Third of destinations worldwide now closed to international tourism: UNWTO | Daily FT
One in three destinations worldwide are now completely closed to international tourism, according to the latest data from the World Tourism Organization (UNWTO). It said the emergence of new variants of the COVID-19 virus, particularly B.1.1.7 (UK), P.1 (Brazil) and B.1.351 (South Africa), has prompted many governments to reverse efforts to ease restrictions on travel, with total closures to tourists most prevalent in Asia, the Pacific and Europe. The UNWTO Travel Restrictions Report provides a comprehensive overview of the regulations in place in 217 destinations worldwide. While previous edi…Read More
In America, Covid Vaccine Eligibility Is a ‘Crazy Quilt' of State Rules
In North Carolina, the nation's leading tobacco producer, any adult who has smoked more than 100 cigarettes in their lifetime can now be vaccinated against covid.
In Florida, people under 50 with underlying health conditions can get vaccinated only if they have written permission from their doctor.
In Mississippi, more than 30,000 covid vaccine appointments were open Friday — days after the state became the first in the contiguous United States to make the shots available to all adults.
In California — along with about 30 other states — people are eligible only if they are 65 or older or have certain health conditions or work in high-risk jobs.
How does any of this make sense?
“There is no logical rationale for the system we have,” said Graham Allison, a professor of government at Harvard University. “We have a crazy quilt system.”
Jody Gan, a professional lecturer in the health studies department at American University in Washington, D.C., said the lack of a national eligibility system reflects how each state also makes its own rules on public health. “This hasn't been a great system for keeping, you know, the virus contained,” she said.
The federal government bought hundreds of millions of doses of covid vaccines from Pfizer, Moderna and Johnson & Johnson — as well as other vaccines still being tested — but it left distribution largely up to the states. Some states let local communities decide when to move to wider phases of eligibility.
When the first vaccines were cleared for emergency use in December, nearly all states followed guidance from the federal government's Centers for Disease Control and Prevention and restricted use to front-line health workers and nursing home staffs and residents.
But since then states have gone their own way. Some states have prioritized people age 75 and older, while others have also allowed people who held certain jobs that put them at risk of being infected or had health conditions that put them at risk to be included with seniors for eligibility. Even then, categories of jobs and medical conditions have varied across the country.
As the supply of vaccines ramped up over the past month, states expanded eligibility criteria. President Joe Biden promised that by May 1 all adults will be eligible for vaccines and at least a dozen states say they will beat that date or, as in the case of Mississippi and Alaska, already have.
But the different rules among states — and sometimes varying rules even within states — created a mishmash. This has unleashed “vaccine jealousy” as people see friends and family in other states qualify ahead of them even if they are the same age or have the same occupation. And it has raised concerns that decisions on who is eligible are being made based on politics rather than public health.
The hodgepodge mirrors states' response overall to the pandemic, including wide disparities on mask mandates and restrictions for indoor gatherings.
“It's caused a lot of confusion, and the last thing we want is confusion,” said Harald Schmidt, an assistant professor of medical ethics and health policy at the University of Pennsylvania.
As a result, some Americans frantically search online every day for an open vaccine appointment, while vaccines in other states go wanting.
The assorted policies have also prompted thousands of people to drive across state lines — sometimes multiple state lines — for an open vaccine appointment. Some states have set up residency requirements, although enforcement has been uneven and those seeking vaccines are often on the honor system.
Todd Jones, an assistant professor of economics at Mississippi State University near Starkville, said the confusion signals a need for a change in how the government handles the vaccine. “The Biden administration should definitely be thinking about how it might want to change state allocations based on demand,” Jones said. “If it does become clear that some states are actually not using lots of their doses, then I think it would make sense to take some appointments from these states to give to other states that have higher demand.”
Jagdish Khubchandani, a professor of public health at New Mexico State University, said no one should be surprised to see 50 different eligibility systems because states opposed a uniform federal eligibility system.
