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<font size="1"><a href="https://www.propublica.org/article/early-data-shows-african-americans-have-contracted-and-died-of-coronavirus-at-an-alarming-rate">https://www.propublica.org/article/early-data-shows-african-americans-have-contracted-and-died-of-coronavirus-at-an-alarming-rate</a></font>
<h1 class="gmail-reader-title">Early Data Shows African Americans Have Contracted and Died of Coronavirus at an Alarming Rate</h1>
<p class="gmail-byline">by <a class="gmail-name" href="https://www.propublica.org/people/akilah-johnson">Akilah Johnson</a> and <a class="gmail-name" href="https://www.propublica.org/people/talia-buford">Talia Buford</a> - April 3,
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<p>ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive <a href="https://go.propublica.org/big-story-2019">our biggest stories</a> as soon as they’re published.</p>
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<p>The coronavirus entered Milwaukee from a white, affluent suburb. Then it took root in the city’s black community and erupted.</p>
<p>As public health officials
watched cases rise in March, too many in the community shrugged off
warnings. Rumors and conspiracy theories proliferated on social media,
pushing the <a href="https://www.politifact.com/factchecks/2020/mar/10/facebook-posts/melanin-doesnt-protect-against-coronavirus/">bogus idea that black people are somehow immune to the disease</a>.
And much of the initial focus was on international travel, so those who
knew no one returning from Asia or Europe were quick to dismiss the
risk.</p>
<p>Then, when the
shelter-in-place order came, there was a natural pushback among those
who recalled other painful government restrictions — including
segregation and mass incarceration — on where black people could walk
and gather.</p>
<p>“We’re like, ‘We have to wake people up,’” said Milwaukee Health Commissioner Jeanette Kowalik.</p>
<p>As the disease spread at a
higher rate in the black community, it made an even deeper cut.
Environmental, economic and political factors have compounded for
generations, putting black people at higher risk of chronic conditions
that leave lungs weak and immune systems vulnerable: asthma, heart
disease, hypertension and diabetes. In Milwaukee, simply being black
means your life expectancy is 14 years shorter, on average, than someone
white.</p>
<p>As of Friday morning,
African Americans made up almost half of Milwaukee County’s 945 cases
and 81% of its 27 deaths in a county whose population is 26% black.
Milwaukee is one of the few places in the United States that is tracking
the racial breakdown of people who have been infected by the novel
coronavirus, offering a glimpse at the disproportionate destruction it
is inflicting on black communities nationwide.</p>
<p>In Michigan, where the
state’s population is 14% black, African Americans made up 35% of cases
and 40% of deaths as of Friday morning. Detroit, where a majority of
residents are black, has <a href="https://www.freep.com/story/news/health/2020/04/03/coronavirus-covid-19-cases-wayne-county-detroit-michigan/5116620002/">emerged</a>
as a hot spot with a high death toll. As has New Orleans. Louisiana has
not published case breakdowns by race, but 40% of the state’s deaths <a href="https://www.nytimes.com/interactive/2020/us/louisiana-coronavirus-cases.html">have happened</a> in Orleans Parish, where the majority of residents are black.</p>
<p>Illinois and Mecklenburg
County, North Carolina — where Charlotte is — are two of the few areas
publishing statistics on COVID-19 cases by race, and their data shows a
disproportionate number of African Americans were infected. Neither of
those governments has published breakdowns of deaths by race.</p>
<p>“It will be unimaginable
pretty soon,” said Dr. Celia J. Maxwell, an infectious disease physician
and associate dean at Howard University College of Medicine, a school
and hospital in Washington dedicated to the education and care of the
black community. “And anything that comes around is going to be worse in
our patients. Period. Many of our patients have so many problems, but
this is kind of like the nail in the coffin.”</p>
<p>The U.S. Centers for
Disease Control and Prevention tracks virulent outbreaks and typically
releases detailed data that includes information about the age, race and
location of the people affected. For the coronavirus pandemic, the CDC
has released <a href="https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html">location</a>
and age data, but it has been silent on race. The CDC did not respond
to ProPublica’s request for race data related to the coronavirus or
answer questions about whether they were collecting it at all.</p>
<p>Experts say that the
nation’s unwillingness to publicly track the virus by race could obscure
