Hypervisibility of Race in the Covid Era

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By Ava Sullivan

The use of alternative names for COV D-19, especially those related to race or place of origin, is an example of harmful misinformation during crisis communication. Not only is the use of these names in direct opposition to credible sources of information, like the World Health Organization, but it also creates stigma that encourages discriminatory behaviors. Using racialized language to describe COV D-19 mobilizes the public to react in ways that run counter to effective response efforts, detract from clear risk communication, and undermine the public’s ability to evaluate risks. nfectious disease creates space for fear, uncertainty, and anxiety. These reactions often become distorted as we use them to inform risk communication around an infectious disease outbreak. Novel viruses pose a large opportunity for stigma, and because communication and concept of risk around novel viruses are new, there are more opportunities for errors and misunderstanding. Additionally, increased fear and anxiety during a novel virus outbreak elicit more desperate and emotional responses to these specific disasters.

Naming a virus is the first line of defense in setting up a balanced, fact-based, and clear disease disaster response. The name can either set the stage for creating the ‘other’ or communicate essential natural history elements of the virus, like viral family and date of discovery. “Despite the World Health Organization’s (WHO) efforts to discourage using specific people, places, or animals to name infectious diseases, the continued use of stigmatizing monikers such as ‘Spanish flu’, ‘Mexican swine flu’, and ‘Ebola virus’ can be psychologically damaging and signify how authorities and the public respond to an epidemic.” Below, a CDC product breaks down the intentionality of the naming process:

Fig re 1: A World Health Organi ation report on Social Stigma associated ith COV D-19

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COV D-19, previously known as “2019 novel coronavirus,” was named on February 11, 2020. The name’s success can be understood through the most basic principles outlined by the Crisis and Emergency Risk Communication (CERC) guidelines: “Be first....be right....be credible...express empathy...promote action... and show respect." 2 Despite this, the use of bigoted language to describe COV D-19 continues to circulate, most notably by US federal leadership. Using ‘The Chinese Virus’ is harmful to both the stigmatized group and the population at large, which would instead benefit from appropriate and evidence-based communication throughout the pandemic.

Fig re 2: A t eet in hich Donald Tr mp names COV D-19 sing stigmati ed lang age

While the name of a virus may seem trivial, it is the most visible and repeated aspect of crisis communication during an infectious disease disaster. n the case of COV D-19, the name was set by a credible source, early on in the crisis, and it had the makings of a successful part of the response communication strategy. Only when undermining credible authorities do we see people choose to use bigoted language. These names set the stage for stigma, and worse, discriminatory behaviors rooted in fear, anxiety and misinformation.

The world faces treacherous recovery if the public does not receive messaging that solidifies their understanding of real risk factors and empowers their ability to make healthy decisions to mitigate risk.

1. Noel, T. K. (2020). Conflating Culture With COV D-19: Xenophobic Repercussions of a Global Pandemic. Social Sciences & H manities Open, 100044.

2. Reynolds, B., Galdo, J. H., Sokler, L., & Freimuth, V. S. (2002). Crisis and emergency risk communication.

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Sha er he M h: Racism as a S dden Pandemic As the United States grappled with whether COV D-19 was fact or fiction, the world suddenly identified a new 1 pandemic : racism and police violence.

On March 13, Breonna Taylor had been sleeping in her home in Louisville, Kentucky when she was shot at pointblank range by police officers who were investigating two other suspects. She died. Then later in May, the world discovered Ahmuad Arbery had been killed by two white vigilantes in Georgia, and the footage had been hidden since his actual murder in February. And then there was George Floyd. And then there was Elijah McClain. And then there was Oluwatoyin Salau. The list goes on.

After the coverage of these events, onlookers of the Black experience were convinced that Black people in the U.S. were suddenly experiencing two pandemics simultaneously. The myth of the post-racial society ushered in during the Obama-era had shattered. Racism was alive and well. Social media became flooded with howto guides on anti-racist action, very little of which gave instructions on direct aid to Black americans -- most were fundamental in recognizing the humanity of Black people for the very first time.

