Hidden figures

Hidden figures

By now, most of us are aware of the disproportionate impact COVID-19 has on communities of color, particularly those on the south and west sides of Chicago. But what’s less publicly available—or even tracked at all—is how coronavirus is affecting people based on their gender, gender identity, and sexual orientation. Advocates say not having adequate data hides the dangerous impact of COVID-19 on the most vulnerable, including women, those who identify as nonbinary, trans, or gender nonconforming, and others in the LGBTQ+ community. 

The numbers are staggering—especially compared to where things stood just a few months ago. According to the Chicago Department of Public Health’s COVID dashboard, which measures the city’s positivity rates across several demographics, there were 626 daily confirmed positive cases as of January 30. Although this number was less than half from early December 2020, the number of daily cases spanning May 1 through June 30, 2020, averaged 190. 

And while the numbers are currently trending downward this month, the impact of COVID isn’t uniform across the city; as of January 30, the positivity rate in some areas of Chicago’s near north side was about 2.5 percent, and the rates in the south and southwest sides are 9 to 11 percent. The positivity rate is the percentage of COVID-19 tests that come back positive relative to the total number of tests performed, as opposed to the number of people, as some individuals take multiple tests.

Women of color are bearing even more of a burden and are overrepresented in city case counts. Of 227,690 COVID cases reported in Chicago as of January 28, Latinx women were 41,139 cases; followed by Black, non-Latinx women (21,918); white, non-Latinx women (19,798); and Asian, non-Latinx women (2,932). There are no figures for Native Americans.

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We had to request this demographic information by gender, and it’s not readily available to the public. When we asked how to use CDPH’s COVID-19 data portal to find numbers regarding Black women (which combines two demographics), Nikhil Prachand, CDPH’s director of epidemiology, said, “That’s a limitation of our data. COVID-19 has had an unprecedented effect on our data systems in terms of the amount of data that’s being poured in. The data we’re able to produce and report on a regular basis involve demographics like age and race.” He added that the CDPH can cross-reference data to determine figures for Black women, for example, but added that doing so regularly would be a Herculean task, although the department “honors special requests.”

Health officials say the city is doing what it can to reach the hardest-hit neighborhoods and address health disparities. “We push resources to areas where we see those surges, such as mobile as well as static testing—and we’re also doing outreach,” said CDPH commissioner Dr. Allison Arwady. 

“Historically, we’ve always had health inequities within the city of Chicago when it comes to different sides of the city,” said Antonio V. King, CPDH public administrator/LGBTQ health and outreach liaison. “Our Health Chicago 2.0 was concentrating on some of those inequities by addressing social determinants to health, such as unemployment, food deserts, and access to health care. Historically, there hasn’t been the accessibility to health care on the south and west sides that we’ve had on the north side and downtown.”

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For people who identify as nonbinary, trans, gender nonconforming, or LGBTQ+, regardless of where they live, there is no specific COVID-19 data available from the city or state. This reflects a sad fact: little has been done regarding research that connects LGBTQ+ individuals—including those of color—and the effect of the coronavirus pandemic.

Arwady said numbers related to sexual orientation and gender identity “are not in our high-level dashboard reporting because that’s how we get data back that’s reported from laboratories. We’ve done a follow-up and more specific interviewing in which we ask that data”—information that’s available via special requests. 

Prachand echoed what Arwady said, initially e-mailing that “other than HIV, disease surveillance systems do not typically collect data on sexual orientation or gender identity.” In a followup conversation, he added, “We don’t like to speculate on data we don’t have. Disease surveillance systems [involve] a national system called INET that’s set up by the CDC [Centers for Disease Control]. So those numbers that populate that system come from laboratories, testing facilities, doctors—anyone who’s performing tests or making diagnoses. 

“Unfortunately, we don’t require sexual orientation or gender identity to be collected as part of a routine for diagnostic testing. HIV is different: It’s a separate surveillance system set up by the CDC and adapted by different states. That has its own case-reporting form. But for other diseases—hepatitis, tuberculosis, flu—we don’t receive that information. 

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“I don’t know if other jurisdictions are talking about the effect of COVID on LGBTQ individuals—and, locally, I don’t think there’s been any reporting of that.

“I do know that [LGBTQ people] are being affected,” King said. “But is there any data I can point to? No. But as LGBTQ liaison, I am the first point of contact for many agencies. [The pandemic] is affecting the LGBTQ+ community very greatly.”

King went on to provide examples, saying that isolation is a major factor: “When you’re talking about people who are living in settings such as shelters, LGBTQ people—and, certainly, trans kids—can’t just go to any shelter, as they’re not all welcoming. So how are you supposed to quarantine if you’re homeless?

“We have individuals who are HIV-impacted and -affected. We’re talking about individuals who are used to having community and support systems—mentally and emotionally. When there are stay-at-home orders, that could be a trigger because you’re dealing with isolation all over again. COVID-19 is keeping them away from their support systems, on so many levels.

“And when you’re dealing with our TGNC sisters and brothers, we’re talking about people who may also be in domestic-violence situations where they can’t leave the home, especially if they’re living with someone who’s a breadwinner or provider. [The pandemic] is affecting the LGBTQ+ community in very severe ways that our general health practitioners are not property observing.”  v

This coverage is made possible by support from the Chicago Foundation for Women

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