High Rates of COVID-19 Infection Among Indigenous Maya at a US Safety-Net Health System in California

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• COVID-19 has disproportionately affected minority communities in the US, including Indigenous populations.
• Misclassification in public health data can obscure the true impact on specific ethnic groups.
• The Maya community in Alameda County, California, faced significant COVID-19 burden.

Purpose of the Study:

• To investigate a cluster of COVID-19 cases among the Maya population in Alameda County.
• To determine the COVID-19 test positivity rates and clinical outcomes within this community.
• To inform public health responses with linguistically and culturally appropriate interventions.

Main Methods:

• Retrospective cohort study of COVID-19 tests from April 1 to May 31, 2020, at Alameda Health System.
• Identification of Maya patients using electronic health record language data and medical record review.
• Comparison of COVID-19 test positivity rates and clinical outcomes between Maya and non-Maya patients.

Main Results:

• Overall COVID-19 test positivity rate was 17.0%.
• Maya patients exhibited a significantly higher test positivity rate (72.8%) compared to non-indigenous Latinx (27.1%) and other patients (8.2%).
• Despite higher positivity, Maya patients showed lower rates of hospitalization, ICU admission, and mortality.

Conclusions:

• COVID-19 significantly impacted the Maya community in Alameda County, often due to misclassification in health data.
• Culturally and linguistically tailored public health strategies are crucial for Indigenous communities.
• Further assessment of COVID-19 prevalence and targeted interventions are needed for the Maya and other Indigenous groups.