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 persons.
Centuries of racial structural discrimination have predictably led to communities of color being disproportionately represented in the lower rungs of the socioeconomic 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 persons. A more accurate predictor of infection is poverty, and a higher likelihood of 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 people 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 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 presymptomatic 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 front-line 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.
MarkAlain Déry, DO, MPH, FACOI, is the Chief Innovation Officer and Medical Director of Infectious Diseases at Access Health Louisiana- the largest Federally Qualified Health Center (FQHC) in Louisiana with 39 clinics throughout the State. He is a practicing infectious diseases physician, epidemiologist, and hosts a daily 10 minute podcast called NoiseFilter which looks at COVID-19 news through the filter of social, economic and racial justice.
Dr. Sanjeev K. Sriram contributed to this column, which originally appeared on CommonDreams.org. Dr. Sriram is the host of “Dr. America,” a podcast about public policy and health justice on We Act Radio.
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