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Introduction
Presently, the United States is one of the most affected countries that are facing substantial socioeconomic and human damage during the COVID-19 pandemic. In this situation, minorities, especially Mexican and black, remain the most vulnerable groups of the population because of predominant poverty and limited access to quality healthcare and information resources. Thus, this paper aims at exploring the impact of the COVID-19 pandemic on the Mexican and black and the health care delivery system. The paper will also offer specific recommendations for addressing the health issue related to necessary stakeholders and funding considerations.
General Description
The USA is currently the epicenter for the COVID-19 pandemic, leading the world in terms of the number of reported deaths and infections. In this situation, mortality among White Americans comprises around 61.7 deaths per 100,000, while the mortality among Black and Latino Americans accounts for 114.3 and 78.5 deaths per 100,000, respectively (APM Research Lab Staff, 2020). Herewith, it is worth noting that the research involving the Mexican people by Salinas-Escudero et al. (2020) concluded that people with chronic kidney disease, hypertension, diabetes, or obesity have the highest risk of dying during follow-up. This unfavorable statistic is primarily conditioned by several factors that favor community spread and individual risk concerning COVID-19.
First, one of the core contributors to the pandemics adverse effect on racial communities is existing disparities in healthcare access and quality that have long-standing roots in the US. Garcia et al. (2020) indicate that considering Mexican and black overrepresentation in low-income jobs, these minorities are less likely than Whites to have employer-delivered health insurance, producing considerable barriers to providing and accessing medical care. Furthermore, the researchers add that when Blacks and Latins overcome these obstacles and access the healthcare system, they frequently obtain inferior quality service compared to Whites due to physician bias or structural inequalities. A higher risk of exposure to COVID-19 of ethnic groups also stems from their cultural traditions, values, beliefs, and customs. In addition, Bhala et al. (2020) state that specific variations in community interactions, multigenerational and more crowded households, and shared places of worship and religious rituals may play a notable role in spreading the disease.
The US governments inadequate preparedness and response to the pandemic have also played a critical role in adverse consequences. Rothstein (2020) notes that the US public health funding at the federal and local levels has been reducing for decades. As a result, since the outbreak, the country had a severe shortage of healthcare capacity, including hospital beds and intensive care unit (ICU) beds, ventilators, and personal protective equipment, such as gowns, gloves, face shields, and masks. It should be admitted that this catastrophic situation has stricken ethnic communities than Whites predominantly.
Finally, some indirect issues concern the US healthcare delivery system and population overall. With the beginning of the COVID-19 pandemic, many patients contracting moderate disease with pneumonia and mild disease without pneumonia obtain antibiotics. According to the study by Rawson et al. (2020), less than 8 percent of 72 percent of hospitalized COVID-19 patients receiving antibiotics had respiratory bacterial co-infections. Besides, an increased number of hospital admissions due to COVID-19 also leads to the amplified hazard of healthcare-acquired infections and the dissemination of multidrug-resistant organisms. This causes considerable disruptions to health delivery services, resulting in interruptions with treatments of such conditions as human immunodeficiency virus and tuberculosis (Getahun et al., 2020). Disruptions to vaccination measures, which come from vaccine delivery interruptions and healthcare overloading, can also increase infection risk. Thus, the problem related to non-compliance with antimicrobial stewardship during the Covid-19 pandemic acquires critical, nationwide significance for public health professionals.
Problem Statement
The issues associated with racial disparities in healthcare access and quality, national healthcare preparation, and inappropriate antimicrobial stewardship during the Covid-19 require immediate consideration since they place a heavy burden on the public health sector. Furthermore, the pandemic complicates the operation of the healthcare delivery system by increasing the number of hospital admissions and disruptions to vaccination measures and treatments of other severe diseases. The primary groups under significant risk include older adults with such chronic conditions as hypertension, chronic kidney disease, diabetes, or obesity. Therefore, it is relevant to develop specific measures concerning addressing these concerns and initiating policy change.
