BLACK HEALTH, WELL-BEING WERE STRUCK A BRUTAL DOUBLE BLOW BY COVID-19, GEORGE FLOYD DEATH
Well before the resounding cries of “Black Lives Matter,” doctors have known that Black people suffer disproportionately.
As a group, they face countless challenges to good health, among them food, transportation and income. The stress of living with racism has real, physical effects. And they are especially prone to diabetes, hypertension and other chronic diseases that can be tricky to manage even in normal times.
Then came COVID-19 and George Floyd.
It quickly became clear that institutions designed to ensure the two most important things in life — health and safety — had converged to turn against one segment of the population in a brutal blow to Black people’s well-being that has renewed calls for racial justice in all realms, including health care.
“We are exhausted, and we are not OK,” said Dr. Patrice Harris, a psychiatrist who just ended her yearlong term as president of the American Medical Association.
Floyd’s death is the most extreme example of overpolicing that has long plagued Black and Brown communities and has been linked with elevated stress, high blood pressure and other chronic illnesses that contribute to the high virus death rates among Black people.
As their offices start reopening for regular appointments, doctors are bracing for the fallout: a wave of sicker, shell-shocked patients.
As a physician, Harris knows she has a certain privilege. She also knows firsthand the weariness of Black lives in America. Harris was only the second Black physician to lead the AMA in its 173-year history. Still, she gets “those looks” when going to stores and has been asked to fetch coffee even while wearing scrubs and a stethoscope.
Dr. Brittani James is a primarybcare doctor on the South Side. Most of her patients are Black. Her neighborhood was one of the last in the city to get a COVID-19 testing site.
“When I talk about institutional racism, this is happening in real time,” James said.
She has seen the virus hit many of her patients, while others grow sicker from chronic disease.
“As a Black doctor, I feel like I’m failing my patients every day,” James said.
Her clinic remained open, but many patients are too terrified of the coronavirus to come in. That means trying to treat them without physical exams or blood tests. She has tried sending patients prescriptions for blood pressure cuffs, but some can’t afford them. The options are “have their blood pressure uncontrolled or adjust their medications blind,” she said.
For every patient who has called for an appointment, she hasn’t heard from 10 others in months.
“There is no way that all of a sudden overnight there’s no more heart attacks, no more strokes, no more patients having poorly controlled diabetes,” she said. “We have all seen our patients’ visits stop. Which is scaring me a lot.”
James fears a “second wave” of worsening chronic illness and nonCOVID-19 deaths is coming.
There are signs it’s already happening. Government statistics from late January through May 30 suggest an increase in U.S. deaths from chronic diseases compared with historical trends. They include 7,000 “excess deaths” from hypertension, 4,000 from diabetes and 3,000 from stroke — all disproportionately affect Black people.
James said Floyd’s death has added psychological trauma to the mix, and mental health care in many communities is scarce.
“There is an overwhelming need that we do not have the resources to address,’’ she said.
Terrence Nichols has recovered physically from a relatively mild case of COVID-19 in March. But as a Black man in Chicago, knowing its impact in his community has left Nichols feeling fearful, vulnerable and angry over the president’s push to reopen.
Blacks make up about 30% of Chicago’s population but nearly half of the virus deaths, a disparity seen nationwide.
As of early June, an Associated Press analysis found that roughly 26% of COVID deaths were in Black patients, even though Black people represented 13% of the population in the 40 states that provided detailed demographic data. When Brookings Institution researchers adjusted for age disparities between races on a national level, they found the death rate for Black individuals was 3.6 times the rate for whites.
“He’s ready to reopen because of the economy and rich people are losing money,” Nichols said of Trump. If the virus were disproportionately killing rich white people, “He would think twice,’’ said Nichols, 44.
With Chicago having relaxed stay-home orders and other restrictions, Nichols resumed his pharmacy sales rep job. But he’s in no hurry to go any place but work.
Floyd’s killing “struck a chord,’’ he said. “It’s been happening since before I was born.’’
His father is a physician. When Nichols was a teenager, the family lived in Beverly, where he recalls being chased by bat-wielding KKK members and questioned by the police about where he was going when he was walking home.
More recently, Nichols said, the police “had me up against the car” and called for backup when he drove the wrong way on a one-way street. He routinely checks the rearview mirror whenever he drives past a police car, “to see if they make a U-turn and start following me.” It has happened many times.
“If you’re Black, it’s acceptable to be harassed,” Nichols said.
Rosetta Watson is only 38 but has heart failure and needs valve replacement surgery. When the coronavirus hit Chicago in March, her doctors postponed the operation indefinitely. Obesity surgery to take the burden off her heart also has been delayed.
She has stayed home, knowing COVID-19 could be fatal because of her poor health. It already has killed four of her relatives.
She recently had her first appointment with her heart doctor since the pandemic hit and was told her increasing fatigue could be from the leaky valve. The delays are frustrating.
Meantime, she has watched the news, seen the protests on TV, heard about them trashing the local pharmacy. She supports the cause but not the property damage.
Floyd’s death “is the same as it has always been. We’ve always had prejudice,” she said. The difference now is that “everyone is recording everything they see.’’
She said she’s been racially targeted not by police but by strangers who disparage her white boyfriend with racist terms and by elderly neighbors in her apartment building who deride “you people” and won’t ride with her in the elevator.
She said she has been racially profiled by a doctor who, when Watson asked about her nosebleeds, demanded to know whether she had been “doing any recreational drugs like cocaine or heroin.” Nosebleeds are a side effect of the nasal spray the doctor had prescribed.
“Seriously, it’s 2020. When we gonna grow up?’’ Watson said.