COVID-19 Is Not Fair
Yeah, my quarantine is over! After nine days of keeping to myself and restricting contact with my husband, Greg, and our two dogs, I came out of isolation this Tuesday. And today we came out of our 14 days of quarantine and can now leave the house as needed.
The recommended time to stay in isolation from other family members is 10-14 days, but I had tested negative on the sixth and eighth days of isolation, so it seemed safe to end it a little early. Greg had continued to test negative, indicating that he had managed to stay infection-free during the quarantine. We decided, however, to continue quarantining at home until the end of the 14 days, just to be safe.
Counting My Blessings
Reflecting back on my bout with COVID-19, I am so grateful for how relatively easy it was for me. I was able to get tested quickly, easily, and free of charge. I was asymptomatic and did not suffer physically or emotionally. Greg was able (and willing) to take care of me and to handle all the upkeep of the house and yard. There were no children in the home that required either mine or Greg’s attention and care. There were no elderly relatives living with us, whose health could have been greatly affected by my infection. Our house is spacious and laid out is such a way that I had access to half the house without ever crossing over into Greg’s half. And we have a strong support network of family and friends who were gracious in bringing or ordering meals for us.
I was (and am) very fortunate, blessed, and privileged. But not everyone has similar advantages.
I can’t tell you the number of times I have shaken my head in wonder:
“How would a single parent who gets COVID-19 even handle isolation?”
“How would a family of 8 be able to isolate from each other in a crowded house?”
“How would a person juggle caring for an infected family member, helping the kids with distance learning, working from home, getting enough sleep, and quarantining safely?”
“How frightening would it be to have severe symptoms and wonder whether and when to go to the hospital?”
“How frightening it would be to be alone in your hospital bed, with no family members allowed to visit you, and not being able to communicate with the health providers because of a language barrier.”
“How anxiety-provoking would it be to not have health insurance?”
What’s the Big Deal?
I have personally heard and read people expressing the opinion that COVID-19 should not be such a major focus of attention and governmental oversight. Some have suggested that the chance of a healthy person dying from the disease is so low as to make all the fears, restrictions, and economic consequences indefensible. Others have suggested that individuals should take responsibility for their own safety and health choices instead of looking to the government to prevent tragic consequences. I always cringe when I hear these and similar views, because I am astounded by the lack of comprehension of the situation, the sheer lack of empathy for those who have suffered terrible losses, and the ignorance of the privilege that comes with being able to hold those views.
I know individuals and families who, despite their very best efforts, facing insurmountable barriers, and with limited resources at their disposal, have suffered greatly due to COVID-19. An Asian-American family I know lost both their parents in the same month. Another family struggled with 8 of the 12 people living under one roof being infected and the two oldest members being hospitalized for several months. A young lady died after caring for her father, who recovered from COVID-19. My uncle passed away when he contracted COVID-19 from the physical therapist who was helping him rehabilitate after a surgery.
COVID-19 is a big deal.
COVID-19 is Not Fair to Minority Communities
The number of COVID-related deaths in the US to date is 243,580. Due to lack of uniformity and limited identification of race/ethnicity when reporting COVID-related deaths, we do not have exact number of deaths by race. However, we can examine another set of numbers to extrapolate how COVID-19 may be affecting various racial/ethnic communities.
The number of deaths from any and all causes that occur above and beyond the expected (average) number for a given place and time period is known as excess deaths. While some people do not believe that COVID-19 has killed as many people as is being reported, there cannot be any dispute about the number of people who have died in 2020 compared to the number who died in previous years. According to the CDC, “Estimates of excess deaths can provide a comprehensive account of mortality related to the COVID-19 pandemic, including deaths that are directly or indirectly attributable to COVID-19.”
In the United States, “Overall, an estimated 299,028 excess deaths occurred from late January through October 3, 2020” (compared to the average number of deaths in that same time period from 2015-2019). Two thirds of excess deaths during the analysis period (66.2%; 198,081) were attributed to COVID-19 and the remaining third to other causes.
