Tagged ethnic conflict

Juneteenth. 605,000. 2.9x. 2.0x.

            “All we have to do is look at the situation in India and Nepal…and in the United Kingdom, where variants of COVID-19 have become the dominant virus in those populations—in the UK despite a somewhat successful vaccination campaign. And those variants have different properties that increase the ability of this virus to spread and…eventually cause disease in the population. Anytime we give the virus a chance to get to know its host better, to get to see immunity against it, the natural selection principles laid out by Charles Darwin suggest that variants that are more fit will emerge. And, particularly in the US, we can’t look past that, because we really have sort of a dual population, we have the unvaccinated and the vaccinated, in many places the unvaccinated are larger than the vaccinated populations, and that just sets up a situation where the virus can see immunity, can go into people who don’t have immunity, and that back and forth is essentially how my laboratory selects variants when we’re studying them. So we’re setting up that scenario within the population, and that’s not a good thing for us to be doing.”

Dr. Andrew Pekosz, Johns Hopkins Bloomberg School of Public Health, June 11, 2021

 

Dear Students,

Being in a meditative mood, I want to reflect back as well as forward on this particular day, but being who I am my reflections start with numbers. It is said that a civilized person is one who can look at a page of numbers and weep. I don’t know how civilized I am, but these four numbers become a little blurry when I dwell on them.

Juneteenth, of course, is short for June 19th, the day in 1865 when the last black slaves in Texas were told of their freedom. Today is the 156th commemoration of that day, but the first 155 were unofficial. Now Juneteenth is a national holiday.

The holiday was declared by President Biden just a few days ago, perhaps on the same day that the total number of deaths in our country crossed the milestone of 600,000. It’s hardly something I wanted to be right about, but on December 15th I wrote an update called “Double Down or Double Deaths.” We had just crossed 300,000, and vaccinations had begun, but masks and social distancing were as important as ever, and the vaccine syringe was a shiny object I feared would distract us from these vital preventive measures, which we should have been doubling down on. We did not double down, so we doubled deaths.

George Floyd statue unveiled in Newark, NJ

2.9x is the odds ratio of blacks vs. whites being hospitalized with COVID-19, and 2.0x is their relative risk of dying. Some 89,000 African-Americans have died of it, and it’s a good bet that every one of them said, or if they couldn’t speak, thought, “I can’t breathe,” while dying—just as George Floyd did when he was being murdered by a policeman on a Minneapolis street.

So Juneteenth is well worth commemorating today and on all future June 19ths, but I am not sure how much celebration is in order. Those slaves in Galveston heard about their freedom, but the senses in which they were freed were limited. They were delivered into poverty, landlessness, wage slavery, fake and reversible “Reconstruction,” a century of Jim Crow with its countless lynchings, then a limited process of integration, reversible Voting Rights and Civil Rights laws, police brutality, and essentially permanent gaps in wealth, income, housing, education, imprisonment, and of course health—meaning life.

The same state of Texas they were supposedly freed into in 1865 is taking away their freedom—their voting rights—actively and aggressively, on this first official Juneteenth holiday. The same US Congress that passed the Voting Rights and Civil Rights Acts of the 1960s is, today, aggressively blocking legislation that would protect those laws from being dismantled by Texas and dozens of other states.

So as we celebrate this first Juneteenth National Holiday, white power elites are taking freedom away from blacks—to the cheers of their poor white dupes of course—as they have always done. They are preventing schools from teaching the truth as it actually happened, exactly in the spirit of Holocaust Denial, and with similar consequences. They are building and protecting the New Jim Crow, with state legislators, governors, police, and prison wardens taking the place of the Ku Klux Klan. They are redrawing red lines in housing, jobs, education, and health care delivery that generations have struggled to erase.

Do we think that a federal court system stuffed with young conservative appointees, crowned with a 6-3 hard-right Supreme Court like a rancid cherry on top is going to prevent these nationwide trends? Please. Do we think that with all these new forms of voter suppression the Democrats will keep their paper-thin margin in the Congress a year-and-a-half from now, and the White House two years later? I will let that question hang, and turn to more urgent matters that I personally know more about.

We are about to see the Southeastern Region, including my own state of Georgia, become the new experimental cauldron of differential death. The disparity between the races is much greater down here, in everything, even while the percentage of African-Americans is much higher. Oh, and the vaccination rates? The lowest in the country. The situation is ripe for a new variant of concern to cause a new surge, and as always a new chance for blacks to be sickened and killed more than whites.

Is there such a variant? Yes.

