COVID-19: A New Black Plague?

Dennis Sanders

Dennis is the pastor of a small Protestant congregation outside St. Paul, MN and also a part-time communications consultant. A native of Michigan, you can check out his writings over on Medium and subscribe to his Substack newsletter on religion and politics called Polite Company.  Dennis lives in Minneapolis with his husband Daniel.

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55 Responses

  1. LTL FTC says:

    This is a really good article and frames the situation nicely. If we take the Coates/Kendi line, it’s just another #oscarssowhite, an evergreen complaint among a constellation of others that keeps the Very Concerned middle aged white ladies busy tut-tutting. But if we focus on underlying health factors that are more prevalent but not was exclusive to the black community, those issues of access to care and treatment from medical professionals you highlight don’t get fully addressed as we focus on, say, diabetes writ large.

    Both problems seem intractable and slippery, with excuses aplenty for this or that particular situation always at the ready. The one thing I have confidence in, however, is that the respectable media (NYT especially) has been so geared to race-first reporting that Coatesian pain-performance and Kendian binary thinking will flood the zone and neither of those views offer solutions, just opportunities for self-flagellation among the right thinking. Rinse and repeat for the next public health emergency.

    So how *do* you ensure everyone gets equal treatment from doctors? Our current menu of diversity and implicit bias training seems to simply teach people to mouth the right words when they know they’re being watched. Even More black doctors doesn’t mean most people will see one for any given medical event.Report

  2. Philip H says:

    I think you are on to something, but not forceful enough about it. In Mississippi presently we are seeing African Americans sickened with COVID 19 at a rate that is nearly twice their relative percentage of out state’s population. Most of our African American population is in the Delta and north from there, and they are thus in parts of the state where hospitals have been closing against a backdrop of a state that refused to expand Medicare under the ACA. While many want to couch these things as economic decisions, they have roots in slavery and Jim Crow.

    Thus it becomes clear to me that the plague this time will indeed impact certain population segments disproportionally. Its also no coincidence that down here many of those folks are in the lower paying service economy jobs that are now being pushed to be reopened by rich whites who don’t have to imperil themselves to earn money.Report

  3. George Turner says:

    I’m not sure if the data would show a health care problem (of which there are plenty, but none of them might relate to the likelihood of getting the initial infection), versus being in a denser urban environment and having more daily interactions, with perhaps less wherewithal or inclination to self-isolate. How much of the difference is simply Detroit versus the upper peninsula, with other factors working around the edges?

    I would break it down into the different major factors.

    1) Likelihood of the infection taking hold and spreading in a population.
    a) population density, and prevalence of public transportation systems like buses or subways
    b) quick interactions differences, such as normal greetings (Italian cheek kissing vs German nods) and overall loquaciousness (probability of engaging in long conversations).
    c) after-work social behaviors, such as going home and gardening versus hanging out in bowling alleys or Irish pubs all evening.
    d) The prevalence of young “invincible” teens who won’t do social distancing, such as the Florida spring-breakers who kept spreading it all over the place.

    2) differences in job-related exposure.
    a) percentage who work on the front lines of public interaction.
    Clerks vs stock boys. TSA screeners vs dog groomers. Cops vs firemen. ER nurses vs X-ray techs.
    b) percentage who have “essential” jobs who can’t be quarantined. EMS, grocery store workers, health workers.

    3) Likelihood of an infection becoming serious. – age profile, rates of obesity, diabetes, smoking, heat disease, etc.
    Initial dose rate might also play a role, as evidence by the number of young front-line health workers who got serious infections.

    4) Likelihood of getting good medical intervention.
    a) Ability to get early treatments that might ease the course of the infection.
    This depends on the scope and size of the local health care sector and how hard it’s getting hit. Urban hot spots will of course be more overwhelmed.
    b) Behavioral differences in when someone seeks health care. Some folks won’t go to the doctor until they’re spitting up blood, while others will rush to the hospital for hiccups or an ingrown hair. That might be part of the reason more men die from it. Past experiences and ability to pay might figure into these choices.
    c) exhaustion rate of the health care workers. Having the county’s only Covid case means the patient will get tons of focused attention. Being the 10,000th case just adds you to the assembly line, like the episodes of MASH where the OR gets swamped during major battles.