Breaking down the number of excess deaths by race reveals a startling disparity. The CDC reported:
“For White persons, deaths were 11.9% higher when compared to average numbers during 2015–2019. However, some racial and ethnic subgroups experienced disproportionately higher percentage increases in deaths. Specifically, the average percentage increase over this period was largest for Hispanic persons (53.6%). Deaths were 28.9% above average for American Indian/Alaska Native persons, 32.9% above average for Black persons, 34.6% above average for those of other or unknown race or ethnicity, and 36.6% above average for Asian persons.”
COVID-19 is not fair. It does not treat everyone the same. Those who have financial resources, sufficient healthcare access, insurance coverage, white-collar jobs, and adequate housing have a better chance of weathering the challenges of COVID-19 and surviving it.
Looking at Health Equity Considerations and Racial and Ethnic Minority Groups, the CDC noted:
“Some of the many inequities in social determinants of health that put racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19 include:
Discrimination: Unfortunately, discrimination exists in systems meant to protect well-being or health. Examples of such systems include health care, housing, education, criminal justice, and finance. Discrimination, which includes racism, can lead to chronic and toxic stress and shapes social and economic factors that put some people from racial and ethnic minority groups at increased risk for COVID-19.
Healthcare access and utilization: People from some racial and ethnic minority groups are more likely to be uninsured than non-Hispanic whites. Healthcare access can also be limited for these groups by many other factors, such as lack of transportation, child care, or ability to take time off of work; communication and language barriers; cultural differences between patients and providers; and historical and current discrimination in healthcare systems. Some people from racial and ethnic minority groups may hesitate to seek care because they distrust the government and healthcare systems responsible for inequities in treatment and historical events such as the Tuskegee Study of Untreated Syphilis in the African American Male and sterilization without people’s permission.
Occupation: People from some racial and ethnic minority groups are disproportionately represented in essential work settings such as healthcare facilities, farms, factories, grocery stores, and public transportation. Some people who work in these settings have more chances to be exposed to the virus that causes COVID-19 due to several factors, such as close contact with the public or other workers, not being able to work from home, and not having paid sick days.
Educational, income, and wealth gaps: Inequities in access to high-quality education for some racial and ethnic minority groups can lead to lower high school completion rates and barriers to college entrance. This may limit future job options and lead to lower paying or less stable jobs. People with limited job options likely have less flexibility to leave jobs that may put them at a higher risk of exposure to the virus that causes COVID-19. People in these situations often cannot afford to miss work, even if they’re sick, because they do not have enough money saved up for essential items like food and other important living needs.
Housing: Some people from racial and ethnic minority groups live in crowded conditions that make it more challenging to follow prevention strategies. In some cultures, it is common for family members of many generations to live in one household. In addition, growing and disproportionate unemployment rates for some racial and ethnic minority groups during the COVID-19 pandemic may lead to greater risk of eviction and homelessness or sharing of housing.
These factors and others are associated with more COVID-19 cases, hospitalizations, and deaths in areas where racial and ethnic minority groups live, learn, work, play, and worship.”
Naming My Privilege
While I am grateful that my experience with having COVID-19 was marked by ease, I am deeply humbled by possessing all the factors that allowed me to experience it this way. I am not ashamed of the privileges I have but acknowledge that they are privileges that too many do not enjoy. Having gone through an easy bout of COVID-19 makes me even more keenly aware of the innumerable challenges and risks faced by many people. And I am more troubled now than ever before that our nation is characterized by such large disparities that fall too closely along racial lines.
If 2020 has taught me anything, it is that people and relationships are precious and life is precarious. I don’t have any answers or quick fixes to the inequities all around me, but I plead for all of us to be more thoughtful and kind to one another as we navigate these difficult times together and make concerted effort toward greater equity and shared privileges.
