CORONAVIRUS INTERIMRACIAL EQUITY PLAN

July 2020

This document summarizes what the Philadelphia Department of PublicHealth (PDPH) knows about racial and ethnic inequities and COVID-19,and what we are doing and planning to reduce those disparities. It alsosummarizes our approach to addressing disparate impact of COVID-19

on other communities that have also suffered from historicdisinvestment and structural inequity including immigrants, people withdisabilities, people experiencing homelessness and housing insecurity,

and people with criminal justice system involvement.

Prepared by:

Philadelphia Department of Public Healthphila.gov/covid

CORONAVIRUS INTERIM RACIAL EQUITY PLAN

Disparities in outcomes from COVID-19 between racial and ethnic groups result from theaccumulated impact of centuries of systemic racism. To mitigate the impact of the pandemicon the city’s communities of color and to ensure that our response to this pandemic focuses

resources on those at highest risk, the Department of Public Health will work withcommunity stakeholders to:

EXECUTIVE SUMMARY

Improve access to COVID-19testing with a focus on accessfor communities of color, low-income neighborhoods, andpopulations that are high-risk:

Provide testing opportunities that donot require a car; partner with sitesthat already have trusted relationshipswithin communities of color. Current:56 testing sites; Goal: 75 sites.

Through an RFP process, PDPH iscollaborating with Federally QualifiedHealth Centers, the Black Doctors’Consortium, and other communitypartners to expand testing.

Collect and publicize data onthe impact of the pandemicon racial and ethnic groups

PDPH will post COVID-19 data daily byrace, ethnicity and age onPhila.gov/COVID.

Conduct community outreach

PDPH has created plain languagematerials and simple infographics inmultiple languages and is working withcommunity partners to shareinformation broadly with communitieswho otherwise may not receive theinformation.

Prevent chronic healthconditions that increase therisk of severe COVID-19infection and disparatelyimpact communities of color

PDPH will monitor progress via datafrom partners at area FQHCs andhospital-based practices and from aquarterly online survey of a randomsample of Philadelphians.

Protect essential workerswho are disproportionatelypeople of color

We have created simple infographicson required protections for workersand disseminated them via fooddistribution boxes, communitypartners, and to businesses.

Environmental Health Services andLicenses and Inspections will respondto complaints, educate employers, andticket persistent violators.

Reduce community spread,with a focus on communities ofcolor who are at highest risk

PDPH will disseminate messages aroundmasking, distancing, and essential workerprotections via mass media, communitypartnerships, and community meetings.

PDPH has put out an RFP to offer supportincluding temporary housing to non-homeless individuals who have COVID-19infection and cannot safely isolate at home.

 

Minimize spread in congregatesettings, which have seendisproportionate numbers ofinfections and deaths

PDPH is working with congregate settingsto ensure that infection controlrecommendations are being followed andto provide technical assistance.

PDPH is working with the Office ofEmergency Management to providepersonal protective equipment (PPE) tostaff and residents in congregate caresettings.

The City has created multiple sites tohouse homeless city residents with COVID-19 or possible COVID-19, as well as a site tohouse homeless individuals at high risk.Conduct contact tracing

PDPH will complete the recruitment ofa diverse contact tracing team thatrepresents the people who they will beserving. A public-facing dashboard isavailable here.

As of 7/3/20, of 114 people hired tostaff the new division, 52% are Black,28% are White, 6% are Latino, and 9%are Asian. Of 14 managers in this newdivision, 43% are Black and 7% areLatino.

CORONAVIRUS INTERIM RACIAL EQUITY PLAN

This plan is divided into our areas of greatestconcern:

Current data from Philadelphia and otherlarge cities reveal inequities in the impact ofthe novel Coronavirus (COVID-19) pandemicby race and ethnicity. Overall death rates forAfrican Americans in Philadelphia are 50%higher than those for Whites, andHispanics/Latinos/Latinx people over age 75have the highest death rates per 10,000population in the city. The inequities are theresults of differential exposure andsusceptibility to the virus that result fromcenturies of systemic racism. COVID-19 willlikely remain a threat to Philadelphians formonths, if not years, but there are actionswe can take to protect those at highest riskfrom this virus and to mitigate the disparateimpact of the pandemic on groups that haveexperienced historical and present dayracism.

