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By Anne Blythe

It was the first Wednesday after Thanksgiving and Durham County’s COVID-19 cases were surging much more rapidly than Rodney Jenkins, the county health director, wanted to see.

Gov. Roy Cooper had tried to thwart large gatherings by limiting crowds to no more than 10 people, pleading with people to stay home, to forgo travel on a holiday weekend that in more typical years draws celebratory masses to airports, train stations and the nation’s highways.

Some heeded the governor’s counsel. Others ignored his missives as shown by subsequent records in the number of positive COVID cases.

Jenkins joined a Zoom call at noon that day with words of thanks for a group that has played a pivotal role in helping to get public health messages to a small, but exponentially important, segment of the Durham County community hit disproportionately hard by COVID-19.

“Late spring, early summer, our LatinX population was representing up to 78 percent of all of our active cases,” Jenkins told the Zoom call participants. “Seventy-eight percent. As it stands right now, although still over-represented, they represent 20.14 percent of all of our active cases. So again, to go from 78 to 20.14 is a Herculean effort and I just say, ‘Thank you. Thank you to you all. Thank you.’”

The group attracting the health director’s praise was formed by Viviana Martinez-Bianchi and Gabriela Maradiaga Panayotti, two Duke Health physicians who decided in early March to formalize an informal discussion that had been going on among the two women and several of their Latina colleagues since August 2019.

As the end of 2020 approaches, many have looked back on the work of the group as an unexpected gift during such a staggering year.

LATIN-19 is born

Maradiaga Panayotti, a Honduran who came to this country in the late 1990s to further her education, was deeply troubled by a mass shooting at a Walmart in El Paso, Texas in late 2019. A young white man from Dallas had driven some 600 miles across Texas and opened fire inside the store, targeting Hispanics, killing 23, injuring 22 others, according to law enforcement reports, and leaving a community, country and world jarred by the alleged motives.

That knotted her. She knew others from south of the U.S. border also had to be tied up inside, too and sought their friendship, support and counsel for how they could help LatinX patients who most likely were as appalled and troubled as they were.

At the beginning of the year, the Duke Health colleagues spoke mostly among themselves.

Doctors Gabriela Maradiaga Panayotti, left, and Viviana Martinez-Bianchi after getting their COVID-19 vaccines at Duke University Hospital on Dec. 15, 2020. Photo credit:Erin Hull/Duke Health

Then in early March, when North Carolina reported its first COVID-19 case, Maradiaga Panayotti, Martinez-Bianchi and others foresaw the importance of elevating the voices of communities of color during a global pandemic.

They came together officially as Latinx Advocacy Team and Interdisciplinary Network for COVID-19, or LATIN-19.

Not only has the group been meeting on Zoom weekly since March 18, they welcome others to listen, join in the discussion and share information about undersung health programs, new COVID-related apps and more.

They highlight longstanding and systemic health care access disparities that continue to plague this state and elsewhere.

Talking vaccines

Lately, they’ve been talking about the promise of COVID-19 vaccines and the challenges of getting them to LatinX residents while also tackling the thorny questions about their trustworthiness, effectiveness and the science behind them.

Maradiaga Panayotti and Martinez-Bianchi received the first dose of the Pfizer vaccine last week at Duke Health and shared photos and videos on social media and Univision to show their trust in and enthusiasm for the new weapons against the virus.

Jenkins has joined the LATIN-19 Zoom sessions more than once, even as workloads in his and other county health departments get more and more daunting because of COVID-19.

“It’s your advocacy. It’s your willingness to really get the word out that has helped us,” Jenkins said. “But make no mistake about it. We have work to do because our LatinX population in Durham represents 14 percent so for us to have 20 percent is decent at best. However, we want to get it below 14 percent and that lets us know that work continues to be done.”

LATIN-19 takes its focus and mission beyond Duke Health and Durham County. Martinez-Bianchi has spoken at statewide press briefings with Mandy Cohen, secretary of the state Department of Health and Human Services, and others who shape policies, regulations and crucial messages.

They get the word out in English and Spanish with interpreters and a Zoom call interpretation tool that makes it possible for listeners to choose whether to hear the conversation in English or Spanish.

Pediatrician Gabriela Maradiaga Panayotti gives a thumbs-up while getting a Pfizer COVID-19 vaccine at Duke University Hospital on Dec. 15, 2020. Photo credit: Shawn Rocco/Duke Health

They get things done

Through sharing the stories from the ground up, LATIN-19 was able to change the visitation policy at Duke Health for children in the hospital’s care. When an infectious disease specialist was a guest on one of their Zoom sessions and heard that Latinx parents were reluctant to bring their sick children in because they did not want to leave them alone because of the pandemic restrictions, the visitation policy was changed for the pediatric care unit.

“That’s huge,” said Kathryn Pollak, a Duke professor in population health sciences who has sat in on the sessions and proposed research projects to evaluate the impact of LATIN-19.

Typically in her research, Pollak creates the program she’s going to measure, but LATIN-19 was already in the works when she decided to write about their reach.

Pollak had done research on Latinx communities for a while and was well acquainted with Martinez-Bianchi through work. She decided to attend one Zoom session and kept coming back each week.

“It’s pretty phenomenal what they’ve been able to do,” Pollak said.

In the early days of the pandemic, the Latinx population in Durham County and elsewhere in North Carolina was hit disproportionately hard. Many of the residents work in nursing homes, grocery stores, and meat-processing, construction and agricultural jobs that put them at higher risk of contracting the virus, essential employment that does not always come with pay that matches the imperative nature of the work.