“Many governors don't want to be seen as someone who listens to the federal government or the CDC for guidance,” he said. Florida Gov. Ron DeSantis, a Republican, has boasted of ignoring the CDC advice when he opted to make anyone 65 and older eligible beginning in December.
“There is a lot of political posturing in deciding eligibility,” Khubchandani said.
To be sure, governors also wanted the flexibility to respond to particular needs in their states, such as rushing vaccines to agricultural workers or those in large food-manufacturing plants.
Jones said the decision to open vaccines to all adults in the state may sound good, but Mississippi has one of the nation's lowest vaccination rates. Part of that is attributed to hesitancy among some minority communities and conservatives. “It's good news everybody can get it, but there doesn't seem to be a whole lot of demand for it.”
Jones, 34, was able to go online for a shot on Tuesday and was vaccinated at a large church a short drive from his home on Thursday morning. “I was very happy,” he said.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
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New U.S. COVID-19 cases show weekly uptick for first time since January
(Reuters) – New cases of COVID-19 in the United States rose 5% to more than 394,000 last week, the first increase after declining for nine straight weeks, according to a Reuters analysis of state, county and CDC data. Thirty out of 50 states reported more new infections in the week ended March 21 compared with the previous seven days, up from 19 states in the prior week, according to the Reuters analysis. Nationally, the weekly number of new cases had been on a downward trend since January, though health authorities have warned that infections could surge again if Americans relaxed social dist…
Vaccine makers should license technology to overcome ‘grotesque' inequity: WHO
GENEVA/ZURICH (Reuters) – More producers of COVID-19 vaccines should follow AstraZeneca's lead and license technology to other manufacturers, the World Health Organization's head said on Monday, as he described continuing vaccine inequity as “grotesque”. AstraZeneca's shot, which new U.S. data on Monday showed was safe and effective despite some countries suspending inoculations over health concerns, is being produced in various locations including South Korea's SKBioScience and the Serum Institute of India. WHO Director-General Tedros Adhanom Ghebreyesus called for more manufacturers to adopt…
New York lowers coronavirus vaccine eligibility age to 50
NEW YORK (Reuters) -New York will join a handful of U.S. states that have lowered their eligibility age for coronavirus vaccines to 50, Governor Andrew Cuomo announced on Monday. The state, the country's fourth most populous, had restricted eligibility to residents who are at least 60 years old, have pre-existing health conditions or are essential workers, especially those who come in contact with the public. “We are dropping the age and vaccinating more people,” Cuomo said at a church in Mount Vernon, New York, where he launched a campaign to encourage houses of worship to make themselves ava…
So You're Vaccinated Against Covid. Now What?
As you surely know, this country's covid vaccination effort has been plagued by major birth pangs: registration snafus, poor communication, faulty data and a scant supply of vaccine — all exacerbated by inequitable allocation, alleged political favoritism and unseemly jockeying for shots.
Still, as of Friday, over 118 million shots had gone into arms, and about 42 million people, 12.6% of the nation's population, had been fully vaccinated. Nearly one-quarter of U.S. residents have had at least one dose.
The vaccine rollout is finally ramping up — just as the deadly winter surge has ended, dramatically reducing infection rates, hospitalizations and deaths. President Joe Biden has promised enough vaccine for every adult in the country by the end of May and dangled the hope of a return to semi-normalcy by July 4.
We'll see if that happens. Unfortunately, ill-advised behavior, or a mutant strain of the covid virus — or both — could still ignite another surge. And we're not entirely certain to what extent vaccination prevents you from infecting unvaccinated people, or for how long it protects against covid.
Bottom line: Optimism is warranted, but all of us — even the vaccinated — still need to be careful.
In case you missed it, the Centers for Disease Control and Prevention issued new public health guidelines March 8 that offered a small glimpse of what the not-so-distant future might hold if enough people are vaccinated. The most striking point was that it's OK for vaccinated individuals to meet indoors with unvaccinated members of another household, without masks, as long as nobody in that household is at risk for severe covid.