This document summarizes what thePhiladelphia Department of Public Health(PDPH) knows about racial and ethnicinequities and COVID-19, and what we aredoing and planning to reduce thosedisparities. It also summarizes our approachto addressing disparate impact of COVID-19on other communities that have alsosuffered from historic disinvestment andstructural inequity including immigrants,people with disabilities, people experiencinghomelessness and housing insecurity, andpeople with criminal justice systeminvolvement.  This document focuses on the public’s healthand health inequities. The plan is intendedas a complement to the plans from theOffice of the Mayor and the Office ofDiversity, Equity and Inclusion.

ACCESS TOCOVID-19TESTING

SURVEILLANCEDATA

COMMUNITYOUTREACH

CHRONICHEALTHCONDITIONS

PROTECTINGESSENTIALWORKERS

COMMUNITYSPREAD

SPREAD INCONGREGATESETTINGS

CASE INVESTIGATIONAND CONTACTTRACING

INTRODUCTION

Coronavirus Interim Race Equity Plan Page 4

Racial inequities are not new with COVID-19.Prior to the COVID-19 pandemic,Philadelphia had been making progress atdecreasing disparities in life expectancy,chronic conditions and smoking by race,although there is much more work to do.Now, we need to ensure that the pandemicdoes not worsen existing inequities. Weknow that Black and Hispanic/Latino/Latinxcity residents are more likely to live at orbelow the poverty level, likely causing themto live in more crowded conditions and to beless likely to be able to work remotely. Theyare also disproportionately likely to live forperiods of time in congregate settings suchas jails, residential treatment programs, andemergency shelters due to the persistentlegacy of racism. Finally, we know that thesegroups have high rates of chronic conditionsincluding diabetes, heart and lung diseasethat put them at greater risk ofcomplications and death from COVID-19 andthat they are less likely to have healthinsurance. And discrimination and languagebarriers within the health care sector createadditional barriers to timely testing andquality treatment. These factors,intergenerational poverty, high rates ofchronic conditions, and unequal access tohealth care, are the result of structuralinequality, structural racism, andxenophobia that date back for generations.Information from a survey of city residents indicates there are differences by race inadoption of social distancing practices.However, these differences disappear whenwe control for poverty, so may result fromdifficulty adopting these behaviors due tolack of remote work options and/or crowdedhousing.

Because of this, while we believe it is criticalthat we reach every Philadelphian with up todate information about how to preventinfection, information alone is unlikely to beenough to decrease disparities. ThePhiladelphia Department of Public Healthhas developed this Racial Equity Plan toimplement more targeted and intentionalstrategies to prevent further disparities inoutcomes from the COVID-19 pandemic.

Further, we understand that there are waysin which the response to the first phase ofthe pandemic likely exacerbated disparities,for example through lack of access to testingfor those who lack cars or primary careproviders for the first several months of thepandemic response. We believe thatrecognizing and naming these areas isimportant, and that we need to ensure thatwe take a racial equity lens to the responsegoing forward to avoid further exacerbatingdisparities and to help build trust withcommunities most impacted by COVID-19.

We need to ensure that

we take a racial equity

lens to the response going

forward to avoid further

exacerbating disparities

and to help build trust

with communities...

Coronavirus Interim Race Equity Plan Page 5

COVID-19 spreads when people who are infected interact with others in homes, workplaces,houses of worship, or social spaces. Many people with COVID-19 have mild symptoms or nosymptoms at all, and people may be infectious for several days before they realize they are ill. Widespread testing is one important way to track the spread of COVID-19 and prevent moreinfections. Public health experts recommend widescale testing to control COVID-19 and to allowfor the eventual reopening of businesses, communities, and services. COVID-19 testing should beimplemented in a way that assures equitable access for people who are at risk of COVID-19infection, particularly those at highest risk, and should be available to people of all income levelsand in every neighborhood across Philadelphia.