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On a personal level, my DMs and texts overflowed with non-Black people expressing their regret and concern for my well-being. How are you doing? they’d ask, or What can do to help? Others, and my personal favorite: ’m so sorry for how treated you in the past. know now that have not done enough. will do better in the future.

What ’d want to say was: Ac all , m n he be . ake e e da a 7 am f ge ing h b ea he. a k m elf, i c na a e an i ?A e an i ab eeing an he Black e n dea h he ibili f d ing f m c na? O d ac all ha e c na? call he i al medical cen e f a c eening, and he a ha m fine. ac ice m b ea hing e e ci e and hen g he in e ne ee he image f an he Black e n dea h. O ha he m de e a e n aca i n. O ha m fell cla ma e a e a ing d ing a andemic i h n ega d he ci ce ible la i n. O an he in ag a hic de ailing h ackn ledge m h mani . f ge h b ea he again. nstead, ’d heart the message and thank them for their kind words. t’s much less to say. Because for me, this new pandemic is not new. 21 years of life have taught me what no instagraphic could: as Audre Lorde said, we were never meant to survive.

t’s traumatic. The constant display of racism and violence that Black americans have to experience has significantly impacted their 2 emotional and mental health. And to make matters worse: Black americans face higher barriers to receiving adequate mental health treatment. According to the American Psychiatric Association, only one-third of Black americans who need mental healthcare receive it. Besides economic barriers, Black people are at a higher rate of misdiagnosis in comparison to their white counterparts, with little to no understanding as to why this is the case.3 Additionally, they are most likely diagnosed with schizophrenia instead of mood 3 disorders, and subsequently, are incarcerated at a higher rate. And then, of course, the general distrust among Black americans in the healthcare system for its infamous record of exploiting Black 4 people for research purposes. nadequate mental healthcare is a public health issue because Black people are dying -- recent research shows that suicide rates among Black people are rising, especially for Black girls.2 The effects of the last few months on the mental health of Black people sincerely worries me. And it should worry you. What Black people need right now, as they always have, is to be recognized and supported while we are alive. Our lives have always mattered, even before it became an nstagram trend.

1. Yulianto, Vissia ta. (2020) We e Been Facing a Pandemic f Raci m: H can e i? https://theconversation.com/weve-been-facing-a-pandemic-of-racism-how-can-we-stop-it-140284 2. Mental Health America. (2020). Black and Af ican Ame ican C mm ni ie and Men al Heal h. https://www.mhanational.org/issues/black-and-african-american-communities-and-mental-health 3. American Psychiatric Association. (2017). Mental Health Disparities: African Americans. Retrieved from https://www.psychiatry.org/File percent20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-HealthFacts-for-African-Americans.pdf 5 4. Dr. Corey Williams. (2017). Black Ame ican D n T O Heal hca e S em: He e h . https://thehill.com/blogs/pundits-blog/healthcare/347780-black-americans-dont-have-trust-in-our-healthcare-system

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By Tai Soladay

Sha-Asia Washington was a 26-year-old Black woman who died at Woodhull Medical Center in Brooklyn, New York. She died at the hands of medical professionals while giving birth to her baby girl, Khloe. Sha-Asia was a paraprofessional at a Brooklyn Charter School. Her death occurred due to the improper administration of her epidural, which she was pressured into having despite her abnormally high blood pressure. The death of Sha-Asia Washington prompted a petition demanding the New York state to publish data on pregnancy and childbirth outcomes to elucidate the high maternal mortality rates among black women.

Black women are three to four times more likely to die from 1 pregnancy related complications than their white counterparts.

Nearly 60% of these deaths are preventable. Why does this occur? Because of the systemic racism and bias in the United States healthcare system. The most common form of this discrimination is highlighted through doctor s consistent dismissal of B POC patients when reporting health issues.

