Unusually high mortality rate emerged in San Francisco’s Asian COVID-19 cases, raising concerns
An unusual mortality rate showing Asian Americans accounted for half of the COVID-19 deaths in San Francisco has caught the attention of both the elected officials and medical professionals.
According to the data of San Francisco’s Department of Public Health(DPH), Asian American’s COVID-19 infected cases make up 13% of all cases in the city. However, on May 14, among the 35 deaths of the city’s residents, 17 of them, about 49%, are people with Asian descent. Three weeks ago, while San Francisco firstly disclosed the demographic data and the total deaths were 21 at that time, the percentage was similar.
For some other Bay Area counties with a significant Asian population, the percentages of Asian American COVID-19 death cases among all cases in San Mateo, Santa Clara, and Alameda are respectively 18%, 33%, and 18%. In New York City, the rate is lower than 10%.
The higher numbers in San Francisco stunned at least three Asian elected officials.
“This is shocking”, Supervisor Gordon Mar, a Chinese American serving on San Francisco’s local legislature, told the World Journal on April 23, “I am trying to get an explanation from our Health Officer”. Later, Supervisor Sandra Fewer and Norman Yee, another two Asian American elected lawmakers, joined the call for pushing DPH for an answer.
The World Journal also reached out for explanations but heard no reply.
Three supervisors “never received a response” from DPH about the disproportionate number of Asian COVID-19 deaths, according to Mar, until May 12.
DPH responses
On May 12, DPH Director Grant Colfax appeared at the Board of Supervisors meeting for a briefing and provided some initial reasoning and further data within the Asian death cases.
“The number of deaths among Asians is high, accounting for almost half of the deaths”, Colfax said and admitted there’s a “striking difference” between the rate of diagnosed cases and the deaths among Asians.
Digging deeper, Colfax presented the data that 90% of the deaths among Asians are people over 60-year-old, and more than 70% are among people above 80-year-old.
“It appears to be very much correlated with age”, Colfax said, and pointed out another potential factor that the deaths are likely to occur among residents who are in the long-term care facilities, which is a “high-risk setting”.
However, no thorough scientific investigation has been conducted, and the sample size of the deaths might hint to possible randomness.
“These numbers are small, so statistically it’s difficult to draw any firm conclusions here”, said Colfax.
San Francisco’s Health Officer, Dr. Tomas Aragon, also emphasized the unusual rate. “The Asian population is getting infected at a much lower rate”, Aragon said. “However, when they are infected, they are dying at a higher rate.”
Same to Colfax’s theory, he related the Asian deaths to the “much older age”, a generally older group of people, and the residency of senior care facilities. And he revealed that “a number that were also part of the cruise ship”.
UCSF Report
A team of medical professionals from the University of California, San Francisco(UCSF), whose members are all Asians, has issued a report offering some new insights on the COVID-19 Asian death rate.
Medical Doctor candidate Brandon Yan, Fiona Ng, and Professor Tung Nguyen from the Asian American Research Center on Health(ARCH) at UCSF are researching why Asian Americans have the highest proportion among all racial/ethnic groups in COVID-19 deaths.
In the report, lower rates of testing, disparities in access healthcare, and lower rates of English proficiency and income might all contribute to this trend.
“The findings are preliminary due to the small number of deaths and lack of age-adjusted data”, the report says, and advocate for the “better data collection and transparency, more research, and disaggregation of data by Asian national origin groups”.
Diana Lau, the Director of Asian Health Institute at UCSF, told the World Journal that she’s extremely alarmed by the data, and calls for more attention and investigation. “Behind the numbers, we need more research before making the conclusion”.
She also suggested DPH put out information about Asian cases by using a more detailed and diverse ethnic category, such as Chinese, Vietnamese, Korean, Filipino and Japanese, and investigate whether there are culture, language factors leading to the deaths.
The World Journal also learned that the team at UCSF has just assembled a “national team of researchers”, to gather data and investigate the fatality rate in the Asian population.
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A shorter Chinese language version of this story appeared on World Journal on May 15, 2020.