Our Global Voices Posts
My name is Edgar Monterroso. I’m a senior epidemiologist with CDC’s Center for Global Health and board member in CDC/ATSDR’s (Agency for Toxic Substances and Disease Registry) Latino/Hispanic Health Work Group. In the science community, we apply knowledge we’ve learned from past pandemics to current situations, just as we are doing with the current CDC COVID-19 response.
I’ve served for decades on CDC’s global health efforts, including as Country Advisor in Mexico in 1999, Central America Regional Program Director in Guatemala in 2003, and Country Director for CDC Mozambique in 2012 and CDC Cameroon in 2016.
My story is one of many and the work that my team and I conducted recently among the Hispanic/Latino (H/L) communities in Virginia had a clear mission: to help keep H/L communities safe.
In May 2020, there was a significant spike of COVID-19 cases among the H/L population in the Richmond, Virginia metro area of Chesterfield and Henrico counties. The Richmond City Health District contacted CDC and asked for help investigating this outbreak, which was quickly becoming a hot spot. Given my experience working with populations who are underrepresented, I was asked to organize and lead an emergency response team. We assembled the first ever CDC COVID-19 emergency response team made up of CDC H/L scientists and public health experts.
The First CDC COVID-19 Hispanic/Latino Emergency Response Team Deploys
Three important factors were critical for the success of our mission:
- Health districts’ positive reception to our multidisciplinary approach
- Health districts’ openness to consider non-agency support for community members disproportionately affected by COVID-19
- Bilingual and bicultural experienced team
The first request was specifically for an epidemiology team to investigate the outbreak. But they were open to our suggestion to expand the deployment to include bilingual/bicultural, multidisciplinary CDC experts that included physicians, epidemiologists, a behavioral scientist, a communication specialist, and a community engagement expert. Many members of our team also had global public health experience.
The team included H/L public health experts with over 100 years cumulative experience working with communities who are underrepresented in the United States and around the world. We analyze data through a cultural lens, understand health system barriers from an immigrant perspective, and engage with community members in their native language. Our team’s work experience and cultural composition allows us to have a multiprong approach to outbreaks.
As our team considered potential investigation strategies, we realized it was important to describe the COVID-19 outbreak, the H/L communities most impacted by the virus, and the community’s resources to manage COVID-19 complications.
From our global experience, we knew that starting our deployment with an all-encompassing listening session would be key to our success. Upon arrival, we held a listening session with the health district staff, followed by one with community members. These sessions allowed us to build trust and to bridge communities right away. The health district had an appreciation for our linguistically and culturally relevant CDC team. The community members and organizations saw us as part of their community.
Our efforts included engagement with community Spanish TV and radio outlets and local social media channels, such as Facebook, to amplify our messages. We created a sustained synergy and level of trust in CDC’s engagement by pulling diverse members of the community into the fold of our work. For many other entities, medical providers, community-based organizations, immigrants’ groups, and the Governor’s Office on Health, this situation provided the opportunity to come together on a unified response to COVID-19 in their community.
Finding Public Health Solutions Through Collaborative Work
Thanks to this support and interaction, we were able to identify factors that influenced the high rates of COVID-19 among the H/L communities. We recognized multiple social and health-related disparities among H/L communities, when compared to non-H/L communities. Examples included no access to social safety nets, lack of understanding of the health system, lack of health insurance, and language barriers. Food insecurity and fragile housing conditions were identified as key barriers. Many families could not access established assistance systems and social safety nets.
This awareness of the inequities impacting H/L communities allowed us to reach out to the CDC Foundation for support. The foundation and the health districts developed a plan of matching philanthropy funds with local resources that allowed H/L families to leverage food and housing assistance. This model, which we developed for Virginia, was applied to a H/L rural community affected by COVID-19 in Washington state with similar outcome and success.
I am deeply grateful to have participated in this deployment, as it gave me the opportunity to get to know and work with a phenomenal team of CDC H/L experts. It also allowed CDC to cooperate and support Virginia health districts’ leaders and colleagues. The health districts’ willingness to collaborate on this emergency was incredibly significant. I’m also grateful for our community partners, who trusted us, shared challenges, and together we were able to decrease the pandemic’s disproportionate impact on H/L families.
Certainly, recognition goes out to CDC’s COVID-19 State, Tribal, Local, and Territorial Task Force, for deploying the first bilingual/bicultural team in response to a H/L community outbreak. Finally, I am thankful for the hard work, sense of mission and commitment of my H/L CDC colleagues to reduce COVID-19’s impact in the communities we represent.
In public health, we are most effective when we come together as a community. This plays an important and relevant role in solving health-related issues here in our communities in the United States and around the world when we are called to help.
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