In more developed countries, Blacks, Asians and other minority ethnic groups have been found to suffer more severe COVID-19 infections than other ethnic groups. Some have postulated that this is more likely due to genetics. I think than poorer socio-economic states, access to care and health inequality might be a more straightforward reason for this than just genetics.
These articles have eye-opening facts and realities of the effect COVID-19 is having on black and less privileged people in the world:
1. Article COVID-19 and African Americans
2. Article The COVID-19 Pandemic: a Call to Action to Identify and Addr...
3. Preprint Covid-19 and Inequity: A comparative spatial analysis of New...
4. The Disproportionate Burden of COVID-19 for Immigrants in the Bronx, New York https://www.sicp.it/wp-content/uploads/2020/03/Jama-internal_Ross_The-Disproportionate-Burden-of-COVID-19-for-Immigrants-in-the-Bronx-New-York-_8-mag-2020.pdf
5. https://abcnews.go.com/Health/poverty-pollution-neglect-bronx-coronavirus-formula-disaster/story?id=70084738
6. https://theconversation.com/indias-treatment-of-muslims-and-migrants-puts-lives-at-risk-during-covid-19-136940
Improper health care and lack of empathy for minority suffering are the main factors driving up the death rate of minorities from Covid-19 in developed countries. Nothing else can explain why white and minorities with the same co-morbidity go into the same hospitals and the minorities come down with far higher mortality rates. Retrospective data from UK, Canada and US have highlighted this phenomenon.
@rachael Irving, very true. Do you think there is any way we can influence this as HCW?
Ethnic minorities must be involved in health policy management and advocate for more change at the micro level. Social media can drive change.
In my practice, in Lisbon - Portugal, the first cases of covid-19 reached the wealthiest neighborhoods. two months later the most affected communities are minorities, mainly immigrants without papers and manual workers.
The question is complicated. And we should be cautious of reductionist answers that offer simple solutions. Certainly this pandemic has exposed people who are already suffering to greater hardships and tragedy. The ineptitude of many Northern-hemisphere governments and some in the global south, actually belies the reality that we may have many world leaders who believe in Eugenics, social Darwinism and a Nietzschean kaleidoscope for the future.
Minorities especially those of African descent, are caught once again, in a very dangerous position. But something else made us more vulnerable. And this cannot be denied although we may be reticent to acknowledge it. It is lifestyle choices of diet and habits. But these choices did not happen in a vacuum, they are linked to poor education, poor health care, low incomes, living in insanitary conditions, low self-esteem, etc.
The very worst future awaits many communities unless they genuinely move towards self-sufficiency. Governments that are increasingly exclusive and committed to social engineering cannot and will not help. This does not mean of course that we should not lobby those governments, but ultimately this dystopian now, may work for certain political ideologies.
It will be interesting to look at the recovery rate of Africans who were able to get back to their homelands and tested positive when testing and lockdown were imposed and compare this with the studies in the States and Europe. It seems to me that the lockdown as carried out in Europe did not favour these groups. It created greater anxieties, fears and confusion among a vulnerable population many of who were already living from hand to mouth and had to shelter with unwilling friends and country people. It is difficult to measure the impact these collective anxieties had on their immune systems. My contact with Ghanaians suggests that those who were able to get back home are taking the situation with better spirit and humour while those of us in Europe are more depressed .
I believe that this is obvious. More critical is that the same cause-effect relationship may now become manifest on steroids in the crowded and desperately poor mega-cities of the Southern Hemisphere.
Dear Richard
Could you explain what you mean by 'obvious'?
But I agree, it is likely that dynamics of inequality may be multiplied in the southern hemisphere.
In a nutshell, we have a long way to go. The question then is; where do we start from? Ethnic minorities may try to become more involved and try to attain self-sufficiency, but they will be held back by the same systematic constraints that created the situation in the first place. There must be a way forwards however.