The variants now have Greek letter names to avoid stigmatizing countries or forcing us to memorize long strings of numbers. The original variant first seen in Wuhan (FSI-W) is the baseline. The first evolved variant of concern (FSI-UK) is now called Alpha, which because of greater transmissability caused grave problems in Britain in the winter. Beta (FSI-South Africa) is able to overcome a number of vaccines to a concerning extent. Gamma (FSI-Brazil) spread very fast there, has unexplained properties, and has been seen in many US states.

But the most concerning so far is Delta (FSI-India), far more transmissible than Alpha, which was far more transmissible than the baseline virus. It already predominates in the UK and is spreading fast in the US, especially among children and other unvaccinated people. Vaccine experts seem confident that they will be able to come up with solutions to present and future variants, sooner or later—for the vaccinated, currently a fraction of the world.

Good News

  1. New York, California, and many other states are opening up, pretty much completely. Air travel is huge again, and restaurants are humming. Some states and countries have vaccination rates that justify these comebacks.
  2. Continental Europe’s vaccination program has finally gotten traction and looks like it will continue to accelerate for a while. Israel led the world in vaccination success, the UK was not far behind, and Canada has caught up to them.
  3. India, while still very burdened, has seen a decline in cases in recent weeks that suggests that strict lockdowns in April and May worked (the full vaccination rate is 4%).
  4. Monoclonal antibody studies have continued to bring very good news. If you are offered them after testing positive, with or without symptoms, do not say no.
  5. Novovax has added a new vaccine to our armamentarium. It is based on a more conventional technology than mRNA, tried-and-true for several others, and it seems to have fewer unpleasant effects even after the second dose.

Bad News

  1. The relatively high vaccination rate in the US hides marked regional variation. The Southeastern and some other traditionally Republican states have low vaccination rates and are accordingly vulnerable. The politicization of our national response to the virus has been and will be absurd and deadly.
  2. Biden’s vaccination program accelerated from 1 to 3.5 million a day in his first 100 days, but then plummeted to less than a million and is now almost sure to fall short of his target of getting 70% of Americans vaccinated by the Fourth of July.
  3. India is projected to have a third surge in a few months time, and there is little sign that vaccination rates will go up enough to prevent this.
  4. Japan has decided to proceed with the Summer Olympics, already postponed from last year. The vaccination rate is about 5 percent and not likely to increase to adequate levels by the time of the games. Preventive measures will be used, but the majority of the country does not want the games to go on.
  5. The UK was slated to open up completely on June 21st, but the Delta variant is spreading so fast there that Prime Minister Johnson has postponed opening until July 19th, a decision met by widespread protests.

My friend, poet Marilyn Mohr, shared a poem with me recently that captures the message and the anguish of the virus. It reads in part:

Carried on the moisture of our breath,

it contains us in loneliness, cages us in fear.

We cannot sing or touch, even our smiles are masked.

Of course we want to reopen, reconnect, celebrate. We are starting to be able to do that. But we for now we need to keep looking over our shoulders. Please take to heart the exquisite clarity of Dr. Andrew Pekosz’s explanation of our situation and how the disease works. Please remember that the virus is always changing, and that some of us are more vulnerable than others.

Now that Juneteenth is a national holiday, it would be nice to have a period of national reflection between it and July 4th. In a sense July 4th is meaningless without Juneteenth, which was one halting step (among many, with many more needed) toward realizing the promise of our Declaration of Independence.

Jews have a period of self-examination and penitence for ten days from the New Year to the Day of Atonement. Juneteenth to July 4th could be a more celebratory period, but the self-examination could be equally useful.

See you in the fall I hope. Stay safe,

Dr. K

PS: Please don’t just rely on me. Dr. Michael Osterholm’s now biweekly podcast from CIDRAP, the Center for Infectious Disease Research and Policy of the University of Minnesota drops on alternate Thursdays. He combines realistic assessments and warnings with uplifting stories about how people are finding light and small victories in the pandemic. The best resource on what is happening specifically in the state of Georgia is Dr. Amber Schmidtke’s Covid Digest, now weekly. More generally, I recommend the following: This The Bill & Melinda Gates Foundation COVID-19 Update, aka The Optimist; for the science of viruses, especially the new coronavirus, This Week in Virology (TWiV) podcast, including Dr. Daniel Griffin’s superb clinical updates from the front lines. Dr. Sanjay Gupta’s podcast, Coronavirus: Fact vs. Fiction; COVID-19 UpToDate for medical professionals; and for the current numbers: Johns Hopkins University (JHU); Institute for Health Metrics and Evaluation (IHME); Our World in Data (OWiD); The New York Times Coronavirus Resource Center (NYT). For uncannily accurate warnings, follow @Laurie_Garrett on Twitter. I also recommend this COVID-19 Forecast Hub, which aggregates the data from dozens of mathematical models, and this integrative model based on machine learning. For an antidote to my gloom, check out the updates of Dr. Lucy McBride, who doesn’t see different facts but accentuates the positive.  