    There’s plenty of room in all that for major, major differences to manifest in infections and outcomes. Racial differences are going to show up, but so are a lot of other things. Some of this will amount to “Group A had less infections than group B, so group B should behave like group A.” That logic will produce some valid arguments, such as maybe not having eight illegal immigrants sharing one apartment, but also many bad logical conclusions, such as “Nurses should avoid sick people” and “Police and EMS workers shouldn’t interact with the public.”

    The cheap and easy broad-brush arguments are likely a case of someone with a hammer thinking everything looks like a nail, or the dictum “never light a crisis go to waste.”

    Of course how you get from any of that to proclaiming “We must stop people from planting tomatoes!” is a different story.Report

  4. Chip Daniels says:

    Even taking Coleman Hughes at face value, “America isn’t racist! We just have created a society where black Americans are more likely to work in low wage jobs and are less likely to have access to high-quality health care and are more likely to live in areas that are served by over-burdened hospitals and emergency response services.”

    That’s all, no racism to see here!

    Americans get very very upset when racism is mentioned, and as this Vox article explains, many white people stretch to absurd lengths to avoid the conclusion.
    https://www.vox.com/2020/4/23/21228636/alito-racism-ramos-louisiana-unanimous-juryReport

    • George Turner in reply to Chip Daniels says:

      Does Vox make any effort to uncover why all this racism happens in white liberal cities, or is that lost on them?Report

      • Chip Daniels in reply to George Turner says:

        As I mentioned yesterday, there is a lot written about white liberal racism, some by those who fight it, some by those bitterly want to partake of it.Report

        • Jaybird in reply to Chip Daniels says:

          Would you say that “whataboutism” is a way to maintain the status quo when it comes to white liberal racism?Report

          • Chip Daniels in reply to Jaybird says:

            I bet it is.
            What should we do about it?Report

            • Jaybird in reply to Chip Daniels says:

              Which “it” are you referring to?Report

              • Chip Daniels in reply to Jaybird says:

                Which one would you prefer to do something about?Report

              • Jaybird in reply to Chip Daniels says:

                Well, if we want to get rid of White Liberal Racism, a good thing to do would be to discuss what ending it would look like and see what, if any, government policies we could enact to reach that goal.

                If we’re just talking about the engaging of whataboutism as a reflex to protect the status quo, I think pointing out that people are using it to protect the status quo is a good start.Report

              • Chip Daniels in reply to Jaybird says:

                Great, lets have that discussion!

                What steps would like to suggest?Report

              • Chip Daniels in reply to Jaybird says:

                I would prefer to have a discussion about getting rid of racism.

                Would you?Report

              • Jaybird in reply to Chip Daniels says:

                Sure!

                We’d have to define it first. I assume that we’re talking about structural racism as opposed to the whole “internal state of individuals” thing.

                So structural racism is the type of racism that results in such things as so-called “apartheid schools” (among all sorts of other things, of course).

                What are the parts of the country that have the most integrated schools? What government policies do *THEY* have?Report

              • Chip Daniels in reply to Jaybird says:

                Structural racism creates a “society where black Americans are more likely to work in low wage jobs and are less likely to have access to high-quality health care and are more likely to live in areas that are served by over-burdened hospitals and emergency response services.”

                So changing the structure of society isn’t a simple discussion.

                But since racism is primarily a problem created by white people, maybe a good first step is for us white people to honestly accept that yes, racism exists everywhere, and yes, it is still a big barrier to equality, and yes, the solution is going to make everyone a little uncomfortable.Report

              • Jaybird in reply to Chip Daniels says:

                Wouldn’t one of the best ways to address the work that black Americans have access to be to address the sub-standard education that they’re likely to receive in their so-called “Apartheid schools”?