That's big news if you've not seen your children or grandchildren in person for a while. If you are fully vaccinated, it's now likely safe to visit with them indoors without masks, regardless of their vaccination status. You can even hug them.
As long as they don't live too far away, that is: The CDC still frowns on long-distance travel.
If everybody in your group is vaccinated, so much the better. In that case, hosting a maskless dinner party inside your home, for example, is “likely a low risk,” according to the new guidance.
But Dr. George Rutherford, a professor of epidemiology at the University of California-San Francisco, warns not to interpret this new freedom too liberally: “People say, ‘Oh, we can have a wedding reception for 50 people at a hotel as long as they are all vaccinated.' I say, ‘What about the people serving you — are they all vaccinated? And the band?'”
Public health experts and the CDC agree that if you are vaccinated and in the company of people who aren't — or if you don't know their status — you should continue the safeguards of masking and maintaining your distance.
“What I tell people who are vaccinated is, ‘You should assume you are one of the 5 or 6% for whom the vaccination will fail, and that everyone around you is a super spreader,” Rutherford says.
That means you should probably tap your inner brakes before going to a movie, working out in a gym, boarding an airplane or dining indoors at a restaurant.
Dr. Walter Orenstein, associate director of the Emory Vaccine Center and professor of infectious diseases at Emory University School of Medicine, points to a possible side benefit of the new CDC approach. “It may enhance vaccine uptake if it shows people that once you get vaccinated you have more freedom to do things,” he says.
Orenstein, like most public health experts, acknowledges that we still have an incomplete picture of covid and how the vaccines will work in the real world. Officials must set guidelines based on the best data available at the time, he says. “If, in fact, there is a marked spike in cases as a result, they will have to revise them.”
For now, Orenstein says, he is incorporating the new guidelines into his personal life. “We hadn't had people over to our house in ages, and last night we had a couple over,” he says. They were all vaccinated, and they didn't wear masks.
Others are wary of easing up too soon, even if they've been vaccinated.
“I feel a real sense of relief, but it hasn't changed my behavior,” says Sam Sandmire, a 65-year-old retired gymnastics coach in Boise, Idaho, who's had two doses of the Moderna vaccine. “I still mask up and will continue to mask up and social distance until the science shows that I can't infect others.”
Andy Mosley, 74, says he is not entirely convinced by the new CDC statement. “The information that we could start hanging out with each other again was laced with a lot of qualifiers,” says Mosley, a resident of Temecula, California, who's also had two shots of the Moderna vaccine. “That tells me they are not really sure about it.”
But he may alter his behavior in one instance. He has not seen his daughter, a chef who lives in San Francisco, since October 2019. She is scheduled for surgery soon and may need his help. “Because she's been immunized and I've been immunized and her roommate has been immunized, I would feel safe going up there,” Mosley says. “So that would be a change. But I would drive; I wouldn't fly.”
Many others, including state and local politicians, are less cautious. Texas recently did away with its mask mandate. Florida has remained largely open for business through much of the pandemic.
In California, 13 counties accounting for nearly half the state's population have reopened gyms, movie theaters and indoor restaurant dining — albeit at reduced levels. That includes Los Angeles County, one of the hardest-hit regions in the U.S. during the winter surge. And Gov. Gavin Newsom has suggested that California's four-level color-coded system for phased reopening could soon add a “green” tier — meaning pretty much back to normal.
However, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, says localities that open too soon “are going to be in big trouble shortly” because of a new surge he expects to be triggered by a fast-spreading covid strain first detected in the United Kingdom, which is projected to become the dominant strain in the U.S. sometime this month.
For now, stick with masking and physical distancing in most social and commercial encounters. Get vaccinated as soon as it's your turn and try to persuade the people in your lives to do the same. The more people vaccinated, the greater the protection for the community.
