After moving from Peru to Brazil, Katya Corado, MD, waited 10 years before she was able to move again to the United States, where she would later call Los Angeles home. Growing up, she watched her parents struggle to navigate the health-care system without health insurance, which catalyzed her ambition to become an infectious disease doctor. Today, she serves as the Latinx clinical trial investigator for a study sponsored by the National Institute of Health (NIH) and hopes to bring much-needed representation of communities of color and Spanish-speaking patients to COVID-19 treatment trials.
Joining Dr. Corado on the study is Judith Currier, MD, chief of the division of infectious diseases at the University of California, Los Angeles. Although COVID-19 vaccines exist, Dr. Currier and Dr. Corado are hoping to find an effective treatment for people who already contracted the virus with their ACTIV-2 study.
Below, Dr. Corado and Dr. Currier explain why it is important to have more BIPOC representation in clinical trials.
Well+Good: How are communities of color disproportionately impacted by the COVID-19 pandemic?
Katya Corado, MD: People of color are more likely to get hospitalized and die of COVID-19. There are many reasons behind that. Our communities are frontline workers continuing to work at the supermarket. They are Uber drivers. They are people who have constant contact with the community. And on top of that, there is unfortunately a high proportion of diabetes, high blood pressure, and heart disease in our communities as well. I see patients who don’t have documentation to be in this country. And so in many cases, they wait till very late in their disease for care. So that means, they’re walking around with undiagnosed high blood pressure, undiagnosed diabetes. And so when COVID-19 hits them, it doesn’t care if you’re diagnosed or not. When COVID-19 hits them, they’re more likely to have a negative outcome from the infections because their underlying disease has gone undiagnosed.
Judith Currier, MD: There are several factors that contribute to the high rates of COVID-19 among people of color in the United States. Again, one factor is occupation. Working in frontline positions where you’re exposed to people put people at risk.
What inspired you to get BIPOC and Spanish-speaking communities involved in clinical trials?
KC: My family is from South America, from Peru. My father’s dream was to move his family to the U.S. so that his children would have a chance to go to school. We moved from Peru to Brazil where we spent 10 years waiting for a visa. Upon arriving to the U.S., my father and my mother struggled with many things, including not have health insurance for a while. They sought care at safety net hospitals when they needed it. So when I see the patients in the waiting room, when I see patients in my clinic, I am seeing my family.
When you step back, and you look at who’s being infected, you realize that it’s the same populations that need to be represented in our clinical trials so that we have assurance that the vaccine we’re studying will work in our population. It’s more easy for them to look at me as a Latina, and they’re like, “Okay, you know what? I trust you, you are a part of my community. I believe in you.” Versus someone who is not part of the community who tries to do outreach.
JC: It’s important that people be at the table and be included in the way studies are designed and the way they’re done so that when the results come back, they’ll have confidence about using the treatment.
“If we don’t have representation of our communities in these trials, we will not have enough confidence on how those medications work in our communities.” —Katya Corado, MD
What is the importance of having communities of color represented in clinical trials?
KC: When you have a disease that affects communities of color, we have to make sure that the treatments and the vaccines work in those communities.
Say I have a clinical trial that enrolls a hundred people, right? And I’m testing this treatment to see if it works for whatever disease. I enrolled a hundred people, but those 100 people are all young white men. So, the study goes, and it is great, and the treatment works, and we’re all really happy. When I turn to my 60-year-old Latina female, and I’m trying to tell her about this treatment, I, as a physician, have no confidence that the treatment I’m trying to give her will work for her because her demographics was not studied in this clinical trial.
If we don’t have representation of our communities in these trials, we will not have enough confidence on how those medications work in our communities.
As the vaccines start to roll out, what do you hope to see happen in the COVID-19 clinical trial space in the coming year?
KC: Communities of color are less likely to uptake the vaccine. When I think about these things, this really tears at my heart. How do we bridge that gap? How do we create more trust between communities of color and the medical community? One of the ways that it’s done is by having people like me on these studies right? People of color who have gotten our degrees, who are doing these studies are here because we have fought to have representation at a high level in these clinical trials.
JC: The ACTIV-2 trial is aimed at finding early treatments for COVID. When people are first diagnosed, they’re told to stay home and wait and see if they get sick. And we want to intervene early to prevent people from getting sick and needing to go to the hospital.
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