Fighting for a Just COVID-19 Response

As much as hurricanes Katrina and Maria upended African American and Latinx families, the landfall of the coronavirus brings a gale of another order. This Category 5 of infectious disease packs the power to level communities already battered from environmental, economic, and health injustice. If response and relief efforts fail to adequately factor in existing disparities, the current pandemic threatens a knockout punch to the American Dream.

"There's a whole segment of society that's invisible to policy framers, and everything I'm hearing so far about how we're supposed to deal with the coronavirus assumes we all have the same level of affluence," said Robert Bullard, Distinguished Professor of Urban Planning and Environmental Policy at Texas Southern University, and considered the father of environmental justice. "They're doing policy from a privileged position. If the invisible stay invisible to our policymakers, it will create a second disaster."

A major question of the hour is whether this nation can avoid the second disaster. The coronavirus gives us the opportunity to declare in our political and medical decisions that we will not drape the cloak of invisibility over historically neglected victims of disaster, as it was in the hollowing out of the black middle class in New Orleans after Katrina and the inhuman abandonment of Puerto Ricans after Maria.

The early signs are not good. There are stark examples of how the privileged can get tested for the virus, stock up for landfall, and be assured of financial relief well before we hit our likely peak period of infection. But early harbingers do not have to dictate the outcome if we treat the disadvantaged equally in this crisis, medically and economically, rather than triage them away.

Them that have get the test

While most Americans have been left hanging in collective anxiety over the Trump administration's abominable botching of the preparations needed to make COVID-19 tests widely available, actors, athletes, college presidents such as Harvard's Lawrence Bacow, and politicians such as Kentucky Senator Rand Paul have gotten tested.

In terms of math, perhaps the most telling case was the Utah Jazz.

When it was suspected that one Jazz player had coronavirus while in Oklahoma City for a National Basketball Association road game, the state of Oklahoma conducted 58 tests on the team's entire traveling party. At the time, the United States was so short of test kits that state labs were averaging just 55 tests per state according to the Daily Beast.

While that testing thankfully helped trigger a national shutdown of spectator sports, music festivals, and business conventions, it also symbolized the divide between the haves and have nots. Many other NBA teams were quickly tested through official relationships with top medical centers and private services. An NBA official told the Washington Post, "We had, and still have, tests at the ready for our players." The official said that testing was, "One phone call away."

That level of access rightly angered New York City Mayor Bill de Blasio. As he tweeted, "An entire NBA team should NOT get tested for COVID-19 while there are critically ill patients waiting to be tested. Tests should not be for the wealthy, but for the sick."

Or consider the cleaning out of grocery stores in panic buying, a phenomenon that clearly advantages those with disposable income while leaving empty shelves to the disadvantaged. Ironically, some of those left empty handed are the very farmworkers who picked the vegetables for the cleaned-out shelves.

In upstate New York, Luis Jimenez, head of the immigrant farmworker group Alianza Agricola, told The American Prospect magazine and Capital & Main, a California non-profit news organization, "We can't buy food until we get off work, and by then the store shelves are empty--no rice or eggs or meat."

Selfishness is already on full display in the corporate clamor for bailouts, led by the airline industry's request for $50 billion. This is despite the industry being notorious for throwing free cash on stock buybacks to increase shareholder earnings instead of improving consumer service, worker pay or creating rainy day funds. So far, President Trump has said, "We're going to back the airlines 100 percent."

Who has workers' backs?

There is no such pledge of 100-percent backing for workers who keep America humming with honest, humble labor, from cashiers to cleaners in hotels and from farm workers to restaurant servers. Far more needs to be done to take care of these workers who are the backbone of Fortune 500 profits yet are the first to have their backs broken financially in economic crisis.

The proposed one-time check of up to $3,400 for a family of four does not come close to the average monthly living wage of $5,734 in the United States, according to the Massachusetts Institute of Technology Living Wage Calculator. Undocumented workers do not get a check at all. The 60-day foreclosure moratorium for homeowners does not cover America's 40 million renters. That is a huge consideration as close to three quarters of white families own homes, while less than half of African American and Latinx families do.

