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| Black Americans Face Alarming Rates of Coronavirus Infection in Some States | Black Americans Face Alarming Rates of Coronavirus Infection in Some States |
| (2 months later) | |
| The coronavirus is infecting and killing black people in the United States at disproportionately high rates, according to data released by several states and big cities, highlighting what public health researchers say are entrenched inequalities in resources, health and access to care. | The coronavirus is infecting and killing black people in the United States at disproportionately high rates, according to data released by several states and big cities, highlighting what public health researchers say are entrenched inequalities in resources, health and access to care. |
| The statistics are preliminary and much remains unknown because most cities and states are not reporting race as they provide numbers of confirmed cases and fatalities. Initial indications from a number of places, though, are alarming enough that policymakers say they must act immediately to stem potential devastation in black communities. | The statistics are preliminary and much remains unknown because most cities and states are not reporting race as they provide numbers of confirmed cases and fatalities. Initial indications from a number of places, though, are alarming enough that policymakers say they must act immediately to stem potential devastation in black communities. |
| The worrying trend is playing out across the country, among people born in different decades and working far different jobs. | The worrying trend is playing out across the country, among people born in different decades and working far different jobs. |
| There is Donnie Hoover, a judge from Charlotte, N.C., who could not shake a dry cough that arrived in March. On the South Side of Chicago, LaShawn Levi, a medical assistant who rides the bus to work each day, turned to tea and cough syrup — “everything your grandma taught you” — to treat a headache and a cough. And in Detroit, Glenn Tolbert, a union leader for city bus drivers, was coughing so much that he got tested. | There is Donnie Hoover, a judge from Charlotte, N.C., who could not shake a dry cough that arrived in March. On the South Side of Chicago, LaShawn Levi, a medical assistant who rides the bus to work each day, turned to tea and cough syrup — “everything your grandma taught you” — to treat a headache and a cough. And in Detroit, Glenn Tolbert, a union leader for city bus drivers, was coughing so much that he got tested. |
| “This is a call-to-action moment for all of us,” said Lori Lightfoot, the mayor of Chicago, who announced statistics of the outbreak in her city this week. African-Americans account for more than half of those who have tested positive and 72 percent of virus-related fatalities in Chicago, even though they make up a little less than a third of the population. | “This is a call-to-action moment for all of us,” said Lori Lightfoot, the mayor of Chicago, who announced statistics of the outbreak in her city this week. African-Americans account for more than half of those who have tested positive and 72 percent of virus-related fatalities in Chicago, even though they make up a little less than a third of the population. |
| “Those numbers take your breath away, they really do,” said Ms. Lightfoot, who is the city’s first black woman elected as mayor. She added in an interview that the statistics were “among the most shocking things I think I’ve seen as mayor.” | “Those numbers take your breath away, they really do,” said Ms. Lightfoot, who is the city’s first black woman elected as mayor. She added in an interview that the statistics were “among the most shocking things I think I’ve seen as mayor.” |
| In Illinois, 43 percent of people who have died from the disease and 28 percent of those who have tested positive are African-Americans, a group that makes up just 15 percent of the state’s population. African-Americans, who account for a third of positive tests in Michigan, represent 40 percent of deaths in that state even though they make up 14 percent of the population. In Louisiana, about 70 percent of the people who have died are black, though only a third of that state’s population is. | In Illinois, 43 percent of people who have died from the disease and 28 percent of those who have tested positive are African-Americans, a group that makes up just 15 percent of the state’s population. African-Americans, who account for a third of positive tests in Michigan, represent 40 percent of deaths in that state even though they make up 14 percent of the population. In Louisiana, about 70 percent of the people who have died are black, though only a third of that state’s population is. |