                Again, what are the parts of the country that have the most integrated schools? What government policies do *THEY* have?Report

              • Chip Daniels in reply to Jaybird says:

                You’re aiming at something. What is it?Report

              • Jaybird in reply to Chip Daniels says:

                Remember when I said “Well, if we want to get rid of White Liberal Racism, a good thing to do would be to discuss what ending it would look like and see what, if any, government policies we could enact to reach that goal.”

                And then you said “Great, lets have that discussion!
                What steps would like to suggest?”

                And then I started suggesting steps?

                That’s what I’m doing.Report

              • Chip Daniels in reply to Jaybird says:

                You’re aiming at something else, something specific to do with schools.

                What is it?Report

              • Jaybird in reply to Chip Daniels says:

                I’m suggesting policies that will help address white racism.

                I’m not talking about internal states (or being “uncomfortable”).

                I am directly talking about policies that will address racism.

                And over and over and over again, we see people say “Oh, I’d love to discuss stuff” and then, when one makes suggestions, the response is “WHAT ARE YOU AIMING AT”.

                The criticism doesn’t seem to be “that won’t address it”, as far as I can tell. It’s “I need to know what you’re *REALLY* arguing.”

                I’m putting forward policies that will address Liberal White Racism.Report

              • Stillwater in reply to Jaybird says:

                Jaybird, nothing can be done about liberal racism. It exists beyond their control. It’s institutional! Conservative racism on the other hand is a choice. And that’s why the Venn diagram of American Racists and American Nativists is a circle.

                {{QED}}Report

              • Jaybird in reply to Stillwater says:

                There are positions that have responses like “THIS IS A MATTER OF PRINCIPLE!!!”

                There are positions that have responses like “Well, you have to understand…”

                And it is always interesting to see where they pop up.

                Believe it or not, I saw someone say, unironically “There is no room for “it’s complicated” or complex thoughts on internet debates.”Report

              • Chip Daniels in reply to Jaybird says:

                But…you aren’t suggesting any policies.

                Twice you’ve turned the discussion from general issues to schools, which no one else mentioned.

                And you are asking us what policies those integrated schools pursue.

                So obviously you are thinking of something here, and rather than us spending twenty questions, it would be simpler for you to tel us what you are thinking of.Report

              • Jaybird in reply to Chip Daniels says:

                But…you aren’t suggesting any policies.

                Ahem: “Again, what are the parts of the country that have the most integrated schools? What government policies do *THEY* have?”

                Twice you’ve turned the discussion from general issues to schools, which no one else mentioned.

                Well, when we’re discussing Structural Racism, part of that is dealing with The Structure.

                Education is probably one of the biggest ones, given that it’s directly under government purview.

                You mentioned employment, which is great, but I believe that education is prior to employment.

                So obviously you are thinking of something here, and rather than us spending twenty questions, it would be simpler for you to tel us what you are thinking of.

                If the questions I’m asking don’t have answers, that’d be one thing. But the questions I have do have answers.

                Here’s something I suspect: There are a lot of White Liberal Racists who benefit from the current system.

                They very, very much don’t want the current system to change.Report

              • Chip Daniels in reply to Jaybird says:

                Your idea of a suggestion is to ask other people questions?

                I honestly don’t know, what DO these integrated schools have as policies?Report

              • Stillwater in reply to Chip Daniels says:

                Chip, is it worth reminding you that *you* are the member of a political party which, by your own admission, has racist policies in big cities, and that *Jaybird* … isn’t?

                Look, you both agree that big Dem controlled cities have racist policies. Why is it on *him* to fix your party for you?Report

              • Jaybird in reply to Chip Daniels says:

                It’s to ask questions that have answers. Even answers that make people “uncomfortable”.

                Now, one of the wacky things is that “racism” can mean all sorts of things. If a school is majority “White Hispanic and Asian and White”, is it more diverse than a school that is majority Black Hispanic and African-American?

                Because one of the wacky things I noticed while doing research is that a school that is majority White Hispanic, Asian, and White is likely to be more diverse than one that is Majority Black Hispanic and African-American.