ACCESS TO COVID-19 TESTING

We have observed differences in infectionrates by race and neighborhood, with data[1]  showing that Black and Hispanic/Latino/Latinx residents are experiencing higherlevels of disease, greater rates ofhospitalization and ICU admission, andhigher death rates than White residents.Testing can help address these disparities byidentifying people who may not know theyare positive, who need to isolate and whosecontacts need to quarantine at home. Earlyon, in part due to test shortages and theiravailability through a federal program withprotocols that limited access to those invehicles, testing access was limited for thosewithout cars or primary care providers, likelyleading to disparities in testing. Test accesshas improved, but the initial disparities intest access led to loss of trust in the PDPHresponse in the early phases of thepandemic and that trust urgently needs to beregained. We acknowledge that thosedisparities in access took place against thehistorical background of a healthcare systemthat has systematically discriminated against

Disparities in our communities African Americans and Latinos and will havebeen experienced by those communities inthat light. Through well-designed, intentionalefforts to protect communities of color andtargeting of resources to these communities,we can begin the process of building trust.We need to increase testing availability incommunities of color, including providingtesting opportunities that do not requirea car and using sites that already havetrusted relationships within communitiesof color.

What we are doing

PDPH operates a network of eight City healthcenters throughout Philadelphia. Thenetwork provides medical and dentalservices to over 70,000 low-income anduninsured Philadelphians each year. In a citythat is 65 percent people of color, the City’shealth centers serve a population that is 94percent people of color. Philadelphia’s Cityhealth centers serve a patient populationthat is 76 percent Black or African American,almost double Philadelphia’s overall Black orAfrican American population. They provide

Coronavirus Interim Race Equity Plan Page 6

[1] Self-reported survey data from 510 adult residents of Philadelphia were collected using a commercial online survey samplingservice from April 1st – April 6th, 2020. Respondents were demographically similar to Philadelphians based on age, sex, and race.

care, including COVID-19 testing, regardlessof insurance or immigration status and offerin-person and telephone interpretationservices to patients of limited Englishproficiency.

To further expand testing, PDPH has addedadditional testing capacity at city healthcenters and formed collaborations withPhiladelphia’s strong network of FederallyQualified Health Centers (FQHCs), which alsohave trusted relationships with Black andLatinx communities in the city and arelocated in easily accessible locations inneighborhoods across the city. PDPH isproviding test kits and personal protectiveequipment (PPE) to enable the FQHCs toexpand testing and make it publiclyavailable in the low-income communitiesand communities of color that they serve.

City Health Centers and FQHCs areaccessible by public transportation and bythose with mobility impairments, and do notrequire drive-through testing. These sites

offer COVID-19 testing for low-income anduninsured Philadelphians, regardless ofability to pay. A total of 56 sites acrossPhiladelphia are now offering COVID-19testing and a map of these locations is nowavailable at www.phila.gov/testing.

Data on race and ethnicity is critical to trackdisparities in COVID-19 testing and infectionrates. However, this information is usuallynot noted on laboratory slips, creatingdifficulties in tracking testing by race andethnicity that our epidemiologists areworking to solve. PDPH is working to matchexisting test results with other data sourcesto increase the proportion of those tested forwhom we have data on race and ethnicity. Ofthe 74 percent of people tested so far forwhom we currently have information on raceand ethnicity, 54 percent of people testedwere African American, 27 percent werewhite, and 9 percent were Hispanic,suggesting that African-Americans haveactually been tested more than whites so farin the epidemic.

