The World Can Show How Pharma Monopolies Aren’t the Only Way to Fight COVID-19

by PRABIR PURKAYASTHA  JULY 9, 2020

Photograph by Nathaniel St. Clair

The U.S. has bought up almost all of the stock of remdesivir from Gilead, making it nearly impossible for this COVID-19 drug to be available anywhere else in the world. After making America sick again, Trump is trying to compensate for his administration’s failure by buying Gilead’s production for the next three months for the U.S., leaving nothing for the rest of the world.

This makes it all the more urgent for India and other countries that featured prominently in previous drug license fights against Big Pharma in the U.S. and around the world for more than a decade to break Gilead’s patent and issue compulsory licenses to manufacture the drug locally. The patent laws of most countries and the World Trade Organization’s 2001 Doha Declaration have clear provisions for compulsory licensing during a health emergency or an epidemic. COVID-19 obviously qualifies on both accounts.

On July 1, the U.S. reached a point of more than 50,000 new COVID-19 cases in a single day, about 23 percent of the 218,000 new cases worldwide that day, making it the global leader on how not to fight the COVID-19 epidemic. As of July 1, Brazil and India were in second and third place, respectively, for new cases.

Remdesivir is the only drug that in drug trials has shown some benefit in fighting the virus infection. Remdesivir works by reducing the replication of the virus in the human body, and this helps in shortening the hospital stay of the patient by about 25 percent. If the patient progresses to a more serious stage, needing oxygen support or ventilation, remdesivir is of little help. Here, anti-inflammatory drugs like dexamethasone become important. Dexamethasone has shown efficacy treating COVID-19 patients in clinical trials, and, unlike remdesivir, it works by reducing lung inflammation arising out of the infection, rather than by fighting the infection itself. Dexamethasone is off-patent and is widely available at low costs.

But if remdesivir cuts down the infectious period, not only is it beneficial to the patients who receive it, but it is also useful for society. By reducing the patient’s infectious period, it lowers the rate of virus transmission.

I have argued previously that after the battle for access to cheap AIDS drugs, the next big battle would be fought over COVID-19 medicines and vaccines. In the World Health Assembly, the U.S. was the only country that opposed the resolution that all medicines and vaccines should be put in a common patent pool, and accessible to all countries at reasonable costs.

We now know the reason for the U.S. opposition. It wants control over medicines and vaccines for the fight against the pandemic. One reason is to make U.S. citizens feel that Trump is looking after them by providing medicines, even if his administration has failed miserably in the fight against COVID-19. The second reason is that by controlling the medicine for the rest of the world, Trump can bargain with them and try to regain the global hegemon status that the U.S. has lost.

With this step, the U.S. has also made clear its intention regarding COVID-19 vaccines. The U.S. has backed a set of five companies with a $13 billion purse, as a part of its Operation Warp Speed to support vaccine development. One of these five is Moderna, a U.S. biotech company, and one of the frontrunners in the current vaccine trials. The other four backed by the U.S. are AstraZeneca (in consortium with Oxford University); Johnson & Johnson; Merck; and Pfizer with BioNTech. If any of these vaccines succeed and others do not, we can expect the U.S. will guard that vaccine as it is doing with COVID-19 medicine in the case of remdesivir. Fortunately for the world, there are a total of 17 vaccines in the World Health Organization’s list of ongoing clinical trials, and another 132 in the pipeline.

Apart from the U.S. buying up almost all of the remdesivir stock, the other issue in making remdesivir accessible to those who need it is the price at which Gilead is selling this drug. For U.S. patients, the cost is about $3,000 for a typical five-day course (which consists of six vials of the drug—two on the first day, and one per day after that). Gilead has granted a handful of licenses to drug manufacturers in other countries—including three Indian companies, Cipla, Hetero and Jubilant—to sell generic remdesivir. This means a full course of remdesivir to Indian patients will cost about $400 (at $66 per vial, for six vials).

What is the actual cost of a course of remdesivir? According to an article in the Journal of Virus Eradication by Hill et al in April, the active pharmaceutical ingredient for one day’s treatment should not cost more than $1. If we add to that the cost of making it into the typical five-day course of six injections, the total cost should not be more than $6. Calculations by two authors from the Institute for Clinical and Economic Review in the U.S. use Hill’s data to estimate that the price of remdesivir for a full course of treatment (they use a longer course of 10 days) in the U.S. should be less than $10.

Why should a full course of remdesivir, costing less than $10 to produce, be priced at $3,000, or 300 times its cost of production, in the U.S.? Even at Gilead’s concessional price of $400 for India, it is still 40 times the cost of its production! Gilead’s argument is that because its medicine decreases the duration of hospitalization, it saves COVID-19 patients about $12,000 each in hospital bills—and by charging only one-fourth of that, even if it is 300 times the cost of production, Gilead is doing the customers a big favor.

As we know from the results of the clinical trials, remdesivir fights the virus, but if the patient becomes seriously ill, it does not have a statistically significant impact on mortality rates. If it did, Gilead’s price probably would have factored in lifetime earnings saved by remdesivir, and its price would probably have been even 10 times higher!

