By Barrington M. Salmon Contributing Writer @bsalmondc | Last updated: Apr 21, 2020
People wait for a distribution of masks and food from the Rev. Al Sharpton in the Harlem neighborhood of New York, after a new state mandate was issued requiring residents to wear face coverings in public due to COVID-19, April 18. Photo: AP Bebeto Matthews
Covid-19 has carved a deep and deadly path through Black communities across the U.S., snatching the lives of Black Millennials, Baby Boomers and the elderly. The reasons are varied, many and complex.
Beyond the obvious alarm are questions about what Black people must do to protect themselves but an equally important question is what’s available from city officials, the state and federal government of a medical, health, social or economic nature that can stop or stem the disproportionate killing of Black people?
Answers have been generally hard to come by, but in Black communities around the country, individuals and groups have sprung into action, whether to raise money for healthcare providers, set up food banks or create public service announcements to offer psychological advice to Black people stressed out about being suddenly unemployed, not having money to pay the rent, food, utilities or other bills or being fearful of catching Covid-19.
The coronavirus has fundamentally altered the way Americans live, at least in the short-term. Public schools, colleges and universities are closed for the foreseeable future. Businesses large and small are shuttered and about 80 percent of the United States—almost 300 million people—are sheltering in place or living in a state that is under a mandatory lockdown. Hospitals are overwhelmed, staff are trying to save lives and offer medical care without adequate personal protective gear. Doctors and nurses have detailed the shortage of gowns, masks, ventilators and other medical gear and equipment.
Experts warn the U.S. is short on ICU beds and ventilators needed to treat the disease. Trying to prepare for the worst, hospitals were ramping up their capacity and setting priorities. One proposal would draw doctors out of retirement, others are canceling elective surgeries, and calling for setting up “Covid Cabanas” to treat suspected coronavirus cases, setting up tents outside main facilities, and more.
Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University, has been a persistent critic of the U.S. government’s response. “We are so incredibly underprepared for a major onslaught to hospitals, which is basically now inevitable,” he told Yahoo News. “We have to look at Italy and see what happened and I think we’re actually in worse shape. We don’t have enough hospital beds; we don’t have enough ICU beds. And by the way, even if we had the 100,000-plus ventilators that we actually need, we don’t have the staff to operate them.”
Much of the blame for the federal government’s anemic response, the slow ramp up of tests and other resources nationally, and the almost blanket denial of Covid-19’s spread by federal officials has come to rest at the feet of President Donald Trump. From the beginning, critics charge, he has downplayed the crisis, at one point calling it a “hoax,” blamed the pandemic on foreigners and Democrats, and shut down air travel from Europe to the U.S. in a futile effort to stem the proliferation of the disease.
It is customary when dealing with a virus of this nature, epidemiologists and other medical experts say, that the first steps in reining in the disease is to have extensive testing and contact tracing to ascertain who has the disease and where and how it’s spreading. However, the Trump administration has ignored this advice and has left testing to the states. This haphazard approach is exacerbated by the fact that there are not nearly enough test kits or test kit parts to administer the needed number of tests.
“There aren’t enough numbers because we don’t have testing,” said Dr. Ebony Hilton, an associate professor of Anesthesiology and Critical Care Medicine at the University of Virginia, in a recent interview. “The World Health Organization has testing available in January that we could have been using but we chose not to. Sixty countries were testing 10,000 people a day. We have only tested about 2.3 million people.”
An investigation by Nature magazine of several university labs certified to test for the virus discovered that they have been held up by regulatory, logistic and administrative obstacles, and stymied by the fragmented U.S. health-care system. Even as testing backlogs mounted for hospitals in California, for example, clinics were turning away offers of testing from certified academic labs because they didn’t use compatible health-record software or didn’t have existing contracts with the hospital. Researchers warn that if such hurdles remain, labs trying to join the effort to fight coronavirus might end up spinning their wheels.
As long as there remains this confusion and lack of leadership from the federal government, critics say, it’s unlikely that those African Americans most under threat from the coronavirus will be getting tested anytime soon, despite pressure from Democratic lawmakers, governors and other political leaders.
At Final Call presstime, Johns Hopkins University reported that there are 795,960 confirmed cases of coronavirus in the U.S. and at least 42,604 people have died. The totals include cases from all 50 states, the District of Columbia and other U.S. territories, as well as all repatriated cases.
Blacks face higher U.S. coronavirus death rates by population and Latinos suffer the highest death rates in New York, noted CNN during an airing of its special, “The Color of Covid,” that aired April 19.
“In the states where data could be collected and that covers just over half of them, African Americans are dying at two and a half times the rate of Asian Americans, three times higher than Latinos and 3.6 times higher than Whites and in Michigan, Blacks make up nearly half of the death toll but they are only 14 percent of the population. That is a huge difference,” said CNN host Don Lemon, during the broadcast. In at least eight other states in the Midwest, South and East, the death rate for Blacks exceeds the population rate by more than 20 percentage points, he added.
A range of health experts note that Blacks face a higher risk of exposure to the virus, because significant numbers of them are concentrated in urban areas and are working in essential industries. About 20 percent of Black workers reported being eligible to work from home, compared with about 30 percent of their White counterparts, according to the Economic Policy Institute.
Dr. Ramel Kweku Aky refi Smith, a Milwaukee-based psychologist and mental performance coach, said the question about what must be done to protect Black bus drivers, post office employees, restaurant workers and those in the medical field is a tough one. Why? Because those entities one would assume is working to protect Black lives during this pandemic are not. Blacks should not look to the federal government, most in state government or city officials, or hospital systems to save Black lives.