Coronavirus Interim Race Equity Plan Page 7

Data from https://www.phila.gov/programs/coronavirus-disease-2019-covid-19/testing-and-data/ July 23, 2020

PDPH has also put out a Request forProposals, with applications accepted on arolling basis, for funding for communitygroups able to further expand access totesting to populations that might not useother testing sites. Groups funded so farthrough this effort include the Black Doctors’COVID-19 Consortium, Esperanza, andPuentes de Salud, among others.  National shortages of testing supplies anddelays in results from large nationalcommercial laboratories persist, making themuch-needed expansion of testingchallenging. PDPH is talking with smallerregional laboratories to explore strategies toresolve these problems.

and by public transportation in every cityneighborhood and to make mobile testingavailable, particularly in those neighborhoodswhere car access is lowest (e.g. NorthPhiladelphia). We are also updating theinformation on our testing site to includeinformation about whether appointments orphysician referrals are required or not andany restrictions on who can be tested at thesite (e.g. children, people without symptoms).  This network of testing sites could serve aspotential partners for vaccine distribution,once a vaccine is ready. To ensure thatvaccine reaches the city residents most at riskfrom COVID-19, we will need a diverse set ofpartners, trusted by the community, who areable to reach Philadelphians regardless ofwhere they live, what language they speak,whether or not they have cars or healthinsurance, and regardless of immigrationstatus.

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What we plan to do

PDPH is focusing on assuring broadaccess to COVID-19 testing with a focuson access for communities of color, low-income neighborhoods, and populationsthat are high-risk because of underlyingmedical conditions. We will expand COVID-19 testing capacity citywide throughagreements with additional partners(including FQHCs as well as otherorganizations) that agree to provide testingopen to all residents in their communities,with a particular focus on communities ofcolor and those who are high risk and thosewho would otherwise have difficulty gettingtested. We are working to identify additionaltesting supplies and laboratories that canperform tests within 24 hours, allowing forthe rapid identification of cases that will benecessary for contact tracing. 56 testingsites now provide COVID-19 across the city(see phila.gov/testing). Our goal is toexpand this to 75 sites, with access on foot

TRACKING RACIAL AND ETHNIC DISPARITIES VIA PUBLICLYAVAILABLE DATA

Philadelphia’s data reveal disparities inknown cases, hospitalizations, and deaths byrace. As of June 27th, Black city residentsmake up 46 percent of cases, while White cityresidents make up only 16 percent, analmost three-fold difference (race isunknown for 20 percent of cases). Themortality rate among Black residents in thecity is 12.0 per 10,000 residents, compared to7.9 per 10,000 for White city residents and5.6 per 10,000 for Latinx residents. However,when we look at mortality by age group, wesee that Latinx city residents over age 75have the highest death rates in the city (125deaths per 10,000 residents) followed closelyby African Americans over age 75 (110deaths per 10,000 residents). Young agegroups have much lower death rates, butdisparities among African American andLatinx city residents remain marked. [2] Ofnote, although more than half of deaths dueto COVID-19 in Philadelphia have occurredamong residents of long-term care facilities(LTCF), these deaths are much more evenlydivided between Black residents (24 percentof deaths in LTCF) and White residents (25percent of deaths in LTCF).

Disparities in our communities

PDPH collects data on COVID-19 cases inPhiladelphia to track disease activity, identifydisease clusters and identify potential factorsassociated with disease risk to help guideprevention efforts. These data are central toour ability to identify and better understanddisparities in COVID-19 risk and severity. In

What we are doing

addition to daily counts for new positivetests, hospitalizations, and deaths, PDPH alsotracks data on race and ethnicity for peoplediagnosed with COVID-19 and deaths fromthe infection. PDPH data analyses alsoinclude information on cases mapped by zipcode for the city.  A stratified analysis by agegroup demonstrates that risk of infectionamong Hispanic/Latino/Latinx Philadelphiansis approximately as high as that for BlackPhiladelphians. PDPH uses this data to driveresources including testing and communityoutreach to those populations at highest risk.

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[2] See https://www.phila.gov/programs/coronavirus-disease-2019-covid-19/testing-and-data/.