But even if remdesivir becomes significantly cheaper, it is uncertain that it can get to countries outside the U.S. thanks to the U.S.’s plan to buy almost all of Gilead’s stock of the drug. So what can the rest of the world do? It may need to prepare to fight a long battle, as India and other countries did during the AIDS epidemic against the U.S. and its drug cartel allies like Switzerland, France, the UK and Germany.

Big Pharma priced AIDS drugs around $10,000-15,000 for a year’s worth of treatment in the U.S. and Europe, and a ‘concessional’ price of $4,000 for poor countries. Indian companies were manufacturing the generic version of these drugs at a fraction of these prices, but countries who wanted to import AIDS drugs from India faced lawsuits and political pressure from the U.S.

This battle was fought for nearly a decade. In the World Trade Organization’s Doha Round in 2001, the Doha Declaration accepted that in the case of a health emergency or an epidemic, any country has the right to issue a compulsory license for producing lifesaving drugs. And the license to produce the drug could be issued even to a company outside the country’s borders. Indian generic drug manufacturer Cipla could then supply the AIDS drugs at $350 for a year’s course to a number of countries, which would otherwise have been completely bankrupted by patented drugs’ higher prices—or else they would see their AIDS patients die in large numbers without medicines.

The victory to secure cheap generic AIDS drugs sets a precedent for the current pandemic. COVID-19 has already killed an estimated half a million and infected more than 10 million. No one can dispute that is both a health emergency and a pandemic. The remedy of using a compulsory license already exists in most countries’ patent laws and in the Doha Declaration.

Why, then, are other countries not starting the manufacture of remdesivir? Are they hoping that Gilead and the U.S. will behave better than they did earlier during the AIDS epidemic? Or are they afraid of the threat of retaliatory sanctions from the U.S.?

Every year, the U.S. Office of the United States Trade Representative (USTR) issues a Special 301 Report that it has used to threaten trade sanctions against countries that don’t comply with its patents. India figures prominently in this report year after year, for daring to issue a compulsory license in 2012 to Natco to sell the cancer drug nexavar for less than 3 percent of Bayer’s price of more than $65,000 a year. After India issued the compulsory license on Nexavar, Marijn Dekkers, the CEO of Bayer, said, “We did not develop this medicine for Indians… We developed it for Western patients who can afford it.”

In April, Indian Prime Minister Narendra Modi buckled under Trump’s threat and exported hydroxychloroquine to the U.S. even though it was under an export ban at that time. Will he—and the leaders of other countries—be willing to stand up to the U.S. on remdesivir? Or will they agree with Trump that remdesivir should be reserved for only U.S. patients, even if they have the capacity to produce it for their people?

This article was produced in partnership by Newsclick and Globetrotter, a project of the Independent Media Institute.

Tribes Defeat Trump Administration and NRA in 9th Circuit on Sacred Grizzly Bear Appeal

by COUNTERPUNCH NEWS SERVICE JULY 8, 2020

Chief Arvol Looking Horse. Photo: Alter-Native Media.

San Francisco, CA.

The 9^th Circuit Court of Appeals handed tribal nations an overwhelming victory Wednesday (7/8) in its ruling on the Trump administration-led appeal of a US District Court decision on Crow Tribe, et al v. Zinke. Interior Secretary David Bernhardt, the US Fish and Wildlife Service (FWS), and the states of Wyoming, Idaho and Montana sought to reverse the September 2018 ruling by Judge Dana Christensen that returned the grizzly bear in the Greater Yellowstone Ecosystem to Endangered Species Act (ESA) protections.

It was the second major defeat of the week for the Trump administration, following Judge James Boasberg’s ruling in US District Court in DC that the Dakota Access Pipeline had to be shut down pending an environmental review. The Standing Rock Sioux Tribe is a plaintiff in both cases.

The 9^th Circuit panel upheld Judge Christensen’s ruling, and validated key arguments made on behalf of the 17-member tribal plaintiff alliance, who again prevailed over intervenor-defendant-appellants, Safari Club International, the NRA, and a coalition of trophy hunting organizations, Big Ag, and ranching interests.

Tribal plaintiffs raised serious concerns about the FWS’s acceptance and facilitation of state-sponsored trophy hunts of the grizzly, and the impact those hunts would have on the already fragmented grizzly population. Tribes contended that trophy hunts would end any credible possibility of linkage zones between the Yellowstone and Northern Continental Divide Ecosystem populations and would further diminish genetic diversity in these ostensibly island populations. Both would make actual recovery untenable.

The Appellate panel agreed that the Trump administration’s Department of Interior had failed to adhere to its criteria of using “the best available science” in its decision-making process.

“Because there are no concrete, enforceable mechanisms in place to ensure long-term genetic health of the Yellowstone grizzly, the district court correctly concluded that the 2017 Rule is arbitrary and capricious,” the panel wrote in its decision.

Tribal grizzly bear treaty. Photo: Alter-Native Media.

Several of the indigenous community’s most-respected spiritual leaders are among the tribal plaintiffs, including Chief Arvol Looking Horse, Blackfeet Sun Dance leader Nolan Yellow Kidney, Zuni Religious Society headman, Kenny Bowekaty, and Cheyenne Sun Dance Priest, Don Shoulderblade. The tribal movement to protect the grizzly began when Shoulderblade founded GOAL Tribal Coalition.