                Which tells me that “Diversity” seems to be a tool of maintaining the status quo. Which is weird. Like, the policies themselves are maintaining structural racism.

                Even among White Liberals.Report

              • Chip Daniels in reply to Jaybird says:

                So…what policies do integrated schools pursue?Report

              • Jaybird in reply to Chip Daniels says:

                Which definition of “integrated” are we using?

                The “Diversity Uber Alles” ones seem to be following a policy of “No Blacks”.Report

              • Chip Daniels in reply to Jaybird says:

                Jesus man, this is your question, the very one that you asked twice now, so you tell us.Report

              • Jaybird in reply to Chip Daniels says:

                Chip, if we are going to fix the problem, we pretty much have to agree on the problem we’re trying to fix.

                I mean, if you said “California has among the most diverse schools in the nation!” and I pointed out the pervasiveness of so-called “apartheid schools”, I’d quickly come to the conclusion that we were talking about two different things.

                I’m just trying to hammer out what we’re talking about.

                But, I suppose, if I were okay with the status quo, I’d push everything onto others.Report

              • Chip Daniels in reply to Jaybird says:

                You asked the question, twice, and now you are trying to figure out what the question is?

                Ahem: “Again, what are the parts of the country that have the most integrated schools? What government policies do *THEY* have?”

                Your question, not mine.Report

              • Jaybird in reply to Chip Daniels says:

                These are questions that I don’t have the answer to.

                That’s part of why I was asking them.

                The questions have answers… right? They must!

                Do I need to say “I wasn’t asking them rhetorically”?

                I wasn’t asking them rhetorically.Report

              • Chip Daniels in reply to Jaybird says:

                I don’t think its as simple as pointing to school integration as some sort of origin point.

                There really isn’t any origin point to racism, someplace where we can just apply pressure and it all falls apart.

                It takes a lot of pressure on multiple fronts, everything from social shaming to lawsuits to legislation.

                But here’s a start, which I referred to above, which is that white people have to become more accepting that structural racism exists, and is an invisible force behind a lot of things that seem facially colorblind.

                This alone would help things tremendously. Because right now, the Roberts/ Alito faction of SCOTUS doesn’t accept that fact.Report

              • Jaybird in reply to Chip Daniels says:

                So the best way for White Liberal Racism to be addressed is for conservative justices to change their mind?

                Well, I’m sure that White Liberal Racism will not be the status quo any day now.

                Any day now.Report

              • Chip Daniels in reply to Jaybird says:

                Law, and the judiciary, is downstream of public opinion.Report

              • Dark Matter in reply to Jaybird says:

                For all the talk about integration being a big priority of the parents, it’s not. You can only have one top priority. That priority is to get the best education possible.

                So if there are 50 schools, and the best I can get into is #4 (ranked by educational scores), then that’s my choice.Report

              • Jaybird in reply to Dark Matter says:

                The expectation that people love strangers’ children as their own is a fine sentiment.

                But I wouldn’t want to draw up school districts relying on it.Report

              • Dark Matter in reply to Jaybird says:

                From your link (great link btw):

                Stanford sociologist Prudence Carter was deeply involved in shaping San Francisco’s present student assignment system in 2010. She argued that families should take a chance on schools like Willie Brown, if they want to make San Francisco a more equitable place. That means embracing a larger vision of social change.

                The problem so far, she said, has been that San Franciscans “are not thinking about the larger project of American democracy and being representative of the beautiful diversity of this country. …“That means you have to think grander, and beyond your own self-interest,”

                So in other words, I’m supposed to sacrifice my kids’ education to further her view of what society should look like. If she has unrealistic views, or has confused cause and result, then that won’t work well.

                As long as educating my kid isn’t her top priority, she doesn’t deserve to be involved. That’s not so much my opinion as my job.Report

              • DensityDuck in reply to Dark Matter says:

                oh, she’s educating kids, all right. She’s teaching them that white liberal women can’t quite manage to get everyone’s computers working but will spend millions of dollars to paint over a wall with some stupid mural that nobody even looked at.