16,000 George Floyds

“I can’t breathe.”

            Eric Garner, July 17, 2014, as he was being strangled to death by New York City police, for selling single cigarettes on a streetcorner in Staten Island

“I can’t breathe.”

            Elijah McClain, August 24, 2019, as he was being strangled by Aurora, Colorado police, for no reason, resulting in cardiac arrest in the ambulance and death days later

“I can’t breathe.”

            George Floyd, May 25, 2020, as he was strangled to death by Minneapolis, Minnesota police, for allegedly using a counterfeit $20 bill

“Once you get to the other side of it, you can breathe a little bit better… You think you’re gonna die during one of those episodes, I mean, you know you’re gonna die.”

            Kevin Harris, after recovering from the coronavirus infection that almost choked him to death

Dear Students,

These four men had two things in common: being African-American, and having someone or something strangling them. Kevin Harris did not die gasping for breath as the others did, and he was not strangled by police. But he was being strangled by racism.

I’ll come back to this and to the number 16,000, but first consider another number: 3,446. That’s the number of black people who were lynched in the United States between 1882 and 1968, accounting for 72.7 percent of the lynching victims in that time frame—when they made up around a tenth of the population.

We don’t have a record of what most of these 3,446 people said while they were dying, but most of them were murdered by being hanged by the neck until they were dead. They were not dropped to break their necks quickly as in a movie prison. They were usually “strung up” so that the group or mob could watch them struggle. Many were tortured and mutilated before and during the process. It was festive. Children were present. People took photos. They made postcards to send relatives and friends.

Some of the victims proclaimed their innocence before being hanged for crimes they did  not commit. Some spoke messages to loved ones. On March 9, 1892, three black men who had started the new People’s Grocery in Memphis, Tennessee were dragged out of their store by a white mob and lynched; it was simply too much of an affront to white rule for black people to have their own grocery store. One of them, Thomas Moss, said before he was murdered, “Tell my people to go west. There is no justice for them here.”

We don’t know what lynching victims may have said or tried to say while they were actually being strangled by the noose around their necks. They must have known there was no point in begging. But you can bet they were thinking: “I can’t breathe.”

A lynching is defined as a premeditated extrajudicial homicide by a group intending to punish someone or make an example of them. We don’t yet know whether the policemen who killed Eric Garner, Elijah McClain, and George Floyd intended to kill them, but we know that they showed utter disregard for these men’s humanity in their excessive, brutal, completely unnecessary, and ultimately fatal use of force—in each case in the face of victims and even bystanders begging them to stop.

I think it’s fair to say that they probably wanted to kill some black man some time, and this was their chance; otherwise, why would they have shown such disregard for black lives? The police were acting in a criminal manner toward each of these men; and ordinarily, when a homicide is committed in the course of another crime, it’s murder.

We also know that black people are killed by police at a rate between 2.5 and 3.5 times that of whites. We know that many white police officers, not just “a few bad apples,” are overtly or even proudly racist. And we know that the inadequate, even chaotic patterns of selection and training in police departments across the United States at best allow and at worst foster such racism.

This is all part of a pattern that anthropologists call structural violence: day to day destruction of human life by authorities as part of the normal course of things in, for example, colonialism, or the domination of one religious group over another. But if the victims of structural violence commit acts of violence themselves, even in protest or self-defense, only those acts are considered violent, not the day to day acts of the people in power oppressing them.

Today’s heedless murders of black people by white police extend the structural violence of lynchings, which in their day extended the structural violence of slavery, going back 401 years to 1619, when America first became a slave society. No one can doubt that centuries of whips and chains, hanging trees, and police brutality—all condoned or even depended on by the larger society and its day to day need for intimidation and control—deserve the name “structural violence.”

But what about Kevin Harris, who couldn’t breathe because of a new coronavirus?

Well, it turns out that structural violence—including American structural racism—requires a lot more than whips, chains, nooses, guns, and the knees and choke-holds of policemen. It requires a system that relentlessly maintains huge disparities, day by day and generation to generation, between white and black people—in wealth, education, job opportunities, income, education, incarceration, and perhaps most painfully, health and illness.

Are unprevented and uncared-for diabetes, heart disease, hypertension, asthma, AIDS, influenza, and now COVID-19 less violent to a human life than whips, nooses, and chokeholds? I don’t think so, and neither do the growing number of physicians and public health experts who see the structural violence of untreated, preventable disease as just as much or even more an extension of slavery than police brutality is.