a crucial underlying reality: It’s quite likely that a disproportionate
number of those who die of coronavirus will be black.</p>
<p>The reasons for this are
the same reasons that African Americans have disproportionately high
rates of maternal death, low levels of access to medical care and higher
rates of asthma, said Dr. Camara Jones, a family physician,
epidemiologist and <a href="https://www.radcliffe.harvard.edu/people/camara-phyllis-jones">visiting fellow</a> at Harvard University.</p>
<p>“COVID is just unmasking
the deep disinvestment in our communities, the historical injustices and
the impact of residential segregation,” said Jones, who spent 13 years
at the CDC, focused on identifying, measuring and addressing racial bias
within the medical system. “This is the time to name racism as the
cause of all of those things. The overrepresentation of people of color
in poverty and white people in wealth is not just a happenstance. … It’s
because we’re not valued.”</p>
<p>Five congressional
Democrats wrote to Health and Human Services Secretary Alex Azar, whose
department encompasses the CDC, last week <a href="https://www.warren.senate.gov/imo/media/doc/2020.03.27%20Letter%20to%20HHS%20re%20racial%20disparities%20in%20COVID%20response.pdf">demanding</a> the federal government collect and release the breakdown of coronavirus cases by race and ethnicity.</p>
<p>Without demographic data,
the members of Congress wrote, health officials and lawmakers won’t be
able to address inequities in health outcomes and testing that may
emerge: “We urge you not to delay collecting this vital information, and
to take any additional necessary steps to ensure that all Americans
have the access they need to COVID-19 testing and treatment.”</p>
<p>Milwaukee, one of the few
places already tracking coronavirus cases and deaths by race, provides
an early indication of what would surface nationally if the federal
government actually did this, or locally if other cities and states took
its lead.</p>
<p>Milwaukee, both the city
and county, passed resolutions last summer that were seen as important
steps in addressing decades of race-based inequality.</p>
<p>“We declared racism as a
public health issue,” said Kowalik, the city’s health commissioner. “It
frames not only how we do our work but how transparent we are about how
things are going. It impacts how we manage an outbreak.”</p>
<p>Milwaukee is trying to be
purposeful in how it communicates information about the best way to slow
the pandemic. It is addressing economic and logistical roadblocks that
stand in the way of safety. And it’s being transparent about who is
infected, who is dying and how the virus spread in the first place.</p>
<p>Kowalik described watching
the virus spread into the city, without enough information, because of
limited testing, to be able to take early action to contain it.</p>
<p>At the beginning of March,
Wisconsin had one case. State public health officials still considered
the risk from the coronavirus “low.” Testing criteria was extremely
strict, as it was in many places across the country: You had to have
symptoms and have traveled to China, Iran, South Korea or Italy within
14 days or have had contact with someone who had a confirmed case of
COVID-19.</p>
<p>So, she said, she waited, wondering: “When are we going to be able to test for this to see if it is in our community?”</p>
<p>About two weeks later, Milwaukee had its first case.</p>
<p>The city’s patient zero had
been in contact with a person from a neighboring, predominately white
and affluent suburb who had tested positive. Given how much commuting
occurs in and out of Milwaukee, with some making a 180-mile round trip
to Chicago, Kowalik said she knew it would only be a matter of time
before the virus spread into the city.</p>
<p>A day later came the city’s
second case, someone who contracted the virus while in Atlanta. Kowalik
said she started questioning the rigidness of the testing guidelines.
Why didn’t they include domestic travel?</p>
<p>By the fourth case, she said, “we determined community spread. … It happened so quickly.”</p>
<p>Within the span of a week,
Milwaukee went from having one case to nearly 40. Most of the sick
people were middle-aged, African American men. By week two, the city had
over 350 cases. And now, there are more than 945 cases countywide, with
the bulk in the city of Milwaukee, where the population is 39% black.
People of all ages have contracted the virus and about half are African
American.</p>
<p>The county’s <a href="https://county.milwaukee.gov/EN/COVID-19">online dashboard</a>
of coronavirus cases keeps up-to-date information on the racial
breakdown of those who have tested positive. As of Thursday morning, 19
people had died of illness related to COVID-19 in Milwaukee County. All
but four were black, according to the county medical examiner’s office.
