by Carolyn Thomas ♥ @HeartSisters
If you’ve been feeling as stunned as I am by what’s been happening in the U.S. this past week, read this compelling call to action for all physicians and public health experts, originally published in the British Medical Journal (BMJ) by Harvard physicians Drs. Ingrid Katz and Abraar Karan: . .
“We urge all physicians and public health experts to take a firm stance against racism.
“Doctors like us who have been working on the COVID-19 response in the United States have been told to ‘stay in our lane’ as the murder of George Floyd has sent the country into the largest anti-racism movement since the 1990s.
“Unsurprisingly, a number of prominent physicians and public health leaders have remained relatively silent on the topic of racism, which has historically been falsely politicized as an issue of partisanship. It is not. And it is our lane.
“Racism has always been a public health problem. Racism kills our patients, our neighbours, our colleagues, our leaders.
“A number of people who see the protests as possible drivers of more COVID-19 cases have suggested that it is hypocritical of doctors to support anti-racism protestors now when weeks earlier they denounced large crowds due to the risk of spreading COVID-19.
“Framing anti-racism protests against the control of COVID-19 is a false dichotomy. Will crowds possibly lead to more COVID-19 cases? Yes. But so will unabated racism.
“The data tell part of the story.
“Black patients who contract COVID-19 are three times more likely to require admission to hospital because of disease severity. Disproportionately, counties in the United States with a large black population account for nearly 60% of deaths from COVID-19 in the country, despite representing only 22% of counties.
“The vast majority of US states have a disproportionate number of COVID-19 cases among black patients. Black patients are less likely to be able to obtain COVID-19 tests in a number of major U.S. cities. Many black patients have a lower chance of being put on a ventilator where resources are too limited to treat everyone, based on biased algorithms that account for co-morbidities and life expectancy. For black patients, even the decision to wear a mask requires them to weigh the risk of being targeted or even killed by law enforcement, versus getting COVID-19.
“Racism – the explicit and intentional oppression of people from ethnic minorities, not by accident, but by systematic intention for centuries and unabatedly into the present – is the underlying driver of why black patients are at the centre of the American COVID-19 epidemic.
“As doctors, this is the time to speak up and step up. This is not about politics. This is not about preserving the status quo, or being afraid to ruffle feathers.
“This is about life and death.
“This is about the fact that in our country, a police officer felt like he could put his knee on a black man’s neck for eight minutes and 46 seconds while being filmed.
“Staying silent now is saying something.
“It is saying that the death of an innocent black man at the hands of a brutal white police officer is still not enough for you to put your own skin in the game. We are well aware that institutions suffer from racism. We acknowledge that every one of us holds implicit and explicit biases, and that we must take responsibility, and do more to be better, more informed, and more aware as allies to our black community.
“But doing nothing, and staying silent, is unacceptable.
“Many doctors and public health professionals have gained large platforms from the COVID-19 pandemic. It is imperative that they now use those platforms to openly and publicly denounce racism.
“Racism must be stopped because it is morally deplorable. Additionally, there is no preventing COVID-19 without addressing the underlying drivers for its spread, and racism is undoubtedly one of those in the United States.
“This is clear from the data showing the virus’s tragic effects on black communities. This pandemic depends on the exploitation of our societal vulnerabilities and weaknesses to spread – and stopping it demands that we all stand together against racism.
“We urge all physicians and public health experts to take a firm stance against racism. We urge that we as a community use our understanding of the science and transmission of COVID-19 to protect those who choose to protest peacefully against racism by guiding them with the information necessary to minimize viral transmission.
“We urge our institutions to make every effort to ensure:
- that our fight against racism within our own walls is transparent
- that racist actions and words are seen, heard, and dismantled
- that racist people are held to account
- that efforts against racism are actively studied and taught as part of our life-long learning in medicine
- that power structures based on racist ideologies are taken down and replaced
- that people from ethnic minorities are treated with the utmost respect, equity, and justice—including in their promotions to positions of leadership
- that patients from ethnic minorities are no longer killed by racism that has haunted medicine since its inception as a field.
There is so much work to be done.
“In the end, we will remember not the words of our enemies but the silence of our friends”
Martin Luther King Jr.
© 2020 BMJ
Image: Orna Wachman, Pixabay
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For those who are participating peacefully in public protest marches, follow these guidelines from Ottawa Public Health:
- Wear a face covering
- Wear eye protection to prevent injury
-
Stay hydrated
- Don’t yell! Use signs and noise makers instead
- Stick to a small group
- Keep six feet from other groups
- Maintain physical distancing as much as possible
- Bring hand sanitizer and keep your hands clean
- Consider using signs, noise makers or drums instead of shouting or chanting, which “tends to have droplets go farther.”
- Clean all items after the protest which may be contaminated
Please. Stay safe. . .
♥
Dr. Ingrid Katz is Associate Faculty Director at the Hvard Global Health Institute, Assistant Professor in Medicine at Harvard Medical School, and Associate Physician in the Department of Medicine at Brigham and Women’s Hospital.
