Trump has made it incredibly clear that he simply doesn’t care about the millions of Americans who are infected, the hundreds of thousands who have died, as well as those who will die as a result of his complete indifference in the face of the greatest public health crisis of several lifetimes. For members of Black, Indigenous and people of color, or BIPOC, communities, this notion of having no choice hits right in the gut.
In some parts of the country as many as 80 percent of Covid-19-related deaths are in Black or brown communities.
Black and LatinX people are dying of Covid-19 at higher rates in this country. Those who are not dying are almost guaranteed to lose years off of their life expectancy. In short, their lives are cut short no matter what because of Covid-19, aided by an administration that has failed to address it.
This is apparent when you enter the doors of any clinic like mine in the United States, where millions of patients receive Covid-19 testing and more than half of the positive cases are racial and ethnic minorities; in some parts of the country as many as 80 percent of Covid-19-related deaths are in Black or brown communities.
These include patients like Elena, a young Latina grocery store worker who was worried she might have Covid-19, but was desperate to hear otherwise. (For privacy reasons names have been changed.) She was scared she had the virus, she told me in Spanish. She wears her mask religiously and washes her hands all the time; she does exactly as she is told, but she also has to work.
She told me stories about customers who refused to wear a mask or who ask her to get close to them to pick something up. Her household size has doubled in the last months as family members lost jobs to the unrelenting pandemic and were forced into economic insecurity. Her job, along with overtime hours, supports their expenses on a day-to-day basis. Elena came in to my clinic when she started to develop a cough and ran a light fever. After ordering Elena’s test and asking her to stay isolated, knowing that her family might go hungry if she can’t work, Trump’s words are even more insulting. The economic, health, and mental devastation simply doesn’t appear to mean anything to our president.
“They’re getting tired of the pandemic — aren’t they? … That’s all they cover: ‘Covid, covid, pandemic. Covid, covid, covid.” These are more words from the leader of our nation, as we watch embers turn to active rolling flames across the country. We’ve seen 80,000 new cases in a 24-hour period. Alfred, an African American bus driver in Washington, D.C., called my clinic asking for medical advice. He is close to retirement and he loves driving his route, helping people stay safe while navigating traffic lanes filled with distracted drivers. But he had an urgent question: He was worried that one of his passengers might have had Covid-19, and he wanted to find a way to get tested. After discussing testing options and appointment times, he asked about the cost of the test, and sounded surprised when I emphasized that the test is free.
In 23 states, the cumulative incidence of Covid-19 was 3.5 times more frequent among Indigenous people than among non-Hispanic white people.
His response — “Nothing is really free, doc” — rang true on some painful levels. Alfred buried a close friend of his two months prior to our call, and he has seen entire blocks of his neighborhood affected by this silent virus that never announced its arrival but becomes a permanent resident once it’s arrived. African Americans, according to the Covid Tracking Project, are dying at 2.3 times the rate of white people in the country. They are not tired of the pandemic; they are dying from it.
LatinX and African Americans are not the only communities affected directly by the president’s indifference and lack of strategic direction; his constant references to the “China virus” or “Kung flu” has led to an alarming trend among Asian Americans, including higher death rates and barriers to receiving care: Thirty-eight percent of the 123 Covid-19 deaths reported by the San Francisco Department of Public Health are Asian American residents, the highest of any ethnicity. Health literacy is also a critical problem where there is little to no information available in native languages to give people advice on safety tips, testing and other critical health services during the pandemic. At the same time, many Asian Americans are also dealing with growing incidents of anti-Asian hate crimes and concern over stigma from the president’s words.
Native Americans and Indigenous peoples likewise show alarming trends. In 23 states, the cumulative incidence of Covid-19 was 3.5 times more frequent among Indigenous people than among non-Hispanic white people. Even more troubling is data that illustrates that there is frequent practice of racial misclassification where Indigenous peoples are forced to pick between white, Black, Hispanic or “other” which essentially erases the ability to track outcomes and effectively erases and discounts the entire Indigenous experience.
As we gather more data from months of studies and case reports on millions of Americans affected by Covid-19, these are the common themes emerging that are specifically problematic for BIPOC communities:
- Access to health care, including affordable testing, is still a problem; many BIPOC people live in areas with lower numbers of primary care physicians, which requires that people travel farther to get care or resort to expensive options such as emergency rooms and hospitals.
- Information about Covid-19 testing is not reaching BIPOC communities. Language and literacy barriers still reflect major flaws in health care overall.
- The health care workforce does not look like the communities we serve; all minorities with the exception of Asian Americans, are underrepresented in the medical workforce, resulting in implicit unconscious racial bias.
- Resources for contact tracing and isolation/quarantine support are virtually nonexistent in BIPOC communities, resulting in a compounding effect where positivity rates are higher due to logistical household challenges such as an inability for people to maintain safe distance to prevent the spread of the virus.
- Our reporting infrastructure is biased, as well, and lacks accountability measures for accurate racial and ethnic groups, which leads to a skewed understanding of the extent of the pandemic as well as a lack of downstream resources that are often reserved for subpopulations based on data.
While Trump is certainly not to blame for the existence of the coronavirus, it feels necessary to point out that he shows no signs of understanding what “living with” the virus actually means. His response of expressing fatigue at continually hearing about the virus shows how little responsibility he is taking for the millions of lives, especially among our minority communities, that have been forever altered because of his lack of leadership.
Dr. Kavita Patel is an MSNBC columnist, primary care physician in Washington, D.C. and NBC News/MSNBC contributor. She previously served in the Obama Administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. A Brookings Institution nonresident fellow, she is the former managing director of clinical transformation at Brookings’ Center for Health Policy.
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