The police brutality against Black Americans and growing protests amidst the COVID-19 pandemic have made me think more about centuries of racism, infectious diseases, and our healthcare system. Everyone has been engaging in these current events in a different way, mine has been to listen, reflect, and try to engage in difficult conversations to raise awareness. One question that I have been asked is how can health professionals support mass protests in the setting of a pandemic? It is true that mass gatherings could increase the risk for the spread of the coronavirus, but staying silent may pose an even greater risk for perpetuating health inequalities and disparities. In order to understand this, it is helpful to recognize the connections between race and infectious diseases, as well as politics and medicine.
Early on in medical school we learn about Virchow’s triad, 3 factors that influence the formation of blood clots, named after a German physician and one of the founders of modern medicine. What we were not taught is that Rudolf Virchow was a pioneering social thinker who advocated for the poor and fought racism. He saw medicine and politics as inseparable, stating that, “Medicine is a social science and politics is nothing else but medicine on a large scale.” Larger social inequalities were the root of many diseases, and Virchow saw doctors as the ideal advocates. He called them “the attorneys for the poor.” While Virchow had many discoveries (as well as some wrong ideas, such as opposing germ theory), the ideas of the physician as an advocate and medicine as politics are relevant now more than ever.
Over 10,000 health professionals marched together in Seattle this past weekend and an open letter advocating for an anti-racist public health response for protests has been signed by over 1,000 health professionals and stakeholders. The pandemic and protests are inseparable. Both represent a shared history of health disparities and inequalities in our country that need to be addressed. That is why healthcare professionals are advocating for these protests; these actions represent more than the recent events and are about centuries of racism. Racial inequalities throughout our nation’s history have led to disparities in morbidity and mortality due to infectious diseases, such as COVID-19. For this, and many other reasons, healthcare professionals support the protests. In order to decrease risk for transmission, safer measures can be taken such as physical distancing, wearing masks/eye protection among protestors, and stopping the use of tear gas by police. Additional forms of advocacy are also possible that may mitigate transmission. I am inspired by my colleagues and friends who have been leading local advocacy efforts.
At the end of a recent visit with a patient, we talked about COVID-19 and how to reduce risk. My patient said to me, “I hate this virus…it is racist…if you are poor then you die from it.” He was right, deaths due to COVID-19 are disproportionate among people of color, especially within Black communities. The burden of this disease, like many other diseases, reflects structural racism. The virus isn’t racist, our society is.