As the coronavirus spreads and more testing is performed, anxious residents are demanding more information regarding the rate of infection in their communities. In response, the Virginia Department of Health (VDH) changed its long-standing policy not to release data at the ZIP code level to protect patient privacy and due to concerns the difficulty in interpreting ZIP code data (read more about interpreting VDH data here, here and here).
In Fairfax County, Latinx residents account for nearly 60% of COVID-19 cases, more than three times their share of the County’s population. Across Northern Virginia, trends in healthcare data suggest that residents in Manassas, Herndon, Sterling, Bailey’s Crossroads, Annandale, South Arlington, the Route 1 corridor in southern Fairfax County, Springfield and Woodbridge are being affected more severely than their neighbors. Like Arlandria and Del Ray, these communities are home to high percentages of minority, low-income essential workers. Many are immigrants and are unable to secure healthcare or qualify for government subsidies to pay rent. So they continue to work.
Community spread of COVID-19 has reduced the risk to patient privacy and – as a recent news release from the City of Alexandria shows – ZIP code level data reveals underlying disparities that are masked at the locality level.
Last week, the City of Alexandria used the new VDH data to provide an overview of COVID-19 testing and cases in each local ZIP code, including the number of confirmed cases per 1,000 residents for ZIP codes that could be reliably calculated.
Within this overview, there was an alarming statistic that could not be missed. The highest rate of confirmed cases – 19.7 per 1,000 residents in the 22305 ZIP code – was nearly four times the next highest rate of confirmed cases, 5.5 cases per 1,000 residents in neighboring 22304. For context, the estimated number of cases per 1,000 residents in Manhattan is 13.98.
In Alexandria, the Del Ray and Arlandria neighborhoods comprise the majority of residential development in 22305, where approximately 58% of the housing stock is multifamily rental. A sizable majority of residents in 22305 are people of color. The center of a vibrant Latinx community, immigrant households comprise a large segment of the residents in Arlandria. This area is also home to many African American families.
Residents in 22305 are our essential workers – grocery store clerks, delivery persons, bus drivers, and restaurant workers – those who maintain critical economic and community activities while the rest of us shelter in safety at home. For the most part, these are low-income workers who cannot afford to stop working or call in sick. Their choice between feeding their families or protecting their health is a frightening one for them, and should be for all of us, as this pandemic shows the inextricable link between our health and the health of our neighbors.
The disparities evidenced by the disproportionate number of COVID-19 cases in the 22305 ZIP code are not unique to Alexandria and show us how place matters.
We cannot successfully reopen our economy or stem the spread of COVID-19 without addressing the systemic inequities that have enabled the virus to ravage low-income and minority communities, and laid bare our lack of investment and de-prioritization of those who make our economy and our society run. Moving from stabilization to recovery, we must fill the gaps that exist for so many of our residents. Because this pandemic has taught us how interconnected we are.
When we re-open businesses and schools and begin to engage in civic and social activities, what does equitable recovery look like?
Safe, affordable housing opportunities for residents at all income levels;
Healthcare that is affordable and readily available to all residents, regardless of income or immigration status;
Multi-modal transit - bus service, BRT, bike lanes and secure walking paths - that is frequent and affordable for households without a car;
Digital access to broadband and the appropriate devices for online learning and telehealth – our healthcare delivery system of the future – for all residents.
We cannot return to the old way of doing things. As we move into recovery, we must test new ideas and support programs that strengthen best practices. It will require collaboration among all community stakeholders with a role for nonprofits, philanthropy and the public sector. We cannot wait; the time to begin is now.