Introduction
Coronavirus disease (COVID-19) is currently defined as a paramount issue across the globe that immeasurably affects not only the sphere of health care but the majority of industries related to human activities. This severe acute respiratory syndrome was initially identified in Wuhan, China, at the end of 2019, and later it has spread almost all over the world and affected approximately 180 countries (Sanyaolu et al., 2020). According to the World Health Organization (2020), it “is transmitted between people through respiratory droplets and contact routes” (p. 1). In addition, the possibility of atypical modes of COVID-19 transmission, including vertical transmission through the placenta to the fetus, transmission via breast milk, transplantation-related transmission, blood-borne transmission, transmission through sexual contact, and orofecal transmission, currently attracts particular attention of public health specialists worldwide (Wiwanitkit, 2020). In general, COVID-19 infects humans regardless of their race, ethnicity, gender, and age at a highly disturbing rate despite actions taken by authorities and the development of vaccines.
All confirmed cases of coronavirus have a wide range of symptoms “from mild complaints, such as fever and cough, to more critical cases associated with difficulty in breathing” (Sanyaolu et al., 2020, p. 1070). The most common symptoms include cough, fever, chills, headache, shortness of breath, loss of taste and smell that cannot be clearly explained, muscle aches, sore throat, and diarrhea. In general, the disease’s clinical manifestations range from a common cold to pneumonia, multi-organ failure, bronchitis, severe acute respiratory distress syndrome, and other serious illnesses or even death (Sanyaolu et al., 2020). The general treatment of patients with coronavirus focuses on supportive care provision that includes ventilation, oxygenation, and fluid management (Cunningham et al., 2020). In critical cases, a combination of atomization inhalation of interferon and low-dose systematic corticosteroids and anti-virals has been encouraged as well (Cunningham et al., 2020). At the same time, knowledge related to COVID-19 is still considerably limited due to the occurrence of its new strains.
Impact of COVID-19 on Black People
At the same time, despite the fact that the virus has already affected people from all socioeconomic classes – from celebrities to service workers – the inequality of mortality and morbidity rates may be observed anyway. According to recent reports presented by public health researchers, Black people are affected by COVID-19 people at disproportionally high rates (Eligon et al., 2020). For example, although Black citizens are only 22% of the population of New York City, they constitute more than 28% of fatalities from coronavirus (Wingfield, 2020). A similar situation may be observed in other parts of the country – while in Chicago and the state of Louisiana Blacks are 30-32% of the population, they comprise 70% of those who were killed by COVD-19 (Wingfield, 2020). General inequities in the U.S. public health system and a lack of access to medical services for unemployed and low-income citizens that cause high mortality and morbidity rates, inability to work distantly during the pandemic, and the underrepresentation of Black health care specialists are among the main factors that determine this tendency.
Determinants of Health
In general, the health of either individuals or communities is determined by multiple factors combined. Moreover, as health is “a state of complete physical, mental, and social well-being and not merely an absence of disease and infirmity,” these factors should be considered for the improvement of people’s well-being and their health-related quality of life (Healthy People, 2020, para. 6). Thus, the determinants of health traditionally include:
- Individual’s social status and income (Higher social status and income are traditionally linked to considerably better health.);
- Physical environment (Such environmental elements as clean air, safe water, healthy workplaces, and comfortable houses, roads, and communities contribute to individuals’ good health.);
- Education and employment (Poor health, low self-confidence, and stress are frequently connected with low education levels.);
- Gender (Men and women are affected by different diseases, at different ages, and to different extents.);
- Genetics (Inheritance plays an essential role in determining healthiness, lifespan, and certain illnesses’ development.);
- Personal behavior (Individual eating habits, physical activity, alcohol consumption, smoking, and resilience affect health as well.);
- Age (Young people are generally less influenced by infectious diseases and come through them easier in comparison with seniors.);
- Culture (Heath is also affected by traditions, customs, and religious beliefs.);
- Social supports networks and health services (Support from communities, families, and friends, and free access to services that treat and prevent diseases have a substantial impact on health.).