The spiritual leaders all attested to the immense cultural significance of the grizzly bear. The abrogation of the American Indian Religious Freedom Act by the federal government in its attempts to delist and trophy hunt the grizzly was a significant element in tribes’ opposition.

“The grizzly bear is revered as sacred in a multitude of tribal cultures. The grizzly is our relative, a grandparent. For us at Hopi, the grizzly is our brother; a teacher of ceremonial and healing practices,” said Ben Nuvamsa, spokesman for the Hopi Bear Clan. “We don’t trophy hunt our grandparents. To some tribes, the grizzly is a deity. How can the trophy hunting of a deity not impact your religious and spiritual freedoms?” he asked.

Both tribal and environmental plaintiffs argued that FWS prioritized political favor, not science or the established regulatory mechanism, and “gerrymandered” data and its population estimates to fit the Trump administration’s fossil-fuel-oriented agenda. The 9^th Circuit found that FWS’s failure to fully commit to recalibration should new methods of population estimates be employed by the three states – each of which Trump carried in 2016 – again contravened the ESA:

“The FWS violated the ESA’s directive to make listing decisions ‘solely on the basis of the best scientific and commercial data’ when it failed to include a commitment to recalibration despite the FWS’s acknowledgment that a failure to provide such provision could threaten the Yellowstone grizzlies.”

The panel also noted how the states of Wyoming, Idaho and Montana were “deeply involved in the adoption of the Conservation Strategy” and how they “objected to any recalibration commitment.”

Despite petitions led by then-Oglala Sioux Tribe President, John Steele, and present Vice President, Tom Poor Bear, tribal nations were omitted from participating in the formulation of the Conservation Strategy, which was one of numerous violations of the federal-Indian trust responsibility committed by Interior.

Throughout the struggle, tribal plaintiffs emphasized that the Trump administration’s determination to delist the grizzly bear in Greater Yellowstone was a “Trojan Horse” with far-reaching consequences beyond the matter of federal protections for the Great Bear.

The federal government failed to uphold government-to-government consultation mandates, and the record demonstrates that it did not engage in “thorough” or “meaningful” consultation, but instead offered “alternative facts” to the media, which resulted in one tribal plaintiff, the Northern Arapaho Elders Society, filing a cease and desist order.

As the 9^th Circuit highlighted, the states of Wyoming, Idaho and Montana were instrumental in formulating the post-delisting policies and regulations. Documentation exposes how FWS wanted tribal nations with grizzly bear populations on their lands to adopt what were essentially state management plans which would, stated plaintiffs, have undermined tribal sovereignty, and set a “dangerous precedent.”

The federal government has long acknowledged that Greater Yellowstone is ancestral land to some 27 tribal nations, the Pawnee being the latest to be recognized. Prior to taking the issue to federal court, tribal plaintiffs explained how removing ESA protections from the sacred grizzly bear would concurrently remove protections from their sacred lands, and open the door to extractive industry and livestock interests to exploit a greatly diminished regulatory process for land leases. Several tribal organizations testified to this at a fall 2018 US Senate Environment and Public Works Committee hearing.

“This is a historic day for tribal nations,” said Chief Stan C. Grier, Chief of the Piikani Nation. “Today I once again ask President Trump and Interior Secretary Bernhardt, a veteran fossil fuel lobbyist, this question: How can you possibly manage the sacred? One cannot manage the sacred; one seeks, reveres, and stands humbled by the presence of the sacred.”

“To the People of the Land, our tribal nations, our relatives, this momentous decision is a step towards reclaiming that which was taken from us. The future of my children and grandchildren, and yours, depends upon us protecting the environment and halting climate change. The grizzly bear is foundational to that fundamental struggle,” stressed Grier.

Grier became a prominent voice in the grizzly cause. The Piikani Nation introduced the “Grizzly Treaty,” which is now the most-signed tribal treaty in history with over 200 tribal nation signatories. The treaty was authored by Rain Bear Stands Last, then-chief of staff to Grier, who is now executive director of the Global Indigenous Council. Rain managed the tribal plaintiffs’ litigation with lead counsel, Jeff Rasmussen, of Patterson, Earnhart, Real Bird and Wilson, LLP. He also directed the short film, Not In Our Name, that was entered into the Congressional record at a May 2019 hearing on the grizzly bear.

The tenets of the Grizzly Treaty inspired The Tribal Heritage and Grizzly Bear Protection Act that was introduced by House Natural Resources Committee Chairman, Congressman Raul Grijalva (D-AZ).

“Make no mistake, this is a seminal case and moment for Indian Country. Look at the forces arrayed against us, and yet we prevailed. We not only saved the sacred grizzly bear, we saved our religious freedoms, our ancestral lands, and defended tribal sovereignty and our treaty rights. We held this administration accountable for its failure to uphold the federal-Indian trust responsibility,” said Tom Rodgers, President of the Global Indigenous Council.

Images courtesy of Alter-Native Media.