“Social determinants is where you’re born, raised, study, eat, live, work, age and die,” he told The Final Call. “And as social determinants go, we’re at the low end—low birth rate, miseducation, increased school suspensions, unemployment, over-eating, multiple children out of wedlock, diabetes, high blood pressure, etc.”
He added: It’s nation time. How insane is it that you look to the oppressor to save us when that oppressor isn’t generally concerned about the fate of your people? We have to save ourselves. We’ll never get equality from people who never saw us nor will ever see us as equals.”
Dr. Smith said, there are some critical realities that Blacks must come to terms with. One is that they are consumers who must, if they are to survive, become producers. Another question is where are Black people going to get their food from?
“Let’s become our own sovereign nation with our own army and militia and sovereign land,” he said. “There’s nothing wrong with going backwards—let’s have our own schools, businesses and other ways to generate income. This is a perfect time for reparations.”
Dr. Smith said he and a number of his colleagues have been producing public service announcements (PSAs) that are airing on different television stations and other platforms. Others have embraced telehealth and virtual therapy.
“African American groups are pooling together to produce PSAs and are participating in online forums,” he said. “That’s the beautiful thing about Black people. In times of crisis, we are always our own counselors. There are groups on Zoom who have been a great help to the community.”
Professionals have produced segments dealing with the coronavirus, strategies to cope, how to research to amass information, what to do if you’re having suicidal thoughts, and other mental health tips, he said.
Dr. Smith and other critics point to a systemic failure—politically, economically and in health terms—at the highest levels. There has always been an expectation, a social compact that the American public gave their consent to be governed and that in return there were certain protections that the government would provide.
That had been shattered as we are witnessing a political party which is uninterested in providing for the needs of anyone but the rich. Social safety net programs such as the Supplemental Nutrition Assistance Program have been slashed; the GOP has tried and failed more than 60 times to eliminate the Affordable Care Act, which if successful, would throw more than 20 million Americans off of Obamacare; and even as tens of millions of Americans are jobless because of Covid-19, Republican leaders are devising ways to deny workers the unemployment insurance due to them.
Dr. Hilton has been on television, has made presentations at teleconference calls hosted by the Congressional Black Caucus and is using every communication method and opportunity to educate Black people about Covid-19, share health tips, and encourage African Americans to eat fruits, vegetables and healthy meals, walk frequently, drink enough water, get enough sleep, try not to get stressed out.
She, like Dr. Smith, acknowledges that White physicians and hospital staff and much of America’s health care system treat Blacks differently.
“Black people have been dying from chronic diseases like cancer, high blood pressure, heart and kidney disease. Why would we expect, with a virus like this, not to be similarly affected?” asked Dr. Michael A. LeNoir, an Oakland-based allergist and immunologist who served as the 114th president of the National Medical Association. “Eighty percent of those who contract the virus will recover and of the remainder, people will die.”
Dr. LeNoir—both as the leader and a more than three-decade member of the NMA—has for decades worked to eliminate health disparities and advance the quality of health among African Americans, communities of color and the disadvantaged.
He said he and his NMA colleagues have been advocating for the national implementation of Medicare for decades. In the face of the often-distressing state of the health of Black people, Dr. LeNoir and other medical professionals and experts stress the importance of men, women and children being more pro-active in their personal care as a way to offset the socio-economic and living conditions in which many find themselves. Race, he asserts, is a major determinant in health care outcomes.
“There are two parts to this, health disparities and health care disparities,” said Dr. Lenoir. “It’s how we’re treated by hospital systems. White doctors look at Black people differently. Race always defines everything as Black and White. The issue is not oppression. If I had a heart attack, I’d want to be wearing a suit and carrying a briefcase versus overalls because I’d be treated better. There are several aspects to the problem. In terms of self-equity, we are powerless. We don’t have a health care system that gives us equal access.”
Dr. LeNoir, who has been practicing medicine since 1977, helped organize the African-American Wellness Project (AAWP). He believes that while the health care system is slowly changing to eliminate the disparities in evaluation and treatment, that change isn’t occurring fast enough. He and the organization characterize the current health care climate as a managed care system where costs continue to rise and both providers and consumers are unhappy.
Surviving the systems seems more important than changing it, he said. So the wellness project’s focus is on emphasizing the importance of lifestyle and health, prevention, screening and early detection. In addition, the group wants Blacks to become more sophisticated as they navigate the health care system and for them and other consumers to be alert and vigilant when they do not receive quality care. One of the project goals is to create a network of sensitive, caring experts to support the Black community’s health needs.
Dr. Hilton said it’s not from the lack of trying that Black people have been unsuccessful in breaching the proverbial walls of healthcare, social policy and other areas in an effort to get what the community needs.
“We’re in the middle of where they all overlap—individuals are left voiceless to influence the wider community and hospital systems,” she said. There are many vocal activists in every sector trying to do work. But the Black community lacks wealth in a country where everything is tied back to the dollar. If it doesn’t earn money, proposals are usually nixed,” said Dr. Hilton.
One thing government officials can implement in the Covid-19 fight is to set up testing and triage centers in Black neighborhoods, noted Rashawn Ray, a David M. Rubenstein Fellow at the Brookings Institute. “Predominately Black churches may be ideal locations for testing, triage, and treatment. Black churches continue to be the glue that holds many Black communities together. During this crisis, they are proving essential for Black families by giving out food, laptops, and funds. Building on the proposed Health Empowerment Zone Act, Black churches can serve as ‘health action zones’ to bridge federal, state, and local resources with community resources,” he wrote in an April 10 article, “How to reduce the racial gap in COVID-19 deaths.” Implementing paid leave and hazard pay for essential workers, instituting a living wage and universal health care are also critical solutions to save Black lives during this crisis, noted Mr. Ray.
(Final Call staff contributed to this report.)