A Racial Revolution Amid the Pandemic

As the United States experience the global outbreak of SARS-CoV-2, the darkness from our racial past resurfaces and dwindles the light at the end of the tunnel. Currently, individuals in the United States are lost in their path to obtaining redemption. As an American, we hope for the day when we can envision the rebirth of a new nation. A country not controlled by bigotry and hatred. The fall of a dystopian will upbuild a new nation where “unity” is present not only within the name but in our existence. Recently, United States has been experiencing a racial revolution, as individuals protested and held signs that read, “Black Lives Matter.” The repetitive voices in the society chanted, “ I can’t breathe,” to end police brutality. The pieces from the past to end racism remained scattered in the present, as what was broken must one day be repaired. “If you don’t fix the damage dwelling in the past, it will come back to haunt you.” So, this is precisely what happened during the horrific pandemic. The tragedies of people suffering and fighting to survive during the viral outbreak trigged hatred hidden within us, as people fought fiercely to survive. This buried hatred created a racial revolution, and as strangely this may sound, we can appreciate that the virus triggered a “time to heal.”

Although the virus does not discriminate, humans harbor racial prejudices that precipitate the mistreatment observed in a group of individuals. The existence of racism causes racial health disparities; therefore, a racial group in society may not receive the necessary treatment to survive a pandemic. Stricken by the burden of discrimination, a disproportionate percentage of COVID-19 hospitalizations and deaths occurs in minority populations. The prevalence of COVID-19 in the black population from Louisiana was reported in a retrospective cohort study.1 Results indicated that 71% of patients who died of COVID-19 were black; however, interestingly, only 31% of the state population comprised of black individuals.1 This disproportionate burden was validated repeatedly in many different parts of the United States. The epicenter of the coronavirus pandemic, New York City, a crowded region, was another “red flag” area that demonstrated a surge in mortality rate. Although the blacks comprised only 22% of the population in New York City, they accounted for 28% of deaths.2 The disproportionate burden of the pandemic observed in the minority population is a reflection of the disparities in socioeconomic status.

Social determinants of health in the black population is more apparent on account of the COVID-19 pandemic.3 In the United States, there are historical and contemporary anti-Black sentiments working against African Americans. Black people are more likely to live in densely populated communities or housing. Therefore, social distancing seems almost impossible to maintain. Additionally, there is a dependence on public transportation and onsite working conditions. Remote working is beyond attainable in the black community. African Americans are overrepresented in occupations considered “essential workers,” including grocery stores, food service, and courier work.4 Remote working and indulging in the plethora of Zoom virtual events are considered a privilege. In black communities, these privileges are barely accessible. To add to the economic disparities, there is a difference in access to proper health care. Additionally, black individuals may hesitate to seek care because of discrimination in the healthcare system. There is a higher prevalence of chronic comorbidities in the black population, increasing their risk of COVID-19 mortality.5 Considering the higher burden of comorbidities and the adverse social determinants of health, the blacks have a disadvantage in surviving this devastating pandemic.

To manage the COVID-19 outbreak in the African American communities, barriers to PCR testing for SARS-CoV-2 detection must be dismantled. There are limited testing sites in areas where African Americans reside; therefore, it is proposed to offer PCR testing in churches and community health centers.6 To relieve the economic burden in the black community, testing sites that offer free PCR testing should be more widespread. Additionally, African Americans tend to be uninsured and deter appropriate treatment for COVID-19; thus, measures should be implemented to defray costs of treatment. Many African Americans depend on community health centers for outpatient care; however, due to the pandemic, services are no longer stable. It is essential to provide long-term funding to enable these organizations to offer optimal care for patients with severe cases of COVID-19.6 Long-term care facilities are hotspots for the rapid spread of SARS-CoV-2 and comprises the majority of pandemic-related deaths.7 A disproportionate number of African Americans at the age of 65 or older reside in long-term care facilities.8 This disparity is apparent as many older patients cannot afford home care. Unfavorably, these long-term care facilities provide a low quality of care with poor outcomes; therefore, increasing the risk of COVID-19 morbidity and mortality.9 Adherence to appropriate guidelines for the safe operation of long-term care facilities is necessary to improve the quality of care for African Americans.

COVID-19 pandemic induced the recession of many jobs in society. Occupations performed by black individuals afforded limited job security, increasing the rate of unemployment.10 Due to the socioeconomic burden, a national survey reported that African Americans were more likely to suffer from symptoms of depression.11 To alleviate the economic burden, the government should continue the provisions benefitting small businesses, especially minority-owned businesses. Online learning is another hurdle emplaced due to the pandemic. Most young African Americans represent low-income youth who are born into poor families; therefore, lacking the ability to obtain the economic and emotional support for online programs offered by the schools.12 Some free online courses can be provided to defray the costs. Although racial health disparities have led to cascading adversities, it is crucial to dismantle these barriers to afford everyone equal resources to survive.

The COVID-19 pandemic was the bellwether event that triggered the United States to address the health care disparities emplaced due to the long-standing systemic health and social inequities. Front-line healthcare workers can be essential catalysts in enforcing an equitable system that supports the health of all Americans irrespective of race or ethnicity. The pandemic installed a time capsule that involuntarily transported us to a “time of awakening,” and now it is the time to accept that a broken system must one day be repaired.

References:

1. Price-Haywood EG, Burton J, Fort D and Seoane L. Hospitalization and Mortality among Black Patients and White Patients with Covid-19. N Engl J Med. 2020;382:2534-43.

2. New York State Department of Health. (2021, January 20). COVID-19 fatalities. Accessed January 21, 2021. https://covid19tracker.health.ny.gov/views/

3. Centers for Disease Control and Prevention. (2020, July 24). Health Equity Considerations and Racial and Ethnic Minority Groups. Accessed January 21, 2020. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html

4. Bailey ZD, Moon JR. Racism and the political economy of COVID-19: will we continue to resurrect the past? J Health Polit Policy Law. 2020.

5. Wiemers EE, Abrahams S, AlFakhri M, Hotz VJ, Schoeni RF, Seltzer JA. Disparities in Vulnerability to Severe Complications from COVID-19 in the United States. 2020.medRxiv.

6. Kishore S, Hayden M. Community health centers and Covid-19—time for congress to act. N Engl J Med. 2020;383:e54.

7. Barnett ML, Grabowski DC. Nursing homes are ground zero for COVID-19 pandemic. JAMA Health Forum. 2020;1:e200369–9.

8. Feng Z, Fennell ML, Tyler DA, Clark M, Mor V. Growth of racial and ethnic minorities in US nursing homes driven by demographics and possible disparities in options. Health Aff (Millwood). 2011;30:1358–65.

9. Shippee TP, Akosionu O, Ng W, Woodhouse M, Duan Y, Thao MS, et al. COVID-19 pandemic: exacerbating racial/ethnic disparities in long-term services and supports. J Aging Soc Policy. 2020;32:323–33.

10. U.S. Bureau of Labor Statistics. Labor force characteristics by race and ethnicity, 2017. Washington, D.C.: U.S. Bureau of Labor Statistics; 2018.

11. Ettman CK, Abdalla SM, Cohen GH, Sampson L, Vivier PM, Galea S. Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Netw Open. 2020;3:e2019686.

12. Semega J, KollarM, Creamer J, Mohanty A. Income and poverty in the United States: 2018. U.S. Census Bureau, Washington, D.C.;2019.

Cover Image created by Jessica Lewis