Pacific Islanders suffering higher coronavirus rates

For two weeks in March, Dr. Raynald Samoa fought to move air through his lungs.

After recovering from COVID-19, the Los Angeles-based diabetes specialist posted videos on Facebook urging others to stay home.

His posts resonated with California’s small and tightknit Pacific Islander community as questions and stories flooded his inbox.

One family described the anguish and guilt of watching a loved one struggle out of bed to the ambulance — “the least Pacific thing that you can do,” Samoa said — because the first responders wouldn’t come inside.

Another family revealed how three breadwinners were hospitalized with the disease, unable to care for their kids.

Across the country, the coronavirus has laid bare the life-and-death consequences of racial inequality. It has disproportionately killed more African Americans than others.

Now, a stunningly similar pattern has emerged among Pacific Islanders in California, exposing a public health blind spot that likely will require reevaluating coronavirus tracking for this small, communal population.

Already, the rate of infection among Pacific Islanders has alarmed public health experts and community leaders.

As of May 3, the coronavirus had infected Pacific Islanders at a rate more than twice that of the state as a whole, and killed them at a rate 2.6 times higher, the highest rates of any racial or ethnic group.

While the numbers are small — California reported 416 known cases and 20 deaths among Pacific Islanders — they reveal a growing threat in a community that suffers disproportionately high rates of chronic illness, is accustomed to living in multigenerational households and works higher-risk jobs such as food service, transportation and health care that can’t be done from home.

In an email, the state Department of Public Health acknowledged it warrants attention, but declined to elaborate how.

In Los Angeles County, where the infection rate is four times that of the general population and the death rate for Pacific Islanders is six times greater, county officials said they are reassessing outreach efforts.

Other counties, however, warned against jumping to conclusions.

“Even small changes in numbers can mean large changes in rates, and with just one death in this group, there is very little we can conclude,” said Sarah Sweeney of San Diego County’s health agency.

In recent weeks, Pacific Islander community leaders and health advocates have sprung into action, holding countless video conferences, requesting more granular data from county officials and leveraging the central role of faith in Pacific Islander cultures.

To Tana Lepule, that one San Diego death represented the loss of a family member. The longtime health advocate said small numbers have always masked very real health issues among Pacific Islanders.

“The sadness and grief is just the same,” he said.

About 317,000 people with origins in Hawaii,

Guam, Samoa, Fiji, the Marshall Islands or other Pacific islands live in California; less than 1% of the state’s population.

Though the official census category is Native Hawaiian or Pacific Islander, advocates use Pacific Islander to encompass the group.

Common misconceptions that Pacific Islanders are Asian can muddy the data, said Ninez Ponce, director of the UCLA Center for Health Policy Research. So can variations in how hospitals classify Pacific Islanders, half of whom identify with another race.

But after controlling for a shortage of tests and other variables, Ponce and two other UCLA researchers concluded that the rate of infection in Pacific Islanders “is at least twice that of the state rate, and likely to be nearly three times as high.”

The heavy burden didn’t surprise Britanny Morey, a public health professor at UC Irvine researching social and health inequities in Pacific Islanders.

Pacific Islanders are likely more vulnerable to the coronavirus since they are more likely to face poverty, live in dense neighborhoods and crowded homes and work low-wage essential jobs that increase their risk of exposure.

And while public health researchers lump Pacific Islander data with that of Asians, they probably share more social-economic traits and chronic conditions with African Americans, Morey said.

In California, about 23% of Pacific Islanders have asthma, compared with about 16% of all residents, 2017 and 2018 California Health Interview Survey data shows. About 37%