A Second Wave of COVID-19 Looms Large--and It's Not Because of Protests

All over America, protesters have taken to the streets to protest the police murders of African Americans George Floyd in Minneapolis and Breonna Taylor in Louisville and the white vigilante lynching of African American Ahmed Aubrey in Brunswick, Georgia. Part of the news coverage has dwelled on the speculation that the protests will fuel a second wave of COVID-19. One infectious disease scientist, Trevor Bedford of the Fred Hutchinson Cancer Research Center in Seattle, made the rough calculation that the protests could ultimately lead to between 15,000 and 50,000 overall coronavirus infections and between 50 to 500 deaths.

Of course, any additional death is a sad continuance of a tragedy that has disproportionately devastated the same communities brutalized by police. But it barely compares to the rioting of the virus and the looting of lives incited by the incompetence of the Trump administration and state decisions to prioritize reopening for business over public health. Those policies have seriously worsened a pandemic that has already caused 113,000 deaths in the United States according to the latest New York Times figures and is still racking up 50,000 infections in the nation every two to three days and around 1,000 deaths every day.

And even if one does focus solely on the protesters, it should be noted that while people certainly did not stay at least six feet away from each other in the throngs, most of those pictured in photographs from the marches and rallies wore face coverings.

Police contribute to COVID-19 risk

Those same masks worn by protesters were too often ripped off in agony as police around the nation chose to break up usually peaceful protests with tear gas and pepper spray. Researchers told National Public Radio that the gasping and violent coughing can project the virus of an infected person many feet. Many of those gasping people were then herded into packed vans and sent to crowded jails.

The Army has found that tear gas training exercises make soldiers more susceptible to acute respiratory illnesses, and the increased risk of COVID-19 spread triggered by using tear gas is so high that Duke University researcher Sven Eric Jordt told NPR, "Using it in the current situation with COVID-19 around is completely irresponsible."

The police also displayed more irresponsibility than the people they were supposed to control by often spurning face coverings for themselves and practicing no social distancing. Several New York City police officers told the media that face coverings are too hot and difficult to breathe through while dealing with protesters. In Chattanooga, Tennessee, local and county policy said they did not wear face coverings because they hampered communication.

That did not wash with the Rev. Alaina Cobb of the Mercy Junction Justice and Peace Center. She said to the Chattanooga Times Free Press, "We see once again the significance of the police's disregard for the health, safety and even lives of those who they feign they are here to protect."

The police actions mirrored political disregard around the nation for health, safety, and lives--especially those of black and brown people. Governors in many states ignored pleas not to reopen so quickly from mayors of cities whose populations are significantly of color and hard hit by COVID-19.

One of the most dramatic dismissals of the damage and continuing risk of COVID-19 to black people came a month ago in Mississippi, where Governor Tate Reeves announced an aggressive reopening of close-contact gyms, hair salons, and barbershops on the same day the state hit a record high in new cases. He could reopen with unspoken racial comfort as a white governor. Mississippi is 59 percent white, but 52 percent of the state's COVID-19 deaths have been suffered by African Americans, who are more vulnerable to the disease through a combination of poor prior health, congested living conditions, and riskier essential jobs.

As my epidemiologist wife Michelle D. Holmes pointed out in her own commentary in Vox Populi, Reeves justified reopening by claiming that the economic damage was becoming as "disastrous" as the virus. Vigorously objecting to this equating of money with life was Chokwe Antar Lumumba, mayor of Mississippi's heavily black capital of Jackson. He said, "It's a bad decision to freeze economic progress, but a worse one to sacrifice human lives."

White privilege unmasked

The rush back to business by Reeves and so many governors who have pursued aggressive openings gives a new expression of white privilege in America. In striking photographs from all over the country, predominately white crowds are packed shoulder to shoulder, with few face coverings, at raceways, at Lake of the Ozarks, West Coast and East Coast beaches, and at the launch of SpaceX.

These photos showcase a kind of jolly version of the angry, all-white, and supremacist-influenced anti-lockdown protests at state capitols. The images amount to an open declaration that the pursuit of white happiness is an unalienable, unalterable right. It offers up a perverted version of America the Beautiful, where alabaster crowds beam, undimmed by COVID-19 tears from black and brown communities.

