We have previously detailed the staggering statistics of the disproportionate death and infection rates from COVID-19 in the African American community. This is partly due to the healthcare disparities that exist in our communities. Many people suffer with hypertension, diabetes, obesity, asthma, depressed immune systems, and chronic heart, lung, and kidney disease. There are no proven medications to treat this coronavirus infection and it is estimated that it will be 12-18 months before a vaccine is available. The mainstay of treatment is therefore “social distancing” which means staying at home from school, work, religious gatherings, sporting events, travel, vacations, and the usual activities of our prior lives. The health problems that plague us and make us more vulnerable to COVID-19 still require treatment and access to medical advice. This access was difficult even before the pandemic. We still rely upon our primary care providers for advice and they are just a phone call away. In past times, the emergency rooms have often been used for routine care. In this pandemic age, being in an emergency unit potentially exposes us to disease and uses up scarce resources. Therefore, it is necessary to use the telemedicine services of the hospitals, health department, and online resources before venturing out for non-emergent problems, if one has no primary care provider.
There are many factors, commonly known as the social determinants of health, which result in massive disparities in our health and healthcare. It is commonly said that “When Americans catch a cold, black folk catch pneumonia”. In this age a more appropriate saying is “Racism is a killer; a pandemic is a mass murderer”. With this said we cannot afford to wait until after the pandemic is over before we do something about those who are the victims of these disparities.
It has become clear that our pandemic-stricken country is being held up by essential workers. These are not only our nurses, doctors, medical technicians and therapists, but also the overlooked mass transit workers, truck drivers, janitors, home health aides, grocery store workers, farm and food processing workers, sanitation workers, etc. These individuals are underpaid and what is worse, under-protected. They continue to serve us without adequate testing, masks, gloves, and necessary protective gear. Full implementation of the Defense Production Act could address not only their shortages, but also the shortfall in the general public. Remember, the public is supposed to be wearing masks as well. Additionally, we should provide essential workers with health insurance coverage, either by Medicaid expansion or new enrollment into the Affordable Care Act (with subsidies to pay premiums). Another means of addressing their current vulnerability would be to provide appropriate housing away from their loved ones if they normally live in cramped conditions.
The people who are risking their lives, while the rest of us stay home, deserve to be protected by our governments’ best efforts, NOW. When this pandemic is over, we must focus on addressing the systemic reasons for this tragic persistence of healthcare disparities.