CDC report covid-19 cases by census tract

This map, from the CDC report, shows COVID-19 cases by census tract in Elkhart County, from March 11 through July 21. Redder colors indicate more cases.

ELKHART — Months later than expected, a Centers for Disease Control and Prevention report on the COVID-19 outbreak in Elkhart County was released Wednesday.

The CDC was initially expected to give the report to Elkhart County in July but postponed on multiple occasions. Some local leaders have pushed the Elkhart County Health Department to release a draft it had received, but Wednesday the full report was released to the public.

The report covers the local outbreak from July 6 through Aug. 5, which was after the worst parts of the first wave of the local outbreak and before the current surge, which has resulted in more new cases than ever.

CDC staff worked with the ECHD and spoke with residents, manufacturing leaders, and politicians to understand the local response and possible shortcomings. The CDC placed a particular focus on uncovering how the virus was affecting Hispanic and Amish communities and how health officials could better help those communities. Given Elkhart County’s significant RV manufacturing, the CDC also tried to assess that industry’s role in the outbreak but found it difficult to speak with employees, since many feared reprisals for speaking openly.

According to the report, part of the reason that Elkhart County’s COVID-19 outbreak had gotten so bad at the time was that so many residents work in manufacturing, and that thousands of people commute to or from the county every day.

“While most cities were able to shelter in place and stay home at the start of pandemic (sic), many citizens are “frontline workers” including those working in the RV industry and other industries and, thus, kept working,” the report said.

It also noted that some of these employees work in environments where it may be difficult to wear a mask. They may also be incentivized not to miss work even if they are sick, due to a lack of sick leave days. That was a particularly serious issue among Hispanics, the report found.

“The main concern shared by participants was related to having to missed work due to being sick with COVID-19 and not having the means to provide for their family,” the report said.

Employees, many of them Hispanic, also said employers did not always enforce COVID-19 prevention measures. Another main concern among Hispanics was a language barrier, preventing some from being able to understand English communications about the virus. The CDC recommended tailoring communications specifically to the Spanish-speaking population.

The report found that the outbreak in Amish communities may have become worse than it otherwise would have been after some early communication in LaGrange County appeared to blame the outbreak on Amish social gatherings, worsening the relationship between government officials and the Amish. Another issue was a lack of regularly open testing sites near Amish populations.

Among Amish people who spoke to the CDC, most said that they did not believe the media, the government, or the health care systems were providing accurate and reliable information about COVID-19. Some participants simply stated that they were “going to trust God,” the report said. The CDC recommended utilizing Amish places of worship and Die Blatt to reach those populations through outlets they trust.

Other recommendations from the CDC included data collection and analysis. The CDC specifically mentioned improving race and ethnicity data, as many individuals’ ethnicity are labeled “unknown,” making it harder for health officials to understand what populations are most affected.

The CDC also recommended continuing the assessment of the RV industry, which should include a continued effort to speak with RV industry employees to get their perspective on workplace environments.

Finally, contact tracing should be improved, in part by getting the community to understand the importance of it and by increasing the amount of Spanish-speaking contract tracers.

The Elkhart County Health Department will be considering all recommendations provided in the CDC report, a news release from Elkhart County Health Officer Dr. Lydia Mertz said.

“The release of this report comes at a time when we’re experiencing another spike in cases,” she said. “But, we can get this under control. Folks need to go back to wearing a mask in public, social distancing, staying home if they are sick, and washing their hands.”

Mertz said in an interview Wednesday afternoon that she is still looking at the report to see if the CDC recommendations go beyond the improvements that the ECHD has made in the months since the agency left.

“We’re looking at the way that we’re communicating now and seeing if we’ve improved it since they came and did all the studying, and we’re looking to see if the things that they have listed are really things that we can do or something that would make a difference. We certainly need to make a difference,” she said.

On contact tracing, Mertz said the county’s information is so good that they can tell that the current surge is not caused by or limited to any particular groups or activities in the county.

“It’s not just the RV spread, it’s not just the churches, it’s not just any certain event that we can target,” she said.

The CDC report is available at with this article.

Follow Rasmus S. Jorgensen on Twitter at @ReadRasmus

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