In the near future, we may all have extra incentive to get vaccinated: Proof of vaccination could be required for air travel, sports events, concerts and other mass public gatherings. This is being considered in some parts of the U.S. and is already happening in some countries.
Israel, for example, has begun issuing six-month vaccination “passports” that would allow entry to sporting events, restaurants and other public venues. That has “created this kind of push for people who otherwise might not be that interested in getting vaccinated to get vaccinated,” Rutherford says.
This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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Some Dream — Others Scheme — To Find a Vaccine Before Spring Break
Hawaii, Florida, Seattle and the South of France are on the minds of New York City college students. Those are some of the destinations that undergrads mentioned when asked where they'd go for spring break, if they weren't grounded by covid-19.
This story also ran on NPR.
“I'd be getting a house with 10 people, with a pool, and we'd be going crazy in Miami,” said Sile Ogundeyin, 22, a senior economics major at Columbia University, who was sitting on the steps of the library with his friends.
“I was supposed to be in London for study abroad this semester, so I probably would've gone someplace close to there for spring break — maybe in southern Europe,” said New York University sophomore Aliyah Verdiner, 20, a business major from Brooklyn. “That would've been a lot of fun, but I guess not this year.”
Some students, however, are being more adventurous. Rumors on campus abound about students who are exploiting loopholes and getting vaccinated against covid in order to party and go on spring break.
“She's going skiing in Vermont with a bunch of friends,” Aliza Abusch-Magder said of her roommate, whom she declined to name. “She's very excited to be going to parties and — how do I say this? — making up for lost time in quarantine.”
Abusch-Magder said her roommate was “calling on something in her medical history that doesn't actually affect her day-to-day, to qualify for the vaccine.” Other young people shared similar reports, such as of peers getting vaccinated who had asthma in their past but not their present.
“I just don't think it's ethical,” said Abusch-Magder, a first-year English major from Atlanta. But she also expressed doubt that such behavior is widespread at Columbia.
“I think here it's an outlier, and I think at some schools it's standard,” she said, echoing what she'd heard from high school friends on other campuses. “There's a very high standard of ethics here, and there's a lot of discourse on it.”
It's impossible to know how often college students are getting vaccinated. Rumors about it happening illegitimately are widespread, but most of the stories appear to be secondhand. And many aren't so nefarious on closer examination, because some vaccinated students are actually eligible; they work in labs or health care settings, or they have underlying health issues that put them at high risk for severe covid.
“I put in my height. I put in my weight. And it said I was obese,” said Shira Michaeli, who was sitting on the Columbia library steps, “attending” an online lecture on human rights on her laptop. Obesity qualifies you for early vaccination in at least 29 states.
Michaeli is a bit ambivalent, because she feels healthy, and she's comfortable with her body weight, which she believes is not really a “comorbidity.” But she said she has had breathing problems ever since suffering a bad case of covid last year. And she also plans to be a camp counselor this summer. So she feels she qualifies for the vaccine on a few counts, even if her body mass index is what officially qualifies her.
“I think, for a while, I was really insecure about it, and then I thought, ‘Listen, for most of my life [my weight] has been bad for me. Clothing hasn't been my size. People haven't been … ” Michaeli's voice trailed off. “But for once in my life, it'll benefit me, instead of hurting me.”
The 19-year-old Bronx native was scheduled to receive her first shot the next day, so she was several weeks away from being fully vaccinated. She said it wouldn't have mattered for spring break, anyway, because she had planned to stay close to her dorm, working on papers, perhaps sleeping in a little more than usual, and getting coffee with friends.
“I'm excited to get vaccinated, but I don't think it's going to give me any freedom other people don't have,” Michaeli said. “I think I'll be a little less anxious, but I don't think it's going to change any of my behavior. I think there are plenty of people being unsafe, so I don't have any wiggle room to be unsafe.”
