Opinion | Being Black in America During COVID-19 a Deadly "Underlying Condition"
by DARIEN LAMEN
On Saturday it will be one month since Monroe County confirmed the first local case of COVID-19. And what a year this month has been.
As the crisis deepens, we've seen people reaching for easy and familiar explanations to make sense of the societal upheaval we're experiencing (some of us more acutely than others).
Capitalist ideology infuses many of these explanations: shortages of key supplies are a result of greedy individuals, rather than the result of a design flaw in just-in-time production, or of a federal administration more concerned with polling and profiteering than with public health; billionaires are treated as important sources of information about when we should resume business-as-usual; and now this week, racial disparities in Monroe County's most serious COVID-19 cases are framed as the result of bad individual choices.
Following the release Wednesday of racial demographic data on Monroe County's most serious COVID-19 cases (that is, cases involving hospitalization and/or death), the local media provided little explanation for the alarming racial disparities in those numbers other than that “some people in communities of color might not be practicing proper physical distancing.”
Of course, the media was just taking its cue from local leaders, who have been emphasizing individual action and responsibility above all else, while simultaneously downplaying the crisis that is already unfolding.
During a virtual press conference Wednesday, Rochester Mayor Lovely Warren repeatedly reversed herself, saying for example, “We need to make sure we continue to exercise social distancing across the board. But what we’re seeing here in the African American and Latino community is that it’s on track with our population size. However it will get worse based on what we’re seeing in the data today, as well as what we’re seeing across the country.”
Warren continued, “We don’t see that disparity as much here in Monroe County as we are seeing across the country, but we have to be diligent in changing people’s habits and behaviors during this time, or we will.”
While the racial disparities in Rochester’s most serious COVID-19 cases perhaps aren't as stark as those elsewhere, the early data shows that people of color are indeed overrepresented in both hospitalization and deaths.
The headlines Wednesday should have read: People of Color Account for Majority of Serious COVID-19 Cases in Monroe County.
The disparities are especially pronounced for African Americans. Black people make up a little over 15% of Monroe County’s population. Yet as of Wednesday, they accounted for 33% of the 120 most serious confirmed cases, including 28% of hospitalized non-ICU cases, 54% of hospitalized ICU-cases, and 18% of deaths.
Racial demographic data on Monroe County’s 627 cumulative confirmed cases is not available because not all testing sites recorded that information from patients, county officials say.
While it may be technically true that “no one is immune” to the virus, the numbers show that people of color, Black people in particular, are already suffering disproportionately from the pandemic.
The Uneven Distribution of Risk
So what other factors, aside from some imagined moral failing, might account for the outsized impact COVID-19 is evidently already having on people of color in Rochester?
For starters, the abysmal racial disparities in health outcomes for Monroe County are already well-documented. It stands to reason that the prevalence of certain chronic diseases such as asthma, diabetes, and high blood pressure among Monroe County's African American residents may increase the chances that a brush with COVID-19 will result in a more serious case (but more on this later).
In addition, low-wage frontline workers in many of our "essential" industries are disproportionately Black and Latino. They continue to perform the socially-necessary work of stocking the shelves and bagging our groceries at Wegmans; of cleaning our hospitals and offices; of processing and delivering our Amazon orders; of milking the cows that help us feed our families; of taking and making our orders at local restaurants.
Frontline workers by definition do not have the luxury of working from home. Nor do they typically have the "luxury" of paid sick leave, or access to healthcare they can actually afford, if they are insured at all. Many don't have the luxury of a personal vehicle, relying instead on often crowded public transportation.
So in the process of carrying out their jobs, frontline workers increase their own risk of exposure as well as that of their families.
Monroe County’s first documented death due to COVID-19 should have raised more questions about the ways in which risk is unevenly distributed during a public health crisis. But as so often happens, the public narrative tends to absolve a priori the powers-that-be while implicitly placing responsibility back onto the individual.
Alvin Simmons, a 54-year-old African American man who began working maintenance at Rochester General Hospital on February 24th, died less than a month later on March 17th, after suffering acute respiratory distress and a stroke brought on by COVID-19. Simmons’ girlfriend, Lisa Williams, suspects he contracted the virus at work. But hospital officials said there was “no evidence to suggest that Mr. Simmons was at a heightened risk of exposure to COVID-19 by virtue of his training or employment duties at RGH.”
