by Edwin Quinabo
Prior to the outbreak of COVID-19, statistics that measure well-being haven’t been flattering to Hawaii’s Filipino community. In some areas like higher education, Filipinos trail behind Caucasians and Japanese in advanced degrees. In health, Filipinos have some of the highest rates of chronic illnesses.
Following this pattern, it doesn’t stretch the imagination that their stats relating to COVID-19 are bleak relative to other ethnic groups.
What are the hard stats? Hawaii’s Filipinos are second in COVID-19 cases in the state and first in COVID-19 related deaths, according to the State of Hawaii Department of Health (DOH).
Breaking down the numbers
Overall Stats. Since the start of the pandemic, there have been 757 deaths in the state. Filipinos account for 174 or 23% of deaths, placing them at the top, the DOH’s online tracking site shows.
To date, there have been 78,404 cumulative cases of COVID-19 in Hawaii. Of the total, Filipinos make up 20% of cases, behind Native Hawaiians at 24%.
Pre-Vaccine Period. During the Pre-Vaccine Period between March 8, 2020 through Dec. 26, 2020, DOH reported 15,422 cases of COVID-19. Of that total during this period, 3,084 or 20% of Hawaii Filipino residents contracted COVID-19, placing this group only after Pacific Islander at 25%. Behind Filipinos are Native Hawaiians at 19%, Whites at 16%, Japanese at 7%, Chinese at 2%, and the rest fall into the others category.
Post-Vaccine Period. Since the vaccines were rolled out on Dec. 27, 2020 up to Sept. 20, 2021 (the Post-Vaccine Period) Filipinos remain the second highest ethnic group infected by COVID-19 at 19%.
Researchers from DOH and the University of Hawaii authored a report “Addressing Health Equity in Diverse Populations”that was published in March 2021 in the CDC’s Morbidity and Mortality Weekly Report. In it, Hawaii researchers crunched the numbers in Hawaii’s Asian population into subgroups and found infection rates were highest among the Filipino and Vietnamese populations.
At this stage of the pandemic, the hope is for Hawaii’s Filipino community to change course and get vaccinated en masse. A vaccination campaign has been ramped up by community leaders and grassroots organizations to achieve this goal.
Bereaved wish they had vaccines available earlier – vaccines that others take for granted
“If only the COVID-19 vaccination were available sooner” – this is the sentiment millions of family members and friends who had someone they love die before vaccines were rolled out and administered. The U.S. Food and Drug Administration approved the first COVID-19 vaccine (Pfizer-BioNTech COVID-19 vaccine) on Dec. 11, 2020.
The idea that vaccines are available, but people are still not getting it knowing the risk and that millions of Americans have already died from COVID-19, leaves some bereaved families of COVID-19 perplexed, even agitated.
“I always ask myself what if my aunt Andrea and her husband Pio did not contract COVID-19 that early and had the luxury of getting fully vaccinated. I would still be able to talk story with them and enjoy their company,” said Dr. Jon Avery Go, an internist practicing in Waipahu, Hawaii.
Dr. Go elaborates, “My dear aunt worked as a nurse. She and her husband both were living in New York and caught COVID 19 around March 2020. This was the time when New York became the world’s epicenter of COVID-19. Unfortunately, there were no known effective treatment regimen around that time and they both had to suffer and endure being hooked up to a breathing machine. Eventually, their bodies could not fight anymore and they both passed away.”
In this latest surge, the unvaccinated population make up a large majority of Covid infected and hospitalized not just in Hawaii, but globally.
Get vaccinated and save lives
“I just don’t get it,” said Rey Clemente, 57, a hotel worker who said he got vaccinated in late April, 2021. Vaccination to every adult in Hawaii became available on April 19 this year.
“I was out of work for months last year like most hotel workers. I was eager to get vaccinated so that our industry could reopen and I could start to work again,” said Clemente. “I got vaccinated not only for my family and myself, but for our community. We all want to get back to our normal lives. We should also be thinking about saving lives.”
