Health care providers, labs and local health districts will be required to report race and ethnicity data on COVID-19 cases, under a decision from the state Board of Health last week.
Board staff member Kaitlyn Donahoe said the changes would help public health systems determine the impact of the virus on vulnerable populations, as well as help local health districts ensure outreach is culturally and linguistically appropriate.
The board passed the emergency rule unanimously and it took effect Friday. It will be in place for 120 days, at which time it can be renewed.
Donahue said the changes are necessary to align with federal requirements for data reporting.
Federal guidelines for funding from the Coronavirus Aid, Relief and Economic Security, or CARES, Act require labs to report results to the U.S. Department of Health and Human Services through state and local public health departments.
On June 4, the department decided to require reporting of additional data, including a person's age, race, ethnicity and gender. The goal was to standardize reporting to ensure public health officials have access to comprehensive data to inform their response to the pandemic.
As of July 27, race and ethnicity data in Washington state was not known for 34% of confirmed cases, 29% of hospitalizations and 3% of deaths.
So no one has a good grasp on exactly how many people of color have contracted COVID-19, Donahoe said. But that data was enough to show troubling disparities for Hispanics, Blacks, Asian Pacific Islanders and Native Americans, Donahoe said.
The Yakima Health District has experienced similar challenges with the reporting of race and ethnicity data. The district's last race-related update was at the end of June, and at that point, race and ethnicity data was missing for more than 20% of confirmed cases.
Disparate impact on communities of color
Dr. Kathy Lofy, the state health officer, said during a virtual meeting hosted by the Latino Civic Alliance and the Commission on Hispanic Affairs that Hispanics were at least eight times more likely to be diagnosed with COVID-19 than whites, using the available data.
Lofy also said Hispanics were seven times more likely to be hospitalized and three times more likely to die from contracting COVID-19 than whites.
She attributed those disparities to the high number of Hispanics who are essential workers unable to work from home, as well as many Hispanics living in larger households where there are more people.
In Yakima County, Hispanics make up 51% of confirmed cases and are 49% of the population, as of data reported June 29.
Lilian Bravo, with the Yakima Health District, said the district's contract for epidemiology services expired at the end of June, which covered the race and ethnicity breakdown.
"We have had a gap in being able to report this information out simply because we didn't have the capacity to be able to run the analysis on these reports," she said.
Bravo added that the way race and ethnicity is reported makes it difficult to run a simple analysis through statistical software.
Kelie Kahler, with the state Board of Health, said feedback received showed local health districts supported requiring race and ethnicity data reporting.
"The feedback we received from local public health expressed support for more comprehensive data about race and ethnicity, which will enable them to better identify and reduce COVID-19 related health disparities in the community," Kahler said.
The state Department of Health Joint Information Center said the state has daily reported the number of cases, hospitalizations and deaths by race and ethnicity.
But the department has struggled to provide accurate data, given that some of the data simply isn't there.
"It (the data) shows troubling differences," the center said. "But it is insufficient to tell the story of what is happening in Washington by race and ethnicity, especially as the pandemic progresses."
Decisions to make
John Wiesman, the state Secretary of Health, noted the additional data reporting would be more time consuming for labs and providers.
He also noted that reporting a person's primary language and having health care providers report the ethnicity data wasn't required by the federal guidelines, which require race and ethnicity reporting for labs only. Under the changes, that information would be required at the state level.
He added the benefits of having comprehensive data to tailor COVID-19 response for communities would outweigh the drawbacks.
"From the providers' perspective, it will take additional time," he said. "But the burden is outweighed by the advantage of the data and providing culturally appropriate care. Nothing is perfect here, and we are going to learn as we go."
The board will have a public hearing for a permanent rule about COVID-19 qualifying as a notifiable condition on Aug. 12. Any changes likely won't take effect until 2021, they said.
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