We Were Sick Long Before We Were Infected
April 21, 2020
by Alexander Fella | alex@theurcnorfolk.com
You’ve probably seen the word “novel” appearing a lot lately. It’s often a prefix in reports about Coronavirus, “the novel Coronavirus.” There is little that is novel about the Coronavirus challenges we now face. The current pandemic draws into sharp focus societal woes and systemic issues that plagued our communities long before COVID-19 appeared on the scene. But this does not mean they have to remain long after COVID-19 dissipates. In the recent talk about “life returning to normal,” we should remember that for many Americans “normal” was tragedy waiting to happen.
It’s true that a virus hardly knows borders, however who ends up infected can be determined with deadly accuracy almost on a neighborhood by neighborhood basis. What the current data reveals about the pandemic is that Coronavirus is more likely to kill some people than others. Those at higher risk include minorities, particularly African Americans, indigenous nations, rural communities, and the homeless.
Michigan’s population is 14% African American, but African Americans account for 40% of the state’s COVID related deaths. The numbers are starkly similar in Illinois, 14% of the state is African American, while African Americans make up 40% of the COVID deaths. You can break these numbers down even further to the county level. In Mecklenburg County, North Carolina, home to Charlotte, Black residents make up 33% of the county, but nearly half of all those with COVID-19 are Black. In Milwaukee County, the population is 26% Black, but half of all COVID cases and a sobering 80% of COVID deaths are from African Americans. While states have only recently begun collecting racial data on Coronavirus patients, hospitals hardly need to report a patient’s race in order to see which communities are hit hardest. As of writing, Louisiana has not published racial data on their COVID-19 patients, However, New Orleans alone counts for 40% of Louisiana’s deaths, and in New Orleans nearly 60% of the population is black.
Black Americans are not alone in their struggle against COVID-19. Native Americans, many of whom live in rural areas, are faring disproportionately worse in the face of the pandemic. In Arizona, Native Americans account for 6% of the state’s population, but makeup 16% of Arizona’s COVID-19 deaths. Outside of Arizona, the picture is even more grim. The Navajo Nation has more Coronavirus cases per capita than any other state, outside of New York and New Jersey.
As shelters across the country have closed, soup kitchens and churches have shuttered their doors, and bathrooms in libraries and cafes have become unavailable- homeless people are exposed to a heightened threat of contracting and dying from COVID-19. For the nearly 550,000 unsheltered in America, following CDC guidelines like washing hands and social distancing proves impossible given the nature of services they receive. It is not feasible to maintain 6 feet of distance between people in a shelter. Add this to that the fact homeless communities are more prone to having underlying health conditions- particularly respiratory illness and heart disease- and COVID-19 will prove disproportionately fatal to the homeless. Utah and Massachusetts have already experienced concentrated outbreaks of Coronavirus in shelters. In Salt Lake City, 94 cases of COVID-19 were diagnosed at a single men’s resource center. And in Boston, of the 408 people tested at one shelter, 147 tested positive for COVID-19.
The human impact of Covid-19 will be drawn into sharper focus as the United States increases its testing capabilities. But for the moment, we can ask why the data is skewing this way. We can point our fingers at current political blunders- trying to pinpoint the moment where leaders acted imprudently. But in truth, we were sick long before we were infected. Our blame for the catastrophe of COVID-19 lies in our past 100 years as much as it does our past 10 weeks.
Historic policies of building segregated neighborhoods throughout the 20th century forced minority communities to live in areas that lacked access to things like medical facilities, nutritional food sources, schools, and reliable transportation. Housing policies, like redlining, and exclusionary zoning, served to concentrate poverty among minority populations. And poverty is a predictor, especially when it comes to health. Poverty means you are more likely to be uninsured. Poverty means you are unable to make it to your doctors’ appointments. Poverty means you are more likely to live in a food desert, and to rely on school lunches. And it was racists housing policies that ensured that poverty was concentrated into minority neighborhoods- the same neighborhoods where you are more likely to see hospitals shut down. The same neighborhoods where COVID-19 is killing with prejudice.
In Norfolk, V.A., the city’s history of segregated planning has left Norfolk vulnerable to a public health emergency. The last of Norfolk’s slum housing did not come down until the 1970s in East Ghent, where the population was majority black, and 901 out of 972 homes were declared unlivable. Even after demolition, Norfolk’s African Americans were concentrated into public housing built overtop of slums in the Tidewater neighborhood. Today, Tidewater remains a majority black neighborhood where the majority of residents live below the poverty line in substandard public housing units. Norfolk’s housing policies of the past have left Tidewater uniquely exposed to a public health disaster today.
The CDC produces a statistic called the Social Vulnerability Index, or SVI, used to measure a county’s capacity for resilience in the case of public health emergences. The number represents a compound aggregate of 14 different data sets. It takes into consideration things like household income, race, age, transportation, household language, and other socioeconomic factors. The scores range from 1 to 0. 1 means ‘high risk’ while ‘0’ means ‘not at risk’. Tidewater scored a 0.98, making that neighborhood one of the most vulnerable in the nation. Across the street, East Ghent, where urban renewal took place, only scored a 0.07.
This is simply a brief account of how one set of federal policies decades ago laid the groundwork for a public health emergency today. Discriminatory housing policies in the last century may not seem like much of a culprit, and taken alone they might not be. But combine that policy with an eviction epidemic, a homeless epidemic, an obesity epidemic, a heart disease epidemic, and the picture gets more clear. To return to our question: why does the data skew towards killing minorities more often? In short, because we have stacked epidemic on top of epidemic on top of epidemic. And whether or not we were quick to react to COVID-19 in time, we have been slow to react to any of the other epidemics that make COVID-19 particularly deadly. Worst of all, unlike COVID-19, the other epidemics were made by us.
We are at a moment now where our mantra for beating Coronavirus has been to ‘stay at home, and shelter in place’. But what COVID-19 challenges us to consider is that for many, ‘home’ is not, nor was it, a safe place to shelter. Even before Coronavirus hit the United States, home was unhealthy to begin with.
For the first time in recent history, people across the world are sharing the same bodily threat to our existence. Natural disasters happen in another state, wars in another country. Other than climate change, the reality of a shared crisis has never presented itself so clearly to us. But our response to this crisis is to distance ourselves from each other as much as possible. We have seen hoarding, and retreat. Neighbors have become suspect, anyone could be a carrier, anyone can be infected. We are told that we are ‘safer alone’. But we should remember sheltering in place does not make us immune to the social epidemics that have long plagued our communities. Now is the time to realize that what makes our neighbors sick, makes us sick. If we do not, we will still be ill long after the Coronavirus recedes.
There is a story from the Gospel of Matthew that I have been returning to lately. It’s a familiar one, where Jesus walks through a crowd in Gerasa and a sick woman touches the fringe of Jesus’ cloak, hoping to be cured. Jesus turns and asks the crowd who touched him, and the woman throws herself at Jesus feet, beginning for forgiveness. Jesus sends her on her way, healed of her illness. It is a reminder that even in a time when we are told that the slightest touch from a neighbor can infect us, a slight touch is also what heals us.