After many years working in Ghana and Kenya, and living for a year, alone, in Ethiopia, the “obvious” is based on the combination of many challenges that are far from overcome anywhere on the continent. Many millions of undocumented, displaced, and refugee populations are all vulnerable due to crowded and inadequate housing, poor sanitation and frequently insufficient potable water. Even middle class residential areas often lack sufficient good quality water. The market economies cannot “work at home” or participate in self-quarantine. Public and commercial transport is always subject to crowding, often for long distances and time periods.
Primary medical care, respiratory specialists, respiratory emergency services and properly equipped isolation rooms, ventilators, and medical infrastructures all lag far behind nations in Europe or the US where systems that are much better have been overwhelmed. Add to these general facts the presence of internal insurrections, political fragility, hundreds of vernacular languages, especially among the rural elderly, and the historic ignorance of all things African in America and most of Europe, and there is a high probability of an African health catastrophe. Sadly, I could add paragraphs to this but the conclusion would be the same. The saddest fact if all is that too few people in North America or Europe will care and most nations are looking inwardly instead of globally.
Thank you. I agree with what you say, having traveled and visited many parts of the world. I worked for a while in some of the countries you mention. And where I went and what I saw were terrible. The dead unburied by the side of the road, inexplicable poverty, disease, malnutrition. A huge gap between the rich and the poor. etc.
And I am sorry to be seeming to promote a negative idea about the continent of Africa. Because there is a great history there. And there are many people who would change the world, given the right opportunities and resources.
But the reality is that unfortunately a new pandemic there would be devastating.
You may find interesting the following site with a "COVID Racial Data Tracker":
https://covidtracking.com
https://covidtracking.com/race
"The COVID Tracking Project is a volunteer organization launched from The Atlantic and dedicated to collecting and publishing the data required to understand the COVID-19 outbreak in the United States.
Every day, we collect data on COVID-19 testing and patient outcomes from all 50 states, 5 territories, and the District of Columbia. Our dataset is currently in use by national and local news organizations across the US and by research projects and agencies worldwide. As of mid-April, our data API (which allows sites and apps to import our dataset automatically) receives about one million requests per day.
On April 15, we launched the COVID Racial Data Tracker, a partnership between the COVID Tracking Project and the The Antiracist Research & Policy Center that collects, publishes, and analyzes racial data on the pandemic within the United States."
Sometimes I feel that for the last 500 years, at least , Africa just can’t get a break: Centuries of exploitation and abuse from colonial powers, fractional governments and ethnic groups competing for developed resources, relative lack of historical documentation because of insufficient literacy, out-migration of talented people, and collaborative nonsense among some leaders who seek power over justice or human development...iand then, just when things seem to be improving, a kick in the face by a disease that could kill or sicken millions. However I believe that Africa will ultimately have history on her side. No continent has more résiliant people.
Good answer.
The problem is as development occurs, those with vested interests in keeping an entire continent down often step in. Case studies from the 1960's to today.
Colonial powers still regard the continent of Africa as a playground: Mali, Djibouti, Equatorial Guinea, Niger, Chad, Sierra Leone, Libya, Somalia, to name but a recent few.
But you are right there is resilience amongst Africans what I used to call 'sheer bloody mindedness.' There is hope.
Differentiating genetically would have lesser obviousness than ''poorer socio-eco...'' One way of arguing against 'genetical supremacy' is that the poor people may have a higher immune system being involved in physicalities while the other 'medication'. The higher probability for the Socio-economic inequalities laid in the fact that it compels them to more social interaction rather than 'quarantine.
My mother was the daughter of a small farm family in Illinois. She was born in the farm house in 1921. I remember the farm house smelling not too different than the barn. Hygiene of today’s assumptions was unknown. In fact she never was “clean and neat” even well into advanced age. She died of colon cancer at age 92 and fought it for over 20 years. She never got a cold and seemed to laugh at the flu, minor cuts or small wounds. She had a world class immune system, I believe, because she was raised in a sea of pathogens that would close me down in a moment.