Records show that at least 11 of the deceased had diabetes, eight had
hypertension and 15 had a mixture of chronic health conditions that
included heart and lung disease.</p>
<p>Because of discrimination
and generational income inequality, black households in the county
earned only 50% as much as white ones in 2018, according to census
statistics. Black people are far less likely to own homes than white
people in Milwaukee and far more likely to rent, putting black renters
at the mercy of landlords who can kick them out if they can’t pay during
an economic crisis, at the same time as people are being told to stay
home. And when it comes to health insurance, black people are more
likely to be uninsured than their white counterparts.</p>
<p>African Americans have
gravitated to jobs in sectors viewed as reliable paths to the middle
class — health care, transportation, government, food supply — which are
now deemed “essential,” rendering them unable to stay home. In places
like New York City, the virus’ epicenter, black people are among the
only ones still <a href="https://www.nytimes.com/2020/03/30/nyregion/coronavirus-mta-subway-riders.html">riding the subway</a>.</p>
<p>“And let’s be clear, this is not because people want to live in those conditions,” said Gordon Francis Goodwin, who works for <a href="https://www.racialequityalliance.org/about/who-we-are/">Government Alliance on Race and Equity</a>, a national racial equity organization that worked with <a href="https://www.racialequityalliance.org/jurisdictions/milwaukee-county/">Milwaukee</a>
on its health and equity framework. “This is a matter of taking a look
at how our history kept people from actually being fully included.”</p>
<p>Fred Royal, head of the Milwaukee branch of the NAACP, knows three people who have died from the virus, including <a href="https://apnews.com/b52e4e9a63d64e3a25109f09010508b6">69-year-old Lenard Wells</a>,
a former Milwaukee police lieutenant and a mentor to others in the
black community. Royal’s 38-year-old cousin died from the virus last
week in Atlanta. His body was returned home Tuesday.</p>
<p>Royal is hearing that people aren’t necessarily being hospitalized but are being sent home instead and “told to self-medicate.”</p>
<p>“What is alarming about
that,” he said, “is that a number of those individuals were sent home
with symptoms and died before the confirmation of their test came back.”</p>
<p>Health Commissioner
Kowalik said that there have been delays of up to two weeks in getting
results back from some private labs, but nearly all of those who died
have done so at hospitals or while in hospice. Still, Kowalik said she
understood why some members in the black community distrusted the care
they might receive in a hospital.</p>
<p>In January, a 25-year-old day care teacher named Tashonna Ward <a href="https://www.jsonline.com/story/news/2020/01/11/after-waiting-froedtert-er-milwaukee-woman-leaves-and-later-dies/4422064002/">died</a>
after staff at Froedtert Hospital failed to check her vital signs.
Federal officials examined 20 patient records and found seven patients,
including Ward, didn’t receive proper care. The report didn’t reveal the
race of those whose records it examined at the hospital, which
predominantly serves black patients. Froedtert Hospital <a href="https://www.jsonline.com/story/news/2020/02/25/milwaukee-woman-who-died-after-er-wait-wasnt-only-one-who-saw-delays/4857360002/">declined</a>
to speak to issues raised in the report, according to a February
article from the Milwaukee Journal Sentinel, and it had not submitted
any corrective actions to federal officials.</p>
<p>“What black folks are
accustomed to in Milwaukee and anywhere in the country, really, is pain
not being acknowledged and constant inequities that happen in health
care delivery,” Kowalik said.</p>
<p>The health commissioner
herself, a black woman who grew up in Milwaukee, said she’s all too
familiar with the city’s enduring struggles with segregation and racism.
Her mother is black and her father Polish, and she remembers the
stories they shared about trying to buy a house as a young interracial
couple in Sherman Park, a neighborhood once off-limits to blacks.</p>
<p>“My father couldn’t get a mortgage for the house. He had to go to the bank without my mom,” Kowalik said.</p>
<p>It is the same <a href="https://projects.jsonline.com/topics/sherman-park/">neighborhood</a>
where fury and frustration sparked protests that, at times, roiled into
riots in 2016 when a Milwaukee police officer fatally shot Sylville
Smith, a 23-year-old black man.</p>
<p>And it is the same
neighborhood that has a concentration of poor health outcomes when you
overlay a heat map of conditions, be it lead poisoning, infant mortality
— and now, she said, COVID-19.</p>
<p>Knowing which communities
are most impacted allows public health officials to tailor their
messaging to overcome the distrust of black residents.</p>
<p>“We’ve been told so much
misinformation over the years about the condition of our community,”
Royal, of the NAACP, said. “I believe a lot of people don’t trust what
the government says.”</p>
<p>Kowalik has met —
virtually — with trusted and influential community leaders to discuss
outreach efforts to ensure everyone is on the same page about the
importance of staying home and keeping 6 feet away from others if they
must go out.</p>
<p>Police and inspectors are
responding to complaints received about “noncompliant” businesses
forcing staff to come to work or not practicing social distancing in the
workplace. Violators could face fines.</p>
<p>“Who are we getting these complaints from?” she asked. “Many people of color.”</p>
<p>Residents have been urged
to call 211 if they need help with anything from finding something to
eat or a place to stay. And the state has set up two voluntary isolation
facilities for people with COVID-19 symptoms whose living situations
are untenable, including a Super 8 motel in Milwaukee.</p>
<p>Despite the work being
done in Milwaukee, experts like Linda Sprague Martinez, a community
health researcher at Boston University’s School of Social Work, worry
that the government is not paying close enough attention to race, and as
the disease spreads, will do too little to blunt its toll.</p>
<p>“When COVID-19 passes and
we see the losses … it will be deeply tied to the story of post-World
War II policies that left communities marginalized,” Sprague said. “Its
impact is going to be tied to our history and legacy of racial
inequities. It’s going to be tied to the fact that we live in two very
different worlds.”</p>
<p><em><a href="https://www.propublica.org/people/doris-burke">Doris Burke</a> and <a href="https://www.propublica.org/people/hannah-fresques">Hannah Fresques</a> contributed reporting.</em></p>
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