Dr. Fauci says the coronavirus is 'shining a bright light' on 'unacceptable' health disparities for African Americans

BUSINESS INSIDER APRIL 8, 2020

Director of the National Institute of Allergy and Infectious Diseases at the

 National Institutes of Health Anthony Fauci walks on the North Lawn 

outside the West Wing at the White House, after TV interviews Thursday,

 March 12, 2020, in Washington.

 (AP Photo/Manuel Balce Ceneta) Associated Press

Dr. Anthony Fauci struck an emotional tone when discussing the disproportionate death toll facing African Americans from COVID-19 during Tuesday's White House Coronavirus Task Force press briefing.

"And the reason I want to bring it up, because I couldn't help sitting there reflecting on how sometimes when you're in the middle of a crisis, like we are now with the coronavirus, it really does have, ultimately, shine a very bright light on some of the real weaknesses and foibles in our society," Fauci said.

Fauci said mortality rates and ICU intubations are higher among African Americans because of a greater prevalence of "underlying medical conditions — the diabetes, the hypertension, the obesity, the asthma."

Serving as director of the National Institute of Allergy and Infectious Diseases (NIAID) since 1984, Fauci recalled the bulk of his career's work, which has focused on HIV/AIDS.

" ... [I]f you go back then during that period of time when there was extraordinary stigma — particularly against the gay community — and it was only when the world realized how the gay community responded to this outbreak with incredible courage and dignity and strength and activism, that I think that really changed some of the stigma against the gay community, very much so."

Dr. Anthony Fauci took time to look at the big picture of broader societal problems during Tuesday's White House Coronavirus Task Force press briefing, delving into how African Americans have been harder hit by the coronavirus in terms of ICU intubations and a mounting death toll compared to the rest of the population.

In Chicago, more than half of all COVID-19 positive test results and 72% of virus-related deaths have been among African Americans, who make up just 32% of the city's population and 15% for the entire state of Illinois.

In Wisconsin, the numbers have been even more disproportionate. Seventy-three percent of all COVID deaths in Milwaukee County have been among black people, who otherwise make up under half of all positive test results and just 28% of the county's total population.

Fauci raised the subject after President Donald Trump left the briefing halfway through on Tuesday evening.

"And the reason I want to bring it up, because I couldn't help sitting there reflecting on how sometimes when you're in the middle of a crisis, like we are now with the coronavirus, it really does have, ultimately, shine a very bright light on some of the real weaknesses and foibles in our society," Fauci said.

"As some of you may know, the greater proportion of my professional career has been defined by HIV/AIDS, and if you go back then during that period of time when there was extraordinary stigma — particularly against the gay community — and it was only when the world realized how the gay community responded to this outbreak with incredible courage and dignity and strength and activism, that I think that really changed some of the stigma against the gay community, very much so," Fauci added.

"I see a similarity here because health disparities have always existed for the African American community," he said. "But here again, with the crisis, how it's shining a bright light on how unacceptable that is."

Fauci, along with Dr. Deborah Birx, noted that there are no biological reasons why African Americans are dying at higher rates from COVID-19.

Fauci said that it's not the case that African Americans are getting infected more often, but said that prevalence of "underlying medical conditions — the diabetes, the hypertension, the obesity, the asthma" lead to higher ICU and death rates.

Trump also briefly addressed the topic, saying the virus' impact has been "disproportional," but that more research needs to be done to determine why.


Not all states count a patient's race upon hospitalization or death.

At New York Gov. Andrew Cuomo's press briefing on Tuesday, his top adviser Melissa DeRosa said state officials have been contacting local coroners to determine demographic information about those dying from COVID-19.

Fauci later told a reporter that the trend is not limited to particular cities or states.

"The underlying reason why that is happening does not change from state to state," Fauci said.

The disproportionate impact should be a call for broader action once the dust settles, he noted earlier.

"So when all this is over — and as we said, it will end, we will get over coronavirus — but there will still be health disparities, which we really do need to address in the African American community."