Down in Greenwich Village, at NYU, there's very little tension among the vaccine haves and have-nots when it comes to spring break — because there isn't much of a spring break. It's a single day, added to create a long weekend in March.
But that doesn't keep Simran Hajarnavis from dreaming.
“If there wasn't covid, and there was a real spring break, I'd probably try to plan something with my friends,” she said, turning to one of them and asking: “Want to go to Hawaii?”
Sitting in Washington Square Park, Hajarnavis and her girlfriends said they're not too worried about being vaccinated right away, as long as they get their shots in time to study abroad in their upcoming junior year.
A few yards away, Aishani Ramireddy said she has already gotten her vaccine, but she's not doing anything differently from any other student.
“It's definitely weird,” she said. Ramireddy's mother is a physician in Los Angeles. She said that, when she was home, she got the vaccine at the end of the day, at her mother's office, because there were unused doses that would have been thrown out. Still, she feels conflicted about it.
“It just felt like such a privilege to even have that as an option,” Ramireddy said.
Another NYU student, Anna Domahidi, from Chicago, also had an option to get a vaccine, but declined. She doesn't hold it against her friend Ramireddy, but she does question another friend, who she said talked up his childhood asthma to qualify for a shot. Domahidi still thinks he crossed an ethical line, even though he lives with a parent who's immunocompromised: “That's, like, a little better in my mind, but I don't know.”
This story comes from KHN's health reporting partnership with NPR.
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The impact of COVID-19 on LGBTQ communities: A research roundup
The LGBTQ population in the U.S. has been historically affected disproportionately by poverty, lack of health insurance, unemployment, and poorer mental and physical health compared with non-LGBTQ people.
The COVID-19 pandemic has only made those challenges worse.
“Economic effects of COVID-19 have been enormous on LGBTQ people, so it's not just a viral reality,” says Dr. Perry Halkitis, dean of Rutgers' School of Public Health, whose research focuses on LGBTQ populations. “It's a social reality. It's an economic reality. It's a psychological reality.”
Moreover, LGBTQ people of color face additional risks and vulnerabilities, compared with their white counterparts, study after study has shown. While the news media has covered disparities brought to light by the pandemic among racial and ethnic minorities, there has been less coverage of the LGBTQ population.
“We know these disparities exist. We know they're out there, but I'm not reading about it,” says Tari Hanneman, director of the Health & Aging Program at the Human Rights Campaign Foundation, an advocacy organization focused on the LGBTQ community. “There's an old saying, ‘If you don't count us, we don't count.' So it's kind of the same thing: if journalists aren't writing about us, it's almost like we're not existing.”
It's also important to note the dearth of government data about LGBTQ people.
Most government data collection efforts focused on COVID-19 do not include sexual orientation and gender identity measures, including the U.S. Census Bureau's Household Pulse Survey and other state and federal death and disease tracking efforts.
The lack of data hinders “efforts to incorporate the needs of LGBT populations into COVID-19 recovery efforts,” says a February report by the Williams Institute, a public policy research institute based at the UCLA School of Law focused on sexual orientation and gender identities issues.
Journalists can use academic research to better understand and report on the impact of the pandemic on LGBTQ communities. Here, we have selected seven studies and reports on this topic to help you get started.
(Note: Both LGBT and LGBTQ are acceptable acronyms, according to Associated Press style, which Journalist's Resource follows. We have chosen to use LGBTQ, unless a study indicates otherwise.)
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The report finds that several months into the pandemic, LGBT adults were more likely to be laid off (12.4% vs. 7.8%) or furloughed from their job (14.1% vs. 9.7%), have problems affording basic household goods (23.5% vs. 16.8%) and were twice as likely to report having problems paying their rent or mortgage, compared with their non-LGBTQ peers.
The Impact of the Fall 2020 COVID-19 Surge on LGBT Adults in the U.S.
