Discrimination experienced by Asian Canadian and Asian American health care workers during the COVID-19 pandemic: a qualitative study

Zhida Shang; Jennifer Y. Kim; Shuliang O. Cheng

doi:10.9778/cmajo.20210090

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Table 1:

Sociodemographic characteristics of participants

Characteristic	No. (%) of participants n = 30
Gender
Female	18 (60)
Male	11 (37)
Nonbinary	1 (3)
Nationality
American	15 (50)
Canadian	15 (50)
Age, yr
< 25	4 (13)
25–29	16 (53)
30–34	3 (10)
35–39	5 (17)
≥ 40	2 (7)
Ethnicity
Chinese	8 (27)
Filipino, Filipina	5 (17)
Vietnamese	5 (17)
Taiwanese	3 (10)
Cambodian	2 (7)
Korean	2 (7)
Multiracial	2 (7)
Japanese	1 (3)
Malaysian	1 (3)
Pakistani	1 (3)
Worked with COVID-19 patients?
Yes	22 (73)
No	8 (27)
Practice setting or specialty
Medical–surgical	7 (23)
Intensive care	4 (13)
Adult outpatient	3 (10)
Internal medicine	3 (10)
Cardiothoracic surgery	2 (7)
Obstetrics and gynecology	2 (7)
Pediatrics	2 (7)
Anesthesiology	1 (3)
Emergency medicine	1 (3)
Family medicine	1 (3)
Infectious diseases	1 (3)
Neurosurgery	1 (3)
Palliative care	1 (3)
Rehabilitation	1 (3)
Profession
Nurse	16 (53)
Attending physician	5 (17)
Physiotherapist	3 (10)
Resident physician	2 (7)
Midwife	1 (3)
Paramedic	1 (3)
Pharmacist	1 (3)
Physician assistant	1 (3)
Location
Urban	28 (93)
Rural	2 (7)

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Table 2:

Major themes and selected illustrative quotes

Theme	Illustrative quotes
Surge of racial microaggressions related to COVID-19	To protect myself and other shoppers, since I work in a COVID unit, I decided to put a mask and gloves on. But every time I go to grocery shopping, I get this specific look, that uncomfortable look from people. Once I even got told to go back to China. (RN 11, nurse, Canadian)
	A lot of people at the beginning were talking about how bad China is, how they will never eat Chinese food again … . Idiots … . Then people will ask my opinion on COVID and about the markets and bat eating, but I am Filipino! I honestly have no idea about China; I have never been to China! (PT 2, physiotherapist, American)
	I keep on hearing these random comments: “oh those chinks” or “oh those Chinese people.” But I have to keep silent, since I still have to do my job, which is to give meds [to patients]. It is weird, since part of me wants to stand up and say: “I am Chinese; not all Chinese are carriers,” but the bigger part of me just wants to get the day over with and give them medication. (RN 8, nurse, Canadian)
	This lady was in a particular room for a long time, a 4-bedroom patient room, and generally I would be assigned to all the patients in that room. This patient will talk to her neighbours saying, “Don’t take anything from that nurse, she is contaminating everything with the COVID!” (RN 6, nurse, Canadian)
	She kept on screaming that I am provoking fear and that I am the reason for this confusion for society, and that I am COVID positive, since I have a mask on. Then she was questioning that if I was COVID positive, why am I even outside. She said I am from China, and that people like me have COVID and shouldn’t be outside. (RN 3, nurse, Canadian)
	From that experience [verbal abuse while commuting to work and wearing scrubs], I have been too scared to go on the train anymore. I keep thinking back on it. I kept thinking back about her taking pictures of me, and her racist remarks, and I don’t know why everyone’s go-to word is “chink” or “ching chong” … I feel like it was more racially driven than health care driven, or it could have been a combination against both. (RN 3, nurse, Canadian)
Lack of institutional and public acknowledgement	They have signs everywhere saying that they are health care heroes, we get drawings from kids thanking us for what we do. But sometimes it feels like it is theatrics and acting rather than actual action. I have never heard of places giving hazard pay to nurses. It is worth being angry about, basically being a sacrificial lamb, and not protect yourself because you signed up to be a health care professional, and this is what you have to do. It’s pretty disheartening for a lot of doctors and nurses. (MD 4, physician, American)
	I feel like America has failed its health care professionals. I don’t want anyone calling anyone a hero. I do think that the nurses in ICU, doctors and cleaning staff are heroes and are all amazing, but they did not sign up to be a hero; they signed up for a job. I personally have a problem with that rhetoric, and they need to take away that hero talk and compensate people appropriately. (PT 1, physiotherapist, American)
	We need to narrow the gaps in communications between the higher-ups and hospital health care workers. A lot of the time, even our immediate managers were unaware of the plans happening at the higher level, and what has happened within this pandemic was that the health care system was reactive, not proactive. So the moment that the politicians said what was gonna happen, it was a top–down effect. (RN 10, nurse, American)
	It makes me angry that politicians makes these stupid comments, like Trump, about China or Chinese people. Then people will think that if Trump says it, then it is ok for me to say it too. And I think it plays such a big role in how people here think, like people here are protesting against wearing masks, which I don’t think anywhere else in the world people are doing that. (MD 1, physician, American)
	This [COVID-19] is a political issue and it’s rooted in racism and socioeconomics. Honestly, it feels like the French revolution right now, it’s deeply rooted in so many things that are wrong with this country, I knew that something like this was going to happen. And it is seriously wild that Asians are being used as a punching bag for this. (PT 1, physiotherapist, American)