What we plan to do

Initially large numbers of cases had missingdata on race and ethnicity. However, PDPHis working to match data with existingdatabases and working with partners acrossthe city to improve collection of this criticalinformation. We will work to improve thequality and completeness of the data wecollect and make public, and to include age-stratified analyses to ensure that data forHispanic/Latino/Latinx city residents, whoare on average younger than other groups inthe city, does not obscure the disparities thisgroup is experiencing. We will also deepen our analyses of thesocial determinants that contribute todisparities in outcomes in partnership withlocal researchers. Such analyses could serveas the springboard to future policy solutionsthat could help to mitigate risk for thosemost impacted by the virus.

Community engagement is a critical component of our COVID-19 response. We need to ensurethat information about virus transmission and prevention reaches all city residents regardless ofeducational level or language spoken. We also need to learn from community partners whatstrategies are likely to be most effective in protecting city residents at highest risk, includingcommunications strategies, policy and systems changes that can help to decrease transmission.

COMMUNITY OUTREACH

We have heard from community partners thatthere is a need for plain language materials andgraphics and materials in multiple languages tohelp promote social distancing, safe mask use,and other critical prevention concepts.Xenophobia and fears of deportation may limitthe willingness of immigrant groups to get testedand to report symptoms.

Disparities in our communities promoting the messages developed through theproject and others developed with partners acrossthe city on social media.

We have developed an extensive library ofguidance documents including translations intomultiple languages available here. We arecollaborating with colleagues at the University ofPennsylvania, Drexel University, and elsewhere toturn some of our written guidance into graphicguidance and are working with in-house talent todevelop materials requested by community leadersfor use in community outreach efforts. 

And we are collecting data on mask use in a varietyof settings across the city to assess theeffectiveness of our outreach efforts and to ensurethat those efforts are reaching those at highest riskof infection.

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What we are doing

Our current community engagement workincludes initiating strategy meetings withcommunity groups and other stakeholders inhard-hit communities; supporting such groups intheir own COVID-related outreach and educationefforts (e.g., making PDPH health experts availablefor online town hall meetings); and partneringwith other City agencies (e.g., Office of Immigrantand Multi-Cultural Affairs, Philly Counts, Mayor’sOffice of Labor, etc.) to share health messagesthrough established networks and trustedmessengers. 

We are working to make messages visible inhomes and communities, regardless of whetherpeople have internet access. We sent amultilingual mass mailing to 670,000 residencesencouraging all city residents to sign up for theOffice of Emergency Management’s informationaltext messaging service by texting COVIDPHL to888-777. We are funding Mural Arts to place art(floor/ground decals and posters) that promotesphysical distancing in approximately 80 foodstores and other community locations,determined in part through community  demand.This work is supported through grant funds fromthe Partnership for Healthy Cities. We are also

What we plan to do

We have created a Racial Equity Response Teamcomprised of PDPH, other City governmentrepresentatives, healthcare providers, andcommunity stakeholders including faith leadersand other community leaders. This team hasreviewed our draft Racial Equity Response Plan andmade significant suggestions for its strengtheningand improvement. We plan to convene the groupmonthly throughout the remainder of thepandemic response period to assess progresstoward our goals and give input on any changesneeded. This group will also be invited to joincommunity conversations about COVID-19 todiscuss the PDPH COVID-19 Racial Equity Plan,listen to community concerns and help us bettercommunicate and build trust with communityleaders with a particular focus on those mostaffected by the pandemic.

People with chronic health conditions including diabetes, heart and lung conditions, and weakimmune systems are at higher risk of COVID-19 complications and death. Smoking and vapingput people at higher risk of health complications and death from COVID-19.

