November 16, 2023

Lessons in Health Equity from the COVID-19 Response

Join Unidos en Salud—shaping health equity post COVID.

“The single biggest threat to man's continued dominance on this planet is the virus,” wrote Nobel Prize-winning biologist Joshua Lederberg. Despite past warnings and lessons from the HIV/AIDS epidemic, the global response to the COVID-19 pandemic was slow and flawed. 

When COVID-19 hit the United States, the government's initial response was decentralized and lacked coordination, leaving local leaders with insufficient resources. 

Taking Action During A Health Crisis

Access to quality healthcare is a basic human right that is constantly disregarded. Though the healthcare system continues to fail us every day, the COVID-19 pandemic exposed major cracks, fueled structural racism, and increased disparities. Inequalities have disproportionately impacted racial and ethnic groups in the United States for far too long. Even before the pandemic, Americans faced significant barriers to accessing quality healthcare, and those barriers worsen if the person is not White. Where’s the equity in healthcare? 

Equity in healthcare is when every person has the opportunity to attain their full potential of health, and no one is disadvantaged due to their race, ethnicity, age, gender identity, sexual orientation, nationality, socioeconomic status, or geographical background.” 

Already facing barriers, there was a widespread concern that the pandemic would hit racial and ethnic communities harder and there was no room for delay. Our people need an equitable response, and to do so, respondents needed to follow the data to understand where communities were affected most. 

A never-before-seen collaboration between the community, academia, city, and science was rapidly built within a few weeks, focusing on the immediate response to COVID-19. The Latino Task Force (LTF), UCSF, UC Berkeley, CZ Biohub, and BayPLS collaborated to form Unidos en Salud. Trusted local community leaders were involved in crafting the type of studies that were done so they would be applicable to the community's needs. This level of community support makes it easier to ask sensitive questions and increases participation in studies. Without the help of trusted community leaders, officials would’ve been incapable of combatting the widespread mistrust and obtaining data. 

After working with trusted community leaders to acquire community consent, BayPLS and partners were able to conduct the first case study in Bolinas, California from April 20 – 23, 2020, proving assumptions that non-White communities would be hit harder by the pandemic. The case study resulted in 98% of COVID-19 positive patients being Latino, even though they represented 45% of the people tested. These results quickly alarmed the parties involved and majorly influenced response efforts. 

UeS, LTF, UCSF, BioHub, and BayPLS were among the first respondents to the COVID-19 pandemic in the San Francisco, Bay Area. This partnership provided over 1.5 million COVID-19 tests, administered over 120k vaccines, provided technical assistance, financial support, and facilitated research, data collection, and analytics. One of the more recent studies provided strong evidence that rapid at-home tests were accurate enough to utilize, rather than relying on laboratory RT-PCR tests that had caused bottlenecks, thus contributing vital knowledge about COVID to the global pandemic response. 

A key takeaway is that building on existing partnerships and establishing new ones with respected local organizations was essential to gaining the trust of people. We hope these important lessons learned will inform efforts to address health disparities and response efforts forward. 

As we witnessed, private and community-based organizations are the backbone of public health. Without them, the impact of COVID-19 would have been much worse. We applaud the heroic efforts of the pandemic respondents. Thank you for your dedication to improving health within our communities. 

What’s Happening Now

UeS has remained open for the past two years through a combination of funding sources, including the Federal Government, the San Francisco Public Health Department, UCSF, and private donations. However, most if not all of the federal funding is expected to disappear at the end of the year.

Grassroots organizations that work in underserved communities are often overlooked when it comes to funding. As the US government distributes some of the most significant investments ever to improve public health, many grassroots organizations that work in underserved communities are being overlooked. Though it’s good news that the government is increasing its investment in public health, resources need to be equitably distributed among the organizations that took the challenge of COVID head-on.

Join Us in Making a Difference!

Your support can make a significant impact on our mission to address health disparities and promote equity. If you believe in our cause and want to contribute to positive change, consider making a donation today. Every contribution brings us one step closer to a healthier, more equitable future. 

Final Thoughts

The pandemic has emphasized the interconnectedness of humanity. When one suffers, all parts suffer. As a collective, we must unite and continue the fight for equity.

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