Back on the List: A Big Win for Yellowstone Grizzlies and the Endangered Species Act, a Big Loss for Trump and Its Enemies

by MIKE GARRITY – ERIK MOLVAR JULY 9, 2020

Yellowstone Grizzlies. Photo: National Park Service.

The Ninth Circuit Court of Appeals issued a ruling today on the litigation over the 2018 de-listing of the Yellowstone grizzly bear population under the Endangered Species Act, affirming a District Court order that blocked the de-listing of the great bears and kept them listed as a ‘threatened species’ under the Endangered Species Act. Today’s ruling keeps grizzly bears under federal management, and blocks sport hunting of the bears in Montana, Idaho, and Wyoming.

This is a major victory for the embattled Yellowstone grizzly bear population, and a big win for science.  The court clearly recognized that the Fish and Wildlife Service was bowing to political pressure from the states in stripping grizzlies of their ESA protections, while ignoring the very clear scientific evidence that this bear population is too small and too isolated to be assured of long-term survival.

The Circuit Court ruled that because there were no concrete, enforceable mechanisms in place  to ensure long-term genetic health of the Yellowstone grizzly, the district court correctly concluded that the 2017 Rule was arbitrary and capricious in that regard. The Circuit Court also affirmed that “FWS’s decision to drop the commitment to recalibration in the conservation strategy violated the ESA because it was the result of political pressure by the states rather than having been based on the best scientific and commercial data.

The Ninth Circuit’s ruling is very important because the Yellowstone grizzly bear population is expanding but not growing. The population has not been growing for the last 20 years.  Grizzlies are expanding because their food sources are declining, whitebark pine trees and Yellowstone cutthroat trout populations have been decimated.  Yellowstone grizzlies have been moving out of their core habitat in a desperate search for food.  As these bears move out to their former habitat.

Montana, Idaho, and Wyoming are desperate to start shooting grizzly bears which still need to be protected because they will not be recovered until we have one connected population.  The current situation of isolated populations will lead to inbreeding. Once a population is inbred, it is finished.  We are thrilled that the Ninth Circuit ruled that the Endangered Species Act requires that species be managed based on science, not politics.

The plaintiff group of Alliance for the Wild Rockies, Western Watersheds Project, and Native Ecosystems Council was one of five conservation and tribal plaintiff groups (plus one individual) who sued to reverse the de-listing of the Yellowstone grizzly bear population, winning a District Court victory in 2018. They were opposed by state and federal governments and trophy hunting
groups including the National Rifle Association and Rocky Mountain Elk Foundation, seeking to strip grizzlies of protection.

COVID-19 Exposes the Weakness of a Major Theory Used to Justify Capitalism



by RICHARD D. WOLFF

Photograph by Nathaniel St. Clair

A cornerstone of orthodox economics is the idea that capitalists’ decisions about investing and producing are inherently “efficient.” This means that capitalists select among all alternative courses of action those whose costs are minimal and whose benefits are maximal. Keeping costs to the lowest possible level while producing goods and services that yield the most possible revenue is what maximizes profit, the difference between costs and revenues. Capitalism, we are told, is the best system because it drives all those in charge of production (the owners and top executives of enterprises) to maximize profits and thus economic efficiency. Capitalists get profits, and the rest of us benefit from the efficiency of production within a capitalist system.

COVID-19 exposes the sham of orthodox economics. It was not profitable for capitalists to produce and stockpile adequate quantities of tests, masks, gloves, beds, etc., to be prepared for the virus. Given the costs to produce these commodities, there was no way of knowing how long they would need to be stockpiled before there would be a demand for and purchase of them. Stockpiling costs. So do monitoring stockpiles for deterioration and replacing deteriorated stocks or insuring against deterioration. There was, in short, no way to know (and thus be able to calculate) the costs in the manner fantasized by orthodox economics.

Likewise, there was no way for capitalists to know or calculate the prices they might receive for selling the commodities they might stockpile. If no major disease arrived, revenues might be very small and take a long time to materialize. If a pandemic arrived, high prices might be charged, but when? If a national emergency brought in the government as the single buyer of such commodities (then delivered freely to the people in need), the prices would likely be much lower. If the United States cooperated with other countries on producing and distributing these commodities, and if such cooperation included pricing, that too would impact revenues from selling them. In short, capitalists cannot know or calculate revenues in the manner fantasized by orthodox economics.

Capitalists in general—and U.S. capitalists in particular—calculated that profits would be greater in other investments than those that could have produced the items needed to prepare for and contain COVID-19. The results (negative revenues) of having inadequately prepared and inadequately contained COVID-19 far outdistance whatever it might have cost to make adequate preparations. Efficiency in dealing with the pandemic was not what capitalism achieved: quite the opposite.

Most orthodox economics textbooks—those actually used now in most college and university economics courses—teach the simple-minded cost-benefit or cost-revenue “model” as if it captured capitalists’ decision-making. Profit-maximizing capitalism is thus justified, as “efficient” society gets the most return for the least effort. The magical sleight of hand here requires that students be told that the model captures the essence of what capitalists actually do.