CHRONIC HEALTH CONDITIONS

Philadelphia has some of the highest rates ofchronic health conditions and smoking in thenation. Although the city has madesignificant progress in recent years,Philadelphia's rates of residents with chronichealth conditions remain high, and they aremuch higher among Black and Latinxresidents than White residents.  African Americans are disproportionatelyimpacted, with 17 percent living withdiabetes as compared with 12 percent ofLatinos and 10 percent of Whites. [3]Disparate chronic health conditions are theresult of historic disinvestment andstructural inequity. For example,communities of color experience morechallenges in accessing healthy food andgreater promotion of unhealthy foods andtobacco products, as well as more limitedaccess to safe spaces for physical activity.Underlying chronic health conditions anddisparate access to environments thatpromote health worsen COVID-19 healthinequities.

Disparities in our communities marketing of unhealthy food, and increaseopportunities for physical activity in the city.City nutrition guidelines and the Good Food,Healthy Hospitals project, among others,have helped to improve nutrition. Much workremains to be done.

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What we are doing

What we plan to do

As the COVID-19 pandemic continues, we willexplore new strategies in collaboration withcommunity partners for addressingprevention and control of chronic healthconditions, improving nutrition, decreasingsmoking rates, and increasing physicalactivity while maintaining social distancing,with a particular focus on communities ofcolor. We also will work with primary careproviders across the city to ensure thatpeople with chronic conditions are able tosafely obtain care for these conditions,ideally via telemedicine. We will monitorprogress via data on control of hypertensionand diabetes from partners at area FQHCsand hospital-based primary care practicesand through data on smoking from aquarterly online survey of a random sampleof Philadelphians. And we will use thisinformation to target future efforts toprevent and control chronic conditions with afocus on the communities at color most atrisk of these conditions.

[3] Health of the City 2019 Available at https://www.phila.gov/media/20191219114641/Health_of_City_2019-FINAL.pdf.

PDPH utilizes a policy, systems andenvironmental approach to reducing chronichealth conditions. Efforts over the pastdecade have helped to decrease smokingrates and have helped to increase theavailability of healthy food, reduce the

Essential workers are those whose jobs are required to continue even during Pennsylvania’s andPhiladelphia’s “stay at home” orders. Essential workers include Philadelphians working in grocerystores and public transit, at hospitals and health systems, and providing security and janitorialservices in buildings across Philadelphia.  Many essential workers are unable to maintain social distancing, to work from home, or to findreliable access to personal protective equipment. Essential workers including healthcare workershave seen higher COVID-19 infection rates. Measures are needed to ensure that these workers areprotected to avoid further exacerbating those disparities.

PROTECTING ESSENTIAL WORKERS

We know from national data that AfricanAmericans and Hispanics/Latinos/Latinx peopleare less likely than Whites to be able to workremotely and more likely to work in essentialindustries. These work conditions can increasetheir risk of getting COVID-19. Moreover, someworkers may not have paid sick leave and maycontinue working despite having symptoms.This means that the increased burden of riskand spread of COVID-19 for those who continueto go to work is disproportionately shoulderedby communities of color.

Disparities in our communities their rights. Workers are instructed to call 311to report violations and these complaints arereferred to Environmental Health Services,which investigates these reports, educatesemployers, and tickets when appropriate. Weare also broadly disseminating the “SafetyChecklist” of COVID-19 precautions forbusinesses, which includes information aboutthese required protections for workers.

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What we are doing

What we plan to do

We will disseminate information about thesenew required protections in easilyunderstandable formats to essential workersand hold conversations to address ongoingsafety concerns as businesses reopen. Withfeedback from stakeholders across the city, wehave developed guidance for a safereopening process so that essential workerswill be better protected as the city restartsbusiness activities. The Environmental HealthServices Division of the health department willrespond to complaints, educate employers, andticket persistent violators. Through the newDivision of COVID Containment, PDPH willconduct case investigation and contact tracing,including collecting information about theoccupation and work site of those who becomeinfected with COVID-19. This data will enable usto assess our progress in protecting essentialworkers and to take additional actions if we seecase clusters resulting from work exposures.

