Race and Counting ‘The Rona’
When it comes to African Americans and Covid-19, we have been swinging from one extreme to the other. As my African American friend living in Paris described self-isolating days before her workplace made it official, on this side of the pond, Blacks were minimizing its impact.
“Black people don’t get coronavirus!”
“The melanin in our skin protects us.”
I was horrified as I even heard this from highly educated people whom I respect. Living in a racist society had turned Black resistance into Black immunity. Those narratives had the subtext of racist “Blacks being resistant to pain and illness” narratives. But we are not superhuman. If anything, the lower life expectancy, higher rates of diabetes, heart disease, and comorbidities make it clear that African Americans are at a greater risk for developing and dying from Covid-19.
But then, like whiplash, the relationship between Black people and The Rona went from one extreme to the other. Across the country, African Americans were becoming infected and dying at obscenely higher rates. Suddenly, in St. Louis, the only people dying from The Rona were African Americans. Medical experts explained that these health issues were the reason for the greater proportions of Blacks becoming infected by and succumbing to the virus.
The truth is likely somewhere in the middle.
In Europe, there is a lot of variation in counting COVID-19 infections and deaths. England’s public health organization had not used death certificates to count these deaths, so the Office for National Statistics stepped in to do it. In Spain, initial counts included post-mortem examinations but stopped doing so as its health system experienced a greater strain on the system. In Belgium and France, COVID-19 deaths did not initially include people outside of hospitals, like those in nursing or retirement homes. When New York City included the deaths of people who had not been tested but were presumed to have tested positive, the number of victims increased by more than 3,7000. Yet, officials in California, Washington, Louisiana and Chicago, have only been counting Covid-19 deaths confirmed by testing. While half of all European deaths have involved people in nursing homes, it is unclear how many Americans in institutional living have been affected.
Epidemiologists use the number of “excess deaths” to better understand the impact of a disease on a population. Excess deaths show how many more people have died each month in comparison to historical averages. It includes people who exhibited coronavirus symptoms, but who were not tested or those who could not receive care due to health facilities being overwhelmed. In Europe, the statistics show a vast undercount in deaths that are likely attributable to the disease.
From The Economist Tracking covid-19 excess deaths across countries https://www.economist.com/graphic-detail/2020/04/16/tracking-covid-19-excess-deaths-across-countries
In the United States, the risk of not counting excess deaths has led to mass underestimates of Covid-19’s impact. Although Blacks are likely overrepresented due to the health impacts of living in a racist society, the rates may be overstated due to the lack of widespread testing and overlooking nursing homes and institutionalized disabled populations. In this context, we have likely undercounted the number of Whites who have taken ill or died from Covid-19. Even as Blacks face disproportionate mortalities, Whites are still the majority in this country and are the majority of those dying from this disease. The risk of these undercounts can provide a false sense that the disease is “not really as bad as they say” or that it is a “a Black thing.” This may lead non-Blacks to not take the necessary precautions for their well-being. As a professor living in one of the hardest hit states, I can tell you that this disease is affecting my students and their families across colors.
In the United States, we need a massive increase in testing, a national standard for counting Covid-19 infections and deaths, including outside of hospitals, and information on excess US deaths broken down by race, age, and other social indicators. This will help us have a better understanding of how this crisis is affecting our society.
Until then, all we can do is stay at home and wash our hands.
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