April 13, 2020

Race and Coronavirus

“Democratic lawmakers and community leaders in cities hard-hit by the pandemic have been sounding the alarm over what they see as a disturbing trend of the [coronavirus] killing African Americans at a higher rate, along with a lack of overall information about the race of victims as the nation’s death toll mounts… Of the victims whose demographic data was publicly shared by officials — nearly 3,300 of the nation’s 13,000 deaths thus far — about 42% were black, according to an Associated Press analysis. African Americans account for roughly 21% of the total population in the areas covered by the analysis.” AP News

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From the Left

The left argues that it is important to focus on racial disparities, because they stem from structural inequality organized along racial lines, and emphasizes the importance of societal solutions.

“With every day that goes by, it becomes more clear that the virus isn’t an equalizer at all… It starts with who’s able to shelter in place — while many white-collar workers can work from home, a disproportionate share of the front-line workers still going to their jobs in many industries are women and people of color. And among those staying at home, inequality is still a huge issue, with some able to order delivery and others forced to visit overstretched food banks to meet their needs…

“While some health care workers, like doctors, can make a high income, inequality shows up within the health care workforce as well. Women and people of color are ‘much more likely to be in those really front-line staff positions where they’re less well-protected,’ [political science professor Julia] Lynch said, such as catering or janitorial services in hospitals… [In one] poll of 250 hospital workers, mostly housekeepers and nurse’s assistants, 75 percent said they were told they did not need protective equipment or had to ask a nurse for it.”
Anna North, Vox

“A recent PNAS study found that across the US, black and Hispanic people are exposed, respectively, to 56 and 63 percent excess exposure to air pollution — bearing the brunt of [the] health impacts… ‘We’ve known literally forever that diseases like diabetes, hypertension, obesity, and asthma are disproportionately affecting minority populations,’ Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said at an April 7 press conference. ‘There’s nothing we can do about it right now.’ While he emphasized ensuring these communities get the best possible care, that kind of shoulder-shrugging is at the root of the problem — and shows there’s never a convenient time to address a problem like this…

“But there are actually things that could be done right now: For one, expanding federal financial coverage for testing and treatment of Covid-19 so that low-income people have equal access to care. And, as John Balmes, a pulmonologist and spokesperson for the American Lung Association suggested to the New York Times, ensuring that hospitals in the most at-risk neighborhoods are prepared and prioritized for critical supplies. What’s not helpful is placing blame on people of color.”
Lois Parshley, Vox

“As NPR reported, a recent study of several states found that doctors may be less likely to test Black people with COVID-19 symptoms. In the cities that do have testing sites, some of their locations seem to imply whose lives are considered most valuable. In Nashville, NPR reported that more affluent areas have had testing sites up and running, whereas three of the city’s drive-through testing centers in diverse neighborhoods were closed for weeks because they were unable to obtain testing equipment and protective gear… it’s irresponsible to discuss the impact of COVID-19 within the U.S. without discussing race.”
Jameelah Nasheed, Teen Vogue

Camara Jones, a physician and epidemiologist who worked at the Centers for Disease Control and Prevention, states, “The fear is, and in Italy, the reality was, that the very fact that they have diabetes or they have chronic lung disease or hypertension or some other kind of heart issue, that those things are going to be counted against them if a decision has to be made of which of these patients get the last ventilator… We’re applying these criteria evenly to everybody, but without recognizing that the historical injustices that have made themselves evident in people’s health status is not evenly distributed… If you were to disqualify people or even ding them a little bit in terms of a priority- based on preexisting conditions, that will systematically disadvantage people of color in this country.”
Edwin Rios, Mother Jones

“The government built highways that carried white families to new suburban neighborhoods where minorities often were not allowed to live; it provided mortgage loans that minorities were not allowed to obtain; and even after explicit discrimination was declared illegal, single-family zoning laws continued to exclude low-income families, particularly minorities… The inequalities of wealth have become inequalities of health. A middle-aged American in the top fifth of the income distribution can expect to live about 13 years longer than a person of the same age in the bottom fifth — an advantage that has more than doubled since 1980…

“The multi-trillion-dollar scale of the government’s response to the crisis, for all its flaws and inadequacies, offers a powerful reminder that there is no replacement for an activist state. The political scientist Francis Fukuyama has observed that the nations best weathering the coronavirus pandemic are those like Singapore and Germany, where there is broad trust in government — and where the state merits that confidence. A critical part of America’s post-crisis rebuilding project is to restore the effectiveness of the government and to rebuild public confidence in it… The United States has a chance to emerge from this latest crisis as a stronger nation, more just, more free and more resilient. We must seize the opportunity.”
Editorial Board, New York Times

From the Right

The right recommends focusing on the factors that underlie racial disparities, such as poverty and pre-existing health conditions, rather than race itself, and emphasizes the importance of individual responsibility.

The right recommends focusing on the factors that underlie racial disparities, such as poverty and pre-existing health conditions, rather than race itself, and emphasizes the importance of individual responsibility.