Shutting up every scientist they can

The nation's cheerleader for this version of happiness is President Trump, who has overtly shunned mask wearing and social distancing. His administration gave a royal welcome to the coronavirus by shuttering most of the pandemic-warning apparatus built up by prior administrations. Now the White House is helping to assure a second wave by shutting up every scientist they can.

Chief among the silenced has been whistleblower Rick Bright, who said he was removed from a top post combatting infectious threats because he told the administration it was moving too slowly to stem the spread of the coronavirus. He warned a House hearing last month that, without a coordinated national response based in science, "the pandemic will get far worse."

It appears that the silencing of science is also now muting one of the few voices America could count on for sane public health advice during the now-evaporated coronavirus task force press briefings in which Trump ranted about dubious virus remedies, personally attacked reporters, and self-congratulated himself on closing borders despite the dead. CNN reported on June 1 that infectious disease expert Anthony Fauci said he had not talked with Trump since May 18. In a June 1 interview with STAT News, Fauci expanded on this, saying:

"We used to have task force meetings every single day, including Saturday and Sunday, and about 75 percent of the time after the task force meeting, we'd meet with the president. So, I was meeting with him four times a week back, a month or so ago. But as you probably noticed, the task force meetings have not occurred as often lately. And certainly, my meetings with the president have been dramatically decreased."

COVID-19 cases increasing in nearly half of all states

In the absence of federal leadership, not to mention science-based leadership, we find ourselves in the midst of a 50-state experiment, weaving a clashing quilt of regulations and timing in opening up shopping malls, restaurants, barbershops, beauty parlors, gyms, churches, and childcare facilities.

Universities--responsible for 20 million young adults--are releasing their plans for fall re-openings that display no consistency, ranging from the Harvard School of Public Health and the California State University System remaining online to aggressive plans for in-person classes at schools such as Notre Dame and Purdue. Top college football teams are opening facilities, AMC Theaters says it will reopen its cineplexes in July. The National Basketball Association, which jumpstarted the closure of mass events in mid-March by suspending the season, says it plans to resume its season at the end of July.

And on what public health evidence? Not much. Consider that:

• According to the June 11 New York Times coronavirus map, coronavirus cases are increasing in 20 states and Puerto Rico, based on 14-day trajectories;
• According to the June 11 Johns Hopkins coronavirus map, 21 states and Puerto Rico were seeing an increase, based on a three-day rolling average.
• A June 8 Washington Post analysis found that 14 states and Puerto Rico saw their highest-ever seven-day average of new cases in the pandemic. The states were: Alaska, Arizona, Arkansas, California, Florida, Kentucky, New Mexico, North Carolina, Mississippi, Oregon, South Carolina, Tennessee, Texas and Utah;
• According to the June 10 version of The Atlantic's COVID-19 Tracking Project, states "trending poorly" toward safe reopenings outnumber those "trending better" by a 3-to-1 margin. Only six states were trending better while 20 were trending poorly. The other states and the District of Columbia were in a muddled middle, making progress in decreasing infections, but still raising concern given their limited intensive care units and low testing levels;
• And Columbia University infectious disease specialist Wafaa El-Sadr noted to the Wall Street Journal that the national average of cases, which seem to be on a gradual downward trend, might be a dangerous illusion created by the few states that were hit hard early but since have made major progress in curbing COVID-19. "If you take out the impact of New York, New Jersey, Connecticut and so on, you'd have a much more worrisome picture of what's happening in the U.S.," El-Sadr said.

No matter which tracking map you look at, the list of states most poorly controlling the virus are dominated by those which have aggressively relaxed COVID health protections and been most supportive of the Trump administration's drive to get back to business regardless of safety. In the Atlantic map, not a single Southern or Southwestern state shows a decreasing trend in the spread of disease. It is equally scary that the largest blue state in the country, California, is seeing new outbreaks as it begins to lift restrictions after being one of the first states to shut down.

Now that every state has reopened in some way, there are new outbreaks from California to the Jersey Shore and from Utah to Florida from family gatherings, beach vacations, churches, people going back to workplaces, resumption of college sports practices, and factory food processing. In the purple swing state of North Carolina, state health secretary Mandy Cohen told the Wall Street Journal on June 8: "These trends moving in the wrong direction are a signal we need to take very seriously."

A Texas-sized problem

Even though there is plenty of emerging evidence that new outbreaks are spreading out into whiter parts of America, you would not know that from governors such as Greg Abbott of Texas.