We have updated our guidance for essentialbusinesses to include the additional workerprotections from Secretary of Health RachelLevine’s order of 4/15/2020. Together with theMayor’s Office of Labor, we have alsodeveloped a simple infographic about thesenew required protections for workers includingrequirements to provide masks and barriers,ensure employees can maintain distance,cleaning requirements that follow CDCguidance, and closure and additional cleaningrequirements if there is a case of COVID-19. Wehave translated this information into multiplelanguages and are disseminating it broadly inthe city so that essential workers understand

COVID-19 spreads within households, between co-workers, and among people who come intoclose contact in the course of their daily lives. We know from national and internationalexperience that frontline workers are at particular risk and that members of low-incomecommunities living in crowded housing conditions are less likely to be able to safely isolate aCOVID-19 infected person at home without spread to other household members. Low-incomeworkers may not have paid sick leave and may avoid telling their employers that they are sick forfear of losing needed income. And PDPH case investigation and contact tracing efforts mayexacerbate fears of immigrant communities about potential deportation, resulting in potentialfailure to identify cases and contacts. Strategies to decrease the spread of COVID-19 infection inthese settings are urgently needed.

COMMUNITY SPREAD

Preliminary data on people who continue toget infected since the Stay at Home orderhas been in place suggest that many of thesepeople are healthcare workers and otherfrontline essential workers. Others wereexposed at home, through contact with ahousehold member with infection. Asdiscussed above, people of color aredisproportionately likely to live in crowdedhousing, to be essential or frontline workers,and to lack sick leave, all factors that elevatetheir risk of infection with COVID-19.

Disparities in our communities

PDPH will broaden the dissemination ofmessages around masking, social distancing,

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What we are doing

What we plan to do

and essential worker rights and protectionsvia a mass media campaign on masking, tobe released beginning in early July,distribution of guidance materials includingessential worker protections to businessesincluding simple language and a SafetyChecklist, and community discussions toanswer questions and promote safetymeasures.  PDPH has put out a Request for Proposalsfor community organizations able to offerneeded support (for example, food,medications, masks, other supplies, andtemporary housing if needed) to individualswho are isolating or quarantining at home.We recognize that for low-income individualsand families to follow public healthrecommendations about isolation andquarantine, such support is necessary.

In addition to the efforts to protect essentialworkers described above, we are working ona mass media campaign on the importanceof masking as a way that Philadelphians canprotect each other from infection.  We arealso partnering with Philly CountsCommunity Response Captains to trainthousands of Philadelphians to shareinformation with their communities abouthow to prevent infection.

COVID-19  spreads among people living in congregate settings like homeless shelters, prisons, andnursing homes. Strategies to decrease the spread of COVID-19 infection in these settings areurgently needed. In June 2020, 73 percent of people in Philadelphia jails were Black and 18percent were Hispanic/Latino/Latinx, while only 12 percent were White. Nationally, Black peopleare three times as likely as White people to experience homelessness. The spread of COVID-19 incongregate settings, particularly in jails and shelters, adds to the disproportionate burden onpeople of color.

SPREAD IN CONGREGATE SETTINGS

We are seeing cases of COVID-19 in long-term care facilities, prisons and shelters.More than half of deaths thus far have beenamong residents of long-term care facilities.  People of color are more likely to live incongregate settings like emergency shelters,jails, and residential treatment centers wheresocial distancing is difficult when notimpossible.

Disparities in our communities

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What we are doing

What we plan to do

Home health workers and nursing homestaff are among the essential workers whohave become infected with COVID-19. Thisputs them at risk themselves, particularlybecause many fall into high-risk groups, andit also puts them at risk of passing the virusto vulnerable patients and to their co-workers. Many of these workers lack paidsick time, which is likely a factor in continuedspread of the virus among this group. We areexploring strategies to ensure that allhealthcare workers in the city have paid sicktime, particularly those in these often low-paid, high risk positions.

PDPH is working with congregate settingsincluding prisons, nursing homes, personalcare homes and homeless shelters to ensurethat infection control recommendations arebeing followed and to provide technicalassistance where needed.

PDPH is working with the Office ofEmergency Management to provide personalprotective equipment (PPE) to staff andresidents in congregate care settings.