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Clearly, Black mothers are not safe in our medical facilities.

However, trained birthing professionals such as doulas or midwives, have played important roles in helping women have healthy pregnancy and positive birthing experiences. Doulas provide continuous physical, emotional and informational support before, during and after childbirth. Numerous scientific trials have concluded that doula support increases the physical and psychological well-being of both the mother and baby.

Doulas have played a crucial role in closing the gap of birthing disparities, as many doula organi ations are aimed at supporting B POC communities. Some local New Orleans organi ations are Birthmark Doula Collective and Sista Midwife Productions.

Again, doulas not only offer physical and emotional support, but strongly advocate for mothers while in medical facilities. This advocacy is vital in protecting Black mothers and babies while entering into the historically racist realm of Western medicine.

COV D-19 has only made pregnancy and childbirth more difficult and more anxiety inducing than before.

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The Louisiana Department of Health, along with other states, has forced its hospitals to implement visitor-limitation policies. Along with the mother in labor, LCMC Health (a Louisiana medical group) hospitals are only allowing one support person throughout the labor, delivery and postpartum period. This forces mothers to choose between their partners and birthing professionals. The intersection of racism in hospitals and presence of COV D-19 is putting Black mothers in an even more vulnerable position by limiting their support and advocacy within medical institutions.

The state of Louisiana ranks 49th out of all 50 states in maternal 2 mortality. There are numerous organi ations, individuals and advocacy groups in New Orleans working to ensure that all mothers have the right to a safe, healthy and positive pregnancy and childbirth experience.

The following page is a list of organi ations dedicated to reproductive and birth justice in New Orleans as well as petitions in honor of Sha-Asia Washington. t is time to educate, organi e and donate to assure that every single mother and baby is safe in our healthcare system.

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1. " nfographic: Racial/Ethnic Disparities in Pregnancy-Related Deaths - United States, 2007 2016. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, February 4, 2020. https://www.cdc.gov/reproductivehealth/maternalmortality/disparities-pregnancy-related-deaths/infographic.html.

2. United Health Foundation. America's Health Rankings Annual Report , 2019. https://www.americashealthrankings.org/explore/annual/measure/Overall/state/LA? edition-year=2019.

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Meditating on Black Ontology B Sa ah J ne

L g bef e he a de ic, ke a ea a i -fee di a ce be ee e f a d he d. Dis ance. fe ike i a he f f ec i c d gi e e f. The i i ha he di a ce had be ee e f a d he did e ae e ha i g a closeness e f. a , ec ed eff ef f h gh f e i ii g a a. H e e , COV D-19 f ced e ec efi a e a . A a ha ade e f c c e e i e h gh a d he fee i g had b cked ff. f ced e f ha e a fa i e i ih e f. e c ed a c i f b ied ec e , a ed e i de , i ie f ce eb a i , a d e a affec i , ca e, a d e.

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d he e B ack e e a e ad ified, e a i ed, a d fe i hi ed, c e ai a d b di a a d e e ie ci g e ea e a e i e ced. A a B ack a , k b d i ea ef i h e e a i ed a . H e e , a a f a a e f ha i ea be incapable f e f i g. Wha i ea ha e ea e i ed a a f a df b d sh do n. k ha i i ike f b d a d .

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Greener Medicine for he Ne Normal

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The United States is a global leader in health innovation and health expenditures, but compared with other developed nations, it falls short in health outcomes. The unsatisfied need for high value, accessible healthcare is no new problem for the United States, but the COV D-19 pandemic has made the quest for solutions particularly urgent. The introduction of the novel coronavirus threatened many practices and provided an enormous set of challenges for our health system to adapt to.

During a time when adaptation to the new normal was prioritized, many turned to telehealth to reduce exposure to the sick, preserve PPE, and minimize the impact of 1 patient surges on facilities. While healthcare systems have had to adjust their methods of triage, evaluation, and care, the new implementation of widespread telehealth could be incredibly beneficial, especially for demographics that may have otherwise had a much harder time accessing life-saving healthcare.

