Covid Hospitalizations in NYC Saw Biggest Racial Gap During Omicron

(Bloomberg) -- Black New Yorkers were hospitalized at two times the rate of White New Yorkers during the winter omicron surge. It's the widest disparity in hospitalizations seen in two years of the pandemic, according to the New York City Health Department.

“This is a significant inequity — and a particularly alarming one — so far into the pandemic,” said Michelle Morse, NYC Health's chief medical officer. And it came during a time when the dominant variant had a lower risk of hospitalization than its predecessor, delta.

Despite the city's relative success in closing race-based vaccination gaps, long-standing inequities in the U.S. health care system have proven difficult to overcome. A new report from the department highlights how a swath of social and economic factors contribute to disparate Covid-19 outcomes based on race.

Lagging booster rates among Black and Latino New Yorkers offer a glimpse into what's driving the higher hospitalization rates. Just over 20% of Black people, and around the same percentage of Latinos, received booster doses — well below the citywide average of 35%.

But Morse says to only look at booster rates, and even vaccinations, presents an “overly simplistic” explanation for why Black New Yorkers were so hard-hit by omicron.

“The other thing we know is at play here is how structural racism shapes social welfare, social wellbeing and health care access,” Morse said. “The cascade of factors we describe that lead to higher hospitalizations among Black people with omicron – structural racism shapes just about all of them.”

Black people had a higher burden of chronic disease well before the pandemic as access to quality health care has long missed marginalized communities. Co-morbidities, such as diabetes, that more commonly affect Black adults also increase the likelihood of getting very sick from Covid, according to the U.S. Centers for Disease Control and Prevention.

NYC Health observed a delay in the time between infection and diagnosis for Black residents. While most New Yorkers were diagnosed at least four days after the onset of symptoms, it took a day or more longer for Black New Yorkers. This delays Black people from getting treatment, such as monoclonal antibodies, Morse said, that can help prevent severe disease. The CDC reported that Black people have been 22% less likely to get monoclonal antibody treatment than White people since the therapy became available.

The report found that the delay between symptoms and diagnosis is largely because marginalized communities are likely to have fewer Covid-19 testing centers and tend to work in jobs where conditions make it difficult to get time off for testing. Plus, during the omicron surge, free testing centers were crushed by long lines, leading people to seek out alternative test options and sending Covid test prices soaring. For those who couldn't afford to buy overpriced online tests, there were few available options.

The U.S. has since emerged from the throes of omicron. The Biden administration has bolstered testing reserves, Covid cases continue to plummet and most mask requirements have been dropped.

Manhattan's Borough President Mark Levine said NYC Health's report comes at a critical time, serving as a reminder that the disparities exposed by the pandemic remain pertinent even in this next stage.

“It has huge implications for the decisions we're making right now on Covid policy, because the steps that we need to take to blunt a future wave clearly have racial equity implications,” Levine said. “We clearly see who is going to pay the price if there's another wave.”