Given the limited local testing available at the time, how much evidence could there be? How many admitted patients had RGH tested for COVID-19 in late February/early March, if any? What criteria did the hospital use for determining whether to administer a test?
Public Health officials agreed with hospital officials that Simmons probably contracted the virus outside of work, although they didn’t offer any guesses as to where or how. If public health officials believe community spread was already prevalent enough by early March to put someone like Simmons, who had no relevant travel history, at risk, why weren't they doing more to warn the public? As late as March 11, County Health Commissioner Michael Mendoza was assuring the public that "the risk to our community remains low," while on March 12th, County Executive Adam Bello said "There is no immediate threat to the people of Monroe County."
We know now that community spread was probably already happening during the first week of March if not earlier. It wasn't until the end of the second week of March that local and state officials began urging the public to take more drastic precautions.
With better early access to testing, health officials might have had a fighting chance of limiting community spread through contact tracing and mandatory quarantine orders. Instead, the evidence shows community spread was already happening in Monroe County more than a week before officials announced the first confirmed case.
Whether Alvin Simmons was exposed to COVID-19 at work or in the broader community, it should be evident that systemic shortcomings contributed to his untimely death.
Yet the sense we get from the media narrative is that Simmons' death was partly tragic happenstance, partly his own fault.
In public statements to the media, Rochester General Hospital officials pointed to “multiple, serious underlying conditions” that put Simmons at heightened risk of death from COVID-19--hypertension, liver disease, a history of tobacco use.
But this matter-of-fact explanation not only has the effect of obscuring the uneven distribution of such underlying conditions across racial demographics, as noted earlier. It also implicitly redirects responsibility back onto the individual--Was he a drinker? Did he eat too much unhealthy food? Why didn’t he take care of himself?
It’s hard not to hear echoes of the post-mortem victim-blaming that so often occurs in the media when police murder unarmed Black men--Did they have a criminal record? Were they doing something they weren't supposed to? Did they disobey authority?
Being Black in America is a potentially fatal underlying condition.
Racism As Public Health Crisis
A year ago, Milwaukee, Wisconsin--a city that resembles Rochester in many ways--declared racism a public health crisis. The COVID-19 pandemic has both further exposed and deepened that crisis.
What would it mean to actually treat racism--structural, institutional, and individual--as a public health crisis here in Monroe County?
At the very least, it would mean recording and reporting racial demographic data for not only the confirmed cases of COVID-19, but also for tests processed. Are white people being tested at a greater rate than people of color? Is this allowing community spread to go on undocumented and unchecked in communities of color? As Ibram X. Kendi warns in a recent piece for The Atlantic, the "racist lack of racial data" could give officials cover for a premature return to business-as-usual that abandons communities of color to subsequent cycles of infection.
Beyond collecting and publishing racial demographic data, treating racism as a public health crisis would also mean moving decisively and aggressively to mitigate the risk that low-wage frontline workers (and by extension their families) face-- providing them with appropriate PPE, hazard pay, paid sick time, and quality health care. Some brave workers are already engaging in workplace actions to demand as much.
Here in Monroe County, treating racism as a public health crisis would also mean taking extraordinary action to house those who are unhoused (and who are disproportionately Black and Latino), and it would mean "cancelling rent" for those who are housing insecure. Many renters are already engaging in a rent strike to demand as much.
Beyond Monroe County, treating racism as a public health crisis would mean releasing aging people from prisons, releasing detainees from federal immigration jails, rolling back the rollbacks to New York’s bail reform law (all of which would benefit people who are, again, disproportionately Black and Latino). Many people, both incarcerated and not, are already engaging in direct action to demand as much.
In short, treating racism as a public health crisis would require a fundamental transformation of our society, a revolution predicated upon unlearning the harmful lessons we have internalized about individual action and culpability; about the value of low-wage labor and laborers; about whose lives matter and whose lives do not; and about the possibility of making change through collective action and solidarity.
DARIEN LAMEN is news producer/director for WXIR Community Radio. He can reached at firstname.lastname@example.org