As coronavirus spikes in Lexington’s Hispanic community, contact tracing gets harder
Since Kentucky began reopening its economy last month, COVID-19 has started to prey on Lexington’s Hispanic population at an alarmingly high rate.
Lexington’s overall number of cases has more than doubled since late May, edging up to 1,398 as of Friday. More than a quarter of those identify as Hispanic, a group that otherwise comprises 7 percent of the city’s population, local public health officials said this week.
An additional 25 cases were reported in the city’s Hispanic population Friday. Overall, more than half of the 26 percent who’ve tested positive are younger than 34, and 20 percent are under 18, said Ruben Perez, a health educator with the Lexington-Fayette County Public Health Department.
To compare, the viral respiratory disease also disproportionately infects Black people, who account for 25 percent of the city’s cases, but only 6 percent of those who’ve tested positive are under age 18. The health department this week set up a free mobile testing site to increase testing accessibility for Hispanic and Black residents. Friday’s site is at Cardinal Valley Elementary and Saturday’s is at Valley Park.
“From what we can tell, it’s both spreading within families, but there have also been some clusters associated with places of work,” department director Kraig Humbaugh said this week. Those workplace hot spots for the Hispanic community include an outbreak at Keeneland, where more than 40 people have so far tested positive — more than any other business in Lexington. Most who caught the virus work for people who have horses stabled at the race track.
The infection rate swelling in the Hispanic population has emphasized Lexington’s need for bilingual contact tracers, the people who retroactively piece together all who had contact the virus. This month, the department more than doubled its number of non-native speaking tracers. Perez, who is originally from Puerto Rico and a native Spanish speaker, is one of them.
These disease investigators are an integral part of limiting spread of the virus. They do so by reaching out to every individual who came into contact with an infected person, both to notify them of possible transmission and to make sure they isolate for up to 14 days to halt any chance of further spread.
It’s a job that hinges on coaxing personal, often sensitive information out of strangers. The calls can take an hour, sometimes longer. The Lexington-Fayette County Public Health Department, when dispensing information not related to the coronavirus, has an automated translating service as well as translators on call for residents who are non-native English speakers. But health officials decided that wasn’t good enough for these types of calls.
“Think about it, if you’re a translator, that interview could take two hours. It can get people a little bit frustrated,” Perez said, who’s one of at least five bilingual tracers working for the department. Typically he works as the department’s Workplace Wellness Coordinator.
After initial contact with a positive case, the department makes calls every day to each infected person to monitor their symptoms. Right now, there are nearly 300 people the department must call each day. Of those, close to 80 are Hispanic and 50 prefer to speak in Spanish, Humbaugh said.
It’s a lot of calls, in other words. And the ability to connect Spanish speaking contact tracers with non-native speakers in the community means “they’re more likely to take our advice,” Humbaugh said.
A common connection between contact tracers and the people they call has long been something public health departments across Kentucky have advocated for, especially as the state hires hundreds of new contact tracers to correlate with the economy reopening. Getting a call of this sensitive nature from someone in one’s own community can give way more quickly to building trust, public health officials have said. Having a native language in common can work the same way.
If you’re Spanish-speaking and you get a call from Perez, expect him to first explain why he’s calling — you’ve either tested positive for the virus, or you’ve been in close contact with someone who has. But then he’ll explain a little bit about himself. “I tell them, I’m from Puerto Rico, and I ask where they’re from,” he said by phone this week.
He likes to ask them about their jobs and families, maybe ask how long they’ve been in Kentucky, explaining that he’s been here since 2002.
Some of the non-native speakers contacted by Perez have had trouble with the notion of isolating, since for many in this population, it might mean two weeks without a paycheck.
“It’s hard to take in the beginning,” he said. “Ninety-five percent of the cases I speak to are going to be people that have jobs without benefits, [or] they have jobs where, if you don’t work, you don’t get paid,” Perez said. “When you tell them you’re going to have to isolate for 10-14 days, that means 10-14 days without income. That’s what gets them immediately worried.”
Part of his work as a contact tracer involves walking someone through their anxieties to find solutions. “The issue becomes, well, what about food? You start walking them through it. Do you have any family or friends in the area? Do you have a smartphone to order food virtually?”
Perez will, other times, connect someone with programs that supplement groceries, like local food pantries.
With the exception of a few hot spots, Lexington’s spread of the virus has mostly happened between people living at the same residence. This spread becomes more exaggerated among some in this population, who may live with several people cramped under one roof.
Asking one person to self-isolate might turn into asking an entire household to self-isolate, Perez said. “It’s not that they’re not being diligent or not being careful,” he said. But one’s living situation, if they live with several people, means if one person contracts it, they likely all will.
For the younger people who are catching the virus at a much higher rate, most Perez has talked to have few symptoms, if any, which also contributes to spread. So far in Lexington, 56 percent of the Hispanic people who’ve caught the virus are under the age of 35.
On Monday, Perez called a 23-year-old woman to tell her she’d tested positive. Her symptoms were mild and allergy-like, so she had put off a test for five days.
Younger people without symptoms might not realize they’re transmitting the virus, which could explain why COVID-19 has spread so quickly in recent weeks, he said. People in their early 20s can also be more resistant at the prospect of staying home for two weeks, especially now that it’s summer.
When he senses this resistance, he reminds folks that about 14 percent of all cases in Lexington end up in the hospital. “We’re trying to protect you from [becoming part of that] 14 percent,” he says. “That’s what we’re trying to do.”
This story was originally published June 26, 2020 at 11:30 AM.