“The first thing that should be said is that the outsized number of deaths in the black community is a very real and very serious issue that points to our nation’s great failures in serving that community for decades… While disparities in the black community, not just medical, but economic and educational as well need to be dealt with in the long term, it is wrong to make it a focus of our immediate response to the coronavirus, which of late is looking to be very effective…

“The mantra on both the federal and state level during this crisis has been to get medical professionals and supplies to where they are needed as fast as possible. This has been achieved by looking at testing, hospital rates, models and an abundance of other tools that need not and should not take race into account. If a hospital in Detroit needs ventilators we send it ventilators. We don’t take a census of the patients to ensure some kind of demographic equality… There will soon be a time for lessons, noting things we got right in fighting the virus, and examining the things we got wrong. At that time, the racial disparities, which long predated the virus must be interrogated; better answers must be arrived at. But we aren’t there yet.”
David Marcus, The Federalist

“Our response to the virus should be as comprehensive as possible. We wouldn’t want to miss, for instance, the possibility of a tragic and destructive outbreak in the county that in 2016 held the title for America’s lowest male life expectancy due to its high concentration of health problems — that was West Virginia’s McDowell County, a locale that is around 90 percent white…

“Rather than trying to draw a circle around a racial approximation of who has it ‘worst,’ we should marshal our resources and sympathies to ensure that nobody squeezes through the cracks. It may very well be true that in many locations, the majority or a disproportionate number of the people who hold the actual causal risk factors are African American or Latino. But if we care for those people who hold the actual at-risk factors rather than trying to approximate them with racial generalizations, we should be able to respond in a way that encompasses everyone — whether they be black, Latino, white, Asian, Native American, or mixed-race.”
Zaid Jilani, National Review

“While economic inequality and unequal community resources are real, and society must work relentlessly to ensure equality of opportunity, those underlying maladies have a large behavioral component that remains within individual control. Black people tend to be poorer, and poor people exercise less and smoke more, according to the CDC. It is not compassionate to constantly drill home the message that members of favored victim groups are incapable of determining the shape of their lives. Underclass whites have similar health problems because they, too, are making bad lifestyle choices. And they will be similarly overrepresented among coronavirus fatalities.”
Heather Mac Donald, Spectator USA

“I grew up in the rural South, and let me tell you, the diet of country people — black and white — is not what you would call healthy. What people call ‘soul food’ is delicious, but heavy on pork fat and salt… A lot of [liberal] commentators assume that poor people eat bad diets only because they have no choice; they don’t give them agency, which is a mistake. Here in Louisiana, you run into people all the time who are solidly middle class, or even upper middle class, who have the money to eat healthier, but who won’t do it because they were raised on high-fat, high-carb food, and that’s what tastes good to them…

“You can’t blame poverty for non-poor people choosing to eat food that makes them unhealthy. I am a yuppie type who has a much healthier diet than many people, but if I have to choose between going to Sonic for a double cheeseburger, and going somewhere else for a salad, that sure enough requires an exercise of willpower… Guess who is about 40 pounds overweight? Me! I think I technically qualify as obese. If I get coronavirus, I will suffer more because I am overweight, and I am overweight because of my diet and my lack of physical activity. Society didn’t force me to be this way. I’m lazy, and I like to eat things that are not good for me.”
Rod Dreher, American Conservative

At the same time, “It is both possible and essential to provide poor communities with public health information and, where possible, testing and other health care resources via faith-based and other community institutions as well as public agencies. Increasing funding for federally funded community health centers is also essential, especially since many such centers have had to lay-off workers as they have shifted to providing mostly COVID-19-related services. Beyond these immediate steps, any ‘after-action’ study of the COVID-19 crisis needs a sharp focus on the relationship between race, illness, and the responses of federal, state, and local governments in preparing for and responding to the pandemic. Like the response to Hurricane Katrina, we have thus far come up short, and we are running out of excuses.”
Brent Orrell, American Enterprise Institute

A group of doctors write, “We must continue to refine our governmental and health care responses to the pandemic to: 1) Broadly record and report demographic data on virus spread and mortality. This data is critical to mobilize resources to the hardest-hit, most underserved areas. 2) Ensure access to current and emerging therapies and clinical trials. Minorities account for only about 10% of patients enrolled in clinical trials. We recommend using patient navigators and community health workers to enhance diversity in enrollment. 3) Provide mobile access testing sites for vulnerable urban and rural communities. People in these areas need either transportation or onsite testing…

4) Communicate with these communities through trusted local stakeholders and leaders. Establish leadership groups to sustain vital involvement from the health care community in these neighborhoods. 5) Commit and organize nationally, regionally and locally to address the medical and social determinants of health that have created and sustained the preexisting COVID-19 health disparities… If we fail to address the unique needs and concerns of vulnerable populations, when the coronavirus pandemic finally recedes, we may find that these communities have paid an unthinkable price for our inaction.”
Dr. Selwyn M. Vickers, USA Today

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