| North Carolina and South Carolina also have reported a ratio of black residents to white residents who have tested positive for the virus that well exceeds the general population ratio. Black people are overrepresented among those infected in the Las Vegas area and among people who have tested positive for the virus in Connecticut. In Minnesota, black people have been infected with the coronavirus at rates roughly proportionate to their percentage of the state’s population. | |
| On Tuesday, President Trump acknowledged the growing signs of disparity, and said that federal authorities were working to provide statistics over the next two or three days that might help examine the issue. “Why is it that the African-American community is so much, numerous times more than everybody else?” he said at a daily briefing on the coronavirus. | |
| For many public health experts, the reasons behind the disparities are not difficult to explain, the result of longstanding structural inequalities. At a time when the authorities have advocated staying home as the best way to avoid the virus, black Americans disproportionately belong to part of the work force that does not have the luxury of working from home, experts said. That places them at high risk for contracting the highly infectious disease in transit or at work. | For many public health experts, the reasons behind the disparities are not difficult to explain, the result of longstanding structural inequalities. At a time when the authorities have advocated staying home as the best way to avoid the virus, black Americans disproportionately belong to part of the work force that does not have the luxury of working from home, experts said. That places them at high risk for contracting the highly infectious disease in transit or at work. |
| Ms. Levi, the medical assistant from Chicago who fell ill, thinks that her daily bus ride to work could have been the source of her exposure. Or, she said, she could have picked it up in the hospital where she works, at the grocery store, or from food served to her. | Ms. Levi, the medical assistant from Chicago who fell ill, thinks that her daily bus ride to work could have been the source of her exposure. Or, she said, she could have picked it up in the hospital where she works, at the grocery store, or from food served to her. |
| “I’m just not sure,” said Ms. Levi, 45, who has asthma and high blood pressure. | “I’m just not sure,” said Ms. Levi, 45, who has asthma and high blood pressure. |
| Longstanding inequalities also make African-Americans less likely to be insured, and more likely to have existing health conditions and face racial bias that prevents them from getting proper treatment. | Longstanding inequalities also make African-Americans less likely to be insured, and more likely to have existing health conditions and face racial bias that prevents them from getting proper treatment. |
| Initial indications are that doctors are less likely to refer African-Americans for testing when they visit a clinic with symptoms of Covid-19, the disease caused by the virus. Since the disease can progress quickly, researchers say, a disparity in testing can lead to considerably worse outcomes. A lack of early communication about the threat of Covid-19 and confusing messages that followed left an information vacuum in some black communities that allowed false rumors to fester that black people were immune to the disease. Some places ended up behind in taking measures to slow the spread. | Initial indications are that doctors are less likely to refer African-Americans for testing when they visit a clinic with symptoms of Covid-19, the disease caused by the virus. Since the disease can progress quickly, researchers say, a disparity in testing can lead to considerably worse outcomes. A lack of early communication about the threat of Covid-19 and confusing messages that followed left an information vacuum in some black communities that allowed false rumors to fester that black people were immune to the disease. Some places ended up behind in taking measures to slow the spread. |
| Sharrelle Barber, an assistant research professor of epidemiology and biostatistics at Drexel University, said the effects of government redlining policies that began in the 1930s linger. Many black residents live in segregated neighborhoods that lack job opportunities, stable housing, grocery stores with healthy food and more. | Sharrelle Barber, an assistant research professor of epidemiology and biostatistics at Drexel University, said the effects of government redlining policies that began in the 1930s linger. Many black residents live in segregated neighborhoods that lack job opportunities, stable housing, grocery stores with healthy food and more. |
