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It's interesting how the mainstream media and politicians have shifted to arguing that black people are dying of COVID-19 at alarming rates because of pre-existing medical conditions, environmental racism, and poverty alone... it's a slippery slope toward abstracting the problem
Our pre-existing medical conditions and poverty within our communities affect our chances of surviving COVID, but they aren't the only or even the primary reasons why we are dying.
Yes, our high rates of pre-existing medical conditions (like asthma, heart disease, lung disease, diabetes) are due to centuries of racist healthcare and economic policies. These pre-existing conditions make us more vulnerable to contracting and having severe cases of COVID-19.
But, it's the decisions that have been made over the course of the last 2-3 months that are killing us.
1) We are dying because our communities were denied access to testing at the outset of the outbreak. Philly is a good example. The first testing sites in Philly opened in March in the majority-white neighborhood of South Philadelphia.
Until a few days ago: You could only get tested with a doctor's referral, if you were a first responder or medical provider (narrowly defined), or over the age of 50 (only at an outdoor site open a few hours a day). There were fewer testing sites in black neighborhoods.
2) Unlike other demographics, our pre-existing conditions tend to be unknown, untreated, or uncontrolled because we are disproportionately uninsured and under-insured. This means COVID will affect us more severely than other populations with similar pre-existing conditions.
It hasn't helped that our government and media have falsely touted known treatments for Lupus (and other diseases) as panaceas for COVID, creating shortages for those (mostly black women) in need. https://www.buzzfeednews.com/article/tanyachen/kaiser-permanente-lupus-chloroquine
Also, by refusing to create an emergency universal health insurance or waive all medical costs (not just the COVID-related ones), our politicians failed to provide black people with the means to see a doctor, refill medications, or access testing and treatment.
^ These things are the difference between surviving COVID and dying of it.
3) Black people are also dying at alarming rates because of everyday implicit bias and explicit medical racism. I and many many others before me have written about the history of this elsewhere.
Medical providers (regardless of their race) do not trust black people when they report symptoms. Medical providers (regardless of their race) routinely dismiss the severity of black people's symptoms.
These provider biases are the difference between who gets a COVID test referral and who doesn't, who gets sent home with a nebulizer and a Z-Pak and who doesn't. These biases decide who gets to stay on the vent and for how long - who dies and who lives.
4) Black people are also dying of COVID because of 3 intersecting information breakdowns that happened between February and March.
a) The misinformation campaigns that said that black people were immune and/or cited technology as the "true" cause of the disease.
b) The absence of any targeted information campaigns or even a moniker of effort from public health officials to send targeted information and collaborate leaders in black communities in January, February, and some of March.
If folks wanted to save black lives, every black religious leader, yoga teacher, acupuncturist, body worker, STI testing site, barber, hairstylist, podcast host, pharmacist, bodega staff member, and cosmetologist should have been given information about COVID. They weren't.
Instead, we were marketed cheap flights and conspiracy theories.
c) Translations for ESL black people: There were no materials in Spanish until mid/late February, some cities didn't translate until mid-March. There is still limited material in Portuguese, Kreyòl, French, and Arabic. I don't even know if East African languages are represented.
5) Black people (rightly) distrust medical providers and the government because of their histories of violent and racist practices. Black community leaders have demonstrated time and again that the best way to overcome that distrust is with grassroots community engagement.
For example: Black women organizers and intellectuals had to make their own information, campaigns, and community discussions that centered black experiences with HIV/AIDs during the early years of the pandemic. https://www.tandfonline.com/toc/usou20/21/2-3
Thankfully we are now seeing similar work on a variety of fronts. But, we are playing catch up as COVID fractures our communities. Knowing this history, our government, media, public health leaders should have established this kind of outreach from jump.
6) BLACK PEOPLE ARE DYING BECAUSE MANY OF THEIR EMPLOYERS FORCED THEM TO WORK WITHOUT PUBLIC HEALTH BRIEFINGS, HANDWASHING STATIONS, PPE, MEDICAL LEAVE, FAMILY LEAVE, OR PAY RAISES THAT COULD OFFSET THE COST OF AVOIDING PUBLIC TRANSIT FOR COMMUTES OR MEDICAL VISITS.
To my knowledge no federal, state, or local governments stepped up to force these employers to protect their workers.
7) OUR FEDERAL, STATE, AND LOCAL GOVERNMENTS ARE DRAGGING THEIR FEET ON DECARCERATION. If they don't #freethemall, the pandemic will continue to spread and kill the mostly black populations inside these institutions and those outside their walls
There are probably a host of other reasons too. But my point is: failing to acknowledge the very recent racist decisions that are causing black people to die, risks absolving everyone with decision-making power of their responsibility.
While centuries and decades of American racism contributed to this crisis. The decisions made in 2020 are why we are dying and the decision-makers have to be held accountable.