Recommendations
To resolve the problems with racial disparities in healthcare access and quality and antimicrobial stewardship, the federal and state governments and respective healthcare organizations should design a comprehensive strategy pursuing several aims. Firstly, the US authorities should seek and collect adequate financial and social resources. The CARES Act, comprising over $2 trillion and aiming at eliminating the economic and health implications, is an excellent example of the needed financial aid. (Perkowitz et al., 2020). Secondly, the focus should be placed on improving clinical competence among healthcare providers, especially nurses and clinicians who are at the forefront of fighting COVID-19. Clinical staff should be instructed to treat all people, irrespective of social and ethnic affiliation, equally, without discrimination and biases. Moreover, the main skill includes identifying the signs of severe COVID-19 and imposed bacterial or fungal illness to obviate needless antibiotic use. Besides, healthcare providers should implement clear infection prevention and control measures.
Thirdly, hospitals and clinics should be supplied with required qualitative testing, protection, and treatment equipment to reduce the turnaround time of COVID-19 and identify other communicable diseases timely. Besides, Rothstein (2020) claims that affordable, instant, widespread testing is critical to detect asymptomatic persons who carry or conceal the infection and their contacts and avert additional transmission. Protection equipment will restrain infection spread, while alternative treatment methods will minimize the antibiotic therapy use. Fourthly, chief executives of medical facilities should pay adequate attention to communication quality within the clinical staff and between staff, administration, and patients overall.
Fifth, governments, together with profit and non-profit entities engaged in healthcare, should urgently address gaps in research to ensure that pertinent antimicrobial stewardship activities are integrated into the pandemic response. The research agenda should comprise affordable and fast diagnostic tests that distinguish viral and bacterial respiratory tract infections. The studies involving comprehensive data will help avoid different misunderstandings and disinformation, which can cause excessive panic and problems in the treatment of various diseases. For instance, despite a lack of research studies and FDA approval, President Trump endorsed hydroxychloroquine and chloroquine as being effective for COVID-19 treatment (Rothstein, 2020). Consequently, many physicians supported such statements, which resulted in a significant deficit of these medicines for patients with rheumatoid arthritis and lupus.
In conclusion, the paper has examined the issue of antimicrobial stewardship during the COVID-19 pandemic and its effect on a particular population and the health care delivery system. The overuse and misuse of antibiotics, significantly aggravated by COVID-19, poses a growing threat to public health by promoting antimicrobial resistance and undermining preventive medical activities. Specifically, increased hospital admission due to COVID-19 also leads to the amplified dissemination of multidrug-resistant organisms. In addition, the current pandemic causes considerable disruptions to health delivery services, resulting in interruptions in vaccination activities and treatments of other conditions. The paper has offered specific recommendations, including gathering adequate financial and social resources, improving healthcare providers competence, and delivering testing, protection, and treatment equipment. Moreover, chief executives of medical facilities should pay adequate attention to the quality of staff communication, and governments, along with healthcare profit and non-profit organizations, should urgently address gaps in research.
References
APM Research Lab Staff. (2020). The color of Coronavirus: Covid-19 deaths by race and ethnicity in the US. APM Research Lab.
Bhala, N., Curry, G., Martineau, A. R., Agyemang, C., & Bhopal, R. (2020). Sharpening the global focus on ethnicity and race in the time of COVID-19. The Lancet, 395(10238), 1673-1676.
Garcia, M. A., Homan, P. A., García, C., & Brown, T. H. (2020). The color of COVID-19: Structural racism and the disproportionate impact of the pandemic on older Black and Latinx adults. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 20(20), 16. Web.
Getahun, H., Smith, I., Trivedi, K., Paulin, S., & Balkhy, H. H. (2020). Tackling antimicrobial resistance in the COVID-19 pandemic. Bulletin of the World Health Organization, 98(7), 442 442A. Web.
Perkowitz, R. M., Speiser, M., Rehr, R. C., & DeJarnett, N. (2020). Environmental health leadership on climate solutions amidst COVID-19. Journal of Environmental Health, 83(1), 38-40.
Rawson, T. M., Moore, L. S., Zhu, N., Ranganathan, N., Skolimowska, K., Gilchrist, M., Satta, G., Cooke, G., & Holmes, A. (2020). Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing. Clinical Infectious Diseases, ciaa530. Web.
Rothstein, M. A. (2020). The Coronavirus pandemic: Public health and American values. The Journal of Law, Medicine & Ethics, 48(2), 354-359. Web.
Salinas-Escudero, G., Carrillo-Vega, M. F., Granados-García, V., Martínez-Valverde, S., Toledano-Toledano, F., & Garduño-Espinosa, J. (2020). A survival analysis of COVID-19 in the Mexican population. BMC Public Health, 20(1), 1-8.
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