At greater risk

Immigrants more likely to contract coronavirus

Muhammed Omar discovered the impact of COVID-19 the hard way when his wife and two children tested positive. h His 35-year-old wife, Amina Ali Abdullahi, was hospitalized and put on a ventilator and released two weeks later on Nov. 16. The scare prompted Omar to warn his relatives in Somalia and ask his children’s school to allow them to take classes online. h Infection rates are higher for immigrants than native-born residents because of poverty and living and work conditions that

make physical distancing difficult, according to the Organisation for Economic Co-operation and Development in France, which found rates as twice as high in some countries.

In Columbus, Dr. Jamie Robinson, a family medicine physician and director of Ohio State University Wexner Medical Center‘s immigrant and refugee clinic, has seen a higher incidence rate in her patients as well.

“I think just like anything it’s probably multifactorial,” Robinson said.

Many refugees lack education about the virus and live in multigenerational homes, work in essential jobs with low pay and don’t have the ability to stay home from work to reduce risk of exposure, experts said.

Omar, 38, of the Northwest Side, said some immigrants don’t trust that the virus is real and said he’s seen local mosques stop social distancing and fail to require masks. He said he has talked to mosque leaders, but they told him that they don’t believe masks work.

It’s even worse in his native country, he said.

Omar said he was talking to his brother in Somalia while his wife was hospitalized.

“I told him to be careful, I said ‘Don’t take this virus easily, you are in Somalia, you might not get the medical care you need,’” Omar said. “He was laughing.”

Omar’s brother said people who wear masks in Somalia are made fun of and bullied.

Amina Abdule, co-owner and a family nurse practitioner at the Medcare Clinic on the West Side, has seen similar false beliefs among her patients, 95% of whom are immigrants, many from Somalia like she is.

“Someone will tell them this is created and then they believe it,” Abdule said. “So they ignore the truth and they ignore the symptoms and you will see a lot of people who will argue ‘COVID is a lie, there is no COVID.’”

Within the local immigrant community, COVID is taboo, Abdule said.

“HIV used to be a taboo. I feel like COVID is becoming the same thing,” Abdule said. “If you tell them ‘You have symptoms of COVID, let me test you,’ they say ‘No, I don’t have COVID.’”

There’s also a sense of mistrust between some immigrant communities and health care providers, Abdule said.

“They think hospitals are killing people because nobody goes into the hospital and comes back healthy. They all die from COVID problems,” she said, which isn’t true.

Immigrants are also more likely to be uninsured, which may mean they are concerned with costs associated with getting a COVID test, said Samantha Artiga, vice president and director of racial equity and health policy with the Kaiser Family Foundation, a Washington, D.C.based nonprofit group focused on national health issues. They may also not have a regular doctor and face more barriers to care, she said.

A lack of preventive health care is also pervasive among immigrants and refugees, said Yolanda Board, director of organizational development at North

Community Counseling Centers in Columbus.

Board works with the Bhutanese Nepali community in central Ohio and said she has seen COVID-19 disproportionately impact immigrants.

She said if no one in a household is advocating for members to wear a mask, sanitize and distance, other members might not know they that they should.

“I think the other challenge is it’s not something you can see … until someone gets sick,” Board said.

The counseling center has done social media videos and posts to reach Bhutanese Nepali immigrants and educate them about the virus.

“We’re not trying to use fear, but we’ve got to remain realistic.” she said. “You don’t want to make it out to be this big boogeyman. … You don’t want people walking around in a constant state of fear, but we do have to be on our toes.”

Some of Robinson’s patients are scared of the virus, so much so that they are scared to come to the clinic that she runs to receive care.

Trusted messengers are key to educating immigrants about the virus, Artiga said.

“That really means utilizing local leaders that have a shared background of the people you’re trying to reach,” she said.

Abdule said she thinks the virus spreads so quickly among immigrants partly because many don’t know all the symptoms.

“If they have a fever they don’t believe it’s COVID,” even if it could be, she said.

Robinson said it’s harder to social distance if “maybe you live in a smaller home and there’s eight people there and two work in a factory and two get it and they bring it home to everybody.”

It’s also nearly impossible to quarantine one member of a large household unless the person leaves the home, Board said.

The nature of many immigrants’ work also doesn’t allow for working from home.

“A lot of these people have essential jobs that might be putting them at risk,” Robinson said.

Many immigrants and refugees work in warehouses, food service, construction, hospitality and other jobs that can’t be done remotely, according to the Pew Research Center.

Immigrants make up nearly a quarter of the workforce in industries that produce and distribute food, according to a Pew survey this past summer, all of which are essential jobs during COVID-19.

“With very few sources of income in the household, if they stop working everybody stops eating,” Board said. “So they’re going to work until they physically can’t anymore, and that’s really dangerous.”

Immigrants play a key role in the nation’s workforce, Artiga said.

“Our nation’s health and economic stability really depends on the health of all communities,” she said. “Addressing these disparities is not only important from a social justice standpoint … It’s also really important for securing and improving our nation’s overall health and economic stability going forward.” dking@dispatch.com @Danaeking

FRED SQUILLANTE/COLUMBUS DISPATCH Amina Abdule, a nurse practitioner and co-owner of the Medcare Clinic, stands at the West Side clinic. She and the other owner primarily see Somali patients, many of whom don’t understand the virus threat.

PROVIDED “HIV used to be a taboo. I feel like COVID is becoming the same thing.” Amina Abdule Co-owner and a family nurse practitioner at the Medcare Clinic Somali refugees Muhammed Omar and his wife, Amina Ali Abdullahi, pose with their daughters.