Possible Reasons for high COVID-19 cases among Filipinos
There are several reasons floated as to why Filipinos are hard hit by Covid — the type of work they do (service oriented) and multigenerational living are the most common.
Work Environment. Lt. Gov. Josh Green, who is also an Emergency Room Physician, told the Filipino Chronicle, “The Filipino community is one of the very hardest working communities in our state, however during a pandemic this work can come with risk. Jobs like being a caregiver, a doctor, running a care home or working in a hotel (some examples of prominent jobs in the community) means a lot of close contact with people and therefore more chances to catch COVID. I’m proud of the hard-working Filipino community.”
Like Lt. Gov. Green, Dr. Lyla Prather of the Philippine Medical Association of Hawaii told KITV 4 in Aug. 2020 that Filipinos’ work environment – including healthcare, the service industry and other frontline working jobs – is fueling higher infection rates in Filipinos.
Clemente makes the point that most hotel workers were furloughed or laid off last year, “but there are many Filipinos who were essential workers back then, like our grocery store employees, dock workers, truck drivers, delivery drivers, healthcare workers.”
He said, we should be thankful for what Filipinos did during the pre-vaccination period. “They sacrificed and risked their health so that our state could keep running.”
Multigenerational living. Due to the high cost of living, rent, and real estate, multigenerational living is common among all ethnic groups in Hawaii. It is a contributing factor to Filipinos high infection rate, health experts say. Lt. Gov. Green said, “Filipino families often live with three generations under the same roof, so with unvaccinated children returning homes from school there is added risk of spread. Kupuna who catch COVID are at the greatest risk so they must get vaccinated to avoid the delta variant.”
Public health specialists say multigenerational infections are far more common with the Delta variant than the original virus. They say they’re seeing two or more members within a household, or the entire household getting infected in this latest surge.
Dr. Go, who also believes multigenerational living spikes COVID-19 in Filipinos said, “If one family member contracts Covid19 then the whole household are vulnerable due to their living situation.”
Less Access. Lt. Gov. Green points out that there are less healthcare services in several rural parts of Hawaii like Ewa on Oahu or Ka’u on Big Island. ”These areas are often home to our Filipino families and therefore it’s harder to get care sometimes. Our community health centers have stepped up to help though.”
Not due to risky behavior. Dr. Prather doesn’t believe Filipinos are at higher risk due to a lack of practicing prevention like social distancing or wearing a mask. “We’re always really diligent about wearing our masks.”
Survey: Filipinos are last among vaccinated in Hawaii
The DOH tracking website as of Sept. 27, 2021 shows 67.2% of Hawaii residents are vaccinated.
A breakdown of vaccination in the state based on ethnicity is not available. But a DOH commissioned survey (not a comprehensive data-tracking) conducted by Anthology Research (among 482 adult Hawaii full-time residents statewide) from April 20, 2021 to May 3, 2021 found that among the major ethnic groups in the state, Japanese (71%) and Caucasian (68%) respondents were more likely to be fully vaccinated than were Native Hawaiians (49%) and Filipinos (40%).
Filipinos are more vulnerable because of preexisting conditions. Lt. Gov. Green, said “the high rate of hypertension, diabetes or kidney disease means that our Filipino brothers and sisters can get more sick if they contract COVID. This makes it even more important to get vaccinated if you or a family member has these health challenges.”
The DOH released two reports that illustrate how transmissible the Delta variant is and the importance of getting vaccinated. “These reports reinforce what we know about the alarming increase in cases across Hawaii. Delta is different— it is twice as transmissible as other variants,” said Health Director Dr. Elizabeth Char, FACEP. “COVID-19 vaccines are highly effective at preventing severe disease, hospitalization and death, including from the delta variant.”
Disinformation/misinformation. Dr. Go believes one reason Filipinos have low vaccination rates (based on the DOH-commissioned survey, not actual data), is untrue facts about COVID-19. “There are too many misinformation and fake news floating around both social media and the Filipino communities against getting vaccinated.”
