Risk of SARS-CoV-2 Higher Among Latinx, Mayan People

Latinx individuals were more likely to be infected with SARS-CoV-2 than non-Latinx individuals, and Mayan individuals had an even greater risk of infection, according to a recent study in Oakland, Calif.

The study, published in JAMA Network Open, involved 1186 participants, including 108 Mayan individuals 661 non-Mayan Latinx individuals and 417 non-Latinx individuals. They were tested for SARS-CoV-2 infection on Sept. 26 and 27 in the Fruitvale neighborhood of Oakland, which had the highest rates of infection Alameda County, Calif.

“The biggest takeaway from this research is the heightened level of risk for COVID-19 infection observed among Mayans,” corresponding author Paul Wesson, PhD, epidemiologist at the University of California, San Francisco told Contagion. “Among those who came to the Fruitvale COVID-19 testing event, Mayans were significantly more likely to test positive for recent infection (polymerase chain reaction, PCR) and a history of infection (serology), compared to non-Latinx testers.”

The study found that 8.8% of Mayan participants tested positive for SARS-CoV-2, compared with 4.5% of non-Mayan Latinx and 0.5% of non-Latinx participants. Positive serology tests were reported among 25% of Mayan participants, 10.1% of non-Mayan Latinx and 5.9% of non-Latinx participants.

“My colleagues and I were surprised to learn of the heterogeneity in risk and vulnerability within the Latinx community,” Wesson said. “While Latinx testers tended to be poorer and often essential workers, Mayans were more likely to report socioeconomic vulnerabilities that either increased their risk for COVID-19 or created barriers to accessing care. Our partnerships with local community-based organizations were essential to reaching the Mayan community for the testing event and to alerting us to the disparities in risk and infection that should be investigated in the survey.”

Among Mayan participants, 62.4% reported food insecurity, compared with 41.8% of non-Mayan Latinx participants and 35.1% of non-Latinx participants. The percentage of participants living in households with 5 or more people was 53.3% of Mayan participants, 32.6% of non-Mayan Latinx, and 14.8% of non-Latinx participants. Mayan participants also were more likely to lack health insurance – 38%, compared with 20.7% of non-Mayan Latinx and 7.8% of non-Latinx – and have low English proficiency – 58.3%, 46.2%, 18.8% respectively.

The authors noted a need for health policies and outreach that prioritize subgroups of people in increased risk of infection.

“Clinicians working with Latinx immigrant populations should recognize that indigenous people may be at higher risk for COVID-19,” Wesson said. “All Latinx patients who contract COVID-19 should be screened for food insecurity and other social/economic needs.”

Efforts are underway in the community to address the health disparities and reach individuals at higher risk during the pandemic.

“A collaboration of community-based organizations, known collectively as Resilient Fruitvale (led by the Unity Council, Giuliana Martinez), has referenced these findings in a community campaign to advocate for additional economic resources from the county to support the increased demand in services they are experiencing,” Wesson said. “Furthermore, we need to ensure that everyone has access to vaccination, including people who speak neither English nor Spanish and have no health care access. To this end, the Alameda County Public Health Department has been partnering with community organizations and clinics (such as La Clinica de La Raza) to offer interpretation in various Mayan languages at COVID vaccine sites.”

The study is consistent with previous research showing that Latinx populations are disproportionally affected by the pandemic, with higher rates of infection, morbidity and mortality.

A recent study that looked at health disparities in Denver and San Francisco found that many Latinx patients avoid or delay seeking medical care due to financial constraints, misinformation, and fears about immigration implications.

Last year, Latinx individuals were reported to account for 70% of all COVID-19 deaths among people aged 18 to 49 years in California, despite making up just 43% of that population.