| High levels of segregation in large urban counties lower the life expectancies of African-American residents but have little effect on the life expectancies of white residents, according to an analysis of the County Health Rankings by the University of Wisconsin Population Health Institute. Before the pandemic hit, officials had calculated that white Chicagoans had an average life expectancy of 8.8 years longer than black residents. | High levels of segregation in large urban counties lower the life expectancies of African-American residents but have little effect on the life expectancies of white residents, according to an analysis of the County Health Rankings by the University of Wisconsin Population Health Institute. Before the pandemic hit, officials had calculated that white Chicagoans had an average life expectancy of 8.8 years longer than black residents. |
| “These communities, structurally, they’re breeding grounds for the transmission of the disease,” Dr. Barber said. “It’s not biological. It’s really these existing structural inequalities that are going to shape the racial inequalities in this pandemic.” | “These communities, structurally, they’re breeding grounds for the transmission of the disease,” Dr. Barber said. “It’s not biological. It’s really these existing structural inequalities that are going to shape the racial inequalities in this pandemic.” |
| Work kept Mr. Tolbert, 54, who drove a Detroit bus for 24 years before becoming president of the Amalgamated Transit Union Local 26, from staying home as the virus spread. | Work kept Mr. Tolbert, 54, who drove a Detroit bus for 24 years before becoming president of the Amalgamated Transit Union Local 26, from staying home as the virus spread. |
| All through March, Mr. Tolbert said, he proceeded with his responsibilities of checking on the well-being of drivers at the bus depot and on passengers along city routes. | All through March, Mr. Tolbert said, he proceeded with his responsibilities of checking on the well-being of drivers at the bus depot and on passengers along city routes. |
| On April 2, Mr. Tolbert was coughing so much during a meeting with Mike Duggan, the mayor of Detroit, that Mr. Duggan suggested he get tested. He was one of the first people in the city to take a rapid test and got his results back in 15 minutes. | On April 2, Mr. Tolbert was coughing so much during a meeting with Mike Duggan, the mayor of Detroit, that Mr. Duggan suggested he get tested. He was one of the first people in the city to take a rapid test and got his results back in 15 minutes. |
| “I was social distancing — at least I thought I was,” Mr. Tolbert said. “I don’t know where it happened.” | “I was social distancing — at least I thought I was,” Mr. Tolbert said. “I don’t know where it happened.” |
| The death toll has been particularly devastating among African-Americans. | The death toll has been particularly devastating among African-Americans. |
| “What’s really important is who is succumbing to the infection,” said Dr. Phillip D. Levy, the associate chairman for research in the department of emergency medicine at Wayne State University. “That gives you an idea of the severity of the illness and the impact on the community.” | “What’s really important is who is succumbing to the infection,” said Dr. Phillip D. Levy, the associate chairman for research in the department of emergency medicine at Wayne State University. “That gives you an idea of the severity of the illness and the impact on the community.” |
| One factor that might make the coronavirus more devastating for African-Americans is that they experience high levels of stress-mediated wear and tear known as “weathering,” said Arline Geronimus, a professor of public health at the University of Michigan who studies the concept. | One factor that might make the coronavirus more devastating for African-Americans is that they experience high levels of stress-mediated wear and tear known as “weathering,” said Arline Geronimus, a professor of public health at the University of Michigan who studies the concept. |
| Updated June 5, 2020 | |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | |
| Stresses like exposure to toxins, lack of sleep and racial discrimination, Dr. Geronimus said, can cause a kind of accelerated aging. The coronavirus is most lethal in people over 65. | Stresses like exposure to toxins, lack of sleep and racial discrimination, Dr. Geronimus said, can cause a kind of accelerated aging. The coronavirus is most lethal in people over 65. |
| Watching news reports of coronavirus racial disparities this week, Dr. Geronimus said she had found herself shouting at her television. “They’re saying, ‘We don’t know why,’” Dr. Geronimus said, “and I’m standing there saying, ‘It’s weathering!’” | Watching news reports of coronavirus racial disparities this week, Dr. Geronimus said she had found herself shouting at her television. “They’re saying, ‘We don’t know why,’” Dr. Geronimus said, “and I’m standing there saying, ‘It’s weathering!’” |
