The first cases of Coronavirus were reported in Rio Arriba County. All the local paper could discover is one was travel related and one was being investigated. [1] The earliest date the virus could have been contacted was March 3.
I’m not sure I believe the statistics. There are so many reasons people might not be tested.
First there are the official hurdles. Testing didn’t begin in Espanola until March 19, and then the hospital only had 45 test kits. While four days was the usual delay in results in other parts of the country, laboratories in New Mexico were only processing "a few hundred specimens each day." [2]
Because resources are so limited, the local hospital is only testing people who show serious symptoms. Before an individual is tested, he or she must call the hospital and answer questions to establish a claim.
Beyond the official barriers, there are economic ones. In New York City, which currently has the greatest number of Coronavirus cases in the country, the poverty rate was 17.3% last October, [3] while the rate in Rio Arriba County was 26.4%. [4] The city’s uninsured rate was 7% last July. [5] In Rio Arriba County, it was 13.8%. [6]
The New York statistics are deceptive. The city has some very wealthy neighborhoods. The uninsured rate among non-citizens was 22%, and probably much higher among those who weren’t legal residents. [7] This may be comparable to Rio Arriba County.
Rumors are rife that while the testing is free, the treatment is not. Several weeks in a hospital’s intensive care unit is not cheap. People who are not insured may not bother, because they can’t afford to be sick.
Variations in insurance plans are another impediment. A third of the insured have their coverage through their employers, which may be the national laboratory or a local government. Another 13.8% are on Medicare. It has copays, unless one buys a supplemental insurance policy. Nearly 30% are on Medicaid or VA plans. [8]
The remaining 9.52% of the insured are on other private plans, which are notorious for high co-pays. [9]
Contact with someone in Santa Fé or Albuquerque who was ill knows no economic boundaries. Families are spread along the length of the Río Grande, and travel is not restricted to the upper classes. The local post office processes passports.
One woman I with whom talked a while back said her daughter was scheduled to go on a cruise, and wasn’t sure what to do. She didn’t want to lose her money. The cost of a cruise could represent some effort at savings, and losing it without reward would be a serious blow.
People who work as maids for the wealthy or hotels in Santa Fé may include people who are not citizens. The fear of the Immigration Service is not limited to those without papers. Anyone who speaks Spanish may be suspect, and that fear inhibits people’s willingness to risk answering questions to get tested.
The greatest barrier is probably cultural. Many people do not trust western medicine, and rely on chiropractors and herbal medicines.
The county is telling people, if they aren’t sick enough to be tested, to "provide self-care until you are either fever-free for 24 hours without medications or until you need emergency care." [10]
Unfortunately, this reinforces people’s tendencies to avoid doctors until things are so serious they must go to the emergency room.
Sources:
1. Molly Montgomery. "Two People in Rio Arriba Test Positive for Coronavirus." Rio Grande Sun, Española, New Mexico, website. 25 March 2020; last updated 26 March 2020.
2. Molly Montgomery. "Coronavirus Testing Underway in Rio Arriba." Rio Grande Sun, Española, New Mexico, website. 19 March 2020; last updated 26 March 2020.
3. "Mayor de Blasio Announces New York City Poverty Rate Hits Historic Low." New York City, Office of the Mayor website. 1 October 2019.
4. "Rio Arriba County, NM." Data USA website. Viewed 28 March 2020.
5. "Are NYC Health + Hospitals Facilities Located in Community Districts With the Highest Shares of Uninsured New Yorkers?" Independent Budget Office website. 1 July 2019.
6. Data USA.
7. Independent Budget Office.
8. Data USA.
9. Data USA.
10. Montgomery, 19 March.
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