In another arena where the working poor are barely backed at all, only about 20 percent of private-sector workers are covered in the new coronavirus paid sick leave legislation. According to the New York Times, a combined 2 million people work at McDonald's, Walmart, Kroger, Subway, Burger King, Pizza Hut, Target, Marriott, Wendy's, and Taco Bell alone and all of them normally lack any paid sick time. In recent days, President Trump has praised many such companies for pledging to offer pick-up meals and parking lot space for drive-through virus testing.

Many of those companies have temporarily covered their public relations flanks by offering two weeks of COVID-19 sick pay. But if coronavirus is anything like the 1918 flu that killed 675,000 Americans in three waves, we need permanent paid sick pay to account for future illness. While 75 percent of Americans receive some paid sick days, only 25 percent of fast food workers do, according to the Washington Post. The United States is also the only nation in the developed world with no form of paid family leave. In a 2013 survey by the Centers for Disease Prevention and Control, 60 percent of food workers said they have worked while ill and 43 percent said they came to work because there was no sick leave policy.

Congressional Republicans steadfastly refuse to consider making paid leaves permanent, even though science says we would all be better off if low-wage workers had these safety nets. Paid family leave is particularly beneficial to low-income mothers, reducing the incidence of early birth, low birthweight, infant mortality and maternal health. It also results in better long-term health for disadvantaged children, with less obesity and attention deficit. One study bluntly said, "Paid maternity leave has particularly large impacts on the children of unmarried and black mothers."

Disparities the coronavirus exploits

The risk of unequal treatment is embedded in even the seemingly universal "we're-all-in-this-together" advice we are getting to protect ourselves and stop the spread of the coronavirus. One person who sees this clearly is Lawrence Reynolds, a pediatrician in Flint, Michigan. He served on the 2016 Michigan task force which determined that the Flint Water Crisis in that 54-percent African American city was "a story of government failure, intransigence, unpreparedness, delay, inaction, and environmental injustice."

Reynolds retired a year ago but was asked by Flint's mayor to be an advisor for COVID-19 care.

He said he already sees where daily life for disadvantaged people is not being factored into public health advisories. "Take social distancing," he said. "That is much easier to do for a family that owns a single-family home where they can spread out inside the home and have a backyard to get some fresh air in private. That is much harder for people who live in small apartments in buildings where people are always passing each other in the hallways. No one has come up with a strategy as to how those folks are supposed to 'social distance.'"

Ana Baptista, chair of the Environmental Policy and Sustainability Management Program at the New School's Tishman Environment and Design Center, worries about higher rates of COVID-19 among people of color as they are more likely to have jobs that cannot be telecommuted. While 37 percent of Asian Americans and 30 percent of white Americans told the Census they can work at home, only 20 percent of African Americans and 16 percent of Latinx respondents say they can work at home. Only 9 percent of low-wage workers in the lowest quartile of wage earners say they can telecommute, compared 62 percent of those in the highest quartile.

One of those job categories requiring workers on site, of course is hospital and nursing home care. One-third of nursing, psychiatric and home health aides and a quarter of vocational nurses who work under the supervision of registered nurses and physicians are black, and a quarter of medical assistants are Latinx--well above their share of the general population. Both Baptista and Reynolds rightly point out that current shortages of protective gear for our health care and other frontline workers mark not only an unconscionable failure by the federal government in its preparations but also one that will disproportionately affect workers of color.

Social distancing also has created other ironies for the working poor and communities disproportionately breathing in the particulates of pollution. With retail stores closed, Amazon says it will hire 100,000 people to fill the explosion of online shopping. Reports are widespread that the frantic pace of teams moving around each other at warehouses makes it impossible for this army of the working poor to observe the dictum of staying six feet apart.

