Coronavirus: “Man bites dog” or “Dog bites man”? (Hidden Figures I)

Journalists have often emphasized to me the difference between news and not-news by comparing, “Man bites dog” which is news, to “Dog bites man” which is not.  So the growing number of headlines about disproportionate death from Covid-19 among African Americans strikes me as not-news.  This is perhaps because I started to do AIDS research in 1986 looking at the question, “Why was there excess risk for AIDS among Blacks and Hispanics in the United States?”  After some years of work, I could confidently say that the answer lay in the dismantling of the communities of color, a process that was vicious then and has not stopped since.  While gentrification has been temporarily driven out of the headlines, it is the latest form that this disruption has taken. 

In fact, even if you don’t know about serial forced displacement and deindustrialization – the prime movers of excess risk for anything – it’s obvious from the simple observations of who can get out of the way of infection and who can’t, who can pay the rent for some months without work, and who can’t, who can get prompt access to excellent medical care and who can’t.  Those are the people who are at greatest risk, and Blacks, Hispanics and immigrants are over-represented among them.  That they are likely to die in outrageous numbers is a foregone conclusion.  We can parse the disparities among those at highest risk, if we need to.  Many immigrants, for example, are younger and in excellent health, even if terribly poor.  They are in better shape to survive than the African American population, which includes older people and people with a high rate of chronic illness from “weathering,” as Arline Geronimus styles it.  While some are saying that the issue is a desperate lack of data, I am reminded of my colleague Dr. Jennifer Stevens Dickson, who, at the end of her dissertation on the failure of AIDS care to reach poor women of color, declared, “No further research is needed.”

That was stunning.  That was news. 

Dickson broke with tradition, which always says more research is needed.  She concluded that the patterns were too entrenched to need more study.  What we needed was sound policy to address the underlying structural causes.  That our society did not do that – in fact, the trends of serial forced displacement and concentration of wealth have made things worse – brings us to this moment and the “discovery” that Black people are at excess risk for death from coronavirus.  As a scholar who has been writing about this for decades, I can only shake my head.

Paul Krugman has said of this moment that we have put our economy into a medically-induced coma, and what we need is disaster relief, particularly for those most at risk. This is hampered by neoliberal policies that have dismantled much of the safety net and left us all inadequately sheltered from this storm.  Still we must try to fill the gaps, such as opening access to health care for all, supporting weak health systems, getting money in the hands of all the poor – not just some – and protecting the vulnerable from eviction.  The call in Britain to support the National Health System brought out hundreds of thousands of volunteers.  We could do the same.  Many are willing to deliver food to the housebound, raise money so the poor can eat, and carry out other tasks that make it possible for those at most risk to get the help they need. 

We could do this.  The question is not, “What is the data?” The question is, “Will we act?”