Why African Americans are dying at higher rates from COVID-19

AFP / JEFF KOWALSKYThere is no nationwide data available on COVID-19 cases by race, but a pattern of over-representation by black Americans has emerged in states or jurisdictions that are sharing the numbers

The new coronavirus isn't biased about who it infects -- so why does data emerging from some states suggest that African Americans are bearing the brunt of the pandemic in the US?

Experts say blacks are disproportionately impacted by underlying health conditions linked to poverty, face discrimination in medical care, and are more likely to work jobs that require them to leave their home.

"We know that blacks are more likely to have diabetes, heart disease, lung disease," the nation's top doctor, Surgeon General Jerome Adams told CBS News on Tuesday.

These chronic illnesses, which are in turn linked to poverty and structural racism, can lead to more serious forms of the COVID-19 disease.

Adams, who is himself black and has high blood pressure and asthma, added: "I represent that legacy of growing up poor and black in America.

"And I, and many black Americans, are at higher risk for COVID."

- Emerging trend -

AFP / SAUL LOEBPeople wearing masks to try and prevent the spread of COVID-19 leave a supermarket in Washington, DC, April 7, 2020

There is no nationwide data available on COVID-19 cases by race, but a pattern of over-representation by black Americans has emerged in states or jurisdictions that are sharing the numbers.

Sixty-eight percent of coronavirus deaths in Chicago have been among African Americans, who make up just 30 percent of the city's population.

"Those numbers take your breath away," the city's mayor Lori Lightfoot said Monday at a coronavirus briefing. "This is a call to action for all of us."

The trend is repeated in North Carolina, Louisiana, Michigan, Wisconsin and the capital Washington.

Doctor Georges Benjamin, executive director of the American Public Health Association, told AFP the issue was also linked to social class, with black people more likely to work jobs deemed essential that expose them to potential infection.

"That population is more public facing," he said. "More bus drivers, more people taking public transportation to work, more people providing services in nursing homes, more folks working in grocery stores."

- Structural bias -

AFP / KAMIL KRZACZYNSKIA man waits in long line to vote in a presidential primary election outside the Riverside High School in Milwaukee, Wisconsin, on April 7, 2020

The problem is compounded by implicit and explicit bias that African Americans face in the medical system.

Doctor James Hildreth, president of the historically black Meharry Medical College in Nashville, Tennessee told AFP that in his city, most of the initial testing took place at Vanderbilt University Medical Center.

Most of the patients who go to hospital systems like these have insurance, and it was only recently that three assessment centers run by the city of Nashville were built for the underprivileged and minority communities -- one of them located at Meharry's campus and run by its staff.

"My point is, depending on which community you live in, and whether or not you have insurance... the chances for getting assessed are much less," he said.

What's more, it's well documented that when black people seek care, they are less likely to have their symptoms believed or get adequately treated, Doctor Ebony Hilton, an anesthesiologist at the University of Virginia Medical Center told AFP.

For example, black women are less likely to have their breast cancer mammograms seen by a specialist as opposed to a general radiologist, according to a 2012 study from the University of Illinois at Chicago.

Black heart patients who present with elevated levels of a group of proteins indicating cardiac injury are also less likely to be seen by specialists, per a 2018 study.

A civil rights group wrote this week to the US health secretary, Alex Azar, calling on him to "release daily racial and ethnic demographic data related to COVID-19 testing, disease burden and patient outcomes."

This, said the Lawyers' Committee for Civil Rights Under Law, was necessary to ensure a robust public health response, and to make certain care and testing aren't being administered in a discriminatory manner.

The group said the Centers for Disease Control and Prevention (CDC) was already collecting the information but deliberately withholding it.

Hilton stressed that it was in the interests of Americans as a whole to address the problem, because -- unlike high rates of heart disease or cancer -- a wave of coronavirus spreading through the black and Hispanic population will ultimately impact everyone else.

"When you have a system that's not treating these people of lower social economic status and these minority groups, they are then not being tested, they're sent back home to infect their community," she said.

"Those workers who are now infected are going to the grocery store, and when the upper echelon of America are going to get their food, they will get infected too."