Dr. Abraar Karan is an internal medicine physician at the Brigham and Women’s Hospital/Harvard Medical School and is working on the COVID-19 response in Massachusetts state. I’ve previously quoted Dr. Karan in this 2019 post on doctor-patient communication
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Q: How have the events of this past week affected you?
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NOTE FROM CAROLYN: I wrote more on dealing with stress and uncertainty in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 20% off the list price).
See also:
– More Heart Sisters articles about COVID-19 and heart patients
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Heart Sisters 
Excellent essay, thank you for this…
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We Canadians stand in solidarity with our American friends who are rising up in protest over the social injustices of what’s going on in their country in terms of racial discrimination, through their “Black Lives Matter” demonstrations. Many of us in Canada (and in countries all over the world) have also been having peaceful demonstrations (and may I stress “peaceful”) in sympathetic support of America’s “Black Lives Matter” campaign.
In our neck of the woods (within British Columbia, Canada) however, it makes me sad to see an apparent rise in Sinophobic racism going on toward those of Chinese descent, ever since the onset of the COVID-19 pandemic.
In light of that, would it not also be appropriate to have an “Asian Lives Matter” campaign?
For most Canadians, it’s taken as a ‘given’ that “Black Lives (or rather, ALL Lives) Matter” and rarely do we ever see people being killed by those in whom we trust to serve and protect us all. However, we do see growing evidence of racism within the general population toward our fellow Canadians of Chinese ancestry, as though somehow they need to be blamed and punished for the pandemic.
How absurd to place blame on any group of Canadians for what might be going on in other countries. No Canadian is at fault here, so let’s all remember to be kind to one another.
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Hello Coleyna – I’m in B.C. too (in Victoria) and have been alarmed by those same news reports out of Vancouver of Chinese-Canadians being assaulted on public transit and elsewhere. Horrible! I hope these incidents are the result of a small number of ignorant outliers…
Canadians aren’t immune to systemic racism (just look at centuries of abuse of First Nations people by whites – and not only in ancient history, e.g. more recently in the Saskatchewan “starlighting” cases, where RCMP officers drove intoxicated indigenous men miles out of town and deliberately dumped them on the side of the road to freeze to death; only two officers have ever been charged).
Of course I agree that all lives do matter, but the Black Lives Matter movement cannot be co-opted as “All Lives Matter”. There’s an important difference with BLM, which was launched in 2013 because of the acquittal of (black) Trayvon Martin’s (white) murderer – a unique movement specifically focusing on black lives at risk of police violence.
Take care, stay safe! ♥
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I agree whole-heartedly, Carolyn (or at least with whatever part of my heart is still functioning after just having had my first heart-attack, and am waiting for my stress-test appointment).
An article in today’s edition of abbynews.com explains it well that ‘Black Lives Matter’ doesn’t mean only Black lives matter. The author, Tyler Olsen, explains that “Demonstrators are stating, simply, all lives SHOULD matter, regardless of race, but that they don’t. That’s the core message of Black Lives Matter. It’s just that ‘Black Lives Also Matter’ doesn’t have quite the same potential as a rallying cry.”
Olsen also offers a great definition of what ‘systemic’ means, in terms of racism. He explains that “It doesn’t mean everybody is racist. It means that our society is riddled with things, big and small, that collectively end up penalizing people for having a different skin tone”.
Maybe I’m just going through the post heart-attack blues right now, but living in a world that replaces the “Golden Rule” with hatred and racism makes me find myself crying – A Lot!
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Thanks for sharing that link to Tyler Olsen’s article on Black Lives Matter, Coleyna. Even the title of his column is clear and convincing: “Why You Probably Agree with the Black Lives Matter Slogan, Even if You Think You Don’t!”
It’s really offensive to think that anybody even has to convince us that Black Lives Matter, as if that’s a theory that must be proven…
I have never had to worry that my (white) son Ben might be pulled over during a routine traffic stop and harrassed or even killed by police officers. It doesn’t even cross my mind that my (white) daughter Larissa will be followed around a store by security staff who assume she must be there to steal something. White Mums like me simply haven’t experienced that humiliation happening to our children. Yet these are incidents that black people have learned to expect to happen to their kids.
I’m also glad that Olsen included Canada’s shameful record of pervasive racism aimed at our indigenous citizens. We have such a long way to go.
No wonder you feel like crying – a lot! These are distressing times we’re going through. We live in hope…
Take care, stay safe… ♥
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Did you see this?
https://drive.google.com/file/d/1Jyfn4Wd2i6bRi12ePghMHtX3ys1b7K1A/view
It showed up in my RSS reader the day after an Austin city council work session concluded that racism was so inherent in the pandemic that they had to address the underlying social determinants of health due to which the ca. 30% of the Austin population which is Hispanic has ca. 60% of the confirmed cases.