                Important life lessons, and even some applied mathematics instruction, although maybe not what’s on the actual curriculum.Report

              • DensityDuck in reply to Chip Daniels says:

                “Jesus man, this is your question, the very one that you asked twice now, so you tell us.”

                chip, my man, do you…understand how questions work?Report

      • CJColucci in reply to George Turner says:

        The short answer is that they or their ancestors left someplace even worse.Report

  5. Doctor Jay says:

    I think this is the first time I have noticed that you have a husband. I think that it’s wonderful that you have a congregation that supports you and him.

    I was a charter member of Ta-Nehisi Coates’ Golden Horde, back when he had a blog with a comment section. We would conversate daily. I don’t find what you think to be all that different from what he thinks, especially when compared to what the average white person thinks.

    To be fair, there is a difference. I don’t want to sweep that under the rug either.

    I think the 5-day course you got is probably tied to the kind of antibiotic they gave you, but who can say for sure?

    One thing I note is that even supposing an encounter that takes place where the policies are in place, are non-racist, and executed effectively, there’s still going to be fears and suspicions on the part of black people encountering the system. Because of things like that doctor’s waiting room your mother experienced.Report

    • Brandon Berg in reply to Doctor Jay says:

      I can’t think of any reason why racism would lead to a doctor giving an inadequate does of antibiotics. I’ve heard speculation that doctors tend to be more reluctant to give opioids to black patients out of fear they’ll abuse them. True or not, that at least makes sense, but antibiotics don’t have potential for recreational abuse, and it’s widely believed that too short a course of antibiotics increases the likelihood of antibiotic resistance, though apparently this has recently come into question.Report

  6. veronica d says:

    Anecdote: many decades ago I worked at a gas station in a posh suburban area. We didn’t have many black customers, and very few black regular customers.

    This was in an era when you could just pull in, pump your gas, and pay afterwards. It was a different age. Anyway, at some point we changed that policy, but only at night. At night, customers had to pay for their gas before they pumped it.

    However, we had a lot of regular customers. We knew them. They regularly had their car serviced in our shop. The policy was thus: if I knew the customer, they didn’t need to pay first. Only customers I didn’t know needed to to that.

    Here is the scenario: a black customer pulls in, I make them pay first, then a “regular customer” arrives, usually white, and I don’t make them pay first.

    This was not me being racist. Our policy was on the surface non-racist. However, after a while I began to change what I did. If I noticed a black customer had to pay first, I would then ask the regular customers to pay first also.

    Why?

    Because I know how it looks! I know how it makes people feel. I’ve felt excluded many times in my life. I’ve felt singled out for bullshit. I didn’t want to be part of that.

    It’s a small thing to make a person feel included, but it matters. Small things add up. They form civility.

    #####

    Over the years I’ve learned that it’s not just about racist feelings in an individual. That’s a copout. That’s white folks (or str8 folks or cis folks, etcetera) trying to feel good about themselves, instead of achieving good in the world.

    The problem isn’t only racist feelings in individual white people — although that is a problem. The problem is also two systems, one for whites, another for blacks, one for the poor, another for the rich, one for queer folks, another for str8s. On and on.

    #####

    I’ve used the example of compound interest before. I’ll mention it again. Small things add up, but more than just “adding,” they have a compounding effect over the course of a lifetime. Small detriments applied consistently over a lifetime can lead to very different outcomes. Perhaps cops, judges, teachers, doctors, etcetera are only “a little bit racist,” but each instance makes things a little bit harder. Perhaps “the system” is only mildly unfair, but each instance of unfairness makes everything else that much harder down the road.

    Some people are openly bigoted. Others hold bigoted assumptions, but understand that it sounds bad, so they choose their words carefully and work to appear non-bigoted, even when it’s kind of obvious. They might even fool themselves, through intricate rationalization. Whatever. The results are the same. It adds up.Report

    • DensityDuck in reply to veronica d says:

      “If I noticed a black customer had to pay first, I would then ask the regular customers to pay first also.”

