by Dr. MarkAlain Déry, DO, MPH, FACOI
The United States makes up less than 5 percent of the world’s population. Yet we have 25 percent of the world’s coronavirus cases — and those cases are not distributed evenly among the population. It has been well-documented that racial and ethnic minorities have sustained a disproportionate burden of illness and death when compared to white people.
Centuries of racial structural discrimination have predictably led to communities of color being disproportionately represented in the lower rungs of the socio-economic ladder.To be clear, there is no evidence that racial and ethnic minorities have an inherently greater predilection of being infected with the SARS-CoV-2 virus or dying from it when compared to white people. A more accurate predictor of infection is poverty, or working at jobs that can’t be done remotely.
A recent study of a large health system in Louisiana observed that a preponderance of COVID-19 cases and mortalities were experienced by a minority of the health system’s population, African Americans.
Statistical analysis, however, revealed that Black race was not associated with higher mortality rate when compared to white race. The higher prevalence of cases and mortality rates experienced by African Americans is more likely due to income disparities.
In San Francisco, researchers from the University of California San Francisco conducted a testing “blitz” of active COVID-19 infections in the Mission District, a neighborhood that is 55 percent Latinx and 34 percent white. Their results were staggering. Ninety-five percent of those who tested positive were Latinx. Not coincidentally, 90 percent of those who tested positive were workers who were not able to do their jobs remotely.
These results suggest that working outside of the home may be a risk factor for COVID-19 infection. This theory is also supported by a Journal of Epidemiology study that found counties with higher levels of unemployment had a lower prevalence of COVID-19.
Across the country, states are rushing ahead with ending social distancing measures even as COVID-19 cases continue to rise. In many states, workers lose eligibility for unemployment benefits if their employers reopen and ask them to come back. That leaves them with no way to put food on the table or pay their rent except for returning to their jobs, even if the jobs put them at high risk for contracting COVID-19.
An estimated 25 to 30 million front-line workers have underlying health conditions or live with someone who does. Members of this group, disproportionately people of color, are at the highest risk of dying or becoming severely ill from COVID-19. Many of them have no access to sick leave or quality health care.
All of us must join together to demand that governments and businesses take steps to protect these workers.
The first demand is that employers provide the safest work environment, as evidenced by scientific studies developed to determine best practices, to lessen the risk of exposure to COVID-19. A top priority should be mandatory face coverings for both employees and customers.
It has been well-established that asymptomatic and pre-symptomatic circulation of the SARS-CoV-2 virus is a major mode of transmission, especially indoors. Face coverings (or masks) are a simple, cheap, and effective intervention that protect both employees as well as customers from exposure to the SARS-CoV-2 virus.
Another efficient means of lowering the risk of exposure to COVID-19 is physical distancing. The use of plexiglass to create a barrier between employee and customer is an excellent approach that will likely decrease transmission of the SARS-CoV-2 virus and help to protect the employee.
Protecting frontline workers and their families is a matter of both economic justice and racial justice. Governments and businesses must act now to make every workplace as safe as possible from COVID-19.
Dr. MarkAlain Déry, DO, MPH, FACOI is Chief Innovation Officer of Access Health Louisiana.
Chenier Reynolds-Montz is Director of Outreach & Development for Access Health Louisiana, a registered 501(c)3 organization. She can be reached at creynolds@accesshealthla.org. For information about our services, log onto our website at accesshealthla.org
