Dr. Rai says systemic racism a "public health crisis"
"Systemic racism has been a public health crisis for over 100 years if not longer." That's what Prevea Health President and CEO Dr. Ashok Rai said on Action 2 News This Morning as he discussed race and mental health and the COVID-19 crisis.
Dr. Rai says multiple traumas are playing out for the Black community due to the virus and the killing of George Floyd by a Minneapolis Police Officer.
Watch the videos for more on Dr. Rai's discussion on why change is needed in the health care system.
"Systemic racism has been a public health crisis for over 100 years if not longer. And what we've seen today, or in the last week, is one mental health crisis that has been ongoing for a very long time, and another mental health crisis layered upon that with stay at home orders through COVID-19, which were necessary but definitely created mental health strain. And then we have an acute situation, an exacerbation by people watching a murder over and over on TV. All of that added together is a real strain for any person's mental health--especially those who have been victims of racism over the years, and then have had to stay home and isolated due to COVID-19 and then watching what we had to watch on TV--all of that together has created needs throughout the society. And unfortunately, in health care, we have discrepancies. We've seen that in research over time on how different races have the opportunity to access health care. And one of the biggest discrepancies is how different people in different cultures and races and different socio-economic classes get to access mental health. And we have a lot of discrepancies we have to fix now," says Dr. Rai.
"There are a lot of activities that are happening right now that could make COVID-19 worse. When the state opened up--like other states opened up--other states had regulations, we didn't. So we've seen people with activities that have exposed themselves to a variety of situations where they're not masking and they're close together. At least when the protests have been happening and a lot of the messages going out to invite people to these gatherings have recommended social distancing, have recommended masking. Are we going to see more positive cases? We've said we will. We know COVID-19 has not left our community and it won't for a long time. And when we have activities, whether it be a demonstration or a little league game, we know there's a risk factor involved for more cases. And we'll see in the next 10-14 days how big of a factor that's been," says Dr. Rai.
"If you have any type of symptom--so if you've left that situation and you now have a fever, but you have a cough or a sore throat, headache, body aches, whatever it may be, you should be tested. And those opportunities exist in this community. And in a lot of cases there's no charge for that. So if you have any type of symptom you should be tested right away, and if you've been exposed to somebody who has COVID-19 and you know it, then you should be tested too. And all of those opportunities exist for you."
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"We've seen the statistics out of New York and Milwaukee, where there's a significant diversity of a population, that the Black community is affected more negatively by COVID-19 then other communities. A lot of that has to do with not who they are, but what they have access to. And how they don't have access to good health care in a lot of communities. Those discrepancies, that systemic racism that exists within health care itself have created an unfortunate situation for the Black community, on top of that with the mental health issues that are not being addressed. COVID-19 has definitely affected that community worse than other communities," says Dr. Rai.
"As we look forward, as we always should, we can't forget the wrongs of our past. But as we look forward, especially as a health care provider, we need to fix the discrepancies in how different people access health care. Everybody should be able to access it equally. And we really should focus on the mental health issues. If you're a young Black man in this world today, you've been exposed to a lot of mental trauma over the years. What you've had to see on TV. What you've had to hear said to your face. And the fear you live with. You compound that with all of the other discrepancies. In health care, we have an opportunity to change that. We have opportunity to create avenues for change--and more importantly avenues for people to get the right care. And hopefully we'll be able to do that in the coming days, years and decades to come.
"I think we have to break down the stigma in all society around accessing mental health. When you are somebody who is young and have these stresses--especially these mental health stresses--recognizing them and then being able to get help. There's a stigma around mental health. People feel that if you go to a mental health care provider it's a sign of weakness, or getting help is a sign of weakness. We need to get over that as a society. Whether it's the Black community, the Indian community, the Native American community or the White community, all have this bias that we need to get over. That's a good first step, and then making sure that they have access points for that care."
"It's important to understand what you're seeing when the state reports its results is actually when the result comes in. Not when the test was actually done. And because the results come different days. Some come in two days. Some take four days, depending on the lab it was sent to, maybe your distance from the lab, that it's not really a representation of how many people are being tested a day.
It's how many results we're getting back that day, so we expect to see some fluctuation in that and some discrepancy. And also the dates and times the testing centers are open so for example, it's not open on a Monday or they're not open on a saturday or have limited hours on a Saturday, your Monday numbers may be a little lower. Your Tuesday numbers may be a little lower. So there's a little discrepancy in there and that's why we look at things from a trend line standpoint. And it you look at the percentage of positive tests, depending on how many tests are done that day, it's still been a very good negative trend line here in the state of Wisconsin and in Brown County. And we expect to see a little ebb and flow. We'll have days where it's a little higher and we'll have days where it's a little lower. What we're really looking for is to make sure that trend line doesn't flip. In other words, it's going down right now. Does it go up in the wrong direction and if it's continuously going up. Those are the things we're watching for and that's why it's so important to continue the testing if you have symptoms."
"You know, we're really lucky that early on we planned for the surge and we planned for more bed, more ventilators and that planning has paid off," says Dr. Rai. "We were able to take care of all the patients as we saw that big outbreak here without having to go into what's called a crisis. Right now I'd say, you know, the last count and yesterday's count, probably around fifteen patients total among the health systems in town here and that number continuously has gone down. Especially the number of people on ventilators has gone down. I can speak to St. Mary's itself. We're down to two people on a ventilator right now. So they spent a long time in the hospital. We've had patients spend up to 20 days on a ventilator, but we're starting to see progress and people get better and people be discharged. It's just a really long stay, but we still have a good amount of capacity in this town."