Religious reason. Clemente said he doesn’t pay attention to the lies on social media. He says what he has noticed is “church people [mostly Evangelicals] on the mainland are resistant to getting vaccinated. I hope this is not the case here. I’m Catholic and I haven’t heard anyone telling me at church to not get vaccinated.”
One of the exemptions for not getting vaccinated recognized by the State and counties for their employees is religious exemption. But there is a strict procedure to qualify for that exemption.
Community efforts to increase vaccinations in Filipino community
Pop-up vaccination clinics. As part of the DOH’s goal to address health equity, it has been working with grassroots organizations to get more diverse populations vaccinated. DOH has worked with organizations like the Filipino Community Center. It has partnered with Kalihi-Palama Health Center, Kaiser Permanente and Project Vision Hawaii to organize pop-up vaccine clinics at the FilCom Center and other places like churches.
Filipino language as outreach strategy. Filipino community leaders say getting volunteers who speak Tagalog, Ilocano or Visayan helps not only to communicate the need for vaccination, but it also builds trust in Filipinos, especially among immigrants. That trust often can motivate someone skeptical of vaccines to get their shots, community volunteers say.
To bridge the language gap is why Emme Tomimbang with the support from The Queen’s Health System and AARP Hawaii, produced a Public Service Announcement (PSA) in three different dialects: Ilocano, Tagalog, and Visayan, which aired on State mainstream television and radio stations.
Clemente said any effort to get Filipinos or any Hawaii resident vaccinated is something he supports. He also believes Filipinos are getting vaccinated more than people think. “All of my Filipino coworkers, family and friends are vaccinated.”
Get the facts about vaccination out to community. Clemente said earlier in the year only one of his sisters and her husband were reluctant to get vaccinated because they have been hearing vaccinated people are getting infected and dying anyway. My sister said, “why risk getting some side-effect through vaccines when the outcome is the same.
“But by June, they [his sister and brother-in-law] changed their minds and got vaccinated. My sister said they decided to do it because of information they heard that ‘people who are vaccinated are less likely to develop severe symptoms that would require hospitalization, even if they become infected,’” said Clemente.
He believes the attitudes on vaccination among Filipinos has changed. “That survey was taken a long time ago earlier this year [May]. I think our vaccination percent is higher today. And it should continue to rise as more people in our state get vaccinated.” He said getting Filipinos the facts — like how his sister eventually came to understand — will help to encourage people to their vaccine shots.
“You hear people going to hospitals because they’ve caught COVID and were not vaccinated. I haven’t heard people rushing to hospitals because they had some severe reaction to a COVID vaccine,” said Clemente.
Filipino community leaders as pro-vaccination advocates. Dr. Green says Filipino physicians “are looked up to and may be the very best spokespeople for this mission [to get more Filipinos vaccinated].” He encourages Filipino community leaders to reach out to the vaccine resistant population.
To illustrate the urgency for vaccination and how the virus is taking a toll on hospitals, Dr. Green wanted to share a story with Filipino Chronicle readers. “One of my dearest friends is a Filipina nurse and when her husband had a large heart attack, we worked together to get him to Oahu to get cardiology care.
“Because the hospitals were so full he almost died before he could get life flighted to Oahu. Together we got him care, and he lived and also avoided catching COVID. This shows how much COVID can affect us all. I have, also am proud to report that all of my Filipina aunties (from my wife Jaime’s side), the Borromeo’s, are fully vaccinated and healthy,” said Green.
Latest update on vaccination
The Food and Drug Administration last week approved a third jab for those inoculated with the Pfizer-BioNTech vaccine for Americans 65 and older, as well as those with high-risk conditions or in workplaces with greater exposure risk.
DOH said those who match the federal guidelines requiring a third shot must schedule their booster at least six months after their second Pfizer shot.
Hawaii currently has about 90,000 doses of the Pfizer-BioNTech vaccine. Char advises people who have questions about vaccinations and booster shots should contact their personal physician. The state’s health department website also has information on booster shots.
by Edwin Quinabo