The letter’s signatories are recommending protest during the pandemic for some of the same reasons touched on in the work session. Racism is part and parcel of the pandemic and its impact on vulnerable populations.
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Holy holey Ray! This letter is really something, e.g. “White supremacy is a lethal public health issue that predates and contributes to COVID-19. Black people are twice as likely to be killed by police compared to white people, but the effects of racism are far more pervasive. Black people suffer from dramatic health disparities in life expectancy, maternal and infant mortality, chronic medical conditions, and outcomes from acute illnesses like myocardial infarction and sepsis…..” And the pages of signatories is impressive.
Imagine if every city council undertook an initiative like this… And then actually took proactive steps to act on it.
Thanks for sending this. Stay safe….
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I’m proud that there have been large, peaceful demonstrations in my city, but concerned about the lack of physical distancing and inconsistent use of masks.
Personally, I live in a very small social world because my health issues keep me from being active. I had to stop working in 1998. That lead to loss of contact with my colleagues. The few friends I have are like me, white.
If my health improves I would like to do a little volunteer work. I have a lot of experience and a lot to give. I hope I could help others facing crises that I have survived. In this way I might also gain friends, or at least acquaintances, of different ages and skin tones
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Hi Jenn – I too have been alarmed about physical distancing and lack of masks out there (not just in huge mass gatherings like protest marches, but at my local shops too!) It’s as if people have forgotten what the past three months has been all about! That’s why I decided to include in this post a list of precautions for those who are out demonstrating in crowds.
In my day to day life, I too live in a white bubble (only about 3.5% of our town’s population is black or bi-racial). I have one friend in my Toastmasters club and one neighbour in our apartment building who are black – but have developed many connections with black people online. My friend Cheryl Strachan (a Registered Dietitian in Calgary) wrote an interesting article today in which she wrote that she, like you and me, has few black colleagues, and so has expanded her own online contacts to include women of colour who are also professional dietitians like her. Perhaps if/when your health improves, your volunteer activities might include diversity in online resources, too.
Take care, stay safe…. ♥
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For me, as a white middle class female American, who worked in Health Care for over 40 years, the most important thing that has happened for me is to look at my own life in regards to racism.
It is because COVID19 has forced us to pause our lives, that this is a perfect time for self-examination and the redirection of energy towards positive change.
Discrimination according to race, income, sex, age all start to become more apparent.
Groups of defensive people with deep underlying fears of “the other” anything “different” from themselves….reacting from a base animal nature… fuels discrimination.
Hopefully the country and the world take the time to LISTEN with an open mind and take a moment to imagine themselves in another human being’s shoes.
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Hello Jill – speaking of defensive people with deep underlying fears of “the other”, have you seen this clip from the Oprah show back in 1987, just five months after her TV show started? Oprah went to visit Forsyth County, Georgia near Atlanta, described as a “hotbed of racism” where no black people had lived for over 75 years. Watching this video gave me (a white middle class Canadian) a glimpse into the deep-seated historical prejudice towards “the other” (and some of her guests expressed equal hatred towards many other kinds of “others”).
I hope that all of us will devote time to some brutal self-examination (if the NFL can do it, after all…. ) But given the current reality of openly active white supremacists, violent extremism, the ultra-conservative evangelical movement, and right-wing conspiracy theorists in the U.S. (on top of systemic racism), I can’t quite imagine (pandemic or no pandemic) that people who hold the hate-filled views of Forsyth County will take this opportunity to do much soul-searching with an open mind. I don’t know when or if that might even be possible for some people…
Take care, stay safe… ♥
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Yes, it is difficult when people are so tightly attached to a set of beliefs. What I have seen in my limited observations is that one of the few things that can bring people together is a natural disaster.
I think there will be more natural disasters sooner than later and as we elders die off, there is a new group of upcoming youth that do not have the prejudices many of us grew up with.
So keep watching!
I looked back at my career a lot of it in city hospitals…I can’t ever remember treating any patient different than another because of race, sex, religion etc.
Blessings, stay well!
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I’d likely say the same thing about my own career, Jill – except that I understand that unconscious bias exists in all of us. Because it’s unconscious, most of us don’t acknowledge it. (Check out the self-tests at Harvard’s “Project Implicit“)
Recently, for example, one of my longtime readers asked me why I never use photos of black women (or Asian, or Hispanic, or any women of colour) whenever I choose a woman’s photo to illustrate my blog articles here. My first reaction was defensive. I’ve written over 800 articles so it’s hard to keep track of every image I choose, but I DID recall at least one stock photo I ran of a black woman. But then I realized – that’s what she was talking about!! 800 articles in over 11 years and every time I decide on which image I’d like to accompany an article that needs a woman’s photo – it’s a blonde blue-eyed white woman?!?! She was right.
That was a real eye-opener for me. I can’t change the world just by running photos of dark-skinned women, but if I never choose to do so, I’m being as unwittingly biased as those who omit photos like these out of prejudice!
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