But that is false. The model captures nothing of the irreducibly unknown and unknowable in both costs and revenues. Instead, the model blithely assumes the opposite, that costs and revenues are in general knowable and known. Only then can the textbook claim that capitalism is efficient. And that is the point of the model and of the textbook: to justify and rationalize a capitalism that would otherwise risk the exposure that COVID-19 now performs.

Actual capitalists know perfectly well how they must constantly guess about costs and revenues, how their guesses are often wrong, and how the fortunes of their enterprises rise and fall as their guesses encounter realities. The difference between economics textbooks and capitalist reality explains the difference between academic departments of economics and “business schools.” Most U.S. universities include both. They don’t have two history or anthropology or English departments. There is a reason for two separate faculties: In economics departments, capitalism is justified and rationalized by “models” such as those based on calculating costs and benefits. In business schools, the models are mostly ignored in favor of examining how to run actual businesses confronting irreducible unknowns (not only in costs and revenues but also in personnel management, enterprise organization, and financing).

One desperate effort of orthodox economics to banish the unknown from their models is worth considering because it seems to have persuaded some. They can admit that the costs and revenues they refer to are not known for certain, but that the “probability” of specific costs and revenues occurring can be known. We can then speak, they tell us, of costs and revenues that are 50, 30, or 1 percent certain, and that can then allow for efficient capitalist decisions based on the known probability of outcomes.

This is yet more magical sleight of hand. Simply put, to know the probability of any specific cost or revenue requires that we know the full range of possible costs or revenues and how frequently each specific cost occurs (how costs are “distributed” across all possibilities). But that is precisely what is not known or knowable. Poor capitalists: in fact, they can know neither what their costs and revenues are nor what all the possible costs and revenues might be nor what probability attaches to each of them. Uncertainty and unknowability are irreducible; they always were.

Thus capitalism does not generate, let alone guarantee efficiency. It’s all a mirage of ideological justification. Capitalism serves capitalists first and foremost. That minority occupies or selects the occupants of most of the dominant positions in society. In this they are like the masters and lords in slave and feudal societies. In those societies, the self-justification of their dominant minorities concerned their physical, mental, or moral superiority and/or their special relationship to God or Gods. Capitalist societies that broke from slave and feudal predecessors also rejected those systems’ self-justifications. Capitalism had to find a different kind of self-justification.

It found one: the fantasy of “efficiency” as guaranteed by capitalists’ profit maximization. We are all supposed to bow down to capitalism the way our ancestors bowed down to slave masters, feudal lords, and kings. COVID-19 exposes what is at stake in continuing to believe in this fantasy.

For centuries, capitalists undertook investments that were “profitable” only because they did not know (and thus miscounted or ignored) all the ecological costs entailed. It was capitalists who moved enterprises from one part of the world to another for higher profits who did not know (and thus did not take into account) the social and human costs involved. It was capitalists who found more profitable investments than to prepare for and stockpile the needed protective equipment to defend public health against COVID-19. They did not know either.

Moreover, it was partly belief in the fantasy—that private profit-driven enterprise is the “most efficient” economic system—that hobbled governments around the world. They did far less than they could and should have done to compensate for capitalism’s failures adequately to prepare for or contain the virus. Across the globe, the more entrapped in that fantasy (as in the U.S., the UK, and Brazil), the worse the death and destruction of COVID-19. Where entrapment was less (as in New Zealand, Vietnam, and Japan)—sometimes because of competing traditional values not or not yet displaced by the capitalist fantasy—death and destruction were minimized.

A positive outcome of the coronavirus disaster would be a wider appreciation that liberating ourselves from capitalism requires rejecting its self-justifying ideology of efficiency.

This article was produced by Economy for All, a project of the Independent Media Institute.

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More articles by:RICHARD D. WOLFF

Richard Wolff is the author of Capitalism Hits the Fan and Capitalism’s Crisis Deepens. He is founder of Democracy at Work.

THIRD WORLD USA
Racial disparities follow pandemic’s path across political divide

No matter where the virus strikes, communities of color bear the brunt.
People wait for a distribution of masks and food in the Harlem neighborhood of New York City. | AP Photo/Bebeto Matthews

FEATURE ARTICLE LONG READ 

By LAURA BARRÓN-LÓPEZ, ELENA SCHNEIDER and ALICE MIRANDA OLLSTEIN
07/08/2020 POLITICOhe story of Covid's trajectory isn’t blue to red. It’s Black and brown.

As the virus has shifted from coastal big cities to conservative states, political pundits and analysts have declared that “Trump country” is under siege.
But the politicization of the pandemic hides an enduring reality: It’s Black, Latino and Native American populations that are bearing the brunt of the disease.

“Despite the shift to red states, it's clear that the disproportionate impact is taking place in communities of color,” said Greg Millett, an epidemiologist and director of public policy at amFar, an AIDS research group that is monitoring the pandemic’s impact on minorities. “The one constant for this whole COVID-19 crisis is that communities of color remain at highest risk.”

The rapid rise of cases and hospitalizations in red states fed speculation that the economic and cultural fault lines that emerged early in the pandemic would disappear — that the spreading illness would elicit a more comprehensive response from the administration. Instead, over the July 4 holiday President Donald Trump again downplayed the virus’ danger, saying almost all cases were “totally harmless.”

