New variants have arrived from the United Kingdom, South Africa and Brazil, and COVID-19 is about to get worse in America. It may be hardest to affect our black communities – if we do not devise a new plan to prevent a potentially catastrophic increase in deaths and prolonged illness.
Last year, we quickly learned how black populations suffered disproportionately compared to most other groups in the United States. About 56,000 blacks have been reported to have lost their lives due to COVID-19, and the number is probably insufficient. This number represents 16 percent of all documented COVID-19 deaths nationwide, exceeding the percentage of black Americans in the US population. One in 792 black Americans died from coronavirus, about three times the rate of white people. Also, people of color are more likely to contract COVID-19 or require hospitalization.
Equally disturbing, black Americans, at least at the beginning of the pandemic, seemed to die from COVID-19 at a younger age compared to the rest of the US population. While 13 percent of white deaths examined by the CDC were under the age of 65, 30 percent of non-white deaths decreased in that age range.
The reasons for the high rates of serious illness and death at a younger age require further investigation. These are likely to include higher exposure rates due to the essential nature of work in low-income neighborhoods connected to construction sites or small businesses, and possibly virus infections among homeless and incarcerated populations. There are also substantial rates of diabetes, hypertension, kidney disease and obesity among black populations.
The bottom line is that we are losing thousands of black mothers, fathers, brothers and sisters in the 1940s, 1950s and early 1960s to COVID-19. We are heading for a new reality in which, soon, most people of color can personally meet someone who lost his life because of COVID-19.
Our best hope to prevent further devastation is through vaccination. But there, again, we fail in black families.
Although vaccination data are not yet widely available in many states, it seems that black Americans are lagging behind white ones. A new Kaiser Health News analysis from 16 states finds that white residents significantly outnumber black residents, often by a factor of two or three, in terms of immunization rates. For example, in Mississippi – a state with a population of 38% black – only 18% of those vaccinated were black.
A major concern is the lack of access to vaccines. Under President Trump, our national vaccination program for COVID-19 has relied significantly on hospital and pharmacy chains, even though many slums no longer support community hospitals or have become “pharmaceutical deserts.” Hospital closures in segregated communities are well documented, and a 2014 study in prestigious Health business the policy journal highlighted the desertification of pharmacies in segregated communities in Chicago.
Inadequate medical care and access to the pharmacy are high rates of vaccine rejection or hesitation. A recent study I took part in, published in Social sciences and medicine and led by Dr. Tim Callaghan of the University of Texas A&M, found that 31 percent of Americans do not intend to be vaccinated against COVID-19 – with blacks 40 percent more likely not to try immunization. Among the main reasons cited were concerns about the safety and efficacy of the COVID-19 vaccine, as well as the costs and lack of health insurance. A previous Kaiser study had similar results.
A perfect storm is developing in black communities in America. Increased exposure to COVID-19 in low-income neighborhoods, high rates of comorbidities, and deaths in younger age groups, lack of access to the vaccine, and denial of the vaccine all work to ensure that black adults suffer devastating losses.
And now we are facing the impact of emerging variants.
The variants have already gained a foothold in 32 US states and could surpass those in the coming weeks. COVID-19 is about to become even more contagious and probably more lethal. By spring, the new COVID-19 variants may cause the historical decimation of black communities.
Beyond the infrastructure issues needed to improve health systems in low-income communities, we need to take steps to quickly immunize black Americans before the options. The Biden administration has proposed a solid plan for achieving equity in communities of color – and for vaccinating the American people by the fall. But as the options increase, we are running out of time and need to complete a national vaccination campaign by the summer. Avoiding a prolonged route of destruction requires immediate expansion of access to vaccines in black communities.
We must also effectively communicate the dangers of COVID-19 to black Americans, especially those in their middle-aged adulthood, who would otherwise succumb to the virus in large numbers. This includes addressing the terrible legacy of Tuskegee in the 20th century and assuring the black community that vaccination against COVID-19 is not a twisted experiment.
Our message: Vaccination provides the only safe way to avoid hospitalization, intensive care, or death.
There is also another important element in the game. In 2019, anti-vaxxer groups specifically targeted communities in Harlem, New York, through a disinformation campaign, as did the Somali immigrant community in Minnesota in 2017 and Orthodox Jewish groups in New York in 2018 and 2019. The vaccine’s hesitation may be a consequence of the 2019 Harlem anti-vaxxer rallies. In response, scientists and doctors must work to reach the black public through radio programming, podcasts and zoom calls.
We must counter the terrible claims of anti-vaxxer groups and make it a national priority to prevent the dramatic loss of life on an almost unimaginable scale.