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Telehealth technology is not new, rather it has been a possibility since the invention of the phone and has only become more advanced as technology has progressed.

Doctors now have the possibility to video call with patients and patients can even use digital therapeutic products to receive necessary health interventions from home.

We must ask the question of why telehealth now? The answer seems obvious, as the COV D-19 pandemic provides the clear reason of risk of disease transmission.

At the onset of the pandemic, immediate efforts were made to expand telehealth technology and coverage. This includes the CARES Act, the $2.2 trillion assistance package to mitigate the economic impacts of the pandemic. While this expansion is necessary for coping with the pandemic, we must take the time to examine that coverage and accessibility to this vital service only occurred when the white majority group was in need of the service. ndividuals living below the poverty line, people of color, and marginalized groups have been in desperate need of expansion of health services far before the COV D-19 pandemic. There are many barriers to accessing health care that are lowered with increased accessibility to digital healthcare for these groups for a variety of reasons. Namely, transportation, inability to take time off work, and provider bias pose threats to an individual's ability 2 to attend an in-person appointment.

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Tulane Green Medicine nitiative works to address the concern that the medical industry is 2nd in production of 3 landfill waste, generating about 6,600 tons of waste daily.

The onset of the COV D-19 pandemic has made the amount of medical waste soar even higher, as PPE has necessarily increased. Consider the use of disposable masks alone. Telemedicine drastically limits the waste that the medical industry must produce, saving multitudes of patient rooms from sterilization and a fresh pair of gloves.

This consideration is important for all people living on the planet, but marginalized groups are much more likely to experience the negative impacts of this pollution.

Systemic racism and classism has led to toxic waste being much more likely to be disposed of in a Black neighborhood than in a white neighborhood. This in turn leads to health issues for these communities. Our medical industry must work to provide accessible and effective care without taking a toll on our planet. Telehealth is a step toward sustainable changes in the medical industry that should be built upon. The social and physical environment creates determinants of health, so that different groups are set up for more or less success when it comes to living a healthy life. We must take an upstreamist approach when addressing our health system by working to fix health problems at their root cause. n practice this entails advocating for positive environmental policy and taking part in positive social change through anti-racist actions.

1. Using Telehealth to Expand Access to Essential Health Services during the COV D-19 Pandemic, Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html.

2. Opportunities and Barriers for Telemedicine in the U.S. During the COV D-19 Emergency and Beyond, Women s Health Policy, https://www.kff.org/womens-health-policy/issue-brief/opportunities-and-barriers-for-telemedicine-in-the-u-s-duringthe-covid-19-emergency-and-beyond/.

3. UCSF Sustainability Stories, UCSF Office of Sustainability, https://sustainability.ucsf.edu/1.124#: :text=Healthcare%20centers%20are%20the%20second,%2Ddelivery%20rooms%20 %5B1%5D.

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A he i e f hi blica i , i i c k ledge ha Black a d b e le i A e ica a e, ce agai , e e e e ed i h i ali a i a d COV D-19 dea h . Addi i all , Black a d La i e le a e al di i a el liced a d 1 ed c f cial di a ci g i la i .

Da a f Black Li e , a i f ac i i a d cie i h h e e da a a a lf cial cha ge i ead f a a ea f li ical e i , ha e e ed i ila c ce ab he efficac f c ac aci g a f g e a ce 2 a d eilla ce.

A COV D-19 ha c fi ed he c e f cial a d h ical li e , ech l g - ie ed l i ha e e e ged a e e ial f ai ai i g c ec i i be ee e le a d hei l cal e ce . H e e , he ili i g ech l g , e eciall a l i f cial ble , e ac i el i i i e he eed f h e l e able. Beca e hi e e ac a d acial ca i ali ha e de e i ed he a e ial c di i f ld, l e abili i fe e c ibed Black e le a d l -i c e ke .

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