Workers at more than a dozen Amazon facilities in the US have tested positive for coronavirus, and more than 1,500 workers have signed a petition demanding stepped-up safety measures. In the world of immigrant farmworkers, Jimenez said living conditions also make social distancing irrelevant. "We live 8 to 10 people in a house, so how would we isolate? Some have their own room, but I know one farm where everyone sleeps in bunk beds in a big room. At work we have to help each other all the time, like when we have to move a cow. You can't do this alone."

The ramp-up in online commerce also means increased truck traffic. Environmental justice advocates fear that the increased exhaust around Amazon facilities will drive up air pollution in abutting neighborhoods, increasing illness and vulnerability to COVID-19. A landmark study last year found that while white households generate the majority of lung- and heart-damaging fine particulate pollution in the consumption of goods and services in the US, African American and Latinx neighborhoods disproportionately breathe it in. That study found that 83,000 premature deaths occur from such commerce.

"Essentially, all the things we do and all the things we buy are those 80,000 deaths," said study co-author Jason Hill, a biosystems engineering researcher at the University of Minnesota.

Drive-through testing--if you have wheels

Another response that policymakers seem to assume is applicable to everyone is drive-through virus testing. While such drive-through locations seem to have proven effective in South Korea and elsewhere, this diagnostic measure of course requires you to have a car.

Vehicle ownership is nearly ubiquitous in white America, with 93.5 percent of white households having wheels. But according to the National Equity Atlas, Latinx and Native American households are twice as likely as white households to be without a car and African American households are three times as likely to be carless. The percentage of African Americans without a car ranges from around 30 percent to 50 percent in many cities, including Milwaukee, Chicago, Pittsburgh, St. Louis, Cleveland, Minneapolis, Miami, Atlanta and San Francisco.

Compounding the problem, many of these drive-through testing facilities are planned for locations such as Walmart and Target parking lots. But big-box stores are often located outside of urban centers, hard to walk to, and not easily accessible by public transit. Such is the case in Southeast Chicago, said Peggy Salazar, executive director of the Southeast Environmental Task Force. Salazar's group has pushed back against coal ash, manganese dust and lead contamination in neighborhoods squeezed between toxic industries on the Calumet River in Chicago and refineries just over the border in Indiana.

"It can take me an hour and a half to take public transportation to downtown Chicago," Salazar said. "We're so isolated down here, if you don't have a car, it's tough."

And, with social distancing, it's not like you can ask a neighbor to give you a lift. In a 2016 column for the Boston Globe, Clayborn Benson, an old friend and founding director of the Wisconsin Black Historical Society, told me he knows of countless African Americans in Milwaukee who "can't get jobs in the suburbs because they can't drive. Even if they can drive, they lose jobs because they can't afford good cars and they break down."

The COVID-19 crisis gives America an opportunity to avoid another response that breaks down once more along color and class lines to treat the least privileged as expendable. For instance, if the exploding levels of online shopping remain a permanent part of our economy, local and state governments must no longer place warehouses in, and run diesel-spewing trucking routes through, so-called "fenceline communities" already stewing in pollution. In those communities, respiratory diseases such as asthma are often already off the charts for African Americans and Latinx, putting them at greater risk of severe illness from COVID-19.

Policymakers must find ways to assure that neighborhoods suffering from food insecurity get security. The lack of quality grocery stores and the oversaturation of fast food chains that heavily target children with advertising and free toys has already fueled levels of diabetes and obesity higher than those for the white population. Diabetes is another disease COVID-19 can exploit. Dennis Derryck, founder of the Corbin Hill Food Project, which delivers fresh produce to low-income residents in New York City, said the multitude of health issues makes a broader range of people more vulnerable to coronavirus. "We define the elderly in Harlem as easily being 55 because of health disparities," he said.

Reynolds said we should also change the way we view water. With everyone being told they must constantly wash their hands, many cash-strapped cities that imposed impossible water bills on low-income residents have said they will not shut off anyone's water for the time being. Reynolds thinks this should mark the end of cutoffs, period, saying, "Water is a human right."

Perhaps most urgently, as medical centers tell patients that they are postponing "non-urgent" care in preparation for skyrocketing COVID-19 emergency treatment, where does that leave African Americans and Latinx, who are twice as likely than white Americans to choose emergency rooms for non-emergency care? Will they be disproportionately displaced?

