Online Extra: LGBTQ Agenda: LGBT people may be at higher risk from COVID-19
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More than 100 organizations sent an open letter to medical groups and the news media stating that LGBT people are at greater risk from the novel coronavirus due to other social and medical issues that affect the LGBT community.
Scout, who goes by one name, is a bisexual and trans man who is the deputy director of the National LGBT Cancer Network. That organization took the initiative on drafting the letter, which was released March 11, and gathering co-signers.
Local organizations that signed the letter include Equality California, Horizons Foundation, National Center for Lesbian Rights, the San Francisco LGBT Community Center, and the Transgender Law Center.
The letter highlights three issues that may put LGBTs at greater risk during the COVID-19 epidemic: higher tobacco use than among the general population, higher rates of cancer and HIV-infection, and instances of discrimination on account of sexual orientation and gender identity (COVID-19 is the respiratory disease caused by the novel coronavirus.)
"We're really concerned because we know that whenever there's a health issue, the pre-loaded issues in our community create an issue for us," Scout, a Ph.D., said in a phone interview with the Bay Area Reporter March 16. "We have more social isolation, more smoking. But we know how to offset that. As coronavirus expands so fast, we wanted to let the public health community know we can take steps to avoid another health disparity."
Scout said that offsetting the effects of these risk factors involve keeping community organizations appraised of governmental decision-making.
"We have a lot of community organizations we trust and a lot of government entities we don't trust — for good reason," Scout said. "The first step is for community organizations to connect with public health channels to get communicated information out."
He said that it was very helpful that the New York State Lesbian, Gay, Bisexual and Transgender Health & Human Services Network had the chance to speak with Governor Andrew M. Cuomo (D).
"Someone asked 'where will we go to get tested without anti-trans discrimination?' And the governor was able to say 'the state is doing the testing and you know we have strong protections, so call me at this number if anyone experiences it,'" Scout said. "That's the kind of support we need."
Officials from the California LGBTQ Health and Human Services Network did not respond to a B.A.R. request for comment at press time.
The letter notes that COVID-19 is particularly harmful to smokers, and LGBTs have a 50% higher smoking rate than the general population, according to a 2017 study. LGBT seniors, like their heterosexual, cisgender counterparts, are at higher risk if they become infected with the novel coronavirus.
One of the goals of the letter is, as it states, "ensuring that media coverage notes the particular vulnerabilities of any person with pre-existing respiratory illnesses, compromised immune systems or who uses tobacco products. While populations — like LGBTQ+ communities — can be at increased risk, it is important to note the overall state of health that contributes to any person's increased vulnerability to contracting COVID-19."
Scout noted that trans people often face discrimination in social environments and medicine is no exception.
"We have a horrible history of access to care," he said. "There's not a trans person I know who has been openly welcomed in medical care throughout their whole life. Many of us are underemployed, making it harder to access health care."
Social distancing, which is being employed to deal with the crisis, may also have effects of its own.
"Other issues of comorbidity — suicide, depression — for all these reasons our lives are complicated with stigma and discrimination," Scout said.
But Scout is hopeful that from social distancing will emerge new ways for people to keep in touch.
"I think we're going to see new, really creative ideas on how to connect in the near future," Scout said. "But for now, every single person — especially those who struggle with depression — should remember how vital social connection is to our health.
"Use video chat, connect with a community center, connect online with people with shared hobbies. We have to find new ways to connect because that is more important to our health than any of us realize," he said.
HIV and coronavirus
As the B.A.R. previously reported, the amount that HIV-positive people are at a heightened risk of contracting or dying from COVID-19 depends on their level of immunosuppression.
"For an HIV patient who is on stable antiretroviral therapy and has a normal CD4 count, their risk may be slightly increased," Dr. Steve Pergam of the Vaccine and Infectious Disease Division at Fred Hutchinson Cancer Research Center wrote in an email to the B.A.R. last week. "HIV is a different disease than it was years ago. For people who have a reconstituted immune system because of treatment, I think the risk is not going to be tremendously different."
Scout said that people with HIV may also suffer from other factors in their lives.
"If you do not have your virus well-managed, get more motivation to get it well-managed," Scout said. "We don't know if people with an undetectable viral load have higher risk, but we obviously know there's too many people — we're not in a perfect world — with HIV and people with HIV sometimes have other factors in their lives, like addiction, poverty and racial discrimination.
"All of our lives are a complicated algebra equation," he added.
To avoid COVID-19, the San Francisco Department of Public Health is advising people to wash their hands with soap and water for at least 20 seconds, avoid touching their faces, cover their coughs and sneezes, try alternatives to the handshake, and stay home if they are sick.
It is not recommended people wear face masks if they are not sick. The greatest risk is from droplets containing the coronavirus on surfaces.
People over 60, those with chronic medical conditions, and those with weakened immune systems are at particular risk if they contract the coronavirus. According to the Centers for Disease Control and Prevention, symptoms of COVID-19 include a fever, cough, and shortness of breath. More serious cases result in pneumonia.
LGBTQ Agenda is an online column that appears weekly, usually on Tuesdays. Got a tip on queer news? Contact John Ferrannini at firstname.lastname@example.org