      So you didn’t change your behavior because of customers in general, you changed it because of black people specifically? If every non-regular customer had been white, you’d have kept on with what you were doing, not changing a thing?Report

  7. Urusigh says:

    George already covered the better data-focused way to look at this. I’m going to take a different tack and be the token Republican who says “Yes, it’s probably racism (Sort of, partly)”.

    I fully advocate for the “color-blind” approach in every aspect of sociology. Medicine IS NOT sociology, nor merely culture. There genuinely are disparities in which medical conditions are more prevalent/severe among different racial groups entirely aside from culture and environment, i.e. sickle-cell anemia. So there very well could be an underlying genetic issue that makes COVID-19 more dangerous to African-Americans, both by itself and/or in conjunction with co-morbid conditions. That said,…

    There could also be prevalent differences in treatment, because as much as “implicit bias” is a BS excuse in most every other context of behavior, there really is good research that shows that the less visible the person, the higher the assumed tolerance for pain/resistance to harm. That’s already a problem when it comes to tense encounters with police, but it also shows up in disproportionate prescriptions for pain meds (even aside from opioids, blacks are often given weaker meds for the same self-reported pain level as whites). So yeah, I’m not saying that doctors are racist, not even implicitly, but effectively “the darker your skin, the tougher you seem” really is the inverse of “you look pale, are you sick?” and that does bias medical assessments in the absence of strict diagnostic criteria. It’s kind of counter-intuitive that a positive stereotype (“you look tough”) is harmful in practice, but when it results in under-treatment it can be lethal.Report

    • Jaybird in reply to Urusigh says:

      I’ve read a handful of stories talking about how the virus seems to do better against people with Blood Type A than Blood Type O.

      Wait, that came out wrong.

      People with Blood Type A have more trouble with the virus than people with Blood Type O.

      I don’t even know how different types are distributed amongst populations (though googling tells me that Europeans tend to have more A than indigenous populations do, I guess).

      As someone who is also Blood Type A, I worry about this sort of thing.

      But if it hits Blood Type A people harder, then a Blood Type-Blind solution will help Blood Type A people “disproportionately”.Report

      • PD Shaw in reply to Jaybird says:

        An early Chinese study from Wuhan reported that virus spread was greatest among type A, and least among type O. A couple of weeks ago a similar study out of NY had similar findings, though its only Rh positive blood types that show the effect. And this is about risk of infection from the virus, not the effect of the virus once infected.

        In the U.S. this would be interesting, Type O is predominately the blood type of African-Americans, Latino-Americans and Irish/Scots. But a few weeks ago the Illinois governor spoke out against a rumor that African-Americans were “immune,” which is something he read on-line somewhere as being a widespread claim. Later the President of the California Nation-State denounced the rumor, so the rumor is being spread at the highest levels now.Report

  8. Chip Daniels says:

    Here is a timely point:
    Michael Caputo, the new spokesman for the Trump Administration HHS Dept, and longtime Republican, is an awful racist;
    https://www.cnn.com/2020/04/23/politics/michael-caputo-tweets/

    What is interesting, is the “longtime” part.
    Its not like this is suddenly new information, or a shocking revelation. This guy has been around a long time.

    How many white reporters, liberal white reporters, covered this guy, and shrouded his racism in the soft politically correct euphemisms like “Impish”, “Controversial” and the like?

    Why are people like this given aid and comfort and respectability?

    What if they weren’t?
    What if people like this became social pariahs, unable to find respectable work, unwelcome at nice restaurants and clubs and parties?

    Well, there are people who attempt to do this, to shame and shun people l ike this, but are themselves scolded by other white people for a breach of civility.

    This is the thing about white people. A lot of us, even liberal white people, look at racism as a vulgar aesthetic, a breach of decorum, but not really anything terribly bad, certainly not the sort of thing that should get in the way of socializing with other white people.Report

  9. Jaybird says:

    Good news, I guess:

    Report