They aren’t. From New York and California to Texas and Arizona — in urban and rural areas alike — people of color are suffering at greater rates, according to county data, state analyses provided to POLITICO by public health researchers, and interviews with more than a dozen experts. And ongoing gaps in data collection and lagging access in “testing deserts” make it hard to know truly how deep the problem runs.Minority populations have long been underserved by health care and overburdened by the chronic diseases that heighten risk for coronavirus — a result of generations of racial inequities, high uninsurance rates, crowded housing and other social factors that contribute to poor health. The fact that minorities make up a disproportionate share of essential workers — who can’t work safely at home during the pandemic — adds even more risk.

“It's not that somehow we're genetically inclined to get [coronavirus],” said Millett.

Not only are infections high among minorities, but a report in late June from the Centers for Disease Control and Prevention found that Black and Latino Americans with coronavirus have been hospitalized at nearly five times the rate of white people. For Native Americans, the hospitalization rate is six times greater.Arizona is a case in point. The state, where Trump made a campaign stop last month, has one of the highest caseloads in the country right now, and Latinos have been hard hit. In Maricopa County, which includes Phoenix, Latinos make up just under one-third of the population but account for half of the infections and 39 percent of hospitalizations. Nearly half the reported cases lack data on race and ethnicity.

Inequities are evident in less populated areas, too. Black Americans are nearly three times more likely than whites to live in rural testing deserts where deaths are increasing, said Sema Sgaier, executive director of the Surgo Foundation, which has been tracking access to tests. The vulnerability of rural regions is based on an index factoring in income, education, racially marginalized status, health care system and underlying health conditions.

In Florida, for instance, the foundation found that 59 percent of Latinos and 70 percent of Black people live in census tracts — statistical subdivisions of counties that better reveal disparities — are more vulnerable to coronavirus. That’s a big over-representation given that Hispanics account for 25 percent of Florida’s population and African Americans 15 percent. In Arizona, 39 percent of Latinos and 71 percent of Native Americans live in vulnerable census tracts compared with 17 percent of white Arizonans.

“Not only are things getting worse but they’re getting worse-er for minority communities,” said Jorge Caballero, a Silicon Valley-based doctor and data analyst. “And when you zoom in to specific areas [you] get a picture of why this may be happening.”
Underneath the Red and Blue

In interviews, local doctors, officials and community advocates across Republican-led states said the mixed or diluted messages on masks and social distancing from state and federal leaders have made the crisis worse. They also noted that the virus has disproportionately slammed communities of color in red states that have not expanded Medicaid under Obamacare — leading many to delay seeking out health care until they're seriously ill.

In Alabama, which hit record hospitalization rates recently, Black people are 27 percent of the population — and nearly 45 percent of coronavirus deaths. Alabama’s governor has urged, but not mandated, wearing masks.

“The health disparities here in Alabama with regard to health care access was already a significant problem, and Covid-19 just made it worse,” said Dr. Ricardo Franco, a professor of medicine at the University of Alabama at Birmingham. “Basically, if you’re Black in Alabama, you’re almost twice as likely of dying of Covid-19 than if you’re white.”

Arkansas, which like much of the South dodged the worst of the pandemic in the spring and did not have a stay-at-home order, has seen cases nearly double over the past three weeks as more businesses reopened. No community has been harder hit than Latino and Marshallese workers in the northwest part of the state.

“We were not prepared to handle this pandemic at all, but we were especially unprepared to protect these minority groups,” said Greg Leding, a Democratic state senator who represents the area.

Latinos make up about 8 percent of the state’s population, but a fourth of coronavirus cases. Marshallese and other Pacific Islanders make up less than a half a percent of the population — and 7 percent of cases.

Mireya Reith, executive director of the immigrant advocacy group Arkansas United hopes the recent deployment of a CDC team to investigate disparities will mark a turning point. Inadequate testing and outreach to Arkansans of color early on, combined with a high proportion of essential workers unable to stay at home, fueled the spread.

“We weren’t counted. Data wasn’t collected. There was no information available in other languages,” she said. The outbreak, she added, “was preventable.”

The Arkansas health department confirmed that just five of its roughly 200 contact tracers speak Spanish and only one speaks Marshallese — though they will soon hire hundreds more tracers, some bilingual. Additionally, phone alerts that went out as part of contact tracing were all in English until a Spanish option was added June 6. There are still no alerts in Marshallese, isolating a population that migrated here in large part after U.S. nuclear tests left their homeland awash in radiation. The five-person CDC team dispatched to the state plans to share its findings soon on how to mitigate spread "specifically within the Hispanic and Marshallese populations,” the state’s health department told POLITICO.

Melisa Laelan, executive director of the Arkansas Coalition of Marshallese, surveyed nearly 1,000 Marshallese households and found that more than 80 percent had a family member designated an essential worker. More than half had a family member with diabetes, obesity or high blood pressure, conditions that increase their risk of death from Covid-19. Adding to their vulnerability, Marshallese were cut off from Medicaid during the 1990s.