Brad Sears, Kerith J. Conron and Andrew R. Flores. Williams Institute at UCLA School of Law, February 2021.
This report draws on one the most recent surveys on the impact of the pandemic on LGBTQ communities. Data are from a nationally representative survey of 12,000 adults conducted by Ipsos between August and December 2020, with 842 respondents identifying as LGBT.
The report finds that several months into the pandemic, LGBT adults were more likely to be laid off (12.4% vs. 7.8%) or furloughed from their job (14.1% vs. 9.7%), have problems affording basic household goods (23.5% vs. 16.8%) and were twice as likely to report having problems paying their rent or mortgage, compared with their non-LGBTQ peers.
It also highlights the disproportionate impact of the pandemic on LGBTQ people of color.
“LGBT people of color are more likely to experience the health and economic impacts of COVID-19 than non-LGBT White people,” the authors write, adding that they're also more likely to get tested for COVID-19, practice social distancing and wear masks, compared with non-LGBT white people.
They add that LGBT people of color are more likely to have tested positive for COVID-19, to personally know someone who died of COVID-19, and to have experienced several types of economic instability as a result of the pandemic.
They write that the federal government should take into account the impact of the pandemic on LGBT people, specifically LGBT people of color, as it responds to the crisis and provides support to those most economically affected.
Sexual Orientation Disparities in Risk Factors for Adverse COVID-19-Related outcomes, by Race/Ethnicity
Kevin C. Heslin and Jeffrey E. Hall. CDC MMWR, Vol. 70, No. 5. Feb. 5, 2021.
This timely report by Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, examines the disproportionate health impact of the pandemic on LGBTQ adults. The report uses the Behavioral Risk Factor Surveillance System survey — a nationwide health-related telephone survey — because the “current COVID-19 surveillance systems do not capture information about sexual orientation,” the authors write.
Researchers combined data from BRFSS surveys between 2017 and 2019, which included 24,500 individuals who identified as gay, lesbian or gay, or bisexual. The report notes that “although BRFSS includes a question on gender identity, the number of respondents identifying as transgender or nonbinary was too small for reliable estimates compared with the majority cisgender population.”
The report identifies several underlying health conditions that increase or might increase the risk for more severe COVID-19-related illness were more common among gay, lesbian and bisexual adults than those who identified as heterosexual.
Those self-reported conditions include cancer, kidney disease, chronic obstructive pulmonary disease, heart disease, obesity, smoking, diabetes, asthma, hypertension and stroke.
Moreover, “sexual minority adults who are members of racial/ethnic minority groups disproportionately affected by the pandemic also have higher prevalences of several of these health conditions than do racial/ethnic minority adults who are heterosexual,” the report shows.
The authors reiterate what other researchers have cited as the reasons behind disparities affecting LGBTQ people: “Because of their sexual orientation, sexual minority persons experience stigmatization and discrimination that can increase vulnerabilities to illness and limit the means to achieving optimal health and well-being through meaningful work and economic security, routine and critical health care, and relationships in which sexual orientation and gender identity can be openly expressed.”
The authors call for expanding sexual orientation and gender identity data collection to surveillance systems to help with decision-making during and after the pandemic.
The Disproportionate Impacts of COVID-19 on LGBTQ Households in the U.S.
Movement Advancement Project. November 2020.
This report is based on data from a polling series by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, conducted between July 1 and Aug. 3, 2020, on more than 3,400 adults, 353 of whom identified as LGBTQ. Consistent with previous research, the poll found that LGBTQ respondents are twice as likely as non-LGBTQ respondents to have very low incomes.
The report, created by a nonprofit think tank, provides a wealth of data points that can help reporters compare the impact of the pandemic on LGBTQ and non-LGBTQ communities. It also provides data based on race, income and region of the country.
The report shows 66% of LGBTQ households reported serious financial problems compared with 44% of non-LGBTQ individuals. Nearly 40% said they weren't able to get medical care or delayed getting medical care for serious problems, compared to 19% of non-LGBTQ households.
