As a doctor, how do I tell a black family of five, struck by the virus, to ‘social distance’ in a two-bedroom apartment?
We’re not dying because we aren’t washing our hands, staying home or doing social distancing. We’re dying because we’ve been “socially distanced” for decades.
I’m an African-American emergency room physician in Chicago. Recently, a friend called asking about his grandmother who lives on the South Side in a two-bedroom apartment with five family members, one of whom recently was diagnosed as COVID-19 positive.
He asked, “What can I do?”
When I told him to quarantine the infected family member from the grandmother and any other family members with underlying health conditions, my friend reminded me that their apartment has only two bedrooms. He also pointed out that the infected person still has to go to work.
I found myself at a loss for words. And then I started thinking about the larger factors that have now put African-Americans at the epicenter of the corona virus crisis, accounting for 70% of the deaths in a city in which we are just 30 percent of the population. So far, the response from governments at all levels is far short of what is needed.
To really address the issue of African American health risks in the age of corona virus, we need to acknowledge the root causes. Broadly speaking, our communities have suffered decades of disinvestment resulting in concentrated poverty. As with so many other issues in society, racism is a factor.
The practice of redlining, which kept African Americans segregated by denying them mortgages in certain communities, has produced astronomical disparities in wealth building for African-Americans. Today, the average white family in America has 10 times the wealth of the average black family.
Economic and social isolation leads to secondary levels of inequity.Food deserts, food insecurity and inadequate access to health care are driving gross disparities in life expectancy. Today, there is a 30-year gap in life expectancy between wealthy white neighborhoods of Chicago and low-income black neighborhoods.
Many, many African Americans are dying young from preventable deaths.Not surprisingly, these same economic and social disparities have laid fertile ground for African Americans to bear the brunt of the COVID-19 pandemic in this city. We’re not dying because we aren’t washing our hands, staying home or doing social distancing. We’re dying because we’ve been “socially distanced” for decades.
As a medical professional, I am honored to be working side-by-side with brave physicians, trauma surgeons, respiratory therapists, nurses and other healthcare professionals to manage the COVID-19 crisis. But unless we do much more as a society to rectify inequities, we will continue to be overwhelmed, even after the virus subsides.
Immediate and targeted intervention specific to African-American communities in Chicago is needed. It should include:
1)Mass testing for the virus for our most vulnerable populations. By doing so, we can understand the extent of the virus and apply targeted strategies to minimize the spread within the community.
2)An action plan to direct COVID-19 positive patients to the treatment they need and provide necessary information to their families and communities to prevent further spread of the virus.
3)Access to housing options if self-quarantine is a challenge and physical isolation is not practical.
4)Ramping up delivery networks so the most vulnerable populations do not need to keep going out for food and medication.
5)Stimulus relief for those who are sick due to COVID-19 to buffer and mimic the length of time a virus is alive — 10 to 15 days from positive identification.
6)If community members have essential jobs, supply protective gear of mask, gloves and hand hygiene.
Longer term, we need paid sick leave and universal health insurance coverage for all. And we need to rebuild our low-income communities and give everyone a fair shot at a good job and a decent life.
Not everyone has the luxury of being able to physically isolate effectively. Not everyone can stay at home safely. If a family member has an essential job, such as delivering mail, driving a truck or working as a grocer, the risk to their family increases.
In a perfect world, we would be testing everyone, but as we know, the availability of testing is far short of what is needed.If Chicago wants to avoid unnecessary deaths, we must target the communities where the virus is most prevalent.
This is a call for great empathy. This is a call for the appreciation of science. This is a call for intention and attention to our most vulnerable communities. Everyone’s lives depend on it.
Dr. Garth Walker is an emergency medical physician at the Jesse Brown VA Medical Center and a public health researcher in Chicago.
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