The NAACP recently issued a resource guide pointing out pitfalls for policymakers to avoid so that the nation's response to coronavirus does not exacerbate inequity. Besides access to testing, worker pay, and protecting frontline healthcare workers and those in essential transportation and service industries, the list includes:

• Ensuring access to quality online education even in less-resourced public-school districts during long closures;
• preventing the crisis from becoming an excuse for increased incidence of racist attacks (already true for Asian Americans as President Trump deliberately calls coronavirus the "Chinese virus");
• halting the militarization of immigration policies that have already targeted Latinx populations;
• addressing virus exposure risk to inmates who are housed and herded in tight proximity to each other;
• protecting our democracy from being upended by disruptions in Census canvassing, delays in primaries, or relocating voting away from senior citizen centers and their reliable, but vulnerable voters.

The Center for American Progress and the Kirwan Institute for the Study of Race and Ethnicity at Ohio State University also called upon the nation to attend to the multiple layers of inequities, urging a moratorium on evictions, foreclosures, penalties on late car payments and credit card debt, and covering all workers with paid sick and family leave. In making the call, the center said, "It's important to note that these communities lack wealth not because of individual choices but instead due to 400 years of collective harms by federal, state, and local governments compounding over time."

Assuring access to care

Finally, it is crucial that our response to the pandemic does not reverse the gains in health care access won under the Affordable Care Act (ACA) passed during the Obama administration.

Under the act, the uninsured rate for nonelderly Latinx people dropped from 33 percent in 2010 to 19 percent in 2016, according to the Kaiser Family Foundation. It dropped for African Americans from 20 percent to 11 percent, for American Indians and Alaskan Natives from 32 percent to 22 percent and for Asian Americans from 17 percent to 7 percent. But uninsured rates have either plateaued or crept up under the ongoing attacks on the ACA by the Republicans and the Trump White House.

This is the last thing that should be happening as African Americans, Latinx, and Native Americans are two to three times more likely to be in the working poor, and are still significantly more likely to be uninsured. It is the last thing needed in communities where poor health outcomes are baked into local environments.

It is also the last thing needed for hard working, but poorly paid Americans who are forced to live in affordable housing, or who must live in three-generation households, with grandparents caring significantly for grandchildren while the mother in the middle goes off to work. This happens more frequent in families of color and is especially visible in many black neighborhoods badly wounded by mass incarceration and the flight of jobs in the last century. Five times more African American women than white women make it into their 40s having never married.

"Everybody is each other's lifeline," Bullard said. "The daughter may be working two jobs, but if she gets laid off, there's no paid leave, no health insurance. The grandmother may be 62 and not yet on Medicare. We know that children can be carriers without getting sick, and if the kid comes home and infects grandma . . . you kill grandma you kill childcare. The coronavirus shows what a house of cards these communities are."

The Trump administration's early complacency and confusion in its response to the pandemic led to a mixture of decisiveness and hesitance by churches, schools, concert halls and museums to close down. Who knows how much that chaos helped spread the virus? We may be all be separated by social distancing far longer than might have been necessary because of this president's distance from science.

That makes it all the more critical that the people who live the farthest from privilege and the closest to pollution not be lost in the effort to stem the pandemic and return to some sense of normalcy. An ominous sign that the White House could care less about this came in late March when the Environmental Protection Agency announced that it was suspending enforcement of environmental standards during the coronavirus crisis.

The EPA said it was trying to "protect workers." But with the EPA being run by a former coal lobbyist who wants to slash staff down to 12,610 (the agency had as many as 17,000 employees during the Obama administration), it is likely very bad news for communities living next to industry.

A cliche among African Americans is that when white folks catch a cold, black people get pneumonia. Now that all of America faces down the pneumonia of COVID-19, America should not make the same mistakes it did in Katrina and Maria. Coronavirus is going to batter us far longer than the worst of hurricanes. We must not let environmental justice communities be flattened in the process.