Meanwhile, 95% of Black LGBTQ survey respondents said they face one or more serious financial problems, compared with 70% of Latino LGBTQ households and 62% of white LGBTQ participants.
The report also shows that more than one in eight LGBTQ people have lost their health insurance coverage since the pandemic started. That's more than twice the rate of non-LGTBQ people in the polling sample.
Also, more than one in four LGBTQ households have had serious problems affording medical care — again, twice the rate of non-LGBTQ households.
The report's findings “point to the need for targeted assistance and explicit protections from discrimination as our country continues to weather the storm and looks to rebuild,” the authors write.
Sex in the Time of COVID-19: Results of an Online Survey of Gay, Bisexual and Other Men Who Have Sex with Men's Experience of Sex and HIV Prevention During the US COVID-19 Epidemic
Rob Stephenson et. al. AIDS and Behavior, September 2020.
This study, based on a survey of 518 gay, bisexual and other men who have sex with men conducted between April and May 2020, aims to understand changes in sexual behavior of this group and access to HIV prevention options, including pre-exposure prophylaxis, also called PrEP.
The study finds that in the early days of the pandemic men reported an increase in the number of sex partners, although the increase in unprotected sex was small. It also finds the increase in sexual behavior during COVID-19 was associated with increases in substance use.
About one-third of the men reported that the pandemic had prevented them from accessing testing for HIV or sexually transmitted infections, the report finds.
The study also finds that nearly 95% of the respondents believed it was possible to contract COVID-19 through kissing, but about half or less believed it was possible to contract the virus through all other sex acts.
About 9% of people surveyed said the pandemic prevented them from accessing their PrEP prescription and nearly one-third said that about getting tested for HIV or other sexually transmitted infections.
“There is a clear need to continue to provide comprehensive HIV prevention and care services during COVID-19, and telehealth and other eHealth platforms provide a safe, flexible mechanism for providing services,” the authors write.
They add that sexual activity and substance use behaviors may be to some degree related to the stress of the pandemic, “and therefore services should consider addressing the mental health needs of those living on lockdown, and incorporate discussions and strategies for managing stress in the delivery of HIV prevention and care services.”
LGBTQ populations: Psychologically vulnerable communities in the COVID-19 pandemic
John P. Salerno and Natasha D. Williams, Katrina A. Gattamorta. Psychological Trauma: Theory, Research, Practice, and Policy, August 2020.
This commentary highlights structural, social and individual challenges faced by LGBTQ populations during the pandemic in the United States. It also includes recommendations to mitigate the psychological effects of the pandemic-related trauma on LGBTQ individuals.
The authors write that mental health disparities among LGBTQ individuals compared with their non-LGBTQ counterparts are related to social inequities, such as higher rates of poverty and lack of insurance.
“Ultimately, mental health burden among LGBTQ persons (e.g., PTSD, anxiety, depression, suicidality) may be exacerbated by the psychological impact of COVID-19 pandemic trauma and its intersection with dimensions of social inequality,” the authors write.
The commentary also points to the significant psychological threats facing LGBTQ elders due to stay-at-home orders earlier in the pandemic.
LGBTQ elders are twice as likely to be single and living alone, four times less likely to have children, and more likely to be estranged from their biological families compared with their heterosexual, cisgender counterparts, according to the commentary.
“This is highly concerning because social isolation, loneliness, and existing health and mental health concerns may be exacerbated among already-vulnerable LGBTQ elders as a result of COVID-19 pandemic trauma,” the authors write.
The authors encourage mental health therapists, social service providers, employers and other institutions serving LGBTQ individuals to move toward online delivery of services “to mitigate the mental health ramifications of COVID-19 psychological trauma and social isolation.”
