By Alexander Salerno
As a primary care physician, I’m not used to seeing my patients in parking lots. It’s not normal to do oral swabs and blood draws out of a van or for patients to be standing six feet apart in a line wrapped around the block. If coronavirus has proven anything, it’s that “normal” is a bygone word. I’ve been practicing medicine in New Jersey for decades and I’ve never seen anything like the coronavirus pandemic. New Jersey is starting to open up, but the virus is still ravaging communities at alarming rates.
In April, I spent $42,000 to purchase a sprinter van and outfit it to specifications required of a mobile COVID-19 testing unit. It’s complete with a sink, a generator, wifi and a refrigerator unit. My family medical practice, Salerno Medical Associates, has been swamped with patients seeking testing and treatment for COVID-19 for months. The influx of patients, 80% of them Black or Hispanic, started to reveal a truth that’s been confirmed on a national scale: Coronavirus is disproportionately affecting communities of color. It became apparent that we needed to act fast to reverse this trend, and we didn’t have time to wait for patients to come to us. We had to go to them in their communities.
I have been taking the van to underserved areas of New Jersey for the past two months and am testing hundreds of patients a day. The Urban Healthcare Initiative Program, a nonprofit I started to provide healthcare education to underserved populations in their communities, has also become almost completely dedicated to testing and treating coronavirus. My team and I do oral swabs to identify people with the active virus, and antibody blood tests to see if they previously contracted it. Both are vital measures to identify the disease and stop the spread.
My home state of New Jersey just confirmed a case total of nearly 175,000. When I started my mobile clinic, 21.3% of COVID-19 deaths involved African American patients, even though they make up only 14% of the population of New Jersey. This is not unique to New Jersey, however, and unless relentless action in the form of testing and treatment continues, it will persist.
This pandemic has exposed our country’s lack of a proactive public health system, and people of color are bearing the brunt. First, Black and Hispanic people are predisposed to chronic illnesses such as hypertension, asthma and diabetes, conditions that when compounded with coronavirus, produce deleterious effects. Underserved minorities are also disproportionately represented in service jobs and occupations where working from home is not a possibility. Lastly, many minority-dominant areas are chronically medically underserved, meaning there is a shortage of primary care doctors for people to see if they do fall ill, as is the case in many urban areas across the country.
To be sure, doctors and public health officials across the country have been going beyond the call of duty during this pandemic. Health professionals are working around the clock to treat and test coronavirus patients in unprecedented acts of heroism. In order to stymie the spread of coronavirus to New Jersey’s most vulnerable, however, we have to remain active and vigilant.
My mobile testing and treatment unit is just one example of a grassroots effort to reach medically underserved populations. Other grassroots public health solutions have popped up across the country. After learning that the Latino community was disproportionately impacted in Alexandria, Virginia, a healthcare clinic primarily serving Spanish-speaking patients set up a testing unit in a local park. A Philadelphia doctor tired of the lagging government response to coronavirus death disparities set up a testing unit in a local church. These are examples of local doctors recognizing a need and acting quickly to fill it. In order to open states safely, it must continue.
It is imperative that as states begin to relax restrictions, we continue our pace with testing. This is the only way we will control the spread and keep the public safe as the summer months get into full swing. Last month, New Jersey doubled coronavirus testing capacity with an influx of 550,000 tests from the federal government. This is good, but we can’t stop there. Physicians on the frontline across the country must continue to work with state and national governments to communicate what is needed and where the need is most acutely felt.
Medically underserved minority populations are dying at disproportionate rates from this virus, a trend that inspired action in my practice and in others across the country. To combat this deadly pandemic in an equitable way, grassroots public health efforts need to continue to mobilize. Coronavirus won’t let up anytime soon, and neither should we.
Dr. Alexander Salerno is a physician at Salerno Medical Associates, a family-run, second-generation practice that serves East Orange and Newark. He’s also the founder of The Urban Healthcare Initiative Program (UHIP), a community-based health and education provider.