San Diego Union-Tribune

LET’S ALL FOCUS ON SOLIDARITY, SCIENCE, EQUITY AND HOPE

- BY CHRISTIAN RAMERS Ramers, M.D., is a specialist in infectious diseases and the chief of population health at Family Health Centers of San Diego. He lives in Burlingame.

This week marks one year since public health officials confirmed the first deaths of COVID-19 in San Diego County. As I reflect on this exhausting and highly unusual year, a few themes emerge over the din of arguments, controvers­ies and anxieties.

We are in this together.

More than simply a rallying cry to motivate altruistic behavior or a call to action for collective sacrifice, these words have proven accurate repeatedly. Whether it be the air we breathe, the indoor spaces we inhabit or our collective status in the color-coded reopening system, our interests are inevitably intertwine­d. As such, the sacrifice of foregoing social activities, postponing travel, staying home when sick and wearing masks even when inconvenie­nt has yielded immense societal benefit in the form of decreasing case counts and relatively contained outbreaks.

While the county has among the highest COVID-19 vaccinatio­n rates in California, our Mexican neighbors have watched their response stumble, logging the third highest COVID-19 death tally of any country in the world. As we contemplat­e increased transborde­r mobility, it will be critical to consider strategies that address our unique binational community. The U.S. has already bought or contracted to buy enough doses of the coronaviru­s vaccine to protect 750 million people, more than three times the number of American adults. It would be mutually beneficial to share this bounty with our neighbors. It is impossible to separate our fates as none of us are safe until all are safe.

Trust the science, not the scientist.

Many confuse science with a scientist’s opinion, but in actuality, science is a process — endlessly critical of itself, iterative, demanding empirical evidence to support claims. The science behind wearing masks to decrease airborne transmissi­on of SARS-CoV-2 took time to mature, but now there is no doubt that close indoor contact without masks is a risky activity for viral transmissi­on. Likewise, treatments did not come as quickly as we would have liked, but there are now several highly effective drugs targeted to different stages and aspects of the disease. If diagnosed and treated early, death from COVID-19 could be a rare event — even in high-risk individual­s — if all had access to these treatments. And ultimately, it was the extraordin­ary scientific process that supported the rapid developmen­t and massive safety and efficacy testing and rollout of vaccines, which now lead us out of this pandemic.

Look through a lens of equity.

Infectious disease epidemiolo­gy often serves as a mirror, reflecting the realities of our societal failings. Through it we see the neglect experience­d by the most vulnerable in our society, and we witness the horrendous physical and emotional harm to its victims. The SARS-CoV-2 virus has shown us in vivid and gruesome detail how our society works. By lingering in our most public spaces, thriving in crowded apartments and selecting victims by occupation, it has divided the haves and the have nots. Those in lower castes with little power to telecommut­e — who happen to be largely Brown and Black people — must continue to pick, process and serve food, pick up trash and clean toilets, deliver our Amazon packages and mind the cash registers, and, in so doing, risk their lives in service of those with wealth and power who can afford to stay home.

To me, as a frontline provider in a community clinic, the most striking and traumatic aspect of the pandemic has been the relentless, pervasive and disproport­ionate impact of COVID-19 cases, hospitaliz­ations and deaths on communitie­s of color, and in particular on Latinx families in the South Bay. The immense and overwhelmi­ng power of structural inequities has prevailed despite efforts forming equity task forces, carefully locating vaccinatio­n sites in the hardest-hit communitie­s, demanding transparen­cy in vaccine statistics, and making painstakin­g efforts to reserve spots for those from the most affected ZIP codes. With only 20.5 percent and 2.7 percent of San Diego’s 1.2 million vaccines going into arms of Latinx and Black San Diegans respective­ly — two of the most impacted population­s — there is so much more work to be done.

Hope is on the horizon.

The horrors of the pandemic cannot be unseen, and we will not be the same San Diego as we lick our wounds, bury our dead and move to close this painful chapter in our history. But thanks to the ingenious vaccines starting to shield our communitie­s, there is a brighter future ahead. I am hopeful that these painful disparitie­s will inspire our leaders to lay the groundwork for a more equitable path ahead. One in which we are all informed, protected and lifted up by one another. Wherein we can soon gather again in public spaces, embrace and imbibe in solidarity, reflecting on the good within us that has carried us through.

 ?? K.C. ALFRED U-T ?? Jovana Arellano Perez of the Escondido Union School District gets a COVID-19 inoculatio­n on March 8 from David Maier at the San Diego County vaccinatio­n center at Cal State San Marcos.
K.C. ALFRED U-T Jovana Arellano Perez of the Escondido Union School District gets a COVID-19 inoculatio­n on March 8 from David Maier at the San Diego County vaccinatio­n center at Cal State San Marcos.

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