All three men have since recovered and are now part of the state’s database of more than 80,000 confirmed infections, but a central part of their identities is missing from that list — the fact that they are gay men.
Public health officials aren’t collecting any data to show how LGBTQ people are harmed by the coronavirus pandemic, although advocates and some health experts say the toll the disease is taking could be more severe than for the population as a whole.
LGBTQ leaders say if the state knows how the coronavirus is spreading among a distinct demographic group, health officials can better identify pockets of outbreaks and tailor messages to reach the community. They also say the information could ensure that LGBTQ people are included in the state’s recovery efforts.
California has documented the coronavirus’ uneven toll on other demographic groups, such as higher death rates among people over 65 and people of color. But public health officials aren’t tracking whether it is disproportionately affecting the LGBTQ community.
Haley, also known as Mercedez Munro, a longtime San Francisco drag queen, said he fears the state is missing pockets of outbreaks among LGBTQ people, and with it a chance to help slow the coronavirus’ spread.
“Nothing that related to my specific demographic as a gay person was asked,” Haley said of his interactions with health workers while he was being treated at St. Francis Memorial Hospital.
Advocates point out that many LGBTQ people are more vulnerable to suffering severe effects from the coronavirus because of a high prevalence in the community of such conditions as HIV, some cancers and respiratory problems from smoking.
LGBTQ people are also more likely to be homeless, especially in their youth, and to avoid medical care because they fear they will face discrimination.
Rick Zbur, executive director of Equality California, the LGBTQ advocacy group, said health officials at all levels of government “are failing our community.” He that said without data, no one can know for certain if the pandemic is infecting more members of the community.
“We’ve been an afterthought, a sideline,” Zbur said. “If LGBTQ people are left out of the data, then we’ll be left out of the response.”
State lawmakers are considering legislation, SB932, that would require providers to ask each patient’s sexual orientation and gender identity, though people could decline to answer.
State Sen. Scott Wiener, the San Francisco Democrat carrying the bill, said the data would allow health officials to identify and combat pockets of infection. He said the data could also ensure the community gets the support it needs to recover.
Wiener said the state’s inattention to LGBTQ health during the pandemic evokes still-raw memories of government’s inaction in the early days of the AIDS epidemic in the 1980s.
“Once again we have marginalized communities that are being very disproportionately impacted, and society is not doing enough,” Wiener said.
He added, “This is the history of the LGBTQ community. Unless we stand up for ourselves, progress for our community doesn’t happen.”
Joe Hollendoner, CEO of the San Francisco AIDS Foundation, said knowing how many LGBTQ people are infected could help the state tailor community-specific messages on how to avoid spreading the virus.
“The more precise information that we have, the more successful that our public health interventions are going to be,” Hollendoner said. “What we know from the HIV epidemic is the better our data, the better the response.”
Wiener’s bill faces little opposition in the Legislature, and unanimously passed the Senate Health Committee last week.
But even if the bill sails through the Legislature, LGBTQ advocates worry it could be too late. More than 30,000 people are tested in California every day, and the state is missing its chance to collect data about them.
“Every day that this doesn’t happen, we are losing valuable data,” Wiener said. “But better late than never.”
Wiener and LGBTQ leaders want Gov. Gavin Newsom to issue an executive order requiring health providers and county health officers to start collecting the data immediately.
Newsom told reporters last week that the state has not been “forthcoming” with information about infected LGBTQ people. He said Wiener’s bill could help solve the problem, but didn’t commit to an executive order.
“The community is absolutely right,” Newsom said. “For decades, we have been underreporting (health information) in the LGBT community space.”
Even health officers in areas with large LGBTQ populations, including San Francisco and Los Angeles counties, have not broken down coronavirus cases for the community. A spokeswoman for the San Francisco Department of Public Health declined to elaborate on the rationale, saying, “This isn’t data that testing sites are required to report.”
The California Department of Public Health said it will ask patients if they are LGBTQ as part of its contact tracing efforts, but it hasn’t asked health providers to do so on a large scale at the time of diagnosis.
The department said asking those questions during tracing interviews could be beneficial because it allows people to “describe their own identity” in person, “versus filling out forms.”
Haley, meanwhile, has recovered and returned to his day job at a local juice store. He said he plans to take a break from drag performances because the powder and makeup could irritate his lungs.
He said that although people in the Castro neighborhood, where he lives, are largely staying vigilant against the virus, with masks and social distancing, he worries that many LGBTQ people are at extra risk because they work in the service industry and interact with customers face to face.
Haley said he’s hopeful the state will start gathering data so it can learn whether the LGBTQ community really is being harmed more, as he suspects, and provide more relief.
“I do think that knowledge is power,” he said. “People that are high-risk are my demographics exactly.”