Mental Health Needs Among Lesbian, Gay, Bisexual, and Transgender College Students During the COVID-19 Pandemic
Gilbert Gonzales et. al. Journal of Adolescent Health, November 2020.
The study, based on an online survey of 477 LGBTQ college students in the U.S., aged 18 to 25, shows that nearly half had immediate families that don't support or know their LGBTQ identity and almost 60% were experiencing psychological distress, anxiety and depression during the pandemic.
“To overcome the high prevalence of frequent mental distress, anxiety, and depression among LGBT students, colleges and universities should ensure that LGBT students receive mental health support during the COVID-19 pandemic,” the authors write.
They recommend telehealth options with flexible hours and identity based virtual groups that help sustain a sense of community. They add that universities should “seek to eliminate any closure-related stressors by providing housing accommodations and financial resources to those expressing need.”
Finally, they write that health-care providers should be mindful of the mental health needs of LGBTQ college students who, due to campus closures, may have returned home to unsafe or unaccepting environments.
“Our study is one of few investigations identifying the mental health needs of LGBT college students during the COVID-19 pandemic, which are substantial based on our results,” the authors write.
LGBTQ individuals — are less likely to seek care due to stigma, discrimination and economic factors that make medical care unaffordable for them.
Addressing the Disproportionate Impacts of the COVID-19 Pandemic on Sexual and Gender Minority Populations in the United States: Actions Toward Equity
Gregory Phillips II et. al. LGBT Health, September 2020.
In this paper, researchers call on public health practitioners to serve as proponents of the LGBTQ community and other marginalized populations and amplify the voices of those advocating for health equity.
“We must recognize the architecture of our social, political, and historical conditions as precedents that create material condition under which marginalized populations could be affected disproportionately by crises such as the COVID-19 pandemic,” the authors write.
Sexual and gender minority populations — the academic term referring to LGBTQ individuals — are less likely to seek care due to stigma, discrimination and economic factors that make medical care unaffordable for them, the authors explain.
They're also affected disproportionately by poverty, lack of insurance and unemployment, while the pandemic could cause a higher burden of poor mental health in this population.
“A lack of cultural responsiveness among health care professionals has perpetuated health disparities, combined with limitations within the epidemiological surveillance system, which have resulted in challenges quantifying the impact of COVID-19 on marginalized populations,” the authors write.
They set out four priorities for immediate action to address the needs of LGBTQ individuals: cultural competency in hospitals and health systems; improvement of data collection at local, state and federal level to include LGBTQ populations; more research on the impact of the pandemic on this group; and the creation of disaster preparedness plans that explicitly include equity-focused initiatives.
Additional resources
- CDC's Lesbian, Gay, Bisexual and Transgender Health page provides data and information on a range of topics related to health of this population.
- The Substance Abuse and Mental Health Services Administration's (SAMHSA) LGBT website includes national survey reports, agency and federal initiatives, and related behavioral health resources.
- The Trevor Project is a national organization providing crisis intervention and suicide prevention services to LGBTQ youth.
- The Williams Institute is a public policy research institute based at the UCLA School of Law focused on sexual orientation and gender identity issues.
- The Human Rights Campaign is a national advocacy organization for LGTBQ individuals with many informational resources for the public and the media.
- The Fenway Institute is a health policy organization that focuses on research, education and policy development on specific health needs of LGTBQ individuals and those living with HIV.
- GLAAD is a media monitoring organization, founded as a protest against defamatory coverage of LGBTQ people. Its agenda has since extended to the entertainment industry and its portrayal of the LGBTQ population.
- GLMA, previously known as the Gay & Lesbian Medical Association, is a national organization that uses the scientific expertise of a diverse multidisciplinary membership to inform and drive advocacy, education, and research.
For more on the disproportionate effects of COVID-19, see “Covid-19 has disproportionately depleted finances of Latino, Black, Native American Households: Survey.”
This article first appeared on The Journalist's Resource and is republished here under a Creative Commons license.
