The two-year project will examine if minority populations have a weaker immune response to the virus.
University of Arkansas for Medical Sciences researchers are being awarded $1.3 million to investigate why minority groups are disproportionately impacted by COVID-19. Wendy Nembhard, a professor and chairwoman of the Department of Epidemiology at the Fay W. Boozman College of Public Health is leading the study, which launches this month.
As African American, Hispanic and Native American populations across the United States began experiencing higher infection rates last summer, the situation “became alarming” and health officials started speculating about the reasons, Nembhard says.
“There was a lot of angst and discussions about why this was happening and everybody’s first reaction was, well, it’s because of historical racism and discrimination in this country, impoverishment, and then also, perhaps intentional or unintentional, acts of racism that were happening in the sense that there was very well documented disparities for where testing sites were located, how the testing was rolled out in various communities,” she says.
The majority of testing sites have been located in white and affluent communities as opposed to lower socioeconomic areas or communities of color, Nembhard says. Another contributing factor leading to higher rates of infection as well as hospitalizations and deaths, could be that minority communities are more likely to have chronic health conditions like obesity, asthma, heart disease and diabetes.
“So while that might be true, we didn’t actually have evidence to support that,” Nembhard says. “We know that they have higher rates. Yes, this is true, but nobody had done any studies to say that the death rates were because African Americans, Hispanics, so forth had these more prevalent conditions and nobody actually had any evidence that the reasons for the infections were what had been speculated.”
Nembhard’s interest in the subject was piqued after reading an article describing the same pattern of higher incidence of hospitalizations and mortalities in European countries for people of African American descent as well as for some other ethnic minority groups.
“So I thought well, how do we know that the immune response to the infection is actually the same,” she says. “We made an assumption that we should see things that are the same for Caucasians, Asians, African Americans, Hispanics, but why are we making that assumption? There are other diseases for which we’ve seen differences in immune response, so maybe this is one of those diseases.”
The UAMS study will examine this hypothesis by analyzing data to determine if minority populations have a weaker immune response to COVID-19 over time.
“There’s a specific pattern of immune response that is characterized as weaker, so it’s not a disparaging term,” Nembhard says. “It’s actually a specific characteristic of an immune response.”
The project is funded by the National Cancer Institute through the new national Serological Sciences Network. SeroNet is led by NCI and involves 25 biomedical research institutions. The network was established using funds from an emergency appropriation of $306 million “to develop, validate, improve and implement serological testing and associated technologies,” according to NCI officials.
The UAMS project is one of 13 research projects in SARS-CoV-2 serological sciences being funded through the initiative. It’s exciting for Arkansas to be part of the consortium, Nembhard says, because many of the other institutions in the project are located on the coasts. The UAMS project will offer representation from a different, more rural part of the country.
“Arkansans’ voices will be heard and will also impact possibly policy and treatments and plans going forward in this country,” she says. “I think that’s really important and that minority populations in Arkansas, not just Caucasian populations but minority populations in Arkansas, will have a voice that can impact the way things are done in the future in the United States.”
Beginning in January, the Arkansas Department of Health will start contacting people who have recently tested positive for COVID-19 and invite them to participate in the study. Researchers hope to recruit about 600 Arkansans — 200 African Americans, 200 Hispanics and 200 non-Hispanic white Arkansans — from around the state.
Once they’re enrolled in the study, researchers will collect blood samples and conduct phone interviews with participants over the course of two years to see how things progress with their immune systems. There are some infections that suppress the immune system long term once you get them. It’s possible COVID-19 is one of those, Nembhard says.
“So if we contact you six months later and you say that you had a respiratory infection, is it taking you three months to get over that when in the past it would have only taken you a week? So again, trying to see how the immune response may have changed or may have been impacted by the SARS-CoV-2 virus,” she says.
Depending on the results, the UAMS study as well as others funded in the consortium could be extended after the initial two years. However, Nembhard says finding Arkansans who want to participate in the research may prove challenging.
“Historically, minority communities are less willing to participate and rightly so,” she says. “There has been a history of abuses that date back for many, many years, but all of those abuses have been addressed and there are provisions put in place to prevent researchers from doing that anymore. So I think minorities don’t have reasons to be concerned any longer.”
While preparing to launch the study, researchers met with focus groups from different minority groups around the state to listen to their concerns. With the prevalence of so much misinformation on the Internet, focus group participants expressed concern over verifying information and the validity of this study.
“They don’t want to just give information out to people that they don’t know if they’re really valid,” Nembhard says. “So they told us where they needed to get the information about the study to know that it was legitimate and who they would not believe if it came from them, so we made note of that.”
Focus groups also expressed interest in the study being mutually beneficial. In this instance, Nembhard says the notion of participating for the greater good is not a sufficient reason for people to sign up for the study. While they aren’t opposed to helping others, Nembhard says they wanted something more tangible in exchange for their participation in the study. Instead of money, focus group participants said they wanted information about the pandemic such as updates on research.
“They said that they wanted a reliable source of information to know that we really cared about them and not just was there to get information out of them, but we really cared about how they were doing and their interests and their needs,” Nembhard says. “I think that that’s really why we’re doing this study, so I think that was an easy match.”
Rolling invitations to potential research participants will be issued by the Arkansas Department of Health on a weekly basis. Possible candidates need to be enrolled in the study within a week of testing positive.