Coronavirus pandemic and racial status: an explosive mixture
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Coronavirus pandemic and racial status: an explosive mixture
Racial Status And The Pandemic
In early March, Madalynn Rucker, then 69, agonized over whether to close her Sacramento consultancy office. On the 16th, she finally succumbed to a barrage of texts and calls from her daughter about the heightened risk of the coronavirus, and told her employees to begin working from home. That was three days before California Gov. Gavin NewsomβsΒ statewide stay-at-home order.
Her daughter was right in more ways than one. While Ruckerβs age alone raised her potential danger of being hospitalized or dying of COVID-19, she and many of her employees share another risk factor: They are black. Rucker wonders if more public health messages targeting African Americans could have helped millions like her better prepare for the diseaseβs onslaught.
Officials and commentators said little about race early in the pandemic, recalled Rucker, now 70 and the executive director of OnTrack, a diversity consulting firm. βCould this have made a difference in some way? Not just in educating ourselves, but in how the pandemic was controlled and managed?β
By late February,Β doctors in China had publishedΒ that, in addition to older patients, those with chronic health conditions, particularly hypertension and diabetes, were more likely to have severe cases of COVID-19 that ended in ICU admission, mechanical ventilation, or death.
It wouldnβt have been difficult, some community leaders say, for officials to make an explicit connection between the coronavirus risk factors and African Americans and Latinos, who are more likely to have chronic diseases, and at younger ages β and then craft tailored, respectful messages for them.
βThe messaging I got from the news was, is that if youβre young, youβre good, and if youβre old, youβve got to stay home,β said Eddie Anderson, the 30-year-old pastor of McCarty Memorial Christian Church, an African American congregation in South Los Angeles.
When Anderson became ill with what turned out to be another viral infection in early March, he was alarmed by the lack of information about how to get tested for COVID-19. The experience motivated him to bring a physician friend to church the next week to explain the disease to his flock.
βI think targeted messaging to the African American community would have been helpful,β he said.
But public health and infectious disease experts say the novelty of the virus, whose targets and mode of attack continue to confound scientists, meant that specific racial disparities werenβt a foregone conclusion.
βI donβt know that itβs fair to say that it would have been something that could be 100% predicted,β said California Surgeon General Nadine Burke Harris. She called the novel coronavirus βa little bit of a head-scratcher.β For example, it doesnβt appear to affect children under age 2 or pregnant women the same way similar viruses would, she noted.
βSometimes when you predict too strongly, it can have the effect of assuming thatβs going to be the outcome, and it can come across pejoratively,β Burke Harris said.
But the disease has disproportionately hurt blacks. In California, 10% of COVID-19 deaths occurred among African Americans, who make upΒ 6% of the state population. A nationalΒ Centers for Disease Control and Prevention surveyΒ showed that 33% of hospitalized COVID patients were non-Hispanic blacks, though that group represented only 18% of residents in the surveyed communities.
Officials are finding itβs still difficult to talk about race and COVID-19. Fear of stigmatization remains high, said Burke Harris, who said she walks a fine line by letting certain groups know about the heightened risks without casting blame on them.
βOne of the things Iβve been dealing with a lot in having conversations with black media and black health researchers, right, is this notion of, well, wait a minute, as this data is coming out, how are we not blaming black and brown communities?β said Burke Harris, who is black. βItβs like, βOh, are you saying weβre sicker?ββ
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Preexisting conditions arenβt the only reason black people are dying at disproportionate rates of COVID-19, said Dr. Sonia Angell, director of the California Department of Public Health.
Despite statesβ orders to stay at home, entire sectors of βessentialβ jobs have disproportionately high rates of minority employees, which increases their exposure risk. These workers donβt benefit as much from social distancing, Angell said.
βTheyβre the ones that are keeping our care delivery system functioning so that when any of us get sick, we have a place to go,β she said. βTheyβre the ones that are keeping our grocery stores running and stocked.β
The absence of coordinated, official public messaging in February and early March about the potential racial disparity of COVID-19βs impact created a vacuum into which conspiracy theories rushed.
Initially came rumors thatΒ black people were somehow resistantΒ to the coronavirus. At the same time, black media outlets like TheΒ Philadelphia TribuneΒ (Feb. 4),Β EssenceΒ (March 2), theΒ St. Louis AmericanΒ (March 11) andΒ The UndefeatedΒ (March 13) made the connection between the virus and Americaβs preexisting health inequalities, publishing forward-thinking pieces about the virusβ potential threat to black Americans because of chronic medical conditions, working and commuting conditions, and a historical lack of access to health care and insurance due to institutionalized racism.
Their predictions soon proved true. Local officials began noting higher death rates for black COVID-19 patients inΒ Milwaukee on March 23. In the first week of April, city officials inΒ Chicago,Β Los AngelesΒ andΒ New OrleansΒ made similar announcements. The CDC published its first national data on racial disparities on April 8. A recent CDC study, published April 29, found that black peopleΒ made up 83% of COVID-19Β hospitalizations in Georgia, a disproportionate level compared with overall hospitalizations.
Public health messages targeting specific populations should be voiced by trusted community leaders, or at least someone of the same race, on media platforms where theyβre most likely to be seen or heard, said Dr. Oliver Brooks, president of the National Medical Association, which represents black physicians.
A week after announcing the statewide shelter order, NewsomΒ tweeted a public service announcementΒ fromΒ Snoop Dogg, who said,Β βThe longer you stay outside, the longer weβre going to be inside.β
Other targeted messages include Spanish-language public service announcements featuring Burke Harris and LA Galaxy soccer player Javier βChicharitoβ HernΓ‘ndez. Those have run on Univision; Radio BilingΓΌe, a Spanish-language public radio network; and other Spanish-language stations, as well as Instagram and Facebook. In HernΓ‘ndezβs clip, he encourages listeners in Spanish to seek medical attention if they have COVID-19 symptoms, no matter what their immigration status is.
Targeted messaging can sometimes offend or insult, even with the best of intentions, said Daniel Schober, assistant professor of public health and behavioral psychology at DePaul University in Chicago.
The city of Chicago offended some with a 2015 flu shot campaign that featured a black baby on a billboard next to the words, βI am an outbreak.β It inspired graffiti artists to weigh in withΒ their own message: βI am beautiful.β
But the cityβs COVID-19 campaign, featuring Mayor Lori Lightfoot, who is black,Β has charmed residents, said Schober. The campaign played off social media memesΒ depicting a no-nonsense LightfootΒ shutting down iconic Chicago landmarks under shelter-in-place directives. The cityβsΒ official video showed the mayorΒ baking, learning the guitar and sipping tea while exhorting people to βstay home, save lives.β
βThatβs a great example of a message that isnβt necessarily tailored toward specific racial or ethnic groups, but is really meant to be universal in its reach,β Schober said.

Kaiser Health News
Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.
Caption:
Preexisting conditions arenβt the only reason black people are dying at disproportionate rates of COVID-19