Denis Kosuth, Chicago Nurse and socialist activist, explains how COVID-19 outbreaks and deaths expose systemic racism and the depths of racial inequality in the U.S.
The numbers of diagnosed cases and a corresponding death count continue to rise exponentially – indicating that the U.S. is a far way off from flattening the curve. In a country where most people do not have paid sick days or access to a doctor (either due to lack of insurance or lack of primary care providers) this is unsurprising. They go to work sick and they also send their sick children to school because they cannot afford to stay home.
Since the virus can be spread by asymptomatic people, it was important for communities to shut down schools and encourage people to stay home, so that those with no access to healthcare could stay safe. The elite universities were the first to close.
In Chicago, the third largest city in the U.S., wealthier suburban schools, urban private schools for privileged families, and even Catholic schools, all announced closures. Yet the opposite was being argued by the mayor’s office for Chicago’s public schools, in which 80% of students qualify for free school meals and 90% of students are non-white.
Even after a public school staff member returned from a cruise and tested positive, the Mayor closed only that school, leaving the rest open. It became clear that schools which educate predominately children of colour, from the city’s working class and poorer families would stay open, while children from wealthier families stayed home. It finally took an intervention from Illinois state Governor JB Pritzker before Chicago Mayor Lori Lightfoot would reverse his position.
Disproportionate deaths
Chicago could be described as a de facto apartheid city. Black people make up 70% of the deaths from COVID-19, but only 30% of the population. In fact, Black people are dying at 6 times the rate of white people.
Even before this current outbreak, if you lived on the wrong side of Cottage Grove Avenue, which separates the neighborhoods’ of Hyde Park and Washington Park, the average age of death drops from 83 to 69. 14 years are lost by crossing a street.
Even more recently and outrageously, Chicago became the city with the largest death gap. The average life expectancy of a resident of Englewood, a neighborhood that is predominantly poor and almost all African American, is just 60. Eight miles north in Streeterville, a rich and white area, life expectancy is 90.
Deaths related to coronavirus will only widen this gap, as poor people and people of colour already are disproportionately represented as being at greater risk for worse outcomes due to having more medical issues. Skin tone has nothing to do with asthma, high blood pressure, or diabetes – racial inequality is the only reasonable explanation as to why these conditions exist in significantly higher numbers among African Americans and Latinos.
In city after city, state after state, the coronavirus is ripping through Black and brown neighborhoods, leaving destruction in its wake. In Milwaukee, Black people make up 23% of the population and about half of the corona virus cases, but 73% of deaths. In Louisiana, the death toll surged past 500 people, 70% of whom are Black, when only 30% of the population is Black. In New York City, Black and brown neighborhoods in Queens, the Bronx and Brooklyn are hardest hit; as are the Black and Latino neighborhoods in Boston, such as East Boston, Mattapan and Dorchester.
In St. Louis, the only coronavirus related deaths are African Americans – let that sink in.
Most of the working poor do not have the luxury of working from home. They do the essential work of refuge collection, public transport, food production and distribution, delivery driving, letter carrying, cleaning, as well as caring work as nurses, medical technicians, porters, nursing home workers, etc. And the urban poor in the U.S. is a Black and brown population.
Once sick however, those in smaller, more crowded living conditions are less able to self-isolate from their housemates. And, these populations have less access to medical care. In NYC, 50 transit workers have died from coronavirus, with 6,000 transit workers currently off sick or self-quarantined. And, now famously, the Detroit bus driver who ranted on a video about being coughed on by a passenger, has died of COVID-19.
In a rational society, poor and minority areas would be given more resources to tackle this pandemic, since their starting point is so far behind. However, not only have 17 million Americans filed for unemployment, but there are estimates that up to 35 million Americans may lose their health insurance during this crisis. They will join 28 million Americans who didn’t have insurance before the coronavirus pandemic struck.
Hospitals are already overrun, but instead of funneling more resources into public hospitals, taking the private insurance and hospital system into public ownership – the politicians and health care bosses are depending on market forces to address the shortfalls. A strategy which will lead to more deaths.
What’s more, my own Emergency Department (ED) in Provident Hospital, in a predominately African American neighborhood on Chicago’s South Side, has been ordered to close for a month for a deep clean in the midst of this pandemic.
As an ED nurse, we weren’t even told about this and only discovered it hidden deep in the newspaper. This would never happen in the midst of a crisis in a wealthier area. While we aren’t opposed to remodeling to improve safety of patients; neither the unions, the staff nor the community were consulted about this in the midst of a crisis.
Currently, there is a sign on the door for patients who arrive at the ED to call 911. This neglect is criminal in ordinary times, but during this pandemic it is murder.
COVID-19 in prisons and jails
The virus has been allowed to spread rapidly through the prison system, further exposing institutional racism in the US approach. With nearly 2.3 million Americans held in detention, disproportionately Black and brown, there is a real fear of mass outbreaks. So far, there are over 1,300 confirmed coronavirus cases in prisons and jails across the country, and 32 deaths.