“I had to leave Facebook because I couldn’t bear it anymore to see that we were losing so many important community members," Laelan said.

In Florida, where Trump is set to visit Friday for a briefing on drug trafficking, cases have surpassed 220,000. Coronavirus deaths in heavily Latino counties in Florida are occurring at twice the rate of other counties. In Texas, which Vice President Mike Pence visited last week, deaths in disproportionately Latino counties are occurring at 1.2 times the rate of other counties, according to an amFar analysis.

Two public hospitals in Houston that serve majority-minority, largely uninsured populations feel the racial disparity acutely. Nearly two-thirds of the coronavirus patients in the intensive care unit at Ben Taub and Lyndon B. Johnson hospitals are Latinos, said Dr. Esmaeil Porsa, CEO of Harris County Health System. Most counties talk about an infection curve; Porsa said Harris County’s is a “straight line up.”

Cases are hitting record levels in some Democratic-led states too, notably California. But the different political sensibility didn’t shield people of color.

Los Angeles County is a big, racially mixed area. In the mostly white Santa Monica Mountains, cases per 100,000 rose sixfold from mid April to the end of June. But the rate of infection was even higher in majority Black and Latino cities, according to an analysis by Advancement Project California for POLITICO.

In San Jose Hills, where Latinos account for roughly 85 percent of the population, the number of cases per 100,000 was 143 times greater than it was during the second week of April. In Willowbrook, one of the communities in L.A. County with the highest percentage of Black residents, the rate of infections per 100,000 was 22 times greater in the third week of June than in early April.

Muddled messaging from the top

As cases surged across the South and Southwest in June, the response from state leaders was slow and inconsistent, some local and public health officials said. Republican governors have largely mirrored Trump’s response, declining to mandate masks or imposing and extending stay-at-home orders.

Some governors, despite earlier resistance, have paused or reversed reopening certain businesses in recent weeks, including those in Alabama, Arkansas, Arizona and Florida.

In Texas, Gov. Greg Abbott, after opposing mask mandates and even banning cities from enforcing such rules, changed his mind as hospitals reached capacity. He issued a statewide mask mandate, and expressed regret for reopening bars.

"It's really been inconsistent messaging that has made things complicated, if not dangerous," said Harris County Commissioner Adrian Garcia.

In that county, Latinos make up more than 60 percent of the cases — and 40 percent of the county's population, said Harris County Judge Lina Hidalgo.

“I’ve said: ‘Wear your MAGA mask,’” Hidalgo, a Democrat, added. "This is not about politics.

In Alabama, “our state leaders have taken their cues from national leaders,” said Montgomery Mayor Steven Reed, who added that in June, 70 percent of new cases in Montgomery County were among Black people. He instituted a citywide mask mandate in mid-June, although Republican Gov. Kay Ivey hasn’t done so statewide.

In Arizona, Gov. Doug Ducey’s decision in late May to allow the state’s stay-at-home order to expire may have disproportionately hurt minorities — predominantly Native American and Hispanic populations saw a case rate 40 percent higher than the rest of the state.

“Our analysis strongly suggests that Arizona’s premature reopenings worsened racial disparities in the state, with Native Americans feeling the brunt,” said Sgaier of Surgo Foundation.

A spokesman for Ducey’s office said his administration has "continued to enhance the [state's] guidance, including enforcement and mitigation efforts," adding that it emphasized getting resources to the hardest-hit communities, including the Navajo Nation and minority neighborhoods in Phoenix.
‘People can’t ignore it anymore’

As early as April, the virus’ onslaught on African Americans in Michigan, New York and Wisconsin led public health experts to warn of what could be in store for minority communities. By mid June, cases among Latinos — who disproportionately work in essential services like agriculture, meatpacking and hospitality — started to skyrocket across the country.

“All Covid did was accelerate the inequities that we already know,” said Martha Moore-Monroy, a public health lecturer at the University of Arizona, whose work focuses on improving health in underserved communities. “People can’t ignore it anymore.”

Daniel Dawes, director of the Satcher Health Leadership Institute at Morehouse School of Medicine, is crafting a national plan to address the uneven impact of coronavirus on minorities — trying to change a pattern of inequality that has been a hallmark of other public health crises.

The three-year initiative, which has a $40 million grant from the federal Department of Health and Human Services and includes a network of national and local health organizations, will start in the South. It will gather research and aid Black communities in Georgia, address outbreaks among incarcerated populations in Louisiana, and improve health and information dissemination in Navajo Nation and among migrant workers in Texas. By Year Two, Dawes hopes to focus on vaccine education and access.

In the meantime, local officials are getting creative. In Georgia — where Black people make up a third of the population but nearly half the Covid deaths — DeKalb County chief executive Michael Thurmond realized he needed a better messenger for young people.

“They’re not listening to an old guy like me,” said Thurmond, who asked rapper Killer Mike to cut a PSA for Black radio stations. He did the same with a Spanish-language ad for Latino radio stations, featuring local DJs and radio personalities.

In Arizona, educating and testing rural populations remains a lonely battle, said Amanda Aguirre, president and CEO of the Regional Center for Border Health. The nonprofit health provider makes up roughly 80 percent of the coronavirus testing in majority-Latino Yuma County. As infections have quickly increased, Aguirre said, they’re seeing more children and pregnant women affected.