Many live in multi-generational households, making it difficult to isolate and quarantine after someone in the home might have been exposed at work or in the community.

Some in the LatinX population resist seeking health care in systems where they have to fill out many forms and give out personal information that they fear might be shared with immigration officials.

LATIN-19 members helped get the word out to LatinX communities about the importance of mask-wearing and social distancing. They helped stage community testing events and stressed the importance of getting tested, especially for frontline workers.

Now that vaccines are on the way, the discussion has turned to how to build enthusiasm for the new tool so vital to ushering in the end of this pandemic.

They know they have hard work ahead.

Transparency and clarity

A national survey of 1,050 Black adults and 258 LatinXx adults done this fall for UnidosUS, the NAACP and the COVID Collaborative found that 34 percent of the LatinX Americans and only 14 percent of the Black Americans trusted the safety of a vaccine.

The COVID Collaborative, comprised of national health, education and economy scholars, launched a $50 million national vaccine education campaign in late November.

“Like all Americans, Latinos want to do what is best for their families and their communities,” Janet Murguía, president of UnidosUS, said in a statement distributed at the time to announce a partnership with the COVID Collaborative to create culturally relevant and language-appropriate messaging for U.S Latinos.

“Through this education and awareness campaign, we will help Hispanic Americans have the accurate and easy-to-understand information they need to protect themselves, their families and their communities by getting vaccinated.”

Here in North Carolina, LATIN-19 has developed many contacts throughout the pandemic and already is attacking some of the questions and even misinformation that’s circulating.

In the Zoom discussions, Pablo Friedmann, director of the Durham Public Schools Multilingual Resource Center, often brings questions to the group that he hears from school children and their families. On Dec. 2, he shared questions that came up during a conversation with his mother about people who don’t have health insurance and might experience side effects from the vaccines, such as headaches, fever or in the extremely rare case, an anaphylactic reaction.

“For folks that do have negative side effects from things and they don’t have current insurance, what is going to be their process for getting health coverage and support?” Friedmann asked. “I think these are very real fears and mistrust that are going on. This has always been my fear from the very beginning.”

One person on the call told the group about a family she had encountered who got the flu shot this year, unlike in years past. They were worried about COVID and heeded the public health pleas to get a flu vaccine to try to keep other respiratory viruses to a minimum during the pandemic. Then the whole family got COVID.

Some have been confused about the meaning of a positive test for COVID-19, and whether they are actively contagious.

“As with other things, transparency and clarity is essential, and I think it is so important for us to voice all these concerns, and address them head-on,” said Maradiaga Panayotti. She said that transparency needs to extend to colleagues, in workplaces and to the public.

“As soon as there’s a sense of hiding, or not sharing, the wall will cement itself.”

Many groups get together and have lofty discussions about how to help communities in need. What’s different with LATIN-19 is that ideas and projects generated quickly translate from an idea into implementation.

Viviana Martinez-Bianchi, a physician at Duke Health, gets a Pfizer COVID-19 vaccine at Duke University Hospital in Durham on Dec. 15, 2020. Photo credit: Shawn Rocco/Duke Health

Jenkins, who became head of the Durham County health department in January, told the group earlier this month how instrumental their help had been as he found his way in a new city after eight years as deputy director for the Cumberland County health department.

“Being new, I didn’t know who the players were,” Jenkins told the LATIN-19 members on Dec. 2. “But you all step up to the plate. We reached out to you all and your efforts have really paid dividends.”

‘We’re unstoppable’

The group members also have benefitted from working with each other.

“I’ve been asked to be representing LATIN-19 in other places, and the one thing I have to say is that I don’t feel alone,” Martinez-Bianchi said. “I feel in the company in an amazing group of people.

“As a Latina who’s been taking care of members of the comunidad Latina for so many years, I have to say that it is totally the first time I don’t feel so alone in the care that I am providing,” Martinez-Bianchi added. “And in getting what I have been hearing for so many years from my comunidad, from my patients, understood by others, who may not have that connection, as a clinician.

“I feel like I’m in the company of brothers and sisters and members of a community who really care, and it feels really, really good.”

That sentiment of togetherness, empowerment and a proud sense of moving ideas to “deliverables” was echoed by others in the group.

Some sit in on the meetings during their lunch hour. Others do it as part of their jobs, but say it rarely feels like work. One participant described coming to the Zoom sessions as “like finding a lighthouse.”

Durham City Council member Javiera Caballero said the group’s advocacy reminded local government officials of the need to make virtual meetings accessible in Spanish and other languages. Lessons learned during the pandemic, Caballero said, could well extend beyond this most unusual year.

“This has been such a tough year for all of us,” Maradiaga Panayotti said. “There has been so much negative news and bad news. This group has been such a good reminder to be aspirational and to realize the power of what can be done when people set their mind to it, and people, as so many of you said, have a vision, and a unified vision, so we all believe in it, and we’re all willing to put in the time.

“We’re unstoppable,” she continued. “We can do it.”

She said that the group’s work felt “tangible” and was a good reminder of the power of unity, especially in the face of adversity.

“So much disastrous stuff that’s happening, I sort of try to remind myself, like OK, LATIN-19, look what’s happening, this is amazing,” Maradiaga Panayotti said. “I try to use it as my anchor point of positivity in a world of so much topsy-turvy stuff happening.”

Anne Blythe

Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.