Epidemiological Triad
In general, the epidemiological triad helps experts understand the disease’s spread through three main components – agent, host, and environment. In relation to COVID-19, the agent is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), “including the pathogenicity and virulence of various strains” (Tsui et al., 2020, p. 1). In turn, the host is an uninfected person with characteristics, such as age, gender, and comorbidities, that define individual susceptibility (Tsui et al., 2020). Finally, the environment is extrinsic factors that influence opportunities for exposure and the agent, including contaminated surfaces and droplets. The minimization of interactions between components leads to the reduction of the spread of coronavirus.
The disproportional rates of mortality and morbidity from COVID-19 among Black people are determined by such factors as social status, physical environment, employment, age, and health services that considerably influence the components of the host and the environment of the epidemiological triad. In other words, limited access to health care services for Black citizens because of their financial state leads to a greater risk of the development of various comorbidities, including hypertension, diabetes, and chronic respiratory diseases, in comparison with Whites (Wingfield, 2020). Moreover, Black people hold “a disproportionate share of retail, municipal, first responder and other jobs that interact directly with the public and have been deemed essential throughout the pandemic” (Higgins-Dunn et al., 2020, para. 25). In addition, older people regardless of their race and ethnicity are more vulnerable to coronavirus compared with a younger population. Thus, multiple comorbidities resulted in social status and limited access to health care and the inability to work distantly determine disproportional rates related to COVID-19 among Black, especially senior, citizens.
Role of Nurse Practitioners
That nurse practitioners have already faced multiple challenges related to the spread of coronavirus. In general, they currently help with numerous psychological and physical issues caused by this disease. A considerable number of patients stay in hospitals receiving appropriate treatment and care. At the same time, a lot of people need psychological assistance as they have lost their family members and friends. In addition, they are still responsible for high-quality health care delivery in the context of the pandemic for patients who are not affected by COVID-19. Moreover, nurse practitioners should regularly review all updates on the virus to help people in a time-sensitive manner as guidelines are rapidly changing.
In turn, health care providers participate in research based on their evidence-based practice to improve coronavirus management. For instance, the American Association of Nurse Practitioners (2020) has conducted two surveys related to the role of nurses in the context of the pandemic. The goal of these surveys was to gather information and evidence from nurse practitioners based on their experience in the treatment of patients in their communities in evolving health care environments.
References
American Association of Nurse Practitioners. (2020). Infectious disease: AANP resources by therapeutic area. Coronavirus disease 2019 (COVID-19) update. Web.
Cunningham A. C., Goh, H. P., & Koh, D. (2020). Treatment of COVID-19: Old tricks for new challenges. Clinical Care, 24(91), 1-2. Web.
Eligon, J., Burch, A. D. S., Searcey, D., & Oppel Jr., R. A. (2020). Black Americans face alarming rates of coronavirus infection in some states. The New York Times. Web.
Healthy People. (2020). Health-related quality of life & well-being. Web.
Higgins-Dunn, N., Feuer, W., Lovelace Jr., B., & Kim. J. (2020) Coronavirus pandemic and George Floyd protests highlight health disparities for Black people. CNBC. Web.
Sanyaolu, A., Okorie, C., Marinkovic, A., Patidar, R., Younis, K., Desai, P., Hosein, Z., Padda, I., Mangat, J., & Altaf, M. (2020). Comorbidity and its impact on patients with COVID-19. SN Comprehensive Clinical Medicine, 2, 1069–1076. Web.
Tsui, B. C. H., Deng, A., & Pan, S. (2020). Coronavirus disease 2019: Epidemiological factors during aerosol-generating medical procedures. Anesthesia & Analgesia, 131(3), 1-3. Web.
Wingfield, A. H. (2020). The Disproportionate impact of Covid-19 on Black health care workers in the U.S. Harvard Business Review. Web.
Wiwanitkit, V. (2020). Atypical modes of COVID-19 transmission: How likely are they? Epidemiology and Health, 42, 1-4. Web.