I tell this story because it suggests a reasonable research question: are people raised in poverty, poor hygiene, and with little regard for today’s standards of cleanliness, personal hygiene, and risk avoidance also living with more robust immune systems? If true, then tens of millions of people could be facing challenges like COVID-19 with a biological advantage. Wouldn’t that be a splendid irony!
A recent article below gives an idea why blacks are having more deaths in USA compared with whites
https://www.nejm.org/doi/pdf/10.1056/NEJMsa2011686?listPDF=true
The medical article is very relevant. As a historian and a member of a white minority group in South Africa, I believe that race and cultural-social and economic factors play are of equal importance. I just started researching mortality rates among slave infants and comparing them with that of their owners. At a first glance they appear to be the same. I just went through a sample of death certificates (1 233) in the Western Cape and found a male of 105 years who was classified as mixed = of slave descent; also four 100 year olds - 2 male and 2 female - also "mixed", the oldest "European" reached 97 years - sharing his age with an individual indicated as being a "Hottenot". A final note - the "Hottentot" population of the Cape Colony was nearly decimated by the small pox epidemics that broke it at the slave lodge in Cape Town in 1713 - followed again by outbreaks in 1755 and 1767. Slaves and "Europeans" also died but not nearly in such large numbers as the "Hottentots".
Muhammad, this is a good article, but we still lack critical data to fully understand the mortality and morbidity differential re: COVID-19 . We believe that much of the structural issues of healthcare availability, housing, employment options for working at home, and the preponderance of “essential” workers who are people of colour and implications for spread of the virus are causal. But we are very early in understanding this pandemic and routes of source and spread. I hope this paper is not seen as definitive but rather as a stimulus for more study - sooner and not later. The acuity of need for objective data and understanding is important for all of us.
This is relevant to our discussion.
'The stories about protests are also the stories about covid-19 and racism,' says one epidemiologist
This time, as the nation erupts over the latest example of police violence toward African Americans, there’s a pandemic in the background.
The confluence of massive protests and a pandemic provides an unprecedented and tangible example of the steep challenges black people face every day in the United States.
By nearly every benchmark, the coronavirus outbreak has produced more severe consequences in the lives of African Americans compared with their white counterparts. Black Americans are infected with the virus at higher rates and dying of it more frequently. They are more likely to have lost their employment because of the shutdowns. And they started out with fewer resources on hand to weather the health crisis.
“It became really clear covid was not a leveler,” said Steven Brown, a research associate at the Urban Institute and author of an analysis on how the virus has affected the economic well-being of minorities. “Even though we’re all at risk, it was incredibly clear that some people were more at risk.”
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Demonstrators confront law enforcement during a protest on June 1 in downtown Washington, DC. (Photo by Drew Angerer/Getty Images) ***BESTPIX***
For nearly a week, people protesting George Floyd’s death have held nightly demonstrations in a number of U.S. cities, some of them marching peacefully even as others vandalize stores, government buildings and cars. As protests intensified yesterday in New York, Chicago and St. Louis, President Trump threatened to deploy federal troops if state and city leaders don't act to quell the chaos.
The protests are stoking concerns that black Americans gathering in close proximity could further worsen disparities that have been years in the making. These disparities are now getting unprecedented attention because of two of the biggest news events this year: the pandemic and Floyd’s death.
Just as the protests over Floyd’s death have brought fresh attention to how black Americans are treated by law enforcement, the pandemic also stirred up a focus on how they lag far behind when it comes to personal health and access to affordable, high-quality care.
“The stories about protests are also the stories about covid-19 and racism,” said Zinzi Bailey, a social epidemiologist at the University of Miami.
We live in desperate times. I wish for all my colleagues to be safe of this plague, fervent in seeking truth and justice for all of us at all times, an end to political greed and an end of authoritarians and fools in high office. We live in a marvellous world with resources abundant enough for us all.
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