There has been a lot of concern on how the protests over the past several days may produce a wave of coronavirus cases. This discussion is often framed as though the pandemic and protests in support of black lives are wholly separate issues, and tackling one requires neglecting the other. But some public health experts are pushing people to understand the deep connection between the two.
Facing a slew of media requests asking about how protests might be a risk for COVID-19 transmission, a group of infectious disease experts at the University of Washington, with input from other colleagues, drafted a collective response. In an open letter published Sunday, they write that “protests against systemic racism, which fosters the disproportionate burden of COVID-19 on Black communities and also perpetuates police violence, must be supported.”
The letter and the experts who signed it make a case for viewing the protests not primarily as something that could add to cases of coronavirus (though they might) but as a tool to promote public health in and of themselves. Protests address “the paramount public health problem of pervasive racism,” the letter notes. “We express solidarity and gratitude toward demonstrators who have already taken on enormous personal risk to advocate for their own health, the health of their communities, and the public health of the United States.”
By Tuesday afternoon, more than 1,000 epidemiologists, doctors, social workers, medical students, and other health experts had signed the letter. The creators had to close a Google Sheet with signatures to the public after alt-right messages popped up, but they plan to publish a final list soon, says Rachel Bender Ignacio, an infectious disease specialist and one of the letter’s creators. The hopes for the letter are twofold. The first goal is to help public health workers formulate anti-racist responses to media questions about the health implications. The second is to generate press to address a general public that may be concerned about protests spreading the virus.
“We live in an age where you are privy to seeing veritable lynching on your smartphone,” says Jade Pagkas-Bather, an infectious diseases physician at the University of Chicago. The response now “has been a long time coming.” My colleague Julia Craven described the sensation of watching black people die at the hands of law enforcement, and feeling caught in a loop of trauma:
As protesters pour into the streets of Minneapolis, Louisville, Denver, and other cities, Black folks are jerked back to 2012, when Rekia Boyd was shot by an off-duty police officer and when Trayvon Martin was gunned down by an overzealous rent-a-cop. Or to 2013, when Renisha McBride was killed while seeking help after a car accident. Or to 2015, when Gray’s spine was severed in the back of a police van, when Sandra Bland died in a Texas jail.
It’s not a coincidence that we’re seeing protests against racism during a pandemic. Racism is dangerous to public health because black people experience disproportionate effects of the coronavirus, as Craven has documented extensively. Race can affect how difficult it is to get a test, whether drugs and vaccines are designed to work for you, whether health professionals believe and listen to you. Incarceration rates are higher for black people—the virus thrives in prison—as are rates for diseases that in turn exacerbate COVID-19. “The reason why we have such high levels of diabetes, hypertension, and asthma is directly linked to structural racism,” physician Uché Blackstock told Craven in March. “We’re already very vulnerable.”
That link between racism and disease is why Ayesha Appa, an infectious disease fellow at the University of California–San Francisco, signed the letter when she saw it circulating on Twitter. “It is part of our job as infectious disease doctors to add our words of support.” She calls racism “one of the more dangerous infectious diseases.” The explicit link between white supremacy and public health is why Dashawna Fussell-Ware, a social worker and doctoral candidate at the University of Pittsburgh, put her name on the letter. She felt frustrated with a lack of responses from formal organizations. “I need very public denouncements of racism and white supremacy,” Fussell-Ware said. “We’re not going to condemn the protests—that was really, really important to me.”
In the long term, breaking down structural racism is an unequivocal public health good. In the short term, we are in danger of overemphasizing the viral spread that might come from the protests, these experts argue. “We should have a realistic awareness that we may be tasked with more cases,” says Pagkas-Bather. But she adds that the protests are “not happening in a vacuum.” They’re happening as states are relaxing stay at home orders, as largely white crowds head to pool parties and brunch. “We’re not going to be able to pin this on the protests,” says Pagkas-Bather.
The letter outlines a number of ways that protesters can reduce the risk of spreading or catching the coronavirus, such as wearing masks, distancing, and, if they’re sick, staying home and donating supplies to others instead. But many of the risks of viral spread could be mitigated by law enforcement themselves. “I imagine this wouldn’t happen, but what a wonderful place this would be if law enforcement passed out masks to those that didn’t have them,” says Appa. Instead law enforcement is instigating violence that—beyond the direct harm of rubber bullets and tear gas itself—pushes people into close contact and induces coughing. Putting protesters on buses and in jail also increases the risk of spread, notes Appa. That is: Many instances of increased transmission at protests are stemming from racism itself.
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