On the day that Kevin Harris described his near-death from strangling by the coronavirus, there had been a total of 182 deaths in the whole United States, yet it was already clear that blacks were affected more than whites. As of this writing, more than 140,000 Americans have died of this virus.

But the number 16,000 is not the total number of African-Americans who have died, not by far. It is the number who have died but who would not have died if black people only had the same death rate as white people. In other words, it is the number of extra black people who were killed by the virus just because they were black.

Thankfully, Kevin Harris did not become one of those unfair, unnecessary, extra black deaths. But 16,000 others did. So far. And it’s not over yet. And proportionately more black people than white are being added to the numbers every day. So the excess of 16,000 is only the beginning.

What explains it? The basic deprivation of health is part of the long story of American structural racism and structural violence. Everything about underlying conditions that makes us more susceptible to COVID-19 is more common in black than white people. That includes, but is not limited to, diabetes, heart disease, hypertension, asthma, and a wide spectrum of acute and chronic non-COVID infectious diseases.

And every form of preventive and curative care is withheld from black people but given to whites. Our lack of universal health care is unique among the wealthy countries of the world. We stand out from the world in this exactly the way South Africa did before apartheid ended.

Take a look at the graph in the picture. The American anomaly is astounding. All other advanced countries have had declining maternal mortality for decades. Ours has been rising starkly, and experts agree that a large part of the reason is our gross and growing racial disparity. Infant mortality has declined slightly, but is much higher than in other developed countries, mainly because of how we neglect minorities. Black infant mortality is more than double that of whites. So the structural racism that began in 1619 begins again at the start of every black life.

Oliver Wendell Holmes, Sr., the great 19th century physician, wrote, “The woman about to become a mother should be the object of trembling care and sympathy wherever she bears her burden or stretches her aching limbs. God forbid that any member of the profession to which she trusts her life, doubly precious at that eventful period, should hazard it negligently, unadvisedly, or selfishly.” We always follow that advice. For white women. Black women and their babies are from that moment guaranteed to be more vulnerable to everything, including COVID-19.

In the pandemic, it’s good to stay home if you can. Most black people can’t. Their work requires that they expose themselves to others on public transportation and at their jobs. They are some of the doctors and many of the nurses and respiratory therapists, but they are also overrepresented among the cleaners and sanitation workers, the delivery people, the workers in groceries and restaurant kitchens, and many others who can’t stay home where it’s safe.

But that’s not all. Crowding is good for the virus, and it is much more of a problem for blacks than whites.  Poverty too. Lack of education. Lack of trust in authority (with good reason). Lack of clean air (the virus loves dirty airways). Polluted water. Lack of access to healthy food, which is much more expensive than junk food and much harder to find in black neighborhoods.

Black men are overwhelmingly over-represented in prisons in this country, and given that prisons are well known hot spots for COVID-19, they become another tool of structural racism in the pandemic. Given that incarcerated men are forced to work, manufacturing license plates and the like, incarceration of black men has been seen as a modern form of slavery.

The water crisis in Flint, Michigan, where the government was discovered to be pouring lead into black homes and poisoning children’s brains, has proved to be a problem in many other cities. The disparity between blacks and whites in wealth is far greater even than the disparity in incomes; white American families’ wealth is stored mostly in their homes, which many fewer black people own.

These homes, this wealth, is passed from generation to generation among whites, and in every generation it becomes a more solid foundation for permanent disparities in education, because schools in America are funded locally, from taxes on homes that whites are much more likely to own.

But in addition to the structural racism that withholds health, medical care, wealth, homes, education, opportunities, fruit, vegetables, and water, we have to add air: “I can’t breathe.” So said an unknown number of black police-chokehold victims, 3,446 black lynching victims, and 16,000 excess black coronavirus victims, so far.

If you have easy access to air, be grateful. Not everyone does. Breathe out. Breathe in. Don’t take it for granted.

Stay safe and be well, if you can,

Dr. K

PS: Many of you have been asking me whether I think you should come back to campus. This article should help you decide. As always, you should weigh the risks and difficulties you may face where you are staying now; some people may be better off on campus, assuming it really is open to you a few weeks from now.

One World?

Prof. Mari Fitzduff, who I’m honored to call a friend, set me thinking the other day when she commented on a proposed speech I wrote for President Obama to substitute for the one he gave in Cairo. But before I share our exchange, you need to know that Mari is the director of the Conflict and Coexistence Program at Brandeis University, where she moved after many years as director of INCORE, the International Conflict Research Institute in (as she always says it to avoid taking sides) “Derry/Londonderry,” Northern Ireland. In that role she played an important part in the years and years of mediation that finally brought a blessed end to that terrible conflict. Read more