Like other governors of states in which COVID-19 deaths of people of color outnumber those of white residents, Abbott is reopening Texas as though he can gerrymander the boundaries of the virus to protect privileged communities. We know that social distancing and face coverings offer the best tools we have to prevent the spread of the coronavirus without a vaccine. Despite how badly the White House botched the beginning of the pandemic, a study released June 8 in the journal Nature found that state lockdowns still averted some 60 million infections.

Nonetheless, despite Texas seeing a 53 percent increase in its rolling 14-day average number of virus cases as of June 10, Abbott has announced plans to allow Fourth of July celebrations, to let sports stadiums and retailers operate at 50 percent capacity, and to let restaurants serve meals at 75 percent capacity.

Abbott was quite clear in his statements that he has not taken in any of the science about potential superspreading of the virus from large gatherings. He also seems to take perverse comfort in his reopening based on his perception of where the virus hits hardest, citing jails, nursing homes, and meatpacking plants.

The Midwest Center for Investigative Reporting says that as of June 9, at least 24,000 meatpacking workers and family members have been infected with COIVD-19, with at least 86 worker deaths. "We have the ability to contain those hot spots while opening up Texas for business," Abbott said. Translated, Abbott's statement amounts to a plan to contain the virus to communities that are disproportionally made up of people of color. While he didn't bother to say it, the fact is that inmates, meatpackers, and nursing home staff all tend to be disproportionately black and brown.

Failing to prioritize justice and public health

The major question now is what will come of an America that is smoldering in the photographed displays of white privilege, the pillaging of science by the Trump administration, and an uprising of black grievance.

The uprisings started with police killings but have also reminded us that racism itself is a fatal virus that has been with us far longer than COVID-19. Back in 2005, former Surgeon General David Satcher estimated that 83,500 black lives a year could be saved by eliminating health disparities. In the COVID-19 crisis, the APM Research Lab estimates that at least 14,400 African Americans would still be alive if they died from the virus at the same rate as white Americans.

One source of those disparities--one tied to the COVID-19 crisis--is environmental injustice. Even as protesters marched in the streets, President Trump signed an executive order last week waiving environmental reviews for fossil fuel facilities and pipelines, mining, and other toxic industries. People of color live disproportionately close to lung-penetrating particles and poisonous fumes from industrial plants, increasing their vulnerability to the worst effects of COVID-19.

At a June 9 House hearing, Mustafa Santiago Ali, vice president of environmental justice at the National Wildlife Federation and former senior adviser for environmental justice at the Environmental Protection Agency, tied the protests and environmental justice together. According to The Hill, he said, "Black communities are dealing with the systemic racism that has infected the policing in our communities that is literally choking us to death. The rolling back of environmental rules and regulations has us gasping for air due to the cumulative public health impacts from the burning of fossil fuels," he said, according to The Hill. "When we say, 'I Can't Breathe,' we literally can't breathe."

The looming second wave

A lot more people will not be breathing if we get a second wave of disease anything like the fall resurgence of the 1918 flu pandemic, which killed most of the 675,000 Americans who perished from the virus. If we do, this country will have no one to blame but itself. The widespread abandonment of state lockdowns began a month ago even though just one-quarter of all states were reporting a decline in COVID-19 caseloads and even fewer had robust virus testing programs in place.

The US reopenings are proceeding even though the Imperial College of London has found "little evidence that the epidemic is under control in the majority of states." They are proceeding even though Harvard University global health expert Ashish Jha told National Public Radio on June 10, "It's stunning to me that we have just decided it's OK for tens of thousands of Americans to die. And we aren't going to do what we know we can do to prevent those deaths. And that is, to me, unconscionable."

They are proceeding even though Irwin Redlener, director of Columbia University's National Center for Disaster Preparedness, recently told MSNBC that without strong testing and tracing, it is a "disaster for the country to have these various states opening. We should be reconsidering this right now. If it was up to me, I'd put a halt to this reopening."

That makes it ludicrous to spend a whole lot of time speculating about the spread of COVID-19 from protesters. The far greater concern is the rampage on science and public health now underway by governors and the White House.

To effectively combat the pandemic, we need a just response guided by science and accurate data. But in this terrible moment when Americans have taken to the streets in droves because a police officer put a fatal knee to the neck of a black man, tens of thousands more Americans now risk of dying because the states and the White House have applied a figurative knee to the neck of our public health.