Moving From The Five Whys To Five Hows: Addressing Racial Inequities In COVID-19 Infection And Death | Health Affairs

In recent months, states and municipalities have begun releasing data on COVID-19 infections and death that reveal profound racial disparities. In Louisiana, Black patients account for 57 percent of COVID-19 deaths, while making up only 33 percent of the total population. In Wisconsin, Hispanic patients constitute 12 percent of confirmed COVID-19 cases, but only 7 percent of the total population. In New York City, the epicenter of the pandemic in the US, age-adjusted mortality rates are more than double for Black and Hispanic patients (243.6 and 237.7 per 100,000) compared to white and Asian patients (121.5 and 109.4 per 100,000).

In the past several weeks, the nation has been further shaken by the murders of George Floyd, Breonna Taylor, and Rayshard Brooks at the hands of police. A National Academy of Sciences study estimates that Black men are 2.5 times more likely to die from police violence than white men, and Black women are 1.4 times more likely to die from police violence than white women.

We argue that these disparities are linked. Indeed, George Floyd himself recovered from COVID-19. The data call for a reckoning with a simple question: Why?

The non-immigrant visa proclamation is the latest step toward self-destructive othering | The Hill

Authored by Sandro Galea and Nason Maani.

The Trump administration’s announcement earlier this week of the extension of a visa ban to cover non-immigrant visas including H-1B, H-2B and some J and L visas resulted in opposition from leaders in science and commerce, who claimed this would make the U.S. less competitive, hampering science, education, economic growth and job creation.

The presidential proclamation, entitled “Proclamation Suspending Entry of Aliens Who Present a Risk to the U.S. Labor Market Following the Coronavirus Outbreak,” claims that to allow such “aliens” to enter the country would be “detrimental to the interests of the United States.” This is in contrast to the opinion of most experts, including the editorial pages of reliably business-friendly newspapers like the Wall Street Journal, who suggest that this proclamation would in itself be harmful to the U.S. economy. We agree that this move is self-defeating for a U.S. economy already in dire straits.

Income inequality drives health disparities | Oxford University Press Blog

Pretax incomes for the poorest 50% of Americans have stayed mostly unchanged for the past 40 years, widening income gaps in the country. We leave the question of why inequality matters for the economy to others. What is of concern to us is whether income inequality matters to our health, and, to the extent that it does, how the health profession should respond.

In 1992, Richard Wilkinson, then a professor at the University of Sussex, published a paper in The British Medical Journal called “Income distribution and life expectancy.” The paper concerned 12 European countries and concluded that “the relation between income distribution and life expectancy is sufficiently strong to produce significant associations.” The paper’s thesis launched two decades of intense scientific discussion about the influence of national income inequality on health (and death), including several systematic reviews and books. This work, which continues to the present day, shows that income inequality is a foundational driver of physical and mental health. By way of example, a 2018 systematic review considers the relationship between income inequality and depression, and it concludes that across studies there is “greater risk of depression in populations with higher income inequality relative to populations with lower inequality.”

The COVID Conversation | Inference

THE ENTIRE WORLD has experienced the COVID-19 pandemic, and within three months of the first recorded case, more than half of the global population was undergoing some form of quarantine. Scientists struggled to make sense of a new, poorly understood disease, and decision-makers scrambled to find data that could help them guide policy. From roughly January 2020 to the present, scientific papers devoted to COVID-19 doubled every fourteen days, for a total of more than 100,000 papers. As the pressure for information increased, the health sciences embraced preprint publication—work that was uploaded to the web without scrutiny.

The global media has been galvanized by the COVID-19 pandemic, with print, video, and audio outlets scrambling for news. This followed a decade-long change in the media landscape. Once dominated by a small number of high-profile outlets, it has become fractured: sound bites, headlines, and video fragments now a part of the public conversation. The new media landscape did not scrupulously distinguish among peer-reviewed papers, preprint uploads, and opinion pieces. A preprint study on COVID-19 seroprevalence in Santa Clara County, California, quickly hit the front pages following its publication on the preprint site medRxiv.1 News outlets reported that the virus had spread “50 to 85 times more than confirmed cases”2 before epidemiologists had the chance to comment on the paper’s many flaws.3 Other stories promoted drugs such as hydroxychloroquine,4 and still others were devoted to predictions from various infectious disease models.5 “2.2 Million People Could Die in US,” claimed one news site, citing a controversial model released by the Imperial College in London.6 Politicians reacted to the rapidly evolving narratives, using fragmentary stories of complicated scientific observations to inform policies that ultimately influenced the lives of millions.

2020: The Great American Trauma | BU Today

“It has been a hard year. We are living through a global pandemic unlike any since 1918, an economic collapse unlike any since 1933, civil unrest unlike any since 1968, and the greatest unexpected loss of life since 9/11. The entire country is living, collectively, through four events that, each in isolation, would suffice to make the year darkly memorable. That the four events are being experienced together represents nothing short of a remarkable collective traumatic experience, one with immediate, short-term, and long-term consequences for millions of Americans.
And yet it’s important to remember. There was a 1919. A 1934. A 1969. A 2002. There will be sun after the dark of 2020.”

Cutting ties with the World Health Organization, Trump endangers global public health | STAT News

“President Trump’s announcement on Friday that the United States will cut ties with the World Health Organization was, he said, aimed at punishing China, which he claimed influenced the WHO to “mislead the world” about the Covid-19 pandemic. Cutting ties with the WHO is exactly the wrong move, at the wrong time. It adds fuel to the public health fire we have been collectively dealing with over the past several months.

The president’s announcement came just a few days after the U.S. had passed the 100,000 mark in Covid-19 deaths. The road to this grim milestone was paved with failures at the federal level to adequately prepare for such a crisis by underfunding the public health organizations tasked with pandemic response followed by the administration’s slipshod efforts to quickly deal with the outbreak when it reached the U.S.”

How conspiracies theories hurt vaccination numbers | Oxford University Press Blog

“Near the end of 2018, 1data released by the Centers for Disease Control and Prevention showed that a small, but growing, number of children in the United States were not getting recommended vaccinations. One in 77 infants born in 2017 did not receive any vaccination. That’s more than four times as many unvaccinated children as the country had at the turn of the century. Some of this may be due to lack of access to vaccines; populations without insurance and those living in rural areas have greater rates of nonvaccination. But part of it is also likely due to the rise of conspiracy theories and the willful dismissal of scientific evidence when it comes to vaccines.

Vaccinations have always provoked anxiety. But the data on vaccines that are in widespread use are now clear: vaccines are safe and save lives. Nonetheless, conspiracism insists that we don’t know all the facts, that things about vaccines are not as they seem. Conspiracism fuels the anti-vaccine movement, nudging people to accept anecdotes (e.g., “I heard about one child who got a measles vaccine and developed autism”) over statistics.”

The coronavirus pandemic will turn into a poverty pandemic unless we act now | The Washington Post

“Discussions about the covid-19 pandemic’s effects tend to focus either on public health or the economy, as if they were two separate matters. But they are linked, and not just by data about the disease’s disproportionate impact on poor and minority populations. The worldwide economic devastation from lockdown policies is sending millions into poverty — increasing their exposure to potential covid-19 infection as well as to the deadly threat that comes simply from being poor.

As challenging — and vitally important — as fighting the pandemic has been, the long-term health costs of an economic depression could ultimately far eclipse what covid-19 has wrought.”

This is the personal website of Sandro Galea. All photos are taken by Sandro Galea.