| Medical experts, community activists and policymakers are pushing for greater transparency on racial data. | Medical experts, community activists and policymakers are pushing for greater transparency on racial data. |
| Officials who are reporting racial data are doing so only for cases in which the patient’s race is known. For a large percentage of total cases in some places — sometimes more than 40 percent — no racial information is available. | Officials who are reporting racial data are doing so only for cases in which the patient’s race is known. For a large percentage of total cases in some places — sometimes more than 40 percent — no racial information is available. |
| And officials in many states, including those hit hard by the pandemic — California, New Jersey, New York and Washington State — have not provided statewide information about the race of patients. | And officials in many states, including those hit hard by the pandemic — California, New Jersey, New York and Washington State — have not provided statewide information about the race of patients. |
| That has raised anger in some corners. Senators Elizabeth Warren of Massachusetts, Kamala Harris of California and Cory Booker of New Jersey have demanded that the Trump administration collect race and ethnicity data on coronavirus testing and treatment. And Jumaane D. Williams, the public advocate for New York City, sent a letter to Mayor Bill de Blasio calling for the release of a breakdown of cases by race. | That has raised anger in some corners. Senators Elizabeth Warren of Massachusetts, Kamala Harris of California and Cory Booker of New Jersey have demanded that the Trump administration collect race and ethnicity data on coronavirus testing and treatment. And Jumaane D. Williams, the public advocate for New York City, sent a letter to Mayor Bill de Blasio calling for the release of a breakdown of cases by race. |
| In Mecklenburg County, N.C., where black residents are overrepresented in the number of positive tests, George Dunlap, the chairman of the county commission, said he was skeptical of the data. He said he believed that African-Americans in that county, which includes Charlotte, were overrepresented because the group was being tested at a higher rate, according to information he said he received from county health officials. | In Mecklenburg County, N.C., where black residents are overrepresented in the number of positive tests, George Dunlap, the chairman of the county commission, said he was skeptical of the data. He said he believed that African-Americans in that county, which includes Charlotte, were overrepresented because the group was being tested at a higher rate, according to information he said he received from county health officials. |
| But North Carolina’s top health official said the disparities aligned with historical trends. | But North Carolina’s top health official said the disparities aligned with historical trends. |
| “This current crisis lays out what we have known for a long time, which is that your ZIP code is often a determinant of your health outcome,” said Dr. Mandy Cohen, secretary of the North Carolina Department of Health and Human Services. | “This current crisis lays out what we have known for a long time, which is that your ZIP code is often a determinant of your health outcome,” said Dr. Mandy Cohen, secretary of the North Carolina Department of Health and Human Services. |
| Judge Hoover, the Mecklenburg County Superior Court judge who has tested positive for the virus, is 70. His wife, Josephine, has also tested positive. He was receiving chemotherapy for multiple myeloma and she has diabetes, underlying medical issues that put them at higher risk of severe illness. | Judge Hoover, the Mecklenburg County Superior Court judge who has tested positive for the virus, is 70. His wife, Josephine, has also tested positive. He was receiving chemotherapy for multiple myeloma and she has diabetes, underlying medical issues that put them at higher risk of severe illness. |
| While Judge Hoover recuperated in their condominium in downtown Charlotte, Ms. Hoover, a retired math teacher, was hospitalized for two weeks. Even now, they are staying at least six feet apart in their home. | While Judge Hoover recuperated in their condominium in downtown Charlotte, Ms. Hoover, a retired math teacher, was hospitalized for two weeks. Even now, they are staying at least six feet apart in their home. |
| “I am assuming that I picked it up in the courthouse and gave it to her,” he said. “We were so scared. And we are still scared because we do not know for sure if we are out of the woods.” | “I am assuming that I picked it up in the courthouse and gave it to her,” he said. “We were so scared. And we are still scared because we do not know for sure if we are out of the woods.” |
| Amy Harmon, Mitch Smith and Matt Furber contributed reporting. | Amy Harmon, Mitch Smith and Matt Furber contributed reporting. |