“I don't know whether we can stop it at this point,” she said. “This whole epidemic has brought us to our knees.”

Maya King contributed to this report.

THIRD WORLD USA
Stark racial disparities emerge as families struggle to get enough food

The pandemic has left Black and Hispanic households much worse off than white families.


People line up for a Chicago food giveaway sponsored by the Greater Chicago Food Depository in May. | AP Photo/Charles Rex Arbogast

By HELENA BOTTEMILLER EVICH
07/06/2020 

Nearly four in 10 Black and Hispanic households with children are struggling to feed their families during the coronavirus pandemic — a dramatic spike that is exacerbating racial inequities and potentially threatening the health of millions of young Americans.

The percentage of families who are considered food insecure has surged across all groups and is already much higher than during the depths of the Great Recession, according to new research by economists at Northwestern University based on Census Bureau data.

But Black and Hispanic households with children are now nearly twice as likely to be struggling with food as similar white families. The wide racial gaps have persisted week to week throughout the pandemic, according to the analysis, first shared with POLITICO. The gap between Hispanic and white households now also appears to be worsening.

The figures are based on weekly surveys conducted by the Census Bureau — a little-noticed data tool that’s giving a near real-time look at the economic fallout of the pandemic as well as the stark racial disparities emerging.

Economists who closely track the numbers have been deeply concerned by the rise in rates. They are particularly dismayed that the figures are so high even after Washington has spent hundreds of billions of dollars on additional unemployment insurance and other forms of aid.

“This is uncharted territory,” said Diane Whitmore Schanzenbach, an economist and director of the Institute for Policy Research at Northwestern University. “We’ve never seen food insecurity rates double, or nearly triple — and the persistent race gaps are just appalling.”

The high levels of food insecurity do not appear to be improving even as some states reopen. The report comes as Democrats on Capitol Hill are again trying to get a 15 percent increase in food stamp benefits into the next coronavirus aid package. Republicans, however, have repeatedly refused to include it.

When it comes to food insecurity, policymakers tend to pay special attention to households with children. Hunger among children can cause behavioral problems and lowered academic performance, which can lead to lifelong setbacks.

The government defines food insecurity as a household that’s either uncertain about or unable to get enough food to feed everyone under their roof at some point during the year because of a lack of money. During the pandemic, the Census Bureau has been asking households about their ability to access food and feed their households during the past seven days.

Economists at Northwestern have been analyzing the government’s weekly survey data and translating the figures so the findings can be compared to historical trends.


Cars line up to receive food during a donation drive in Baltimore. | AP Photo/Julio Cortez

The last time the government formally measured food insecurity nationally was in 2018. At that time, about 25 percent of Black households with children were food insecure. Today, the rate is about 39 percent, according to the latest analysis by the Northwestern economists, which is set to be published this week. For Hispanic households with kids, the rate was nearly 17 percent in 2018. Today, it is nearly 37 percent.

The rate for white households with children is significantly lower at 22 percent. Still, that is more than double what it was before the pandemic and much higher than it's been since the government began measuring food insecurity two decades ago.“There’s just appalling levels of food insecurity and it’s clear there’s a disproportionate impact,” said Geri Henchy, director of nutrition policy and early childhood programs, at the Food Research & Action Center, an advocacy group based in Washington. “It’s infuriating.”

When the earliest food insecurity estimates for children came out, about six weeks into the pandemic, the numbers were so high that anti-hunger advocates and some economists thought they had to be wrong. But the early numbers have since been backed up by other national surveys. 

In late April, one large national survey found that more than 17 percent of mothers reported that their children under the age of 12 were not getting enough to eat because the family couldn’t afford enough food — a 400 percent increase from the government’s last estimate in 2018.

Asking specifically whether children in the household are getting enough to eat, rather than asking generally about access to food for the household, is an important distinction. Even in food insecure households, adults tend to shield children from going without food by skipping meals themselves or making other sacrifices. That can make it difficult to suss out the direct effects of economic woes on young people.

But a few weeks ago, the Census Bureau added a specific question to its weekly survey to ask whether children in the household were “not eating enough” because the family couldn’t afford enough food in the past week.

As the results have been released, the numbers are alarmingly consistent: About 16 percent of households with kids were reporting that children were not eating enough in the previous week, according to an analysis by the Brookings Institution’s Hamilton Project to be released this week.

The racial disparities are stark, with 29 percent of Black households and 24 percent of Hispanic households reporting that children were not eating enough, compared with 9 percent of white households, according to the forthcoming report. For all groups, those levels are extremely high compared with before the pandemic.

Before Covid-19 hit, food insecurity rates had been falling across all groups over the past several years, although major racial disparities have persisted for decades. Black households with children have about double the rate of food insecurity compared to white households with children.

Rates for Hispanic households have varied somewhat. At some points in the wake of the Great Recession, for example, Hispanic families with children had higher rates of food insecurity than Black households with kids. But as the economy improved, the picture improved much faster for Hispanic families than for Black ones.