NC Was Slow to Hire Bilingual Tracers While COVID-19 Exploded Among Latinos

NC officials touting push for bilingual contact tracers today, but some say officials dragged on tracking the virus in Latino community.

Over the last three weeks, the number of confirmed COVID-19 cases in the state rose by nearly 1,350 a day, and each day over that span some 16 people died. And on Wednesday, the state reported 1,843 new cases, its biggest one day increase. 

The numbers are climbing at such a rate that North Carolina paused its reopening, made masks mandatory in public, and delayed a pivotal decision on when and how to reopen public schools.

But there is one key metric climbing too slowly.

The coronavirus is having a disproportionate effect on Latino communities, but the number of bilingual contact tracers meant to ease that spread lags far behind the rate of new cases, a reflection of the challenges that accelerated the spread in these communities in the first place. 

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According to state numbers, Latinos make up 9% of the state’s population but account for 46% of its positive COVID cases. In NC, there were 20,485 total COVID-19 cases designated as Hispanic as of July 1, a leap of nearly 3,000 in about a week.

And there are now 188 bilingual contact tracers, 162 of them able to speak Spanish, up from 69 the first week in June. But in just the last week alone those Spanish-speaking tracers would have each received 19 new cases to track on top of their existing load. That number is almost certainly a major undercount, given the state is missing ethnicity data on about a third of its cases.

While state officials are declining to say what’s a target range for a tracer’s caseload, that’s a lot of cases. 

“The state responded late to this pandemic,” said Paola Jaramillo, the co-founder and executive editor of Enlace Latino NC, a Spanish-language nonprofit news outlet. “We’d been asking them to release the ethnic data in March, but it was not until June that they took this step.”

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Jaramillo added that while it is important that the state is now turning its attention to the disparity, advocates had been calling for a more aggressive approach for months.

“The state needs to do more and better.”

“We are called essential workers but not treated like essential workers.”

Contact tracing is only one part of the battle plan, but an NPR survey of contact tracers across the country in mid-June showed that a majority of states fell short of the anticipated need, North Carolina included. 

While the number of bilingual and non-bilingual cases for each tracer is comparable in NC, according to state officials, advocates say tracers working in Spanish-speaking communities will face an altogether different task. 

Pilar Rocha-Goldberg, the president and CEO of El Centro Hispano, said the state and its network of tracers must recognize that COVID disparities stem from pre-existing conditions. Limited health insurance, a lack of knowledge of navigating the system, and a lack of resources all predate the pandemic and helped feed its outsized effect. 

“We are seeing those gaps exacerbated by COVID,” Rocha-Goldberg told Cardinal & Pine. “We need to have those things in mind.”

In Spanish-speaking communities, tracking just one case can be particularly difficult: Many of the people the tracers are trying to find, don’t want to be found.

Latino residents comprise a large percentage of workers in meat packing plants and other essential industries that stayed open even as others shut down. They could not work from home, mask rules in these plants were often loose, and employees worked side by side as infections soared. 

A distrust of state officials over immigration concerns also means that many Latino workers are either afraid to speak up against lax workplace rules, or don’t want to return calls from state officials looking to trace their contacts.

“The communities have to first understand the information,” Rocha-Goldberg said. “But they also have to have the resources, having masks available for the community members, having resources for those who lost their jobs.” 

And employers may threaten them with firing if they don’t show up, she said. 

Rocha-Goldberg says she has heard from numerous people that their employers have told them,“‘OK, if you don’t come to work, you won’t get paid and I can’t assure you that when you decide to come back we’ll have the space for you.”

“We are called essential workers,” said Rocha-Goldberg. “But not treated like essential workers.”

‘For our community, everything is immigration.”

State leaders, it seems, are aware. 

In a news conference last week, NC’s Secretary of Health and Human Services Mandy Cohen announced a partnership with Latino nonprofits, including a series of grants to help the organizations fight the spread.

Cohen said the effort to work directly with Latino organizations would ensure that all tracers and other front line officials come from the communities they were trying to serve. 

That approach, advocates say, is essential to curbing the distrust.

“This is a unique opportunity to overcome the systematic barriers between the Latino community and the state and local governments,” Juvencio Rocha-Peralta, the executive director of the Association of Mexicans in North Carolina, said in a news conference with Cohen last week. 

Rocha-Peralta’s association is one of those groups receiving a state grant. So is Rocha-Goldberg’s organization. 

They have a significant challenge in front of them.

Health experts say contact tracers will be pivotal in not only tracking but slowing the spread of the deadly coronavirus.

They contact people who have confirmed coronavirus infections, as well as anyone they have been in proximity to in the previous days, connecting them with both testing and treatment. 

The NPR analysis concluded that NC was one of 37 states without sufficient tracers to meet new cases.  That analysis factored in all tracers, not just bilingual tracers, but the message was clear: States like NC that are gradually reopening during the pandemic are in a precarious position.

It’s a problem experts are blaming on overly hasty state leadership and missing federal leadership. Public health experts estimated the states need billions of dollars to hire sufficient tracers. Democrats’ HEROES Act, which passed the US House in May, included $75 billion for tracing, but GOP leadership in the Senate has mostly dismissed the bill. 

Meanwhile, NC is “actively working” to hire more Spanish-speaking tracers, according to NC Department of Health and Human Services spokesperson Catie Armstrong. Some advocates say the focus on Spanish-speaking tracers came too late, especially given the specific challenges of both treating and tracking the virus in these areas.

There are just under 22,000 cases for which ethnicity is not available, also up about 3,000 over the same time frame, which means another possible 1,380 cases if the current trends are applied.

Jaramillo said the issue is as much cultural as it is epidemiological. 

Every phone call or letter that comes to members of the Latino communities, she said, is seen as a “phishing” attempt by immigration officials. 

“Because for our community, everything is immigration,” she said.

“Tracers need to understand this,” Jaramillo added. “They need to not just speak the language of the community, but to understand it.”

The state is now fully focused on the issue, Armstrong said, and leaning on these groups to make sure it is done right.

“Our local leaders are building trust within our Hispanic/LatinX communities that will make efforts like contact tracing more effective,” Armstrong said in an email.

The focus may have come late, advocates say, but it is important that the state continue to give the communities the resources they need.

Whatever the delays may have been, it is crucial that all parties now work together, said Rocha-Peralta. Because the workload grows daily. 

Indeed, NC updated its COVID-198 numbers around noon Thursday. Of NC’s total cases, more than 21,000 identified as Hispanic.