Bias & the COVID-19

On April 9, 2020, USA Today published an article on the high risk of dying from COVID-19 for Blacks and Hispanics in New York state and New York City (NYC). Black people were 18% of the deaths in New York state and Hispanics were 14%. Since Blacks are 9% of the state population and Hispanics are 11% of the state population. Given the population, the Black death rate is 100% greater than expected; and Latino’ death rate is 27% greater than expected.

For NYC, Hispanics are 34% of the COVID-19 death and 29% of the NYC population and Blacks are 28% of the COVID-19 death and 22% of the NYC population. Given the population, the Latino death rate is 17% higher than expected and the Black death rate is 28% higher than expected. Asian Americans are 14% of NYC population; they are 7% of the NYC COVID-19 deaths. Whites are 35% of the NYC population; they are 27% of the NYC COVID-19 deaths. The death rate for the Asian population of NYC is 50% less than expected; and the death rate for the White population is 30% less than expected.

The disparity in death rates is partially explained by health issues and occupations. According to Medical Express, 46% of the Black population and 40% of the Asian population have hypertension, while only 35% of the White and 34% of the Latino communities have hypertension. According to the American Diabetes Association, 7.5% of non-Hispanic Whites, 9.2% of Asian Americans, 12.5% of Hispanics, 11.7% of non-Hispanic Blacks and 14.7% of American Indians/Alaskan Natives have diabetes. According to the U.S. Bureau of Labor Statistics, over 50% of cleaning and maintenance staff, almost 50% of cashiers and over 40% of bus drivers are people of color.

In these essential jobs that help keep our nation afloat, the workers do not have the luxury of working remotely from home or sheltering in place. They are on the frontline. As I watched video of custodians washing down the NYC subway, I was struck by the absence of personal protective equipment. They had on rubber gloves, but no masks or covering for their mouth and nose. This was especially troubling given the higher rate of diabetes in the Latino and Black communities and the compromised immune system for people with diabetes. Blacks are especially vulnerable, given they are also more likely to have hypertension and diabetes, as a comorbidity.  

The lower death rate of 50% of expectation for the Asian population of NYC is striking. I wonder if this is because the Asian population was being ostracized before social distancing and shelter in place were enacted. When I was in Chicago’s Chinatown at the end of February, it was like a ghost town. When I talked to friends across the United States, they commented that Chinatown in various cities had empty restaurants and parking lots. The streets were empty.

The emotional scar of being treated like pariahs may have led to less exposure to COVID-19 for the Asian population. Many had no jobs to go to or co-workers with whom to work because there were no customers. Asian restaurants and retail stores have been essentially closed since mid- to late February. The Asian small businesses may be in more peril than other small businesses because they have been in de facto closure before there was an official closure by any state or municipality. And I deliberately, use Asian rather than Chinese Americans, because there is also the bias of lumping all people of Asian ancestry into one category. It was not just Chinese restaurants and retailers that were being avoided.

The irony is that instead of ostracizing a particular group, we should have stopped going to restaurants, theaters, and conferences earlier than we did. I can only hope that the vast majority of small businesses will be able to survive the crisis. And that we practice a logical patronage of restaurants and theaters after the height of the crisis. Immediately after the suspension of shelter in place, we would be wise to follow Dr. Fauci’s suggestion of a nod or a bow rather than a handshake or a hug. A nod or a bow would not be culture appropriation, but it would be a sign of acknowledgement, respect and safety.

Let’s avoid a second wave. Be safe and stay well.

To those who have lost love ones, my prayers are with you