The City has created multiple sites to househomeless city residents with COVID-19 orpossible COVID-19, as well as a site to househomeless individuals at high risk (olderadults and those with chronic conditions).

“Once I discovered the contact tracing opportunity, I knew Ihad to be part of the team that will put an end to thepandemic. As an immigrant myself, I feel it is my duty totake care of Philadelphians from all walks of life and makesure they are provided with the right information so totake care of themselves and their loved ones." 

- Nikos Dimopoulos, Contact Tracing Coordinator

“The most important reason I joined the COVID-19Containment team was to do my part in ensuring thatcomprehensive messaging and support services areallocated to all Philadelphians, especially communities ofcolor. I remember one of my very first calls where I tookextra time answering a Contact’s questions. She was soappreciative that someone took time to connect with her,explain how she can protect herself and ways to preventthe spread of COVID-19 in her household. Moments likethese keep me motivated each and every day! As animmigrant and first-generation college graduate, Iunderstand how hard it is to navigate complex systems toget the are we ALL deserve.”  

 - Tolulope Oyetunde, Contact Tracing Coordinator

“I personally experienced the loss of my mother due to Covid-19. It is my hope that I can make an impactwithin our community and I want to ensure that those affected by the virus do not have to go throughwhat my family and I had to experience during this pandemic. This virus does not discriminate and thereare many families disproportionately affected by Covid-19, so doing my part in honor of my mother is mybiggest motivation. I am proud to work among a group of passionate and diverse individuals who aremaking a difference in the safety of our community.”

-      COVID-19 Case Investigation Team Member (Name withheld to protect privacy)

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Case investigation and contact tracing are key to an effective response to COVID-19. To succeed,we will need a diverse team who can communicate effectively with Philadelphians across the cityand build the trust needed for people to be willing to share information about their contacts,their work, and how they may have contracted and potentially spread the virus.

CASE INVESTIGATION AND CONTACT TRACING

PDPH has a diverse staff, but like many citydepartments, that diversity tends to bebetter represented among frontline staffthan among program managers andsupervisors. To design a program thateffectively reaches all communities, we willneed a diverse team whose skills includeknowledge obtained through livedexperience.

Disparities in our communities

PDPH will complete the hiring of a diversecontact tracing team that represents thepeople who they will be serving. A public-facing dashboard on the demographics ofthe case investigation and contact tracingteam is posted here.

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What we are doing

What we plan to do

Case investigators and contact tracers willconnect people with COVID-19 and thosewith potential exposures with neededservices including community supports (food,medication) and connection with theirprimary care providers. For those withoutprimary care providers, they will provideinformation about a variety of optionsincluding FQHCs in the city.

PDPH is using a health justice approach tohiring, sharing job descriptions throughgrassroots community partners and using arecruitment approach that values livedexperience and knowledge of Philadelphia’sdiverse communities along with otherqualifications. As of July 3, 2020, of 114people hired to staff the new division, 52percent are Black, 28 percent are White, 6percent are Latino, and 9 percent are Asian.Of 14 managers in this new division, 43percent are Black and 7 percent are Latino.

Once finalized, this document will be posted publicly and sharedwith PDPH staff.

We will hold a training on the plan co-led by members of theresponse team for PDPH staff working on the COVID-19 response.

We will incorporate the metrics on progress toward the objectivesin each section of this plan into the COVID-19 public dashboard.

Racial inequities in health do not spring from the novel coronavirus. They are the result oflongstanding, structural inequities that are present all around us: in housing, in work, ineducation, in health care, in our criminal justice system and in our environments. Rightnow, we need to do everything in our power to ensure that COVID-19 does not furtherexacerbate existing inequities. Going forward, PDPH – together with other City agencies,nonprofit and business partners, community and faith leaders, and people of conscienceacross Philadelphia – need to work to eliminate these inequities for future generations.

WHAT'S NEXT?

Next Steps:

Coronavirus Interim Race Equity Plan Page 17