NYC South Asian Leaders Say Community COVID-19 Toll Undercounted

By Christine Chung, Claudia Irizarry Aponte and Ann Choi, Originally published in THE CITY

City health officials estimate that 830 New Yorkers of Asian descent have died from coronavirus as of Tuesday, the fewest deaths of any racial group.

But some local South Asian leaders say the official numbers may not tell the whole story.

“There’s no way it’s as low as they say it is,” said Annetta Seecharran, executive director of Chhaya, a nonprofit representing South Asians and Indo-Caribbeans.

She and other community leaders note there’s no breakdown by ethnicity within the expansive “Asian” category, which represents people from dozens of countries in the world’s largest continent.

Large South Asian populations fill some of the neighborhoods hardest hit by the coronavirus. Yet many South Asian New Yorkers — a category that includes people whose roots trace back to India, Pakistan and Bangladesh and neighboring countries — have long been ambivalent about what box they should check off on all kinds of forms, advocates say.

As of Tuesday, some 1,065 confirmed or probable COVID-19-related deaths were relegated to the “other” or “unknown” race categories. That represents about 9% of the nearly 11,700 city deaths logged through Tuesday, when the city Department of Health’s most recent racial breakdown was released.

“This has been one of my biggest concerns: that the community is not being counted,” said Seecharran. “Both in terms of deaths and in terms of infection rates.”

Seecharran and other local South Asian community leaders say accurate accounting is crucial in allocating and focusing resources in aiding treatment and fighting spread.

‘Analysis Is Still Limited’

City officials have acknowledged that the data is “preliminary.” They rely on lab reports and medical records to identify the race or ethnicity of those who died of the virus. When the information is missing, victims are categorized as “unknown.”

The city Department of Health and Mental Hygiene does not track the fatalities by ancestry or country of origin.

“This kind of surveillance data, while helpful, is an incomplete picture given that it relies on the data of those who have been tested,” Patrick Gallahue, a Health Department spokesperson, said on Saturday.

“We are doing everything we can to expand testing, but our analysis is still limited by the lack of widespread testing.”

As for infection rate, the governor’s office conducted antibody testing on 3,000 seemingly healthy people to measure what share of those without symptoms may have already been infected with the virus.

The preliminary results released Thursday showed  “Multi/None/Other” race state residents with the highest share of positive cases, 22.8% — followed by Hispanic (22.5%), black (22.1%), Asian (11.7%) and white (9.1%). New York City made up 43% of those who were tested and 21% of positive cases.

On Sunday, Mayor Bill de Blasio announced that he was putting his wife, first lady Chirlane McRay, in charge of a new coronavirus task force that will look at the racial and ethnic inequities highlighted by the pandemic.

Doesn’t Fully Add Up

South Asians represent one of the fastest-growing ethnic groups in America, and New York City is home to the largest concentration in the country — an estimated 434,000 according to latest Census Bureau figures.

Some South Asian community leaders believe even that statistic fails to capture the true size of the population, due to language barriers, as well as fears of government data collection and retaliation due to immigration status. The coronavirus data marks an extension of this chronic undercounting, advocates said.

Shahana Hanif, a Bangladeshi organizer from Kensington, Brooklyn, said that “every single day,” she hears about another death in the community. She doesn’t trust the city data, so she and other community leaders have taken it upon themselves to keep their own unofficial count.

She said that well over 100 Bangladeshi New Yorkers have died in recent weeks, based on reports from community groups and Bangla ethnic media outlets.

“We’re all relying on our own block associations and neighborhoods,” said Hanif, a member of grassroots group Bangladeshi Americans for Political Progress (BAPP) who is also running to replace her current boss,  term-limited City Councilmember Brad Lander, in the 39th District.

“Bangladeshis are in the hardest situations right now,” added Hanif. Many, she said, “are working class and they are our most essential workers and they happen to be undocumented.”

On Thursday, the first day of Ramadan, Hanif and her sister Sabia launched a fundraiser for New Yorkers to pledge or match their stimulus checks to undocumented Bangladeshis.

‘Have to Brace Ourselves’

Fahd Ahmed, executive director of Desis Rising Up and Moving (DRUM), which advocates for South Asian and Indo-Caribbean New Yorkers, agreed that the city death count did not “seem accurate.”

“Are people being classified differently, or are they not being counted?” Ahmed said. “Other communities are much, much more heavily being impacted, and at the same time, if we actually break down the percentages of these numbers, it doesn’t fully add up.”

Prarthana Gurung, a campaigns manager at Adhikaar, a nonprofit that works with Nepali-speaking community, said she’d heard of a handful of cases of Nepali people dying at home and a lack of clarity regarding whether they sought medical aid.

“Every day we have to brace ourselves,” Gurung added. “You see it that we need to fight tooth and nail to get services in languages we need.”

Some advocates say that one reason for what they called an undercount boils down to identity.

Hanif observed that some racial and ethnic categories, such as “Asian,” “black” or “mixed race,” feel constricting for some. That may affect how they self-identify, if they choose to do so at all.

“The available racial categories at the hospitals —  and even for the census — are limiting to certain ethnicities for many of us from South Asian countries, that definitely creates a barrier,” Hanif said.

“We’ve had many discussions about what racial categories mean and their implications,” especially for recently arrived immigrants and elders, she noted. “Unlike other categories, I would think the ‘Asian’ category is controversial because we’ve had to refocus our identity from the country where we migrated from.”

Living in Hard Hit Areas

Meanwhile, the majority of South Asian New Yorkers live in central Queens, southern Brooklyn and Parkchester, The Bronx — all areas with a high share of workers in food preparation, delivery, janitorial services and construction.

South Asians in New York also tend to live in areas more densely populated than the citywide average. For instance in Elmhurst, where South Asians make up 20% of the neighborhood, around 61,700 people live per square mile, about three times Queens’ overall density.

Elmhurst, Jackson Heights and Corona —  some of the city’s hardest hit neighborhoods — are home to at least 33,000 or 8% of all South Asians New Yorkers, according to the U.S. Census’ latest estimates.

Though the city and state provide daily updated tallies of COVID-19 cases, hospitalizations and deaths, a racial breakdown is only sporadically available. The data does not parse ethnicity, a limitation that advocates said is a disservice to serving communities.

“We need granular ethnic specific data, like urgently. It’s not just because we want to know, for the sake of knowing,” Seecharran said. “We need to be able to figure out how to tailor our response.”

Language Access

Advocates are also calling on public hospitals to diversify their Asian language offerings for hospital intake forms.

The city Health and Hospitals Corporation provides intake forms in the “top 13 languages” spoken by the agency’s patient population, said agency spokesperson Stephanie Guzmán.

Among those languages are Bengali, Arabic, Urdu, Hindi, Korean, Cantonese and Mandarin, Guzmán said, adding that interpreter services are available in more than 200 languages and dialects.

Since 2017, the city has been required by law to provide official material in 10 different languages, including Bengali, Korean, Urdu and Arabic. Online resources related to the pandemic, spanning topics such as COVID-19 treatment, food assistance, housing, are also available in these languages.

But organizations like DRUM, Adhikaar, Chhaya, and BAPP say their communities are leaning heavily on them for translation services and language support.

“There’s this huge language barrier and for organizations like us we’re having to literally insert ourselves at every single point in this journey making sure people actually understand,” Gurung said.

Moumita Ahmed, a founding member of BAPP, said she’s acted as an interpreter several times for Bangladeshi acquaintances who weren’t able to communicate with their doctors. Ahmed described one instance of assisting a Bangladeshi woman who was tested at Brooklyn Hospital in Fort Greene but had difficulty accessing her results.

“It took a lot just to help one person,” said Ahmed.

Dr. Raihan Faroqui, also a member of BAPP, said that he was hearing of Bangladeshi New Yorkers who were calling 911 for the first time and experiencing difficulty navigating the service. Along with several others, he is planning to launch a hotline next week for Bangladeshis to hear COVID-19 information and straightforward guidance, spoken in Bangla.

“It’s not like we’re trying to make Bangla 911, that’s not what we’re trying to do,” Faroqui said. “You call us, you hear a prerecorded message in Bangla … Just hearing that in Bangla is so empowering.”

From the beginning of March to Thursday, 311’s Language Line, a vendor that provides interpretation services, logged 50,000 calls, nearly twice as many calls the city received during the first two months of the year.

The 311 system operator will hire additional 270 call-takers consisting of temporary workers and NYPD cadets in the next several weeks to increase its staff size to 860, according to the mayor’s office.

“311 is in the process of staffing up significantly, with a specific emphasis on Spanish-speaking call takers,” said Laura Feyer, a City Hall spokesperson.