically but also emotionally and mentally from the fear of the unknown.
With lives and livelihoods changed and lost, many patients are experiencing stress and anxiety, which staff members are also attempting to address. “In the end, our duty as physicians is to try to minimize harm to the body and mind whenever possible,” she says.
An ounce of prevention
As with many other illnesses, the best way to limit the impact of COVID-19 is to prevent transmission. Dr. Arnold emphasizes that basic precautions touted in recent weeks and months are the most effective measures for reducing exposure and risk of contracting the virus. These measures include:
- Keeping a safe distance from other people
- Washing or sanitizing hands
- Wearing face masks
For anyone who fears they may have contracted the virus, Dr. Arnold notes that there is plenty of testing available locally. As much as possible, people who are sick (or awaiting test results) should quarantine themselves and maintain a safe distance from other members of their households.
A positive COVID-19 test result can have profound effects on a patient and their loved ones. For those who do test positive, Dr. Arnold encourages turning to community-based organizations for support, as taking time off work to recover and isolate can have financial, emotional and mental ramifications.
“I recommend that positive COVID-19 patients reach out to local agencies, churches and nonprofits for support,” she says.
“There are so many helping hands willing to stabilize families who are pulled away from their workplaces, social fabrics and incomes. It can be really challenging and anxiety-provoking, so I urge patients to lean on their neighbors and community when possible. We need to remember that we’re in this together.”