‘They have put my people on death row.’ Commissioners question sites for COVID-19 testing.

Editor’s note: This story has been updated to include a previously omitted portion of a quote by Kinneil Coltman, senior vice president for Atrium.

When the first confirmed cases of coronavirus arrived in March, the Charlotte area’s biggest medical providers opened drive-through test sites across the region.

In all, Atrium Health and Novant Health chose eight locations where those seeking tests for COVID-19 could go.

But as cases mounted, some elected officials grew increasingly concerned that resources — including testing sites — were not targeting Charlotte’s most vulnerable neighborhoods.

Residents especially at risk live in neighborhoods that form a crescent just north of uptown, stretching from West Boulevard in the west to Idlewild Road in the east, according to data from the federal Centers for Disease Control and Prevention.

In some cases, neighborhoods there are 10 times more vulnerable to a health crisis than other, more affluent parts of the county, according to an Observer analysis of CDC data. Households in those areas suffer from problems such as high rates of poverty, lack of transportation and crowded housing.

The hospital systems said they did set up two sites in ZIP codes that serve Charlotte’s most vulnerable areas. One was in a sparsely populated location near Charlotte Douglas International Airport. The systems would not identify the location of the other, except to say that it was in the 28216 ZIP code, which extends northwest from uptown to the outerbelt.

Three county commissioners told the Observer that, as weeks passed, they grew distressed that coronavirus was infecting African Americans at a disproportionately high rate. Only after they sounded alarms, they maintain, did the not-for-profit hospital systems shift more testing into low-income Charlotte neighborhoods.

Now, commissioners Vilma Leake, Mark Jerrell and Susan Harden and the local chapter of the NAACP say early decisions by Atrium and Novant contributed to unequal access to testing and medical treatment as the virus began spreading across the county.

“They have put my people on death row,” said Leake, who represents some of the poorest neighborhoods in the county in west Charlotte. “Seniors are coming up to me saying, ‘What future do we have to look forward to? They have written our death certificates.’”

Atrium set up coronavirus screenings in Concord, Fort Mill, Shelby and Monroe, in addition to the Charlotte locations. Novant put sites in Huntersville and Matthews.

Mecklenburg had about 1,850 confirmed cases as of Wednesday and 58 deaths, according to the county health department. Almost all the deaths involved people over age 60 with underlying health conditions, the agency says. The county has said there are “persisting disparities” among patients with COVID-19. As of Sunday, 44% of confirmed cases were African Americans even though blacks comprise 32% of the county’s population.

Jerrell, who lobbied for more testing in east Charlotte, said it is difficult to come up with a reasonable explanation for why the hospital systems or county administrators did not prioritize neighborhoods in Charlotte that for generations have suffered high rates of diabetes, hypertension, lung disease and other conditions that can cause life-threatening complications from coronavirus.

“We should have done better at identifying communities that were vulnerable,” Jerrell said. “It was not good. We have got to get resources where people are the most vulnerable.”

Since the public health crisis began, Charlotte-Mecklenburg government leaders and Atrium and Novant have worked with each other to coordinate the local response to COVID-19, the illness caused by the novel coronavirus.

In written responses to questions from the Observer, County Manager Dena Diorio said the hospital systems determined where they conducted drive-through testing.

Atrium and Novant officials said they were working under intense time constraints as the global pandemic reached Charlotte and that they followed CDC recommendations.

At the time, they said, the CDC suggested officials focus testing on people who had traveled internationally, showed severe symptoms or had been exposed to someone diagnosed with the virus.

“The information was changing from minute to minute,” said Dr. Jerome Williams, Novant’s senior vice president for consumer engagement.. “Social distancing had not started.”

Kinneil Coltman, senior vice president, chief community and external affairs officer for Atrium, said the Charlotte-based hospital system put more focus on vulnerable Charlotte neighborhoods when it discovered data showing a need for more testing in communities of color.

“Large, complex healthcare systems do not easily pivot on a dime, but that’s exactly what we did,” Coltman said.

Testing locations

The CDC’s Social Vulnerability Index ranks how susceptible neighborhoods are to pandemics, storms or other disasters. CDC officials rate the neighborhoods based on 15 factors from health and income to housing and education.

Local public health officials and local planners should use the index to help determine where to allocate preparedness funding, personnel and supplies and identify communities that will need extra support to recover from an emergency, the CDC says.

But at least six of eight drive-through testing locations chosen in March by Atrium Health and Novant Health are outside those areas.

Novant opened coronavirus screening sites adjacent to its hospitals in Matthews and Huntersville.

The median household income in Huntersville is more than $97,000 a year and nearly $79,000 in Matthews, according to U.S. Census Bureau statistics from 2018. Median household income overall for Mecklenburg is about $64,000 a year.

Novant chose the sites because it needed properties large enough to handle heavy traffic and close enough to relocate personal protective equipment and other supplies quickly, Williams said.

Officials feared a sudden surge in coronavirus patients and set up the screening sites overnight, he said.

Infection rate

Some county commissioners said they believe a failure to put drive-through testing in areas near uptown has worsened a disproportionate number of coronavirus infections in African Americans in Mecklenburg County.

Harden, the commissioner, said it is clear that the hospitals did not prioritize the needs of low-income neighborhoods despite a longstanding lack of access to healthcare.

“I cannot explain why this happened,” Harden said. “We are supposed to be the voice of the people.”

African Americans and other minorities who largely comprise the residents in Charlotte’s most vulnerable neighborhoods often work in grocery stores, custodial services, construction and other jobs that don’t allow them to social distance by working from home, said Corine Mack, president of the Charlotte chapter of the NAACP.

That means the hospital systems and local public health officials should have realized those residents would need access to testing as soon as possible, Mack said.

“The decisions that were made were harmful,” Mack said. “You can talk all day, but your actions say that you don’t really care.”

Atrium and Novant officials said the testing sites did not play a role in the disproportionate number of African Americans becoming infected with coronavirus.

A long history of racial discrimination in the United States has left chronic diseases such as diabetes, hypertension and lung disease over-represented among African Americans, leaving the community more susceptible to severe complications from coronavirus, said Williams.

“It highlights not just COVID-19 but inequities in ZIP codes not just in the county but the country,” Williams said.

Testing shift

In April, Atrium and Novant expanded coronavirus testing in minority neighborhoods by sending out roving mobile units. Patients do not need an appointment or physician’s referral to get tested.

Novant has also opened a respiratory assessment center at the Michael Jordan Family Medical Clinic along Freedom Drive in west Charlotte to screen and diagnose patients with respiratory symptoms.

Williams said Novant was working on its plan before learning about questions raised by county commissioners.

Coltman, the Atrium executive, said the hospital system is now forging relationships with churches, where mobile testing sites are sometimes set up in parking lots.

Atrium also launched a public information campaign by working with minority media outlets and clergy, she said. Novant said it has done the same.

“We listen,” Coltman said. “We try to be responsive.”

But commissioners Leake and Jerrell said they are still frustrated drive-through testing was not initially located in low-income Charlotte neighborhoods.

“I don’t know why we’re in this situation,” Leake said. “The people who suffer the most, got the least.”

This story was originally published May 7, 2020 at 1:23 PM.