Cook County Jail in Chicago, with over 4,500 inmates in a single facility, has become the latest hotbed of the virus. So far, 3 inmates have died of COVID-19 and over 400 inmates and staff have tested positive. Social distancing is impossible in the jail, and there aren’t adequate handwashing facilities or even hand sanitizer. Whilst social justice groups have been calling for the release of all non-violent inmates – many of whom are imprisoned for being unable to pay fines or for non-violent drug related offences – the county has only released a few inmates and focused mainly on ordering impossible social distancing within the over-crowded jail.
Anti-Chinese racism
Another aspect of racism in this crisis is in how China and Chinese people are being scapegoated. The coronavirus was seen as something affecting a country that President Trump’s administration was in a trade war with, and therefore an issue they were unconcerned with. When it did start presenting in the United States, they switched from denial to blame, from calling it a hoax to calling it a “Chinese Virus.” Clearly a ridiculous description, because a virus cannot be assigned any ethnicity, since it is nothing more than RNA wrapped in protein.
Unfortunately, word choices do matter, and there has been a sharp uptick in attacks on anyone appearing to be Asian. According to the reporting forum Stop AAPI Hate, there have been over a thousand incidents reported in just two weeks. In one extreme example, a Chinese family suffered a knife attack in Texas, where two of the injured people were just 2 and 6 years old, and the assailant stated he did it because he thought the family was Chinese, and they were infecting people with the coronavirus. The attacker may end up getting charged with a hate crime, but the preachers of hate will go unpunished.
And the shameful reality is that this trend is being led from the very top – from the White House.
Such racism is being used to divert attention away from the actual causes of the pandemic’s unnecessary impact upon people. Rather than blaming those in charge of society for the poor healthcare that people receive despite great cost, or the fact that working conditions drive people to go about their typical business despite being sick, the establishment rather have us think China and Chinese people are the problem.
Trump’s ‘criminal’ response
Despite clear examples from South Korea and Germany that mass testing can help flatten the curve, testing sites set up in the US are sitting idle, because of a lack of testing supplies and protective gear.
And while the economy has slowed, Trump’s government has put together a bailout package fit for the kings of industry. Some crumbs will be dropped for the vast majority in the form of a lump sum payment that may be enough to cover rent and some food for one month.
Many are out of work, over 17 million have applied for unemployment benefits, job losses in the past few weeks match job losses over the last recession of 2007-09. Some have estimated that 20 million may end up unemployed by July – the worst since the Great Depression of the 1930’s.
Workers in “essential services” have found themselves in dangerous situations, and from grocery delivery workers to Amazon warehouse employees, organising and strikes are occurring. Factory workers at General Electric are demanding that they are brought in to produce lifesaving ventilators – an item in short supply.
Since one of the common central demands is safe working conditions with social distancing, new forms of protest have evolved so that participants maintain proper distance from one another.
The demand for personal protective equipment (PPE) and ventilators is being most sharply raised by hospital workers across the country. In a normal functioning society, you would expect infectious disease specialists to coordinate the international response when the pandemic was just weeks old in China – discussing what worked, what didn’t, what was worth trying, and what shouldn’t even be attempted. Precious time has been wasted, and now production is trying to catch up with needs that far outstrip capacity.
Moreover, any society which valued the basic needs of humanity over profit, would have had no problem with stockpiling PPE. But piles of PPE don’t generate cash flow.
It doesn’t take a licensed healthcare professional to understand that if doctors and nurses get sick in significant numbers, this will further hamper the ability of hospitals to manage volume. The curve must certainly be flattened by mass testing, wearing masks, and significantly altering our behavior – but if there are fewer healthcare workers to provide assistance, bad outcomes are inevitable.
In Italy, 66 nurses and doctors have already died from Covid-19. In New York City, nurse Kious Kelly died from the virus, and he worked at the same hospital where nurses had posted pictures on social media of them using garbage bags for PPE, because nothing else was available. The morbid irony of treating healthcare workers like disposable trash was obvious to everyone.
Fighting unions take the lead
In every one of the biggest districts, New York, Los Angeles, and Chicago, the call to close schools was led by teachers unions, or teacher leaders within their union. In New York City, the caucus Movement of Rank and File Educators started organizing a sick-out when the mayor initially refused to close schools. Where politicians have fallen short, regular working people, and the unions that represent them, have stepped up. A recent piece by the leaders of the Chicago Teachers Unions in a local newspaper continues their practice of bargaining for the common good.
National Nurses United (NNU), which represents 150,000 nurses across the country, has been leading the way as advocates for patients in the response of governments and hospitals to Coronavirus. When NNU organised a conference call to provide information to anyone interested, the number of calls overloaded their system, and shut it down. With bosses so focused on their profit margins, it is unsurprising that unions have to fill the void of advocating for workers’ safety.
This crisis is shining a stark light on existing systemic racism, wealth inequality, and a crumbling infrastructure. It undeniable, now, that grocery clerks, warehouse workers, healthcare workers, bus and delivery drivers, custodians, and more, are essential workers who deserve living wages and safe working conditions.
The unadulterated greed of the CEO class does no benefit towards our collective good, and the politicians who bail out Wall Street over Main Street are wrong for that. It is likely that as workers return to their jobs, new demands and more struggle will accompany them, and small gains could be won, but it has never